Headache in the writings of Elizabeth Gaskell (1810-1865).

Science.gov (United States)

Larner, A J

2015-11-01

Mrs Elizabeth Gaskell was a celebrated author of the Victorian era, a friend of both Charles Dickens and Charlotte Brontë and the latter's first biographer. References to headache in Mrs Gaskell's six major novels, published between 1848 and 1866 as well as some of her shorter fiction, have been collated. These multiple references suggest that Elizabeth Gaskell used headache as a narrative device, possibly based on her own experience of headache and that of female acquaintances, most notably Charlotte Brontë. © The Author(s) 2013.

Elizabeth Belle’s Birth Story

Science.gov (United States)

Boro, Jessica; Boro, Samuel

2014-01-01

In this article, Jessica and Samuel Boro share the story of the birth of their daughter, Elizabeth Belle. With the physical and emotional support of her husband and her doula, this mother was able to cope with a long labor and have the natural birth she wanted. Her husband describes how important the doula was for him. PMID:25364215

76 FR 70345 - Drawbridge Operation Regulations; Elizabeth River, Eastern Branch, Norfolk, VA

Science.gov (United States)

2011-11-14

... DEPARTMENT OF HOMELAND SECURITY Coast Guard 33 CFR Part 117 [Docket No. USCG-2011-1022] Drawbridge Operation Regulations; Elizabeth River, Eastern Branch, Norfolk, VA AGENCY: Coast Guard, DHS. ACTION: Notice... periodic maintenance. The Norfolk Southern 5 Bridge, at mile 1.1, across the Elizabeth River (Eastern...

Audit of gynaecological cancers Queen Elizabeth Central Hospital ...

African Journals Online (AJOL)

The aim of the audit was to assess the trend of the gynaecological cancers for the first quarter of 2008, and the prevalence of HIV and syphilis among the cases. Gynaecological cancer cases accounted for 6% of gynaecological admissions at QECH between January and April 2008. The findings show that cervical cancer ...

78 FR 16816 - Television Broadcasting Services; Hampton-Norfolk, Virginia; Norfolk, Virginia-Elizabeth City...

Science.gov (United States)

2013-03-19

... FEDERAL COMMUNICATIONS COMMISSION 47 CFR Part 73 [MB Docket No. 11-139; RM-11636; DA 13-258] Television Broadcasting Services; Hampton-Norfolk, Virginia; Norfolk, Virginia-Elizabeth City, North Carolina... modify its television station, WHRO-TV's license to specify Norfolk, Virginia-Elizabeth City, North...

77 FR 37319 - Safety Zone for Fifth Coast Guard District Fireworks Display Pasquotank River; Elizabeth City, NC

Science.gov (United States)

2012-06-21

...-AA00 Safety Zone for Fifth Coast Guard District Fireworks Display Pasquotank River; Elizabeth City, NC... the Pasquotank River, Elizabeth City, North Carolina. The fireworks display ordinarily originated from... vessel traffic in a portion of the Pasquotank River, Elizabeth City, North Carolina, during the event...

Elizabeth Brown (1830-1899), solar astronomer

Science.gov (United States)

Creese, M.

1998-08-01

Were it not for the fact that she was a woman, Elizabeth Brown might well be thought of as a fairly typical nineteenth-century British amateur astronomer. She has a place, although a relatively modest one, in the distinguished group of people who, with their own fortunes, carried out much of the astronomical research being done in the country at a time before extensive government support was forthcoming for the work.1 Her career in fact follows a pattern common to several of the nineteenth-century men astronomers in that her full productive period came only after she was freed from her primary responsibilities; she did not have to amass the necessary financial resources as did many of the men,2 but she had the time-consuming responsibility, not unusual for a Victorian woman, of caring for a parent through a lengthy old age. Only after her father died at the age of ninety-one, did Elizabeth, then in her early fifties, begin her sixteen years of remarkable public activity in astronomy.

Environmental risk factors for oesophageal cancer in Malawi: A case ...

African Journals Online (AJOL)

Methods A hospital-based case-control study of the association between environmental risk factors and oesophageal cancer was conducted at Kamuzu Central Hospital in Lilongwe, Malawi and Queen Elizabeth Central Hospital in Blantyre, Malawi. Ninety-six persons with squamous cell carcinoma and 180 controls were ...

Elizabeth II üle Diana ja Tony / Kristiina Davidjants

Index Scriptorium Estoniae

Davidjants, Kristiina, 1974-

2007-01-01

Stephen Frearsi mängufilm "Kuninganna" ("The Queen") : stsenarist Peter Morgan : kuninganna Elizabeth II kehastab Helen Mirren peaminister Tony Blair'i Michael Sheen: Suurbritannia - Ameerika Ühendriigid - Itaalia 2006

76 FR 582 - Elizabeth Hartwell Mason Neck National Wildlife Refuge, Fairfax County, VA, and Featherstone...

Science.gov (United States)

2011-01-05

...] Elizabeth Hartwell Mason Neck National Wildlife Refuge, Fairfax County, VA, and Featherstone National... comprehensive conservation plan and the environmental assessment (CCP/EA) for Elizabeth Hartwell Mason Neck (Mason Neck) National Wildlife Refuge (NWR) and Featherstone NWR for a 45-day public review and comment...

76 FR 59153 - Elizabeth Hartwell Mason Neck National Wildlife Refuge, Fairfax County, VA, and Featherstone...

Science.gov (United States)

2011-09-23

...] Elizabeth Hartwell Mason Neck National Wildlife Refuge, Fairfax County, VA, and Featherstone National... plan (CCP) and finding of no significant impact (FONSI) for Elizabeth Hartwell Mason Neck (Mason Neck...: Download a copy of the document at http://www.fws.gov/northeast/planning/MasonNeck_Featherstone/ccphome...

Liz’s Bali Journey Ends In Love In Elizabeth Gilbert’s Novel “Eat Pray Love”

OpenAIRE

Simanjuntak, Lenni

2011-01-01

This paper entitled "Liz's Bali Love Ends with Love in Elizabeth Gilbert's Eat Pray Love". There are three main characters in the novel, namely: Elizabeth Gilbert, Felipe and Ketut Liyer. Elizabeth Gilbert is 31-year-old who is a widow and worked as a writer in New York. Liz experienced hard times after having broken up several times and felt could never find a man who is match for her. All this makes her to search her true identity. Liz traveled alone across in the three countries. Although ...

Soovin Eesti rahvale õnne ja edu / kuninganna Elizabeth II

Index Scriptorium Estoniae

Elizabeth II, 1926-

2006-01-01

Ilmunud ka: Postimees 20. okt. lk. 17, Koit 21. okt. lk. 6, Postimees : na russkom jazõke 23. okt. lk. 7. Kuninganna Elizabeth II kõne riiklikul õhtusöögil 19. oktoobril Tallinnas Mustpeade majas

Penicillin resistant Gonococci at Q.E.C.H.

African Journals Online (AJOL)

lance with particular reference to the use of antibiotic prophylaxis. Introduction: The Queen Elizabeth Central Hospital in. Blantyre is one of two central government teaching hospitals in Malawi and provides specialist services for over three million people. The surgical department is run by four general- surgical specialists, a ...

Evidence of Rise in Rabies Cases in Southern Malawi – Better ...

African Journals Online (AJOL)

September to November 2011) in the Queen Elizabeth Central Hospital. From previous experience and hospital records, this number of cases is higher than expected. We are concerned that difficulty in accessing post-exposure prophylaxis (PEP) ...

Reflections on the health workers' strike at Malawi's major tertiary hospital, QECH, Blantyre, 2001: a case study.

Science.gov (United States)

Muula, A S; Phiri, A

2003-03-01

Health workers and support staff at Malawi's major referral hospital, the Queen Elizabeth Central Hospital, Blantyre, were on strike between 5th and 19th October 2001. The health workers' grievances included: lack of risk allowances; poor professional allowances; low salaries; and low housing allowances. The strike resulted in almost total closure of the 1500-bed hospital; only the burns and orthopaedic wards continued to serve patients. Volunteer staff, comprising the Red Cross, and nursing and medical students provided services. Verbal and written threats by the authorities had minimal effect on terminating the strike; rather, they encouraged the resolve to continue with the industrial action. We report aspects of the genesis, progress and resolution of the strike. Although not much seems to have been achieved, both the employer and the workers need to draw lessons from the experience.

Impact of nationwide centralization of pancreaticoduodenectomy on hospital mortality

NARCIS (Netherlands)

de Wilde, R. F.; Besselink, M. G. H.; van der Tweel, I.; de Hingh, I. H. J. T.; van Eijck, C. H. J.; Dejong, C. H. C.; Porte, R. J.; Gouma, D. J.; Busch, O. R. C.; Molenaar, I. Q.

Background: The impact of nationwide centralization of pancreaticoduodenectomy (PD) on mortality is largely unknown. The aim of this study was to analyse changes in hospital volumes and in-hospital mortality after PD in the Netherlands between 2004 and 2009. Methods: Nationwide data on International

Impact of nationwide centralization of pancreaticoduodenectomy on hospital mortality

NARCIS (Netherlands)

de Wilde, R. F.; Besselink, M. G. H.; van der Tweel, I.; de Hingh, I. H. J. T.; van Eijck, C. H. J.; Dejong, C. H. C.; Porte, R. J.; Gouma, D. J.; Busch, O. R. C.; Molenaar, I. Q.

2012-01-01

Background: The impact of nationwide centralization of pancreaticoduodenectomy (PD) on mortality is largely unknown. The aim of this study was to analyse changes in hospital volumes and in-hospital mortality after PD in the Netherlands between 2004 and 2009. Methods: Nationwide data on International

Twenty-Five Years and Counting of "Sweet Valley": Jessica and Elizabeth in Romance Novels for Young Children?

Science.gov (United States)

Roberts, Sherron Killingsworth

2010-01-01

With the 2008 reissue of Francine Pascal's (1983) "Sweet Valley High", the popular cultural icons of twins Jessica and Elizabeth have been revitalized. Jessica and Elizabeth are the much-beloved protagonists in romance novels strategically targeted for young adults in "Sweet Valley High" or "Sweet Valley U", and for first- and second-grade readers…

Briti kuninganna Elizabeth II Eesti-visiidil lasub saladuseloor / Priit Rajalo

Index Scriptorium Estoniae

Rajalo, Priit, 1975-

2006-01-01

Ilmunud ka: Postimees : na russkom jazõke 30. jaan. lk. 2-3. Buckinghami palee teatas 25. jaanuaril, et Briti kuninganna Elizabeth II tuleb koos oma abikaasa Edinburghi hertsogi prints Philipiga oktoobris riigivisiidile Eestisse, Lätti ja Leetu. Lisa: Kõrged külalised

J. M. Coetzee’s unsettling portrayals of Elizabeth Costello = Os retratos vexatórios de J. M. Coetzee sobre Elizabeth Costello

Directory of Open Access Journals (Sweden)

Laura Giovannelli

2011-01-01

Full Text Available This paper addresses the vexed question of animal and human rights byfocusing on Coetzee’s ‘trilogy’ connected with Elizabeth Costello’s lecturing and experiencing, from her anti-Cartesian stances and sympathetic imagination advocated in The lives of animals, through the eight lessons which she frantically goes over and delivers like a ‘circus seal’, or even happens to be taught (in Elizabeth Costello, up to Slow man, where she turns into the waspish, vulpine ‘Costello woman’ preying on tortoise-like Paul Rayment. As such a debasing hybridization may already suggest, the committed intellectual shall lose track of her formerly heated debates on animals as ‘embodied souls’ and divinely created beings to be held in great respect, to enter a region of ethical ambivalence where biological and axiological boundaries are deviously blurred. Textual evidence andcommentaries on Coetzee’s fictional world and thematic concerns are provided to single out the stages of this unsettling metamorphosis, a process through which Costello wavers between Franciscan self-effacement and dictatorial omniscience. In the upshot, the striving after a recognition of animal dignity is seemingly supplanted by a debasement of the human person into a pet or a beast, as though she had lost herself in a labyrinth of fumbling speculation.O problema vexatório sobre os direitos dos animais e das pessoas é analisado pela trilogia de Coetzee, ou seja, a partir das conferências e das experiências de Elizabeth Costello, nas quais propõe sua posição anticartesiana e sua imaginação simpatética defendida em The lives of animals, versando sobre as oito aulas que ela ministra como ‘uma foca circense’ ou até quando é tutelada (em Elizabeth Costello, até Slow man, onde se transforma na ‘fêmeaCostello’, uma loba que age como predadora junto ao lento Paul Rayment. Como a hibridização acima mencionada pode sugerir, o intelectual pode se esquecer dos

Leadership: Subject to the State Personnel Act (SPA) Employee's Perceptions of Job Satisfaction at Elizabeth City State University

Science.gov (United States)

Leary, Mary

2010-01-01

This evaluation was conducted at Elizabeth City State University (ECSU) in Elizabeth City, North Carolina, located approximately 40 miles south of the Virginia state line. ECSU, a historically Black institution of higher learning, was founded in 1891 and is one of 17 constituent universities in The University of North Carolina system. The…

Helen Mirren võitis Elizabeth II rolliga brittide Oscari / Triin Tael

Index Scriptorium Estoniae

Tael, Triin

2007-01-01

Stephen Frearsi mängufilmis "Kuninganna" ("The Queen") kuninganna Elizabeth II kehastav Helen Mirren sai oma rolli eest parima naisnäitleja Bafta (Briti filmiakadeemia auhind). Linateos pälvis ka aasta parima filmi tiitli. Ka teistest võitjatest

Elizabeth Boynton Harbert and the Woman Suffrage Movement, 1870-1896.

Science.gov (United States)

Buechler, Steven M.

1987-01-01

The Woman Suffrage Movement experienced ideological changes so that earlier and later suffragists had different views. Elizabeth Boynton Harbert was one reformer who first criticized female socialization and the system of separate spheres. Later her views became more sentimental and she idealized the traditional role of women. (VM)

Queen elizabeth class battleships

CERN Document Server

Brown, Les

2010-01-01

The 'ShipCraft' series provides in-depth information about building and modifying model kits of famous warship types. Lavishly illustrated, each book takes the modeller through a brief history of the subject class, highlighting differences between sister-ships and changes in their appearance over their careers. This includes paint schemes and camouflage, featuring colour profiles and highly detailed line drawings and scale plans. The modelling section reviews the strengths and weaknesses of available kits, lists commercial accessory sets for super-detailing of the ships, and provides hints on modifying and improving the basic kit. This is followed by an extensive photographic survey of selected high-quality models in a variety of scales, and the book concludes with a section on research references - books, monographs, large-scale plans and relevant websites.This volume covers the five ships of the highly successful Queen Elizabeth class, a design of fast battleship that set the benchmark for the last generati...

Bedside paediatric HIV testing in Malawi: Impact on testing rates

African Journals Online (AJOL)

2017-05-25

May 25, 2017 ... Malawi Integrated Guidelines on 'Clinical Management of ... referred by nursing staff to attend the HIV counsellor's ... Implementation of a bedside testing service at Queen Elizabeth Central Hospital significantly increased HIV ...

Occurrence of Opportunistic Pathogens Legionella pneumophila and non-tuberculous mycobacteria in hospital plumbing systems

Science.gov (United States)

Occurrence of Opportunistic Pathogens Legionella pneumophila and non-tuberculous mycobacteria in hospital plumbing systems Jill Hoelle, Michael Coughlin, Elizabeth Sotkiewicz, Jingrang Lu, Stacy Pfaller, Mark Rodgers, and Hodon Ryu U.S. Environmental Protection Agency, Cincinnati...

"Courageous, Zealous, Learned, Wise, and Chaste" - Queen Elizabeth I's Biblical Analogies After Her Death

Directory of Open Access Journals (Sweden)

Aidan Norrie

2015-11-01

Full Text Available During her reign, Queen Elizabeth I of England was the subject of various biblical analogies. Much of the current historiography, however, does not continue analysis of these literary devices after the Queen's death in 1603. Primary source documents show that their use did not cease with the Queen's death. These analogies appear to have continued for two primary purposes. Analogies legitimised a questionable event that had occurred during Elizabeth's reign, and portrayed these decisions as an example for the current Protestant monarch to imitate. Also, in the years after the Queen's death, analogies reinforced England's Protestantism (and its divine sanction, and gave the Stuart monarchs an example to emulate in religio-political matters.

Elizabeth II tervitas Briti ja Eesti sõjaväelasi / Allar Viivik, Katrin Rohtla

Index Scriptorium Estoniae

Viivik, Allar

2006-01-01

Kuninganna Elizabeth II avas Eesti uue miinijahtija Admiral Cowani vapi ning kohtus Briti sõjalaeva Liverpool pardal Afganistanis võidelnud kaitseväelastega. Kuningannat saatis Eesti presidendipaar

Bootstrapping data envelopment analysis of efficiency and productivity of county public hospitals in Eastern, Central, and Western China after the public hospital reform.

Science.gov (United States)

Wang, Man-Li; Fang, Hai-Qing; Tao, Hong-Bing; Cheng, Zhao-Hui; Lin, Xiao-Jun; Cai, Miao; Xu, Chang; Jiang, Shuai

2017-10-01

China implemented the public hospital reform in 2012. This study utilized bootstrapping data envelopment analysis (DEA) to evaluate the technical efficiency (TE) and productivity of county public hospitals in Eastern, Central, and Western China after the 2012 public hospital reform. Data from 127 county public hospitals (39, 45, and 43 in Eastern, Central, and Western China, respectively) were collected during 2012-2015. Changes of TE and productivity over time were estimated by bootstrapping DEA and bootstrapping Malmquist. The disparities in TE and productivity among public hospitals in the three regions of China were compared by Kruskal-Wallis H test and Mann-Whitney U test. The average bias-corrected TE values for the four-year period were 0.6442, 0.5785, 0.6099, and 0.6094 in Eastern, Central, and Western China, and the entire country respectively, with average non-technical efficiency, low pure technical efficiency (PTE), and high scale efficiency found. Productivity increased by 8.12%, 0.25%, 12.11%, and 11.58% in China and its three regions during 2012-2015, and such increase in productivity resulted from progressive technological changes by 16.42%, 6.32%, 21.08%, and 21.42%, respectively. The TE and PTE of the county hospitals significantly differed among the three regions of China. Eastern and Western China showed significantly higher TE and PTE than Central China. More than 60% of county public hospitals in China and its three areas operated at decreasing return scales. There was a considerable space for TE improvement in county hospitals in China and its three regions. During 2012-2015, the hospitals experienced progressive productivity; however, the PTE changed adversely. Moreover, Central China continuously achieved a significantly lower efficiency score than Eastern and Western China. Decision makers and administrators in China should identify the causes of the observed inefficiencies and take appropriate measures to increase the efficiency of county

Reflections on the 1862 football match in Port Elizabeth | Hill | South ...

African Journals Online (AJOL)

The oldest recorded football match in South Africa was played in Port Elizabeth on 24 May 1862. This article explores the available evidence for this match before moving on to a more general discussion of three broader contexts in which the match was played. These contexts are contemporary football developments in ...

Towards a New Confessionalism: Elizabeth Jennings and Sylvia Plath

OpenAIRE

Dowson, Jane

2011-01-01

Due to their self-disclosing manner, both Elizabeth Jennings (1926-2001) and Sylvia Plath (1932-63) have been labelled ‘confessional’ yet have markedly different life experiences and profiles in literary and popular imaginations. Jennings was born in Boston, Lincolnshire, and educated in Oxford where she lived for the rest of her life. She had a broken engagement then a relationship with a married man but never married or had children. Plath emigrated to Cambridge University from America in 1...

Geochemical Characteristics of TP3 Mine Wastes at the Elizabeth Copper Mine Superfund Site, Orange County, Vermont

Science.gov (United States)

Hammarstrom, Jane M.; Piatak, Nadine M.; Seal, Robert R.; Briggs, Paul H.; Meier, Allen L.; Muzik, Timothy L.

2003-01-01

Remediation of the Elizabeth mine Superfund site in the Vermont copper belt poses challenges for balancing environmental restoration goals with issues of historic preservation while adopting cost-effective strategies for site cleanup and long-term maintenance. The waste-rock pile known as TP3, at the headwaters of Copperas Brook, is especially noteworthy in this regard because it is the worst source of surface- and ground-water contamination identified to date, while also being the area of greatest historical significance. The U.S. Geological Survey (USGS) conducted a study of the historic mine-waste piles known as TP3 at the Elizabeth mine Superfund site near South Strafford, Orange County, VT. TP3 is a 12.3-acre (49,780 m2) subarea of the Elizabeth mine site. It is a focus area for historic preservation because it encompasses an early 19th century copperas works as well as waste from late 19th- and 20th century copper mining (Kierstead, 2001). Surface runoff and seeps from TP3 form the headwaters of Copperas Brook. The stream flows down a valley onto flotation tailings from 20th century copper mining operations and enters the West Branch of the Ompompanoosuc River approximately 1 kilometer downstream from the mine site. Shallow drinking water wells down gradient from TP3 exceed drinking water standards for copper and cadmium (Hathaway and others, 2001). The Elizabeth mine was listed as a Superfund site in 2001, mainly because of impacts of acid-mine drainage on the Ompompanoosuc River.

Endometrial pathology in a teaching hospital in North Central ...

African Journals Online (AJOL)

The study was a 5 year histopathological survey of endometrial biopsies seen at the University of Ilorin Teaching Hospital , Ilorin, North Central Nigeria from January 1st 1997 to December 31st 2001. It aimed at identifying the morphological patterns of endometrial disorders, prevalence of these disorders and the ...

76 FR 54189 - Television Broadcasting Services; Hampton-Norfolk, Virginia; Norfolk, Virginia-Elizabeth City, NC

Science.gov (United States)

2011-08-31

...] Television Broadcasting Services; Hampton-Norfolk, Virginia; Norfolk, Virginia-Elizabeth City, NC AGENCY... licensee of noncommercial educational television station WHRO-TV, channel *16, Hampton-Norfolk, Virginia... freeze on the filing of television allotment rulemaking petitions, but since HRETA'S proposal...

Bathymetry of the waters surrounding the Elizabeth Islands, Massachusetts

Science.gov (United States)

Pendleton, Elizabeth A.; Andrews, Brian D.; Ackerman, Seth D.; Twichell, Dave

2014-01-01

The Elizabeth Islands in Massachusetts that separate Vineyard Sound from Buzzards Bay are the remnants of a moraine (unconsolidated glacial sediment deposited at an ice sheet margin; Oldale and O’Hara, 1984). The most recent glacial ice retreat in this region occurred between 25,000 and 20,000 years ago, and the subsequent rise in sea level that followed deglaciation caused differences in the seafloor character between Buzzards Bay and Vineyard Sound. The relatively rough seafloor of Vineyard Sound reflects widespread exposure of glacial material. Shoals mark the location of recessional ice contact material, and deep channels illustrate where meltwater drainage incised glacial deposits. Following ice retreat from the Elizabeth Islands, a glacial lake formed across the mouth of Buzzards Bay, when the lake drained, it scoured two deep channels at the southern end of the bay. Sea level rise began to inundate Vineyard Sound and Buzzards Bay about 8,000 years ago and continues to modify the modern seafloor (Robb and Oldale, 1977). Fine-grained marine and estuarine sediments were deposited in the partially protected setting of Buzzards Bay. These deposits, up to 10 meters in thickness, buried the high-relief glacial landscape and created the generally smooth modern seafloor. In contrast, the Vineyard Sound of today experiences strong tidal currents, which largely prevent the deposition of fine-grained material and constantly rework the glacial sand and gravel within shoals. The seafloor of the sound largely reflects the contours of the ancient glaciated landscape that existed before sea level began to rise. The bathymetric data used to create the hillshaded relief image of the seafloor were collected by the U.S. Geological Survey (USGS) in cooperation with the Massachusetts Office of Coastal Zone Management and supplemented with National Oceanic and Atmospheric Administration hydrographic survey data. The map shows the detailed bathymetry of Buzzards Bay and Vineyard

Malawi Medical Journal - Vol 25, No 2 (2013)

African Journals Online (AJOL)

Adherence to hand hygiene protocol by clinicians and medical students at Queen Elizabeth Central Hospital, Blantyre-Malawi · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. NL Kalata, L Kamange, AS Muula, 50-52 ...

Traditional healers and pulmonary tuberculosis in Malawi

NARCIS (Netherlands)

Brouwer, J. A.; Boeree, M. J.; Kager, P.; Varkevisser, C. M.; Harries, A. D.

1998-01-01

Queen Elizabeth Central Hospital (QECH) and Blantyre district, Malawi. To investigate the use that tuberculosis (TB) patients in Malawi make of traditional healers and traditional medicine. A questionnaire study was carried out on 89 smear-positive pulmonary TB patients admitted to QECH. Seven

An integrated outsourcing solution at York Central Hospital.

Science.gov (United States)

Marr, Jo-Anne; Tam, Richard; Simms, Stephen; Bacchus, Feria

2011-01-01

Canadian hospitals struggle to balance the need to increase and improve operational services and quality with diminishing resources. Many realize that sustaining their organization depends on how well they focus their resources and talents on their core business, clinical care delivery. Outsourcing of non-core, non-clinical support services is a solution for many organizations. Most often, this is put into action one service provider at a time. In 2007, however, York Central Hospital (YCH) implemented Sodexo's integrated Comprehensive Service Solutions (CSS) for all its support service functions. In doing so, YCH achieved significant improvements in patient and staff satisfaction rates, substantial cost savings through improved operational efficiency from process improvements and leveraging technology investments, and increased retail food revenue.

Prevalence of Neonatal Jaundice on Central Hospital, Warri, Delta ...

African Journals Online (AJOL)

Methods: 272 babies (aged 1 – 30 days) the Neonatal Clinic of the Department of Child Health, Central Hospital, Warri, Delta State between June 2009 and June 2010 were examined daily for evidence of jaundice. Those with serum bilirubin ³15mg/100ml were subjected to additional clinical and laboratory investigations to ...

Socio-demographic characteristics associated with HIV and syphilis ...

African Journals Online (AJOL)

Objectives: We aimed to evaluate socio-demographic factors associated with HIV and syphilis seroreactivity in pregnant Malawians presenting for antenatal care in late third trimester of pregnancy. Methods: Between December 2000 and March 2004 at Queen Elizabeth Central Hospital Blantyre, Malawi, we collected ...

Clinical Features and the Factors Associated with Poor Outcome of ...

African Journals Online (AJOL)

Clinical Features and the Factors Associated with Poor Outcome of. Measles Patients at Queen Elizabeth Central Hospital. Robin L Broadhead. Paul Courtright. Lincy Misoya. Affiliation: 1. Department of Paediatrics College of. Medicine University of Malawi. 2. International Eye FoundatiQn. 3. Department of Paediatrics ...

Central radiological department of the Jahn Ferenc hospital and medical center

Energy Technology Data Exchange (ETDEWEB)

Erdelyi, M Jr [Jahn Ferenc Korhaz-Rendeloeintezet, Budapest (Hungary). Koezponti Radiologia

1982-01-01

The design, organisation and functioning of the central X-ray diagnostical unit of the new hospital, inaugurated in December 1980 are reviewed. The experiences of the shortcomings of the planning are summerized, too.

Diabetic retinopathy at the Yaoundé Central Hospital in Cameroon ...

African Journals Online (AJOL)

We carried out a cross-sectional analytical survey using data from patients who had done Fluorescein Angiography at the Yaounde Central Hospital Diabetic Retinopathy Prevention and Management Project between October 2007 and January 2010 to identify the risk factors, incidence and severity of different types of ...

[Elizabeth Fee: a historian reaching out to wider audiences].

Science.gov (United States)

Hochman, Gilberto; Benchimol, Jamie; Wegner, Liene; Azevedo, Nara; Romero Sá, Magali; Martins, Ruth B

2006-01-01

To what activities and topics does a historian in health and medicine, whose articles and books have become fundamental references for scholars of the area, devote her time? Feminism, counter-culture, medical education, global health, the role of international health organizations, and knowledge sharing in the health history are some of the subjects Elizabeth Fee addresses in this interview given at Fiocruz in April where she presented the 2006 inaugural class to the Graduate Program in History of Health Sciences at Casa de Oswaldo Cruz. The topic of her lecture was "The World Health Organization and AIDS: what can we learn from history?"

Elizabeth Bowen, Modernism, and the Spectre of Anglo-Ireland

Directory of Open Access Journals (Sweden)

James F. Wurtz

2010-03-01

Full Text Available The recent scholarly focus on Elizabeth Bowen’s modernism tends to reinforce a false dichotomy between Bowen as an Ascendancy Big House novelist and Bowen as a literary modernist. In keeping with Jameson’s argument that the colonial experience is at the root of Western modernism, I propose that her representations of Anglo-Irish Big House culture, in The Last September in particular, are in fact focal points for understanding Bowen as a modernist, and I argue that the Gothic, with its unavoidable political and colonial resonances, is fundamental to Bowen’s Irish modernism.

Cryptosporidium parvum and Isopora belli infections among patients ...

African Journals Online (AJOL)

Objective: To assess the importance of Cryptosporidium parvum and Isospora belli infections as a cause of diarrhoea among patients admitted to the Medical Wards in Queen Elizabeth Central Hospital (QECH) in Blantyre, Malawi. Design: Prospective case control study. Subjects: One hundred and twenty one patients with ...

Preliminary report on theNeurology workload ina central hospital in ...

African Journals Online (AJOL)

Introduction: Identification of the local pattern of neurological diseases is expected to help setting the priorities for good planning of management and public education. Objectives: To identify the pattern of neurological disorders in a second biggest central hospital in Sudan. Methodology: Review of the diagnosis of 170 ...

Inadequate ventilation for nosocomial tuberculosis prevention in public hospitals in Central Thailand.

Science.gov (United States)

Jiamjarasrangsi, W; Bualert, S; Chongthaleong, A; Chaindamporn, A; Udomsantisuk, N; Euasamarnjit, W

2009-04-01

Forty-two community and general hospitals in central Thailand. To examine the adequacy of indoor ventilation for nosocomial tuberculosis (TB) prevention in public hospitals in central Thailand. A cross-sectional survey was conducted among 323 patient care and ancillary areas in the target hospitals. Data on indoor ventilation rate were collected by the tracer gas method and reported as air changes per hour (ACH). The adequacy of the measured ventilation rates were then determined by comparison with the international recommended standard values. Indoor ventilation rates were inadequate in almost half of the studied areas (144/323, 44.6%). The inadequacy was particularly serious in the emergency rooms (ERs) and radiological areas, where 73.8% (31/42 each) of the rooms had ACH below the recommended standards. Detailed analysis showed that most of the rooms with natural ventilation had air exchange rates that exceeded the recommended standards, while the opposite was the case for rooms with air-conditioning, particularly the window or wall-mount type. Indoor ventilation in high-risk nosocomial TB areas in public hospitals in Thailand was inadequate due to the installation of air-conditioning systems in modern buildings.

Type specimens in the Port Elizabeth Museum, South Africa, including the historically important Albany Museum collection. Part 1: Amphibians.

Science.gov (United States)

Conradie, Werner; Branch, William R; Watson, Gillian

2015-03-18

The Port Elizabeth Museum houses the consolidated herpetological collections of three provincial museums of the Eastern Cape, South Africa: the Port Elizabeth Museum (Port Elizabeth), the Amatole (previously Kaffarian) Museum (King Williams Town), and the Albany Museum (Grahamstown). Under John Hewitt, Albany Museum was the main centre of herpetological research in South Africa from 1910-1940, and he described numerous new species, many based on material in the museum collection. The types and other material from the Albany Museum are now incorporated into the Port Elizabeth Museum Herpetology collection (PEM). Due to the vague typification of much of Hewitt's material, the loss of the original catalogues in a fire and the subsequent deterioration of specimen labels, the identification of this type material is often troublesome. Significant herpetological research has been undertaken at the PEM in the last 35 years, and the collection has grown to be the third largest in Africa. During this period, numerous additional types have been deposited in the PEM collection, generated by active taxonomic research in the museum. As a consequence, 43 different amphibian taxa are represented by 37 primary and 151 secondary type specimens in the collection. This catalogue provides the first documentation of these types. It provides the original name, the original publication date, journal number and pagination, reference to illustrations, current name, museum collection number, type locality, notes on the type status, and photographs of all holotypes and lectotypes. Where necessary to maintain nomenclatural stability, and where confused type series are housed in the PEM collection, lectotypes and paralectotypes are nominated.

East African Medical Journal - Vol 77, No 12 (2000)

African Journals Online (AJOL)

Sexually transmitted diseases at Queen Elizabeth Central Hospital, Blantyre, Malawi · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. OO Komolafe, J Nkumba, M Makoka, A Makhalira, P Bonongwe. http://dx.doi.org/10.4314/eamj.v77i12.46762 ...

Birth weights and gestational ages of Malawian newborns at Queen ...

African Journals Online (AJOL)

Objective: To determine the distributions of birth weight (BW) and gestational age (GA) and calculate rates of still birth (SB) of four years delivery in the Queen Elizabeth Central Hospital( QECH). Methods: Retrospective analysis was carried out on data of deliveries conducted between January 2000 and December 2003.

Factors affecting the utilisation of electronic medical records system ...

African Journals Online (AJOL)

Malawi Medical Journal 29 (3): September 2017. Electronic medical ... care, as they enable storage of large amounts of data and ... EMRs. This study assessed factors that affect the use of EMRs in Malawi, particularly at Queen Elizabeth and Kamuzu Central ..... paperless hospitals in Norway : A socio-technical perspective.

Survey of industrial noise in Port Elizabeth.

Science.gov (United States)

Lane, J L

1976-02-07

The amendment to the Factories, Machinery and Building Work Act of 1941 in regard to hearing conservation is outlined. A survey by the Port Elizabeth Deaf Association on workmen from Cadbury (Pty) Ltd was undertaken in 1973 and on a second group in 1974 and the results are published and discussed. Although the numbers of workmen were small, the results suggest that widespread testing will unearth many cases of unsuspected hearing loss. The implications as applied to industry at large are discussed and the difficulties in adequately assessing large numbers of workmen with adequately trained audiometric testers are stressed. A suggestion is made that mobile clinics under the control of Chambers of Industries would be the most efficient way of approaching the screening problem, and an estimated cost structure in the setting up of such a clinic is introduced.

Decentralization and centralization of healthcare resources: investigating the associations of hospital competition and number of cardiologists per hospital with mortality and resource utilization in Japan.

Science.gov (United States)

Park, Sungchul; Lee, Jason; Ikai, Hiroshi; Otsubo, Tetsuya; Imanaka, Yuichi

2013-11-01

To investigate the associations of hospital competition and number of cardiologists per hospital (indicating the decentralization and centralization of healthcare resources, respectively) with 30-day in-hospital mortality, healthcare spending, and length of stay (LOS) among patients with acute myocardial infarction (AMI) in Japan. We collected data from 23,197 AMI patients admitted to 172 hospitals between 2008 and 2011. Hospital competition and number of cardiologists per hospital were analyzed as exposure variables in multilevel regression models for in-hospital mortality, healthcare spending, and LOS. Other covariates included patient, hospital, and regional variables; as well as the use of percutaneous coronary intervention (PCI). Hospitals in competitive regions and hospitals with a higher number of cardiologists were both associated lower in-hospital mortality. Additionally, hospitals in competition regions were also associated with longer LOS durations, whereas hospitals with more cardiologists had higher spending. The use of PCI was also associated with reduced mortality, increased spending and increased LOS. Centralization of cardiologists at the hospital level and decentralization of acute hospitals at the regional level may be contributing factors for improving the quality of care in Japan. Policymakers need to strike a balance between these two approaches to improve healthcare provision and quality. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Gender, culture, and astrophysical fieldwork: Elizabeth Campbell and the Lick Observatory-Crocker eclipse expeditions.

Science.gov (United States)

Pang, A. S.-K.

The article is organized as follows. It begins with an overview of women in nineteenth-century American science. It then describes the culture of mountaintop observatories and life on Mount Hamilton. Elizabeth Campbell's unique role in the Crocker-Lick expeditions drew upon her equally unique role in the observatory, and also on the meaning given to women's work in general on the mountain. The bulk of the article focuses on the Campbells and their expeditions to India in 1898, Spain in 1905, and the South Pacific in 1908. The third section compares the Lick Observatory expeditions to those conducted by David Todd of Amherst College. Todd's wife, Mabel Loomis Todd, went into the field several times with her husband, but her place in the field was radically different from Elizabeth Campbell's, a difference that can be ascribed to a combination of local culture and personality. Finally, it compares American expeditions to British expeditions of the period, to see what the absence of British women on expeditions can tell us about the way national scientific styles and cultures affected gender roles in science.

A 54 year analysis of articles from Mpilo Central Hospital, Bulawayo ...

African Journals Online (AJOL)

PubMed and Google Scholar were searched to obtain articles originating from Mpilo Central Hospital, Bulawayo, Zimbabwe - 1958 to August 2011 (54 years). 168 articles cited 999 times were retrieved giving about 6 citations per article. Analysis of publication trends over time as well as publication avenues is made.

Perceived effects of rotating shift work on nurses\\' sleep quality and ...

African Journals Online (AJOL)

The aim of this longitudinal study was to assess the effect of rotating shift work on perceived sleep quality and sleep duration of nurses at Queen Elizabeth Central Hospital, Blantyre, Malawi. Twenty four female nurses were recruited at random from among personnel engaged in rotating shift work. The nurses worked a ...

Acute bacterial meningitis in children admitted to the Queen ...

African Journals Online (AJOL)

In order to design appropriate interventioos, we collected clinical and demographic data prospectively on all children aged one day to 14 years admitted with a diagnosis of bacterial meningitis (BM) from April 1st 1996 to March 31st 1997 to the Queen Elizabeth Central Hospital (QECH), Blantyre Malawi. During the study ...

Author Details

African Journals Online (AJOL)

Igbigbi, P S. Vol 46, No 11 (2000) - Articles The incidence of cleft lip, cleft palate, hydrocephalus and spina bifida at Queen Elizabeth Central Hospital, Blantyre, Malawi Abstract. ISSN: 0008-9176. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL ...

Browse Title Index

African Journals Online (AJOL)

Items 501 - 550 of 644 ... Vol 27, No 3 (2015), Supra-treatment threshold neonatal jaundice: Incidence in HIV-exposed compared to non-exposed neonates at Queen Elizabeth Central Hospital in Blantyre, Malawi, Abstract PDF. W Nakanga, P Patel, S Panjwani, N Kennedy, K Kawaza. Vol 13, No 3 (2001), Surgical bacterial ...

Case Report: A man on antiretroviral therapy with painful thighs

African Journals Online (AJOL)

A 54 year old man presented with increasing pain in both thighs for three months during a follow up visit at the antiretroviral therapy (ART) clinic of Queen Elizabeth. Central Hospital. He was first seen at the same clinic three years and eight months before the current presentation, when he started. ART with ...

Clinical features and the factors associated with poor outcome of ...

African Journals Online (AJOL)

In the twelve month period from March 1992 to February 1993. 266 consecutive children with measles were admitted to the children's unit at Queen Elizabeth Central Hospital (QECH). Blantyre. During the 12 month period the overall mortality was 10.9%; mortality was highest (22.5%) in children 12-23 months age. One-third ...

Ward Round - Crocodile bites in Malawi: microbiology and surgical ...

African Journals Online (AJOL)

We present a case series of 5 patients admitted over 5 months to Queen Elizabeth Central Hospital who had sustained injuries from a crocodile bite. Three patients required amputation of a limb. The severe soft tissue injury associated with a crocodile bite and the unusual normal oral flora of the crocodile create challenges ...

(Un)Making Sex, Making Race: Nineteenth-Century Liberalism, Difference, and the Rhetoric of Elizabeth Cady Stanton

Science.gov (United States)

Poirot, Kristan

2010-01-01

Elizabeth Cady Stanton has been celebrated for her astute rhetorical contributions to woman's rights advocacy and highly criticized for her racist and elitist sentiments about citizenship and the franchise. Although there appears to be a discontinuity between Cady Stanton's commitment to (sexual) equality and her racism/elitism, this tension is…

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

Science.gov (United States)

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

2010-01-01

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

Telling About Southern Fluctuations: Elizabeth Spencer at the Back Door

Directory of Open Access Journals (Sweden)

Gérald PRÉHER

2011-06-01

Full Text Available Le troisième roman d’Elizabeth Spencer, The Voice at the Back Door (1956, appartient à son cycle du Mississippi. Il traite des relations raciales et de la violence sudiste, deux thèmes qui n’avaient pas bonne presse à cette époque puisque le mouvement pour les droits civiques débutait. Le roman rappelle L’intrus (1948 de Faulkner en ce qu’il met en scène la recherche du coupable du meurtre d’un homme blanc. Cet article analyse la façon dont Spencer dépeint les manières du Sud en s’interrogeant sur les relations raciales. Le roman est également lu dans le contexte de sa publication puisque Spencer fut perçue comme une traîtresse par les Sudistes. Spencer utilise des sujets impopulaires pour révéler le paradoxe au cœur de la manière de vivre sudiste et montre combien le passé se rejoue constamment dans le présent.Elizabeth Spencer’s third novel, The Voice at the Back Door (1956, is part of her Mississippi cycle. It deals with race relations and southern violence, two highly controversial issues at the time since the Civil Rights Movements were beginning. The novel, reminiscent of William Faulkner’s Intruder in the Dust (1948, stages the search for a culprit after the murder of a white man. This paper focuses on Spencer’s portrait of southern manners and interracial relationships and analyzes the novel in the context of its publication. It will show that Spencer uses unpopular topics to expose the paradox at the core of the southern way of life and show that the past is constantly reenacted in the present.

75 FR 26793 - Beam Global Spirits & Wine, Including On-Site Leased Workers from Adecco, St. Elizabeth Business...

Science.gov (United States)

2010-05-12

... & Wine, Including On-Site Leased Workers from Adecco, St. Elizabeth Business Health, Guardsmark, and Lab... 26, 2010, applicable to workers of Beam Global Spirits & Wine, including on-site leased workers from... on-site at the Cincinnati, Ohio location of Beam Global Spirits & Wine. The Department has determined...

Development of personnel radiation monitoring program for occupationally exposed workers in Malawian Hospitals : A case study of Kamuzu Central, Bwaila and Mtengo Wa Nthenga Hospitals

International Nuclear Information System (INIS)

Chinangwa, Getrude

2016-07-01

Malawi became an IAEA member state in 2006 and developed the Atomic Energy Act and Regulations in 2011 and 2012 respectively. However, regulatory authority and personnel monitoring services have not yet been established. As such, hospitals operating radiological services in Malawi do not have personnel monitoring programme. This study aimed at developing the personnel radiation monitoring program for three hospitals in Malawi namely; Kamuzu Central Hospital, Bwaila Hospital, and Mtengo wa Nthenga Hospital. A radiation protection questionnaire was administered to the X-ray Departments involved in the study to investigate radiation protection practices in the hospitals. Dose rate measurements in the facilities were taken using survey meters and doses to individuals were recorded using personal dosimeters. The results showed that the hospitals lack radiation protection program which covers the critical issues of quality assurance and control as well as the personnel dose monitoring. Average ambient dose rate values were 0.39 μSv/hr for Mtengo wa Nthenga Hospital, 5.03 μSv/hr for Bwaila Hospital and 4μSv/hr for Kamuzu Central Hospital. Average monthly dose for workers was 0.247 mSv. The study recommends the establishment of a regulatory authority, consistent dose assessment, quality control tests and structural shielding assessment in these and probably all the diagnostic facilities in Malawi. The personnel monitoring programme developed from this study is intended to guide diagnostic facilities and personnel monitoring service providers in Malawi in tracking and reporting exposure record for their occupationally exposed workers. (au)

Cuando la musa pinta y escribe: Elizabeth Bishop y las pintoras surrealistas

OpenAIRE

2003-01-01

Este ensayo explora las afinidades entre la poesía de Elizabeth Bishop y la obra de diversas pintoras surrealistas a la luz de la problemática de género asociada al machismo de los surrealistas. Un estudio de las afinidades entre Bishop y estas pintoras nos muestra cómo recurrieron a una serie de estrategias de subversión comunes dentro de la mal disimulada réplica del patriarcado social que crearon los surrealistas. Su búsqueda de una madurez artística las condujo a una poética doblemente su...

Lesson Plans for "Not for Ourselves Alone: The Story of Elizabeth Cady Stanton and Susan B. Anthony."

Science.gov (United States)

Prososki, Lisa; Krouse, Judith; Harper, Judith E.

These lesson plans for high school students were developed to accompany the documentary film by Ken Burns and Paul Barnes which tells the story of Elizabeth Cady Stanton and Susan B. Anthony and their lifelong fight for women's rights. In the lessons students write editorials about women's rights around the world today, interview senior citizens…

76 FR 30827 - Temporary Change of Dates for Recurring Marine Event in the Fifth Coast Guard District; Elizabeth...

Science.gov (United States)

2011-05-27

...-AA08 Temporary Change of Dates for Recurring Marine Event in the Fifth Coast Guard District; Elizabeth River, Norfolk, VA AGENCY: Coast Guard, DHS. ACTION: Temporary final rule. SUMMARY: The Coast Guard will... various river boat races and a parade during the ``35th Annual Norfolk Harborfest Celebration.'' Special...

Book review of "The estrogen elixir: A history of hormone replacement therapy in America" by Elizabeth Siegel Watkins

Science.gov (United States)

Sonnenschein, Carlos

2008-01-01

"The Estrogen elixir: A history of hormone replacement therapy in America" by Elizabeth Siegel Watkins is a thoroughly documented cautionary tale of the information and advice offered to women in the perimenopausal period of their life, and the consequences of exposure to sexual hormones on their health and wellbeing.

Elizabeth Bishop and the Poetry of Meditation

Directory of Open Access Journals (Sweden)

James Matthew Wilson

2017-01-01

Full Text Available Elizabeth Bishop’s poetry has won the admiration of a number of Christian poets and scholars. This essay argues that one reason for this is Bishop’s subtle engagement with the work of the poet-divines Gerard Manley Hopkins and, especially, George Herbert; through their influence, she enters into the guiding western poetic tradition of the meditative lyric, which is rooted in the Platonic and Christian accounts of the human person as an image of the Triune God in virtue of the mind as a trinity of memory, understanding, and will. Bishop practiced poetry as a moral act open to a divinity it cannot account for or even name, but traces of whose significance run through the world her poems depict. By considering her work, and her poem “The Weed” in particular, in the context of Herbert, the historical studies of Louis L. Martz, and the literary theory of Yvor Winters, we see that Bishop the unbeliever cannot properly be understood as a “secular” poet, but as one who recognizes the meditative lyric as a way of arriving at understanding of a truth that transcends us.

Cataract surgery audit at an Australian urban teaching hospital.

Science.gov (United States)

Kahawita, Shyalle K; Goggin, Michael

2015-08-01

To provide local data on visual acuity and surgical outcomes for cataract surgery performed in an Australian teaching hospital. Continuous audit over 7 years in a public teaching hospital. A total of 3740 eyes had cataract surgery performed at The Queen Elizabeth Hospital, South Australia, from May 2006 to September 2013. Visual acuity and complication rates were recorded for cataract surgery cases operated on between May 2006 and September 2013 on a digital database with data entry contemporaneous with final follow-up. Visual acuity and surgical complications. Of the patients, 91.4% achieved postoperative best-measured vision better than preoperative best-measured vision. The rate of posterior capsular tear was 2.59%, endophthalmitis was 0.11% and the overall complication rate was 11.7%. This audit is the first to document modern cataract surgery, overwhelmingly dominated by phacoemulsification in an Australian population and can be used to benchmark cataract surgery outcome in an urban Australian population. © 2015 Royal Australian and New Zealand College of Ophthalmologists.

[Dr. Elizabeth Ross: heroine and victim of the World War I in Serbia].

Science.gov (United States)

Mikić, Želimir; Lešić, Aleksandar

2012-01-01

At the beginning of 1915, several months after the World War I started, Serbia was in an extremely difficult situation.The country was war-ravaged, full of sick and wounded soldiers, there was a desperate shortage of doctors, nurses and other medical personnel, and the epidemic of typhus fever exploded and violently attacked the entire country. At that time, however, a number of both foreign allied medical missions and individual volunteers, from various countries, mostly from Great Britain, came to Serbia to help. Among them mostly were women, and they were of enormous support to Serbia in that grave situation. It is estimated that there were more than 600 foreign women volunteers in Serbia at that time and that 22 of them died there. Dr. Elizabeth Ross was one of those brave volunteers who came to Serbia early in 1915. That noble Scottish lady doctor was born in 1878 and finished her medical studies at the University of Glasgow in 1901. After graduation she worked in various places in Great Britain until 1909, when she went to Persia (Iran), where she worked until the beginning of the so called Great War. When she heard of the urgent need in Serbia she left Persia as soon as she could and volunteered to serve in Serbia. She came to Kragujevac at the beginning of January 1915, where she worked at the First Military Reserve Hospital, which at that time was actually a typhus hospital. Working there intensively and devotedly for several weeks under shocking conditions she contracted typhus herself and died there on her 37th birthday on February 14th, 1915. She was buried in Kragujevac, next to two British ladies who also died in Serbia of typhus. Her grave was restored in 1980 when the town of Kragujevac started holding commemorations at the graveside every February 14th at noon to honor her and all other brave and noble women who lost their lives helping Serbia at that unfortunate time.

Female Factory Workers in Charlotte Elizabeth Tonna’s Quest

Directory of Open Access Journals (Sweden)

Fusco Carla

2016-12-01

Full Text Available Female workers represent a fundamental component of the workforce to the extent that it is true that the Industrial Revolution owes them a huge debt. However, despite the unfair exploitation of many women in factories in which conditions resembled manslaughter, they have been often neglected and reduced to liminal characters by Victorian novelists. An interesting exception in the early Victorian period is represented by the writer Charlotte Elizabeth Tonna, whose fiction works as a medium of social criticism. Her semi-fictional The Wrongs of Woman is a reform novel which sheds a controversial light on female working conditions. On the one hand she indeed deplores the inhuman treatment of female labourers, but on the other hand she also argues that female employment provokes a consequent increase in male unemployment! My paper aims to investigate the role of Tonna’s text and her attempt to alleviate working-class suffering.

Book review of The Estrogen Elixir: A History of Hormone Replacement Therapy in America by Elizabeth Siegel Watkins

Directory of Open Access Journals (Sweden)

Sonnenschein Carlos

2008-01-01

Full Text Available Abstract The Estrogen Elixir: A History of Hormone Replacement Therapy in America by Elizabeth Siegel Watkins is a thoroughly documented cautionary tale of the information and advice offered to women in the perimenopausal period of their life, and the consequences of exposure to sexual hormones on their health and wellbeing.

Clinical risk management in hospitals: strategy, central coordination and dialogue as key enablers.

Science.gov (United States)

Briner, Matthias; Manser, Tanja; Kessler, Oliver

2013-04-01

The study aims to identify key enablers fostering clinical risk management (CRM) in hospitals to guide health care in this vital area of patient safety. A cross-sectional survey was conducted at the national level in 324 Swiss hospitals in 2007-2008 to assess the relationship between key elements and systematic CRM. Therefore, a comprehensive monitoring instrument for CRM was used for the first time. Organizational factors (e.g. strategy, coordination, resources) and structural conditions (e.g. hospital size) were tested as key elements. CRM was assessed by evaluating its maturity (i.e. the level of CRM development) by 12 theoretically derived indices joining together essential aspects of CRM at the hospital level and the service level. Chi-square measures were used to analyse the relationships between organizational factors or structural conditions and maturity of CRM. Participation in this voluntary survey was good, with CRM experts of 138 out of 324 hospitals responding (response rate 43%). Three key enablers for CRM were identified: implementing a function for central CRM coordination, assuring dialogue with and between the different hospital services, and developing strategic CRM objectives. This study offers, for the first time, an assessment of the maturity of hospitals' CRM and identifies key enablers related to CRM. This is a feasible first step in guiding hospitals to shape their CRM and presents a basis for future studies, for example, linking CRM to outcome data. © 2012 Blackwell Publishing Ltd.

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

Science.gov (United States)

Carden, Robert; DelliFraine, Jami L

2005-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2001-10-15

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2001-09-15

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

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

Energy Technology Data Exchange (ETDEWEB)

Angeles C, A.; Vizuet G, J

2001-09-15

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2001-12-15

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2001-12-15

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2001-12-15

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2002-01-15

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

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

Science.gov (United States)

McPake, Barbara; Hongoro, Charles; Russo, Giuliano

2011-06-02

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

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

Directory of Open Access Journals (Sweden)

Russo Giuliano

2011-06-01

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

Prevalencia de displasia y cáncer cervicouterino y factores asociados en el Hospital Central de Chihuahua, México

OpenAIRE

Ivonne Salas-Urrutia; Eyra Alejandra Villalobos; Brenda Lizeth Ramírez-Vega

2006-01-01

Objetivos: Los objetivos del presente estudio fueron determinar la prevalencia y los factores de riesgo asociados a cáncer cervicouterino en; las mujeres que acuden al Hospital Central de Chihuahua en el 2004 ya que no se cuenta registros de esta entidad en la ciudad de Chihuahua.; Material y Métodos: Se realizó un estudio observacional, transversal, donde se incluyó a mujeres que demandaron realizarse la citología; cervical en el Hospital Central del Estado de Chihuahua, en el año 2...

Ethics at War: Review of Elizabeth Scannell-Desch and Mary Ellen Doherty, Nurses in War: Voices from Iraq and Afghanistan

Directory of Open Access Journals (Sweden)

Gillespie, Leigh-Anne

2012-10-01

Full Text Available In Nurses in War: Voices from Iraq and Afghanistan, Elizabeth Scannell-Desch and Mary Ellen Doherty take a journey through the lived experiences of 37 United States military nurses who served in Iraq or Afghanistan during the war years 2003 through 2010.

W3C director Tim Berners-Lee to be Knighted by Queen Elizabeth web inventor recognized for contributions to internet development

CERN Document Server

2003-01-01

"Tim Berners-Lee, the inventor of the World Wide Web and director of the World Wide Web Consortium (W3C), will be made a Knight Commander, Order of the British Empire (KBE) by Queen Elizabeth" (1/2 page).

Beyond the bundle: a survey of central line-associated bloodstream infection prevention practices used in US and Canadian pediatric hospitals.

Science.gov (United States)

Klieger, Sarah B; Potter-Bynoe, Gail; Quach, Caroline; Sandora, Thomas J; Coffin, Susan E

2013-11-01

We surveyed US and Canadian pediatric hospitals about their use of central line-associated bloodstream infection (CLABSI) prevention strategies beyond typical insertion and maintenance bundles. We found wide variation in supplemental strategies across hospitals and in their penetration within hospitals. Future studies should assess specific adjunctive prevention strategies and CLABSI rates.

The spectrum of central nervous system infections in an adult referral hospital in hanoi, Vietnam

NARCIS (Netherlands)

Taylor, Walter R.; Nguyen, Kinh; Nguyen, Duc; Nguyen, Huyen; Horby, Peter; Nguyen, Ha L.; Lien, Trinh; Tran, Giang; Tran, Ninh; Nguyen, Ha M.; Nguyen, Thai; Nguyen, Ha H.; Nguyen, Thanh; Tran, Giap; Farrar, Jeremy; de Jong, Menno; Schultsz, Constance; Tran, Huong; Nguyen, Diep; Vu, Bich; Le, Hoa; Dao, Trinh; Nguyen, Trung; Wertheim, Heiman

2012-01-01

To determine prospectively the causative pathogens of central nervous system (CNS) infections in patients admitted to a tertiary referral hospital in Hanoi, Vietnam. From May 2007 to December 2008, cerebrospinal fluid (CSF) samples from 352 adults with suspected meningitis or encephalitis underwent

Meet Jessica and Elizabeth from Sweet Valley: Who Are the Female Role Models in Popular Romance Novels for Children?

Science.gov (United States)

Roberts, Sherron Killingsworth

Jessica and Elizabeth are two female characters, twins, featured throughout Francine Pascal's Sweet Valley series, the Bantam Publishers popular series for girls from elementary school through junior high, high school, university, and well into adulthood. This paper notes that these books are a part of the same formula that are used for romance…

Mapping New York Irish-American Identities: Duality of Spirituality in Elizabeth Cullinan’s Short Story “Life After Death”

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Nicoleta Stanca

2015-11-01

Full Text Available Elizabeth Cullinan’s short story “Life After Death” depicts a day in the life of a young New Yorker, Constance, walking along Lexington Avenue, attending the evening Mass at a Dominican church and visiting the Catholic college where she worked part time to pick up her paycheck. Though the woman is involved with the married Francis Hughes and confronted with the burden of the past and of intricate family dynamics, her voice, which is “the Cullinan narrative voice has become that of one of those sceptical granddaughters grown into a reasonably assured and independent adulthood [...] balanced between then and now, the ethnic and the worldly, and better able to judge self and others because of the doubleness” (Fanning qtd. in Bayor and Meagher 528. Thus, the paper will discuss the manner in which Elizabeth Cullinan maps, in her story, the oscillation of Irish Americans between the ethnic drive and a cosmopolitan individuality gained in New York, with a focus on the value of the duality of consciousness and spirituality, which facilitates enriching and clarifying answers to identity dilemmas.

‘The thin universe’: the domestic worlds of Elizabeth Burns, Tracey Herd and Kathleen Jamie

OpenAIRE

Thompson, Jacqueline

2017-01-01

As Elizabeth Burns’s paradoxical phrase ‘the thin universe’ suggests, the home is a place of both limitations and possibilities. Domestic life has been regarded by some as a spirit-sapping hindrance to creativity, recalling Cyril Connolly’s famous declaration that: ‘There is no more sombre enemy of good art than the pram in the hall.’ This thesis examines the ways in which Burns, Herd and Jamie demonstrate how domestic life, for all its restrictions, can prove to be the ally of...

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

Energy Technology Data Exchange (ETDEWEB)

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

2003-09-15

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

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

International Nuclear Information System (INIS)

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

2010-01-01

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

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

Science.gov (United States)

Hensley, S

1998-06-22

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

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

Science.gov (United States)

Calvo, Mónica; Escudero, Maite

2009-01-01

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

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

OpenAIRE

Pasini, J; Marcelino, P

2012-01-01

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

Pediatric central venous access devices: nursing interventions

Directory of Open Access Journals (Sweden)

Duffy EA

2017-05-01

Full Text Available Elizabeth A Duffy, Kathryn N Nelson Department of Health Behavior and Biological Sciences, The University of Michigan School of Nursing, Ann Arbor, MI, USA Abstract: A central venous catheter (CVC is an indwelling catheter that provides permanent or temporary stable venous access for both acute and chronically ill pediatric patients. These catheters provide stable venous access that can be used for a variety of medical purposes including drawing blood, hemodynamic monitoring, infusion of intravenous medications, infusion of intravenous fluids, chemotherapy, blood products, and parenteral nutrition. Each day, nurses access and care for CVCs in infants, children, and adolescents; the precision of this care can prevent life-threatening complications. The purpose of this review and the case study is to highlight the importance and components of evidence-based nursing practice in pediatric CVC care. A historical perspective of CVC care is provided in conjunction with current national initiatives to improve patient outcomes for children with CVCs. Infection prevention, clinical practice guidelines, quality improvement, and evidence-based care bundles are discussed. Keywords: pediatric nursing, central venous catheters, central line-associated bloodstream infection, care bundles, pediatric case study 

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

Energy Technology Data Exchange (ETDEWEB)

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

2002-01-15

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2002-01-15

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

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

Directory of Open Access Journals (Sweden)

Nghia Ho Dang Trung

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

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

Institute of Scientific and Technical Information of China (English)

Sameer singhal; Pankaj Banode; Nitish Baisakhiya

2009-01-01

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

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

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Ying Qi

2015-05-01

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

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

Directory of Open Access Journals (Sweden)

Amar Taksande

2016-07-01

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

Suffrage Movement and the Subversion of the ‘Juridico-Discursive’ Power in the Victorian Period: Elizabeth Robins and The Concept of 'New Women'

Directory of Open Access Journals (Sweden)

Esmaeil Najar

2016-01-01

Full Text Available This paper examines the socio-historical subversion of ‘juridico-discursive’ power in the late Victorian period. It briefly investigates the rise of the British suffrage movement and highlights the role of ‘suffrage drama’ as its social apparatus. The authors demonstrate how suffrage artists, especially the playwright/actress Elizabeth Robins, acted against the dominant patriarchal hegemony and were in frontline of social uprisings. It is argued that ‘Suffrage drama’ as a ‘place of tolerance’ functioned as an antithesis to the mainstream theatre and challenged the conventional dramatic forms practiced prior to its birth. Suffrage drama provided a space for women to have their collective voice heard in a social and political context in the early Victorian era. Elizabeth Robins, mostly acknowledged for enacting women heroines of Ibsen’s plays, became an invaluable inspirational figure for suffrage women as she was the actress in whom the strong concept of the ‘New Woman’ was incarnated.

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

International Nuclear Information System (INIS)

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

2001-12-01

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

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

International Nuclear Information System (INIS)

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

2001-10-01

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

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

International Nuclear Information System (INIS)

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

2001-09-01

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

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

International Nuclear Information System (INIS)

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

2001-12-01

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

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

International Nuclear Information System (INIS)

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

2001-12-01

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

Specialized consultant in radiological safety to the south central hospital of high speciality, PEMEX. IV. - October of 2001

International Nuclear Information System (INIS)

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

2002-01-01

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

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

International Nuclear Information System (INIS)

Angeles C, A.; Vizuet G, J.

2001-09-01

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

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

International Nuclear Information System (INIS)

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

2002-01-01

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

To and From the Queen: Modalities of Epistolography in the Correspondence of Elizabeth I

Directory of Open Access Journals (Sweden)

Giuliana Iannaccaro

2014-04-01

Full Text Available The article analyses the connection between modalities of letter writing and the relation between writer and addressee. We take into consideration the case of Elizabeth I of England, situated in the overall panorama of early modern European historiography. The English Queen was a prolific and skilful letter writer, endowed with an uncommon talent for foreign languages; but she was also, thanks to her role, the willing or unwilling recipient of thousands of epistles. By selecting two different corpora of letters, from and to the Queen, it is possible to explore how personal relations, degree of acquaintance, respective status and purpose of the letter influence the very structure of the genre.

Elizabeth Ferri y Stephen Ferry (2017. La batea. Ícono Editores

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Santiago Rueda Fajardo

2018-01-01

Full Text Available El nuevo libro de uno de los fotógrafos que más ha seguido el enrevesado, complejo e interminable conflicto colombiano, Stephen Ferry. Pero el libro es ante todo, un homenaje a los trabajadores del oro en este país. Así como Timothy Prus escogió la vaca y la orquídea como argumento para describir lo que considera una fotografía genérica colombiana, Ferry junto a su hermana Elizabeth, quien realiza con el fotógrafo la investigación y escribe con maestría los textos del libro, han escogido el oro, y en concreto la batea, como herramienta para explicarnos y acercarnos a las luchas de los trabajadores artesanales del metal en tres lugares concretos de Colombia, Segovia, Marmato y Yolombó, con un breve epílogo que suceden en Mompox, donde el artesanato orfebre sobrevive en el tiempo muerto de las riveras del Río Magdalena

Diagnostic, evaluation and handling of the tumors of soft tissues. Experience in the Central Military Hospital

International Nuclear Information System (INIS)

Pineda Acero, Gustavo Adolfo; Torres Quintero, Pio

2001-01-01

With the purpose of analyzing the experience of the orthopedics service and traumatology of the central military hospital in the treatment of the tumors of soft tissues, it carries out a descriptive observational study, type series of cases and retrospective. The incidence of the tumors of soft tissues compared with carcinomas and other neoplasia, constitutes less than 1% of all cancerous and the benign ones are more common than the wicked ones in a range of 100:1. The knowledge of the classification, stadification, evaluation strategies, previous biopsy, surgical treatment, radiotherapy y/o chemotherapy is vital for a good final result. 29 clinical histories were included of patient with tumoral lesions in the soft tissues, valued in the central military hospital between March of 1996 and March of 2001. The age average was of 39 years and the pursuit of 24 months. In most of the cases the anatomical commitment belonged to the inferior members (93%), 79% for benign tumors and 21% for wicked tumors. To avoid incorrect diagnoses and inappropriate treatments it is necessary the coordinated evaluation of all multidisciplinary team

[Primary lymphoma of the central nervous system: 20 years' experience in a referral hospital].

Science.gov (United States)

Calderón-Garcidueñas, A L; Pacheco-Calleros, J; Castelán-Maldonado, E; Nocedal-Rustrián, F C

Primary central nervous system lymphomas (PCNSL) are rare neoplasms. AIM. To study the clinical aspects and the immuno-phenotype of all cases of PCNSL in a 20 years lapse in a referral hospital in Northeastern Mexico. From January 1986 to December 2005 all PCNSL histologically confirmed were studied. The primary lymphomas were 1% of malignant central nervous system neoplasms. 21 cases were studied (ages from 9-70 years) with male predominance (2:1). 24% patients had immuno-suppression. The more frequent clinical data were: papilledema (71%), headache (62%), paresis (48%) and seizures (33%). 33% of patients died during the first six months after diagnosis. The T lymphomas were 19% of cases and corresponded to small cell type. PCNSL are still a diagnostic challenge. Multicenter studies are required in order to determine the best treatment protocol.

Elizabeth City, North Carolina. Limited Surface Observations Climatic Summary (LISOCS). Parts A-F.

Science.gov (United States)

1988-03-01

7691 1 STATION NAME: ELIZABETH CITY NC PERIOD Of RECORD: 78-67 MONTH: JAN HOURSILSTI: ISO -1700 WIND SPEED IN KNOTS DIRECTION i 1-3 4-6 7-10 11-16 17...68.3 88.3 88.3 R8.3 88.3 88.3 88.3 88.3 GE 25001 33.9 73.C 81.0 84.3 87.9 87.9 88.3 88.7 88.7 88.7 88.7 88.7 88.7 88.7 88.7 88.7 0E 27001 33.9 73.4...30.038 29.976 29.929 29.960 29.969 29.978 30.000 30.013 30D4 30-068 30.09C 3U.009 16 ISO .276 .263 .268 .221 .157 .145 .123 .119 .128 .197 .208 .240

Science and stewardship to protect and sustain wilderness values: Seventh World Wilderness Congress symposium; 2001 November 2-8; Port Elizabeth, South Africa

Science.gov (United States)

Alan Watson; Janet Sproull

2003-01-01

The Seventh World Wilderness Congress met in Port Elizabeth, South Africa, in 2001. The symposium on science and stewardship to protect and sustain wilderness values was one of several symposia held in conjunction with the Congress. The papers contained in this proceedings were presented at this symposium and cover seven topics: state-of-knowledge on protected areas...

Lineamientos de un plan estratégico para el mejoramiento de la calidad del servicio brindado en el Hospital Militar Central de Lima

OpenAIRE

Cabrera Rioja, Luis Alberto

2007-01-01

El presente estudio, realizado en el Hospital Militar Central (HMC) de Lima, está dirigido al diseño de los lineamientos de un plan estratégico que permita formular la misión y visión del HMC, analizar el entorno e intorno organizacional y formular objetivos estratégicos orientados al mejoramiento continuo de la calidad del servicio. A fin de superar las dificultades económicas, logísticas y de personal que afronta actualmente el Hospital Militar Central, debido a los recortes presupuestales ...

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

International Nuclear Information System (INIS)

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

2003-09-01

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

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

International Nuclear Information System (INIS)

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

2002-01-01

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

Activismo LGBTIQ y ciudadanías sexuales en el Ecuador. Diálogo con Elizabeth Vásquez

Directory of Open Access Journals (Sweden)

Amy Lind

2009-10-01

Full Text Available Elizabeth Vásquez es abogada por entrenamiento, activista y fundadora del PROYECTO TRVNSGEN3RO de Quito. En esta entrevista, ella nos habla de los logros y desafíos que ha enfrentado a lo largo de su trayectoria: los orígenes de su activismo legal, sus inspiraciones políticas, su participación como asesora en la Asamblea Nacional Constituyente de 2008 y sus visiones del movimiento lésbico, gay, bisexual, transgénero y intersexual (LGTBI en Ecuador.

Variation of central corneal thickness in patients with diabetic retinopathy as detected by ultrasonic pachymetry in patients presenting to a tertiary care hospital

International Nuclear Information System (INIS)

Khan, S.A.

2017-01-01

To compare the central corneal thickness between patients with diabetic retinopathy and non diabetics. Study Design: A cross sectional study. Place and Duration of Study: Lahore General Hospital Lahore, from 1st Dec 2015 to 31st May 2016. Material and Methods: A cross-sectional study was conducted in the ophthalmology outpatient department of Lahore General Hospital. A total of one hundred and fifty subjects from different age groups were selected for the study. An ultrasound pachymeter was used to measure CCT. There were two groups for sample, 75 were patients with diabetic retinopathy and 75 of them were non-diabetic subjects. Results: The diabetic patients had average central corneal thickness of value 554.93 +- 33.73 microns. The average central corneal thickness found in non-diabetic patients was 520.41 +- 26.06 microns. The diabetic patients showed an increased central corneal thickness as compared to non-diabetics. The result of this study was statistically significant (p=0.001). Conclusion: The diabetic patients showed an increased central corneal thickness as compared to non-diabetic patients. (author)

[A Survey of the Perception of Nurses Toward the Practice Environment at a Regional Teaching Hospital in Central Taiwan].

Science.gov (United States)

Hung, Jui-Tai; Lin, Ching-Wen; Wen, Wei-Chun; Lin, Esther Ching-Lan

2015-08-01

The nursing practice environment has been shown to wield significant influence on nursing retention and nursing quality of care. Because a large percentage of Taiwan nurses currently work at regional teaching hospitals, exploring the perception toward the practice environment of nurses working at this type of hospital is important. This study explored the perception of nurses working at a regional teaching hospital in central Taiwan toward their practice environment. A cross-sectional research design with a sample of 474 nurses from a regional hospital in central Taiwan was conducted. Instruments including the demographic data and the Chinese-version Practice Environment Scale-Nursing Work Index (CPES-NWI) were anonymously self-administered. Overall, participants were moderately satisfied with their practice environment, with the greatest dissatisfaction focused on staffing and resource adequacy. Work unit and nursing level, respectively, had significant impacts on perceptions regarding the practice environment. Furthermore, discriminant analysis identified two new compound variables: 1) adequate staffing resources and partnership in the workplace and 2) supportive administrative management environment. Participants who worked in medical and surgical units were significantly more dissatisfied with the adequacy of staffing resources and partnership in the workplace than participants who worked in acute/intensive and special units. Participants at the N2 level were significantly more dissatisfied with the supportive nature of the administrative management environment. These findings support that the nursing practice environment of regional hospitals may be improved using several measures, including: modifying the staffing and resource adequacy of nurses, fostering collaborative nurse-physician relationships, and further involving nurses in administrative management and decision-making.

Etiologic Agents of Central Nervous System Infections among Febrile Hospitalized Patients in the Country of Georgia

OpenAIRE

Akhvlediani, Tamar; Bautista, Christian T.; Shakarishvili, Roman; Tsertsvadze, Tengiz; Imnadze, Paata; Tatishvili, Nana; Davitashvili, Tamar; Samkharadze, Tamar; Chlikadze, Rusudan; Dvali, Natia; Dzigua, Lela; Karchava, Mariam; Gatserelia, Lana; Macharashvili, Nino; Kvirkvelia, Nana

2014-01-01

OBJECTIVES: There is a large spectrum of viral, bacterial, fungal, and prion pathogens that cause central nervous system (CNS) infections. As such, identification of the etiological agent requires multiple laboratory tests and accurate diagnosis requires clinical and epidemiological information. This hospital-based study aimed to determine the main causes of acute meningitis and encephalitis and enhance laboratory capacity for CNS infection diagnosis. METHODS: Children and adults patients cli...

Implementing health care reform: implications for performance of public hospitals in central Ethiopia.

Science.gov (United States)

Manyazewal, Tsegahun; Matlakala, Mokgadi C

2018-06-01

Understanding the way health care reforms have succeeded or failed thus far would help policy makers cater continued reform efforts in the future and provides insight into possible levels of improvement in the health care system. This work aims to assess and describe the implications of health care reform on the performance of public hospitals in central Ethiopia. A facility-based, cross-sectional study was carried out in five public hospitals with different operational characteristics that have been implementing health care reform in central Ethiopia. The reform documents were reviewed to assess the nature and targets of the reform for interpretive analysis. Adopting dimensions of health system performance as the theoretical framework, a self-administered questionnaire was developed. Consenting health care professionals who have been involved in the reform from inception to implementation filled the questionnaire. Cronbach's alpha was measured to ensure internal consistency of the instrument. Descriptive statistics, weighted median score, χ 2 , and Mann-Whitney U and Kruskal-Wallis tests were used for data analysis. s Despite implementation of the reform, the health care system in public hospitals was still fragmented as confirmed by 50% of respondents. Limited effects were reported in favour of quality (48%), access (50%), efficiency (51%), sustainability (53%), and equity (61%) of care, while poor effects were reported in patient-provider (41%) and provider-management (32%) interactions. Though there was substantial gain in infrastructure and workspace, stewardship of health care resources was less benefited. The predominant hindrances of the reform were the working environment (adjusted Odds Ratio (aOR) = 2.27, 95% confidence interval (CI): 1.15-4.47), financial resources (aOR = 3.54, 95%CI = 1.97-6.33), management (aOR = 2.27, 95% CI = 1.15-4.47), and information technology system (aOR = 3.15, 95% CI = 1.57-6.32). s The Ethiopian

Effects of rotation of cotton (Gossypium hirsutum L.) and soybean [Glycine max (L.) Merr.] crops on soil fertility in Elizabeth, Mississippi, USA

OpenAIRE

H.A., Reddy, K. and Pettigrew, W.T.

2018-01-01

The effects of cotton (Gossypium hirsutum L.): soybean [Glycine max (L.) Merr.] rotation on the soil fertility levels are limited. An irrigated soybean: cotton rotation experiment was conducted from 2012 through 2015 near Elizabeth, Mississippi, USA. The crop rotation sequences were included continuous cotton (CCCC), continuous soybean (SSSS), cotton-soybean-cotton-soybean (CSCS), cotton-soybean-soybean-cotton (CSSC), soybean-cotton-cotton-soybean (SCCS), soybean-cotton-soybean-cotton (SCSC)....

Allogenic bone grafts used at Central Hospital during June 1995 to July 1998

International Nuclear Information System (INIS)

Yolchai Jongjirasiri; Yongyudh Vajaradul

1999-01-01

Producing and using allogenic bone graft in Thailand began ten years ago. There are approximately 1,000 cases a year on orthopaedic surgery at Central Hospital. For using allogenic bone graft from the Bangkok Biomaterial Center, 66 cases were operated since June 1995. This was generated by 30 in males, 36 in females and by ages between 12-81 years old. After the operation, 43 cases had bone gap from injuries and 19 cases, fusion of spondylolisthesis and scoliosis were done. Four cases had tumor surgery, and 59 out of 66 cases had good bone union that is 89%. Delayed union happened in 6 cases only. Immune response to allogenic bone graft has not been found yet

Tuberculous meningitis is a major cause of mortality and morbidity in adults with central nervous system infections in Kota Kinabalu, Sabah, Malaysia: an observational study.

Science.gov (United States)

Lee, Heng Gee; William, Timothy; Menon, Jayaram; Ralph, Anna P; Ooi, Eng Eong; Hou, Yan'an; Sessions, October; Yeo, Tsin Wen

2016-06-16

Central nervous system (CNS) infections are a significant contributor to morbidity and mortality globally. However, most published studies have been conducted in developed countries where the epidemiology and aetiology differ significantly from less developed areas. Additionally, there may be regional differences due to variation in the socio-economic levels, public health services and vaccination policies. Currently, no prospective studies have been conducted in Sabah, East Malaysia to define the epidemiology and aetiology of CNS infections. A better understanding of these is essential for the development of local guidelines for diagnosis and management. We conducted a prospective observational cohort study in patients aged 12 years and older with suspected central nervous system infections at Queen Elizabeth Hospital, Kota Kinabalu, Sabah, Malaysia between February 2012 and March 2013. Cerebrospinal fluid was sent for microscopy, biochemistry, bacterial and mycobacterial cultures, Mycobacterium tuberculosis polymerase chain reaction (PCR), and multiplex and MassCode PCR for various viral and bacterial pathogens. A total of 84 patients with clinically suspected meningitis and encephalitis were enrolled. An aetiological agent was confirmed in 37/84 (44 %) of the patients. The most common diagnoses were tuberculous meningitis (TBM) (41/84, 48.8 %) and cryptococcal meningoencephalitis (14/84, 16.6 %). Mycobacterium tuberculosis was confirmed in 13/41 (31.7 %) clinically diagnosed TBM patients by cerebrospinal fluid PCR or culture. The acute case fatality rate during hospital admission was 16/84 (19 %) in all patients, 4/43 (9 %) in non-TBM, and 12/41 (29 %) in TBM patients respectively (p = 0.02). TBM is the most common cause of CNS infection in patients aged 12 years or older in Kota Kinabalu, Sabah, Malaysia and is associated with high mortality and morbidity. Further studies are required to improve the management and outcome of TBM.

A Proposed Solution for Managing Doctor's Smart Cards in Hospitals Using a Single Sign-On Central Architecture

OpenAIRE

Mauro, Christian;Sunyaev, Ali;Leimeister, Jan Marco;Schweiger, Andreas;Krcmar, Helmut

2014-01-01

This paper describes a single sign-on solution for the central management of health care provider?s smart cards in hospitals. The proposed approach which is expected to be an improvement over current methods is made possible through the introduction of a national healthcare telematics infrastructure in Germany where every physician and every patient will automatically be given an electronic health smart card (for patients) and a corresponding health professional card (for health care provider...

Legitimacy of hospital reconfiguration: the controversial downsizing of Kidderminster hospital.

Science.gov (United States)

Oborn, Eivor

2008-04-01

This paper examines the contested organizational legitimacy of hospital reconfiguration, which continues to be a central issue in health care management. A qualitative study which focuses on the controversial downsizing of Kidderminster Hospital, a highly publicized landmark case of district general hospital closure. Rhetorical strategies are analysed to examine how legitimacy was constructed by stakeholder groups and how these strategies were used to support or resist change. Stakeholders promoting change legitimized re-organization pragmatically and morally arguing the need for centralization as a rational necessity. Stakeholders resisting change argued for cognitive and moral legitimacy in current service arrangements, contrasting local versus regionalized aspects of safety and provision. Groups managed to talk past each other, failing to establish a dialogue, which led to significant conflict and political upheaval. Stakeholders value hospitals in different ways and argue for diverse accounts of legitimacy. Broader discourses of medical science and democratic participation were drawn into rhetorical texts concerning regionalization to render them more powerful.

Rifampicin resistance in mycobacterium tuberculosis patients using GeneXpert at Livingstone Central Hospital for the year 2015: a cross sectional explorative study.

Science.gov (United States)

Masenga, Sepiso K; Mubila, Harrison; Hamooya, Benson M

2017-09-22

Since the recent introduction of GeneXepert for the detection of Tuberculosis (TB) drug resistance mutations in both primary resistance and acquired resistance in Zambia, little has been documented in literature on the issue of rifampicin resistance especially in the face of a high National TB burden. The study aimed to determine the prevalence of rifampicin resistance in tuberculosis patients at Livingstone Central Hospital for the year 2015. This was a cross sectional study conducted at Livingstone Central Hospital where we reviewed 152 records (from January 1, 2015 to 31st December, 2015) involving patients who presented with clinically suspected TB or documented TB, whose samples were sent to the laboratory for GeneXpert Mycobacterium tuberculosis/rifampicin testing. Statistical evaluations used a one-sample test of proportion and Fisher's exact test. The age of participants ranged from 8 months to 73 years old (median = 34). Of the participants with complete data on gender, 99 (66%) and 52 (34%) were males and females respectively. The TB co-infection with HIV prevalence was 98.3% (p < 0.001). Prevalence of rifampicin resistance was 5.9% and there was no statistical significant difference between being male or female (p = 0.721). We were able to show from our study, evidence of rifampicin resistance at Livingstone Central Hospital. Hence, there was need for further in-depth research and appropriate interventions (i.e close follow-up and patient care for drug resistance positive patients).

in the queen elizabeth

African Journals Online (AJOL)

called for special attention and forms the subject of this paper. ... occur along the central region of the rift valley (Figure I). .... In area I the hinterland slopes gradually providing suitable beaches and lagoons which ... In area 3 hippo concentrate on the alluvial fans and use the broken ground around the ... (b) Herd structure.

Arthroplasty of hip resection, handling with external fixation - Experience in the central military hospital

International Nuclear Information System (INIS)

Satizabal Azuero, Carlos E; Calderon Uribe, Oscar; Naquira Escobar, Luis F

2006-01-01

This is an observational retrospective study series of cases carried out between January 1998 and July 2004 in the central military hospital, 13 patients were treated with Girdlestone arthroplasty with external fixation, with a pursuit average of 53 months. Function, return to the daily activities and associate complications was evaluated. They were as complication; pain in the fixator site, osteitis, and fixator broke. All patients report at the end of the treatment no pain in the hip. Shortening in the patient without lenghting was 3,5 cm and in the group with lenghting was 1.5 cm. the obtained results demonstrate that Girdlestone arthroplasty with external fixation, is option, to improve the patient's pain and function of the hip

A Case Study in Caribbean Climate Change: Impacts on Crop Suitability and Small Farmer Vulnerability in St. Elizabeth, Jamaica

Science.gov (United States)

Curtis, W. R.; Gamble, D. W.; Popke, J.

2013-12-01

This paper examines some of the implications of climate change for farming in the Caribbean, through an analysis of future crop suitability and a case study of climate variability and agricultural practices in St. Elizabeth Parish, Jamaica. To assess potential changes in Caribbean agriculture, we present results from a water budget model based on a 100-year regional climate projection of temperature and precipitation for the circum-Caribbean basin. We find that future water deficits in the region are climate type-dependent. Savanna climates experience the largest annual changes, while semi-arid environments are greatly impacted in the spring. When the impacts of temperature and precipitation are considered separately, we find that predicted future warming, and the associated increase in evapotranspiration, has a slightly larger climatological effect on crop water need than predicted decreases in precipitation. To illustrate how a changing climate regime may impact agricultural practices, we present results from recent fieldwork in St. Elizabeth Parish, one of the main farming regions on the island of Jamaica. Drawing on data from farmer interviews and a recently-installed weather mesonet, we highlight the ways in which local microclimates influence farmer livelihood strategies and community-level vulnerability. Initial results suggest that farmers are experiencing greater climate variability, and that communities with Savanna and semi-arid type climates may be more susceptible to drought than communities in wetter, higher-elevation microclimates. These changes have enhanced the importance of irrigation technology and water management strategies for successful farming. In this context, we argue, large, well-capitalized farmers may be better able to manage the uncertainties associated with climate change, leading to an uneven landscape of vulnerability across the region.

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

OpenAIRE

Garde Sesma, Idoia

2014-01-01

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

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

Science.gov (United States)

Fujihara, Satoko; Tsukisawa, Miyoko

2014-03-01

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

Organic compounds and cadmium in the tributaries to the Elizabeth River in New Jersey, October 2008 to November 2008: Phase II of the New Jersey Toxics Reduction Workplan for New York-New Jersey Harbor

Science.gov (United States)

Bonin, Jennifer L.

2010-01-01

Samples of surface water and suspended sediment were collected from the two branches that make up the Elizabeth River in New Jersey - the West Branch and the Main Stem - from October to November 2008 to determine the concentrations of selected chlorinated organic and inorganic constituents. The sampling and analyses were conducted as part of Phase II of the New York-New Jersey Harbor Estuary Plan-Contaminant Assessment and Reduction Program (CARP), which is overseen by the New Jersey Department of Environmental Protection. Phase II of the New Jersey Workplan was conducted by the U.S. Geological Survey to define upstream tributary and point sources of contaminants in those rivers sampled during Phase I work, with special emphasis on the Passaic and Elizabeth Rivers. This portion of the Phase II study was conducted on the two branches of the Elizabeth River, which were previously sampled during July and August of 2003 at low-flow conditions. Samples were collected during 2008 from the West Branch and Main Stem of the Elizabeth River just upstream from their confluence at Hillside, N.J. Both tributaries were sampled once during low-flow discharge conditions and once during high-flow discharge conditions using the protocols and analytical methods that were used in the initial part of Phase II of the Workplan. Grab samples of streamwater also were collected at each site and were analyzed for cadmium, suspended sediment, and particulate organic carbon. The measured concentrations, along with available historical suspended-sediment and stream-discharge data were used to estimate average annual loads of suspended sediment and organic compounds in the two branches of the Elizabeth River. Total suspended-sediment loads for 1975 to 2000 were estimated using rating curves developed from historical U.S. Geological Survey suspended-sediment and discharge data, where available. Concentrations of suspended-sediment-bound polychlorinated biphenyls (PCBs) in the Main Stem and the

Rune Frederiksen, Elizabeth R. Gebhard & Alexander Sokolicek (eds.), The Architecture of the Ancient Greek Theatre, Monographs of the Danish Institute, Volume 17 (Aarhus: Aarhus University Press and The Danish Institute at Athens, 2015)

OpenAIRE

William C. Miller

2017-01-01

A review of the book: Rune Frederiksen, Elizabeth R. Gebhard & Alexander Sokolicek (eds.), The Architecture of the Ancient Greek Theatre, Monographs of the Danish Institute, Volume 17 (Aarhus: Aarhus University Press and The Danish Institute at Athens, 2015)

Strength in unity: the power of redesign to align the hospital team.

Science.gov (United States)

Bell, Anthony; Cochrane, Alastair; Courtice, Sally; Flanigan, Kathy; Mathur, Mandeep; Wilckens, Daniel

2014-06-01

The aim of Queen Elizabeth II Jubilee Hospital (QEII) redesign project (QEII United) was to enhance timely access to an inpatient bed and maximise opportunities to value add during the inpatient episode of care. A tripartite relationship between the hospital team, system manager and external consultants. The team, QEII United, was formed to 'diagnose, solve and implement' change under the unifying metaphorical banner of a football team. A marketing strategy and communication plan targeted the key 'players' and outlined the 'game plan'. Baseline data were collected, analysed and reported in keeping with key aims. Strategies for systems improvement implementation were attached to key performance indicators (KPIs). Thematic KPIs were developed to embed internal process change to reflect the contributions made towards the National Emergency Access Target (NEAT) at each stage of the patient journey. As such, access block of under 20%, morning discharge rates of 50% before midday, reduced length of stay for selected elective orthopaedic and general medical diagnostic related groupings (DRGs; i.e. relative stay index ≤1) and hospital in the home (HITH) utilisation rates 1.5% of all admissions were all met. Key to sustainability was the transfer of clinical redesign skills to hospital staff and the fostering of emergent ground up leadership. QEII United's success has been underpinned by the development of themed solution areas developed by the hospital staff themselves. Robust baseline data analysis used in combination with nationally available benchmarking data provided a quantitative starting point for the work. The collaborative elements of the program re-energised the hospital team, who were kept informed by targeted communications, to establish quick wins and build trust and momentum for the more challenging areas.

Stepwise introduction of the 'Best Care Always' central-line-associated bloodstream infection prevention bundle in a network of South African hospitals.

Science.gov (United States)

Richards, G A; Brink, A J; Messina, A P; Feldman, C; Swart, K; van den Bergh, D

2017-09-01

Healthcare-associated infection (HCAI) remains a major international problem. The 'Best Care Always!' (BCA) campaign was launched in South Africa to reduce preventable HCAI, including central-line-associated bloodstream infection (CLABSI). The intervention took place in 43 Netcare Private Hospitals, increasing later to 49 with 958 intensive care units (ICUs) and 439 high-care (HC) beds and 1207 ICUs and 493 HC beds, respectively. Phase 1, April 2010 to March 2011, ICU infection prevention and control (IPC) nurse-driven change: commitment from management and doctors and training of IPC nurses. Bundle compliance and infections per 1000 central-line-days were incorporated as standard IPC measures and captured monthly. Phase 2, April 2011 to March 2012, breakthrough collaborative method: multiple regional learning sessions for nursing leaders, IPC nurses and unit managers. Phase 3, April 2012 to May 2016: sustained goal-setting, benchmarks, ongoing audits. A total of 1,119,558 central-line-days were recorded. Bundle compliance improved significantly from a mean of 73.1% [standard deviation (SD): 11.2; range: 40.6-81.7%] in Phase 1 to a mean of 90.5% (SD: 4.7; range: 76.5-97.2%) in Phase 3 (P = 0.0004). The CLABSI rate declined significantly from a mean of 3.55 (SD: 0.82; range: 2.54-5.78) per 1000 central-line-days in Phase 1 to a mean of 0.13 (SD: 0.09; range: 0-0.33) (P hospitals resulted in significant decreases in CLABSI. Copyright © 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Erving Goffman's asylums and institutional culture in the mid-twentieth-century United States.

Science.gov (United States)

Gambino, Matthew

2013-01-01

Sociologist Erving Goffman based his seminal work Asylums (1961) on a year of field research at St. Elizabeths Hospital in Washington, DC. Goffman described the mental hospital as a "total institution," in which regimentation dominated every aspect of daily life and patients were denied even the most basic means of self-expression; rather than promote recovery, such conditions produced the sorts of disordered behavior for which men and women were ostensibly admitted. A closer look at the changes transforming St. Elizabeths around the time of Goffman's research reveals a far richer portrait of institutional culture. Group therapy, psychodrama, art and dance therapy, patient newspapers, and patient self-government-each of which debuted at the hospital in the 1940s and 1950s-provided novel opportunities for men and women to make themselves heard and to take their fate into their own hands. While these initiatives did not reach all of the patients at St. Elizabeths, surviving documentation suggests that those who participated found their involvement rewarding and empowering. Goffman explicitly set out to describe "the social world of the hospital inmate." His failure to appreciate fully the capacities of his subjects, however, appears to have led him to underestimate the importance of these developments.

Rune Frederiksen, Elizabeth R. Gebhard & Alexander Sokolicek (eds., The Architecture of the Ancient Greek Theatre, Monographs of the Danish Institute, Volume 17 (Aarhus: Aarhus University Press and The Danish Institute at Athens, 2015

Directory of Open Access Journals (Sweden)

William C. Miller

2017-03-01

Full Text Available A review of the book: Rune Frederiksen, Elizabeth R. Gebhard & Alexander Sokolicek (eds., The Architecture of the Ancient Greek Theatre, Monographs of the Danish Institute, Volume 17 (Aarhus: Aarhus University Press and The Danish Institute at Athens, 2015

Transfusion practice in Helsinki University Central Hospital: an analysis of diagnosis-related groups (DRG).

Science.gov (United States)

Syrjälä, M T; Kytöniemi, I; Mikkolainen, K; Ranimo, J; Lauharanta, J

2001-12-01

Transfusion data combined with data automatically recorded in hospital databases provides an outstanding tool for blood utilization reporting. When the reporting is performed with an online analytical processing (OLAP) tool, real time reporting can be provided to blood subscribers. When this data is combined with a common patient classification system, Diagnosis-Related Groups (DRG), it is possible to produce statistical results, that are similar in different institutions and may provide a means for international transfusion bench-marking and cost comparison. We use a DRG classification to describe the transfusion practice in Helsinki University Central Hospital. The key indicators include the percentage of transfused patients, the number of transfused units and costs in different DRG groups, as well as transfusion rates per DRG weighted treatment episodes. Ninety-three per cent of all transfusions could be classified into different DRGs. The largest blood-using DRG group was acute adult leukaemia (DRG 473), which accounted for 10.4% of all transfusion costs. The 13 largest blood consuming DRGs accounted for half the total costs in 1998. Currently, there is a lack of an internationally accepted standardized way to report institutional or national transfusion practices. DRG-based transfusion reporting might serve as a means for transfusion benchmarking and thus aid studies of variations in transfusion practice.

"All the World Is Gone to the Assembly": Elizabeth Carter's Headaches, Nerves, and (In)Sociability.

Science.gov (United States)

Hansen, Mascha

Elizabeth Carter suffered from severe headaches all her life. Her letters are peppered with references to fits of "head-ach" so bad they made her bold enough to demand her own room wherever she visited, and to cherish a preference for solitude contrary to the ideal of Bluestocking sociability. Following her friends and physicians, she bowed to fashionable diagnoses in considering these headaches the result of a nervous constitution, and she was prescribed the usual remedies, including sociable trips to fashionable watering places. While positioning her sufferings within the frame of fashionable diseases, Carter tried to dissociate herself from fashionable sensibility, and struggled to gain acceptance for her pain as part of her body's "mechanism" by using a more old-fashioned, religious interpretative frame. This case study of Carter's headaches thus charts Carter's own understanding of her constitution, her body, and her pain within-and without-the framework of eighteenth-century fashionable diseases.

The Generic Structure of Print Advertisement of Elizabeth Arden’s INTERVENE: A Multimodal Discourse Analysis

Directory of Open Access Journals (Sweden)

Aylanda Dwi Nugroho

2009-01-01

Full Text Available The Elizabeth Arden campaign with Catherine Zeta-Jones as the brand ambassador has deployed the semiotic resources of language and visual images. The analysis of this paper is based on the systemic functional linguistics (SFL proposed by Halliday (1985, 1994 and Halliday and Matthiessen (2004, which says that a text is understood to simultaneously function three metafunctions: Ideational, Interpersonal and Textual. O’Toole’s (1994 framework of analysing visual images, which follows the main concept of SFL, is also used in the analysis. A multimodal discourse analysis is then applied to analyse one of the series, Intervene, using Cheong’s framework (2004, which combined both frameworks to find the generic structure of this advertisement. Further, this paper also analyses the intersemiosis of the linguistic and the visual resources using Wee’s (2009 intersemiotic mechanisms. It concludes that the interplay of the language and the visual image has proved to be very effective in the meaning-making process of this print advertisement.

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

Directory of Open Access Journals (Sweden)

Iván O Espinoza

2011-12-01

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

ARTRODESIS TIBIOTALOCALCANEA CON PLACA PHILOS: EXPERIENCIA EN EL HOSPITAL MILITAR CENTRAL. ENERO 2007 A DICIEMBRE DE 2009

OpenAIRE

MUÑOZ FALLA, GERARDO ALEXI; DELGADO NEIRA, ALEJANDRO; ENRIQUE GAMBA, CESAR; HERNÁNDEZ PERDOMO, EDGAR

2011-01-01

Estudio descriptivo observacional, retrospectivo tipo serie de casos, realizado entre enero de 2007 y diciembre de 2009 en el Hospital Militar Central. Fueron tratados 21 pacientes con artrosis de la articulación tibio talar y subtalar de etiología diversa, con seguimiento mínimo de 6 meses. Se evaluó; la función pre operatoria y post operatoria por medio de la escala AOFAS, el dolor mediante la escala visual análoga, el tiempo de consolidación con controles radiográficos, el tipo de injerto ...

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

Science.gov (United States)

Peixoto, Bruno; Kalei, Isabel

2013-07-01

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

Title: The Impact of 2006-2012 CReSIS Summer Research Programs that Influence Student's Choice of a STEM Related Major in College Authors: Dr. Darnell Johnson Djohnson@mail.ecsu.edu Elizabeth City State University, Elizabeth City, North Carolina 27909 Dr. Linda Hayden Haydenl@mindspring.com Elizabeth City State University, Elizabeth City, North Carolina, 27909

Science.gov (United States)

Johnson, D.

2013-12-01

Abstract: Researchers, policymakers, business, and industry have indicated that the United States will experience a future shortage of professionals in the Science, Technology, Engineering, and Mathematics (STEM) fields. Several strategies have been suggested to address this impending shortage, one of which includes increasing the representation of females and minorities in the STEM fields. In order to increase the representation of underrepresented students in the STEM fields, it is important to understand the motivational factors that impact underrepresented students' interest in STEM academics and extracurricular programs. Research indicates that greater confidence leads to greater interest and vice versa (Denissen et al., 2007). In this paper, the mathematics research team examined the role of practical research experience during the summer for talented minority secondary students studying in STEM fields. An undergraduate research mathematics team focused on the link between summer research and the choice of an undergraduate discipline. A Chi Square Statistical Test was used to examine Likert Scale results on the attitude of students participating in the 2006-2012 Center for Remote Sensing of Ice Sheets (CReSIS) Summer Research Programs for secondary students. This research was performed at Elizabeth City State University located in northeastern North Carolina about the factors that impact underrepresented students' choices of STEM related majors in college. Results can be used to inform and guide educators, administrators, and policy makers in developing programs and policy that support and encourage the STEM development of underrepresented students. Index Terms: Science, Technology, Engineering, and Mathematics (STEM), Underrepresented students

Dizziness in a community hospital: central neurological causes, clinical predictors, and diagnostic yield and cost of neuroimaging studies.

Science.gov (United States)

Ammar, Hussam; Govindu, Rukma; Fouda, Ragai; Zohdy, Wael; Supsupin, Emilio

2017-03-01

Objectives : Neuroimaging is contributing to the rising costs of dizziness evaluation. This study examined the rate of central neurological causes of dizziness, relevant clinical predictors, and the costs and diagnostic yields of neuroimaging in dizziness assessment. Methods : We retrospectively reviewed the records of 521 adult patients who visited the hospital during a 12-month period with dizziness as the chief complaint. Clinical findings were analyzed using Fisher's exact test to determine how they correlated with central neurological causes of dizziness identified by neuroimaging. Costs and diagnostic yields of neuroimaging were calculated. Results : Of the 521 patients, 1.5% had dizziness produced by central neurological causes. Gait abnormalities, limb ataxia, diabetes mellitus, and the existence of multiple neurological findings predicted central causes. Cases were associated with gait abnormalities, limb ataxia, diabetes mellitus, and the existence of multiple neurological findings . Brain computed tomography (CT) and magnetic resonance imaging (MRI) were performed in 42% and 9.5% of the examined cases, respectively, with diagnostic yields of 3.6% and 12%, respectively. Nine cases of dizziness were diagnosed from 269 brain scans, costing $607 914. Conclusion : Clinical evaluation can predict the presence of central neurological causes of dizziness, whereas neuroimaging is a costly and low-yield approach. Guidelines are needed for physicians, regarding the appropriateness of ordering neuroimaging studies. Abbreviations : OR: odds ratio; CI: confidence interval; ED: emergency department; CT: computed tomography; MRI: magnetic resonance imaging; HINTS: Head impulse, Nystagmus, Test of skew.

Central Diabetes Insipidus, Central Hypothyroidism, Renal Tubular ...

African Journals Online (AJOL)

readmitted to the hospital because of jaundice and failure to thrive, for which he was investigated and diagnosed to have central congenital hypothyroidism. Shortly thereafter, he was admitted to our institute with a history of vomiting, decreased oral intake, polyuria, and dehydration having lasted 5 days. He was investigated ...

Effects of dietary pattern and education on glycemic control in patients with type 2 diabetes mellitus at Dr. Sardjito Central General Hospital, Yogyakarta.

Science.gov (United States)

Sinorita, Hemi; Saádah; Jazakillah, Setyowati

2008-04-01

to recognize the effect of education and diet on glycemic control in patients with type 2 diabetes mellitus at Dr. Sardjito Central General Hospital, Jogjakarta. a cross-sectional study was conducted in 88 patients with type 2 DM who had routine visit to the outpatient clinic in Endocrinology Division of Dr. Sardjito Central General Hospital, Jogjakarta. As inclusion criteria, patients who had routine visit in 3 month continuously with fasting plasma glucose (GDN) 126 mg/dl as poor glycemic control group. Data were recorded which included age, sex, period of DM, daily diet pattern, and education received. we found that glycemic control was not affected by sex (p=0.52) and age (p=0.38), but it was affected by period of DM (p=0.02). Glycemic control in the present study was affected by dietary pattern (p=0.01), but not by education (p=1.00). the present study has found significant correlation between regulation of dietary pattern and glycemic control (p=0.01).

Cyclotron will not survive yet this year without state support

International Nuclear Information System (INIS)

Marcan, P.

2005-01-01

In this paper the project of the Cyclotron Center of the Slovak republic is described. On the basis of this project the state joint-stock company Biont was constituted. Small cyclotron is in operation; big cyclotron is in process of manufacture and it will be put in operation in 2007. Small cyclotron will be used for production of radiopharmaceuticals. Positron emission tomograph (PET) in Oncological Institute of St. Elizabeth (in Bratislava) and gamma camera in Central Military Hospital (in Ruzomberok) are constituents of the Biont. The PET will be also in Biont. The hadron therapy of ophthalmic tumors is planned. Financial plans of the Biont up to 2009 are presented

Mansfield Park Comes to Life: Teaching and Staging Elizabeth Inchbald’s Lovers’ Vows in an Austen Course

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Misty Krueger

2015-03-01

Full Text Available This essay discusses how I incorporated readers theatre into a senior seminar on Jane Austen and her contemporaries. The article recounts how my students read Elizabeth Inchbald’s 1798 drama, Lovers’ Vows, and Austen’s 1814 novel, Mansfield Park, and then were inspired at the end of the seminar to take part in a readers theatre production of the play. In order to set up this pedagogical example, the essay addresses the theatrical episode of Mansfield Park, the controversies surrounding Lovers’ Vows, and the ways in which I edited the play and prepared students to create a “little theatre”—to quote Austen character, Tom Bertram—at my university and become their own version of The Mansfield Players. The essay concludes by explaining what students can learn about drama and the novel by partaking in such an exercise.

The Telomere Effect: A Revolutionary Approach to Living Younger, Healthier, Longer Blackburn Elizabeth and Epel Elissa The Telomere Effect: A Revolutionary Approach to Living Younger, Healthier, Longer 417pp £14.99 Orion Books 9780297609230 0297609238 [Formula: see text].

Science.gov (United States)

2017-06-28

Elizabeth Blackburn received a Nobel prize for discovering the molecular nature of telomeres (the ends of our chromosomes that serve as protective caps) and telomerase (the enzyme that maintains telomeres).

Clinical and endoscopic profile of the patients with upper gastrointestinal bleeding in central rural India: A hospital-based cross-sectional study

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Jyoti Jain

2018-01-01

Full Text Available Introduction: Acute Upper Gastrointestinal bleeding (UGIB is one of the common causes with which the patients present to emergency. The upper gastrointestinal (UGI endoscopy remains a crucial tool in identification of UGIB. The aim of the present study was to determine the endoscopic profile of UGIB in adult population of rural central India admitted with history of UGIB (hemetemesis and/or malena. Methods: This prospective, cross sectional study was conducted in rural hospital in central India and we enrolled all consecutive patients aged 18 years and above who were admitted in the hospital ward with the history of UGIB. After obtaining the demographic data, all patients underwent clinical examination, laboratory investigations and video-endoscopy. We used Student's t test to compare means, Chi-square test to compare proportions and Mann-Whitney test to compare medians. P value <0.05 will be considered significant. Results: The mean age of our study population (N = 118 was 46.2 years. Among 118 patients who underwent endoscopy, 47.4% had esophageal varices, 27.1% had portal hypertensive gastropathy, 14.4% had gastric erosions, 5.9% each had duodenal ulcers and esophagitis, 5% had gastric ulcer disease, 4.2% each had Mallory-Weiss tear and had gastric malignancy, 1.7% had esophageal malignancy and 16.1% had normal endoscopic findings. Conclusion: Esophageal varices were the most common cause of UGIB in the adult population of rural central India presenting with UGIB, when diagnosed by video-endoscopy.

Comparision between bed side testing of blood glucose by glucometer vs centralized testing in a tertiary care hospital.

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Baig, Ayaz; Siddiqui, Imran; Jabbar, Abdul; Azam, Syed Iqbal; Sabir, Salman; Alam, Shahryar; Ghani, Farooq

2007-01-01

To determine the accuracy, turnaround time and cost effectiveness of bedside monitoring of blood glucose levels by non-laboratory health care workers and centralized testing of blood glucose by automated analyzer in a tertiary care hospital. The study was conducted in Section of Chemical Pathology, Department of Pathology and Microbiology and Section of Endocrinology Department of Medicine, Aga Khan University and Hospital Karachi, from April 2005 to March 2006. One hundred and ten patients were included in the study. The blood glucose levels were analyzed on glucometer (Precision Abbott) by finger stick, using Biosensor Technology. At the same time venous blood was obtained to analyze glucose in clinical laboratory on automated analyzer (SYNCHRON CX7) by glucose oxidase method. We observed good correlation between bed side glucometer and laboratory automated analyzer for glucose values between 3.3 mmol/L (60 mg/dl) and 16.7 (300 mg/dl). A significant difference was observed for glucose values less than 3.3 mmol/L (p = 0.002) and glucose values more than 16.67 mmol/l (p = 0.049). Mean Turnaround time for glucometer and automated analyzer were 0.08 hours and 2.49 hours respectively. The cost of glucose testing with glucometer was 48.8% lower than centralized lab based testing. Bedside glucometer testing, though less expensive does not have good accuracy in acutely ill patient with either very high or very low blood glucose levels.

“Do the next thing”: an interview with Elizabeth Adams St. Pierre on post-qualitative methodology

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Hanna Guttorm

2015-06-01

Full Text Available Professor Elizabeth Adams St. Pierre’s work focuses on critical and poststructural theories of language and the subject and what she has called post qualitative inquiry or post inquiry. She asks what might come after conventional humanist qualitative research methodology. She’s especially interested in the new empiricisms/new materialisms as well as new research practices enabled by the ontological turn. During St. Pierre's visit to the Finnish Educational Research Association (FERA Conference in Oulu in November 2014, we had the opportunity to talk with her about post qualitative research around some questions we had sent her beforehand. We then transcribed, edited, and translated the interview, and published it in the Finnish journal Kasvatus (Education in spring 2015. In this interview St. Pierre talks in the US context, where qualitative methodology is turning—or being pushed to turn—back to positivism with normalized and formalized practices, St. Pierre encourages researchers to constantly question the prevailing truths and the traditions they have learnt too well.

Towards a smoke-free hospital: how the smoking status of health professionals influences their knowledge, attitude and clinical activity. Results from a hospital in central Italy.

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Giorgi, E; Marani, A; Salvati, O; Mangiaracina, G; Prestigiacomo, C; Osborn, J F; Cattaruzza, M S

2015-01-01

In Italy, the prevalence of smoking among health professionals is higher than in the general population and this might hamper their role in the promotion of health. This study aimed to investigate how the smoking status of healthcare professionals might influence knowledge, attitudes and clinical practice in a hospital in central Italy in order to enforce effective tobacco control measures. Physicians and professionals of the hospital were asked to complete an anonymous questionnaire which yielded epidemiological and environmental information on knowledge, attitude, clinical practice and quality of the hospital environments, in relation to smoking. Overall, among the employees of the hospital, the smoking prevalence was 47%, (42% among physicians and 43% among nurses); 30% admitted smoking in the hospital and three quarters of the smokers would like to quit. Some knowledge, opinions and attitudes differ statistically among the smoking categories. For example, only 35% of the smokers admitted that smoking is more dangerous to health than atmospheric and car pollution compared with 60% of the ex or never smokers (p=0.04). Fewer smokers realize that their behavior is seen as a role model by patients. A greater percentage of smokers state that patients (34%) and visitors (43%) often smoke in hospital and these percentages are significantly higher than those reported by ex or never smokers (p≤0.05). All smokers claim that they never smoke in patient rooms, infirmaries and clinics, whereas over 20% of ex or never smokers report that smoking sometimes occurs in these places (p=0.015). The mean concentration of PM 2.5 in the 25 rooms was 2.4 μg/m3 with a range from 1 to 7 μg/m3. This study implies that the prevalence of smoking among health professionals may be very high, and might be twice the rate observed in the general population. Generally, smokers report less knowledge compared with ex and never-smokers and it seems that they systematically underestimate the

Peripherally Inserted Central Catheters (PICCs) and Potential Cost Savings and Shortened Bed Stays In an Acute Hospital Setting.

LENUS (Irish Health Repository)

O’Brien, C

2018-01-01

Peripheral inserted central catheters (PICCs) have increasingly become the mainstay of patients requiring prolonged treatment with antibiotics, transfusions, oncologic IV therapy and total parental nutrition. They may also be used in delivering a number of other medications to patients. In recent years, bed occupancy rates have become hugely pressurized in many hospitals and any potential solutions to free up beds is welcome. Recent introductions of doctor or nurse led intravenous (IV) outpatient based treatment teams has been having a direct effect on early discharge of patients and in some cases avoiding admission completely. The ability to deliver outpatient intravenous treatment is facilitated by the placement of PICCs allowing safe and targeted treatment of patients over a prolonged period of time. We carried out a retrospective study of 2,404 patients referred for PICCs from 2009 to 2015 in a university teaching hospital. There was an exponential increase in the number of PICCs requested from 2011 to 2015 with a 64% increase from 2012 to 2013. The clear increase in demand for PICCs in our institution is directly linked to the advent of outpatient intravenous antibiotic services. In this paper, we assess the impact that the use of PICCs combined with intravenous outpatient treatment may have on cost and hospital bed demand. We advocate that a more widespread implementation of this service throughout Ireland may result in significant cost savings as well as decreasing the number of patients on hospital trollies.

Thinking with birds: Mary Elizabeth Barber's advocacy for gender equality in ornithology

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Tanja Hammel

Full Text Available This article explores parts of the first South African woman ornithologist's life and work. It concerns itself with the micro-politics of Mary Elizabeth Barber's knowledge of birds from the 1860s to the mid-1880s. Her work provides insight into contemporary scientific practices, particularly the importance of cross-cultural collaboration. I foreground how she cultivated a feminist Darwinism in which birds served as corroborative evidence for female selection and how she negotiated gender equality in her ornithological work. She did so by constructing local birdlife as a space of gender equality. While male ornithologists naturalised and reinvigorated Victorian gender roles in their descriptions and depictions of birds, she debunked them and stressed the absence of gendered spheres in bird life. She emphasised the female and male birds' collaboration and gender equality that she missed in Victorian matrimony, an institution she harshly criticised. Reading her work against the background of her life story shows how her personal experiences as wife and mother as well as her observation of settler society informed her view on birds, and vice versa. Through birds she presented alternative relationships to matrimony. Her protection of insectivorous birds was at the same time an attempt to stress the need for a New Woman, an aspect that has hitherto been overlooked in studies of the transnational anti-plumage movement.

Distribution of polychlorinated biphenyl residues in sediments and blue mussels (Mytilus galloprovincialis) from Port Elizabeth Harbour, South Africa.

Science.gov (United States)

Kampire, E; Rubidge, G; Adams, J B

2015-02-15

Sediment and Mytilus galloprovincialis samples collected from the Port Elizabeth Harbour were analysed for six indicator PCB congeners to assess their contamination status. The concentrations of total PCBs in sediments and M. galloprovincialis ranged from 0.56 to 2.35 ng/g dry weight and 14.48 to 21.37 ng/g wet weight, respectively. Congeners 138 and 153 were dominant and accounted for an average of 29% and 24% of total PCBs in M. galloprovincialis; 32% and 30% in sediments, respectively. Sediments are home to a wide variety of aquatic life. None of the sediments analysed exceeded the PCB limits recommended the Canadian interim sediment quality guideline and the South African recommended sediment guidelines (21.6 ng/g). Both humans and aquatic life are sensitive to the toxic effects of PCBs. Copyright © 2014 Elsevier Ltd. All rights reserved.

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

Energy Technology Data Exchange (ETDEWEB)

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

2002-01-15

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2002-01-15

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

Benefiting from networks by occupying central positions: an empirical study of the Taiwan health care industry.

Science.gov (United States)

Peng, Tzu-Ju Ann; Lo, Fang-Yi; Lin, Chin-Shien; Yu, Chwo-Ming Joseph

2006-01-01

At issue is whether network resources imply some resources available to all members in networks or available only to those occupying structurally central positions in networks. In this article, two conceptual models, the additive and interaction models of the firm, are empirically tested regarding the impact of hospital resources, network resources, and centrality on hospital performance in the Taiwan health care industry. The results demonstrate that: (1) in the additive model, hospital resources and centrality independently affect performance, whereas network resources do not; and (2) no evidence supports the interaction effect of centrality and resources on performance. Based on our findings in Taiwanese practices, the extent to which the resources are acquired externally from networks, we suggest that while adopting interorganizational strategies, hospitals should clearly identify those important resources that reside in-house and those transferred from network partners. How hospitals access resources from central positions is more important than what network resources can hospitals acquire from networks. Hospitals should improve performance by exploiting its in-house resources rather than obtaining network resources externally. In addition, hospitals should not only invest in hospital resources for better performance but should also move to central positions in networks to benefit from collaborations.

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

Science.gov (United States)

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

2016-01-01

Fulfilling the requirements of point-of-care testing (POCT) training regarding proper execution of measurements and compliance with internal and external quality control specifications is a great challenge. Our aim was to compare the values of the highly critical parameter hemoglobin (Hb) determined with POCT devices and central laboratory analyzer in the highly vulnerable setting of an emergency department in a supra maximal care hospital to assess the quality of POCT performance. In 2548 patients, Hb measurements using POCT devices (POCT-Hb) were compared with Hb measurements performed at the central laboratory (Hb-ZL). Additionally, sub collectives (WHO anemia classification, patients with Hb 85y.) were analyzed. Overall, the correlation between POCT-Hb and Hb-ZL was highly significant (r = 0.96, p2.5g/dl occurred. McNemar´s test revealed significant differences regarding anemia diagnosis according to WHO definition for male, female and total patients (♂ phemoglobin concentration measurement methods, i.e. POCT devices and at the central laboratory. The results confirm the successful implementation of the presented POCT concept. Nevertheless some limitations could be identified in anemic patients stressing the importance of carefully examining clinically implausible results.

The Development of Visual Aids for Training Student Employees in Certain Dishroom Procedures in a College Cafeteria

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1951-09-01

irianagement Kansas State College Manhatten, Kansas Ul. Hospitals Major Elizabeth Carloss, WIMSC Mdss Marqareý_ King, hospital Food Servicc Director of...scruboed with a stiff bristled brus ,., We scrubbed dishes are When taken to Whe operator a :-he soiled disk, table whio racks these dishes irato the open

Tuberculosis patients hospitalized in the Albert Schweitzer Hospital, Lambaréné, Gabon-a retrospective observational study

NARCIS (Netherlands)

Stolp, S. M.; Huson, M. A. M.; Janssen, S.; Beyeme, J. O.; Grobusch, M. P.

2013-01-01

Epidemiological data on tuberculosis in Central Africa are limited. We performed a retrospective observational study on clinical characteristics of 719 hospitalized tuberculosis patients in Lambaréné, Gabon. Human immunodeficiency virus (HIV) co-infection rate was high (34%) and in-hospital

Decentralization or centralization: striking a balance.

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Dirschel, K M

1994-09-01

An Executive Vice President for Nursing can provide the necessary link to meet diverse clinical demands when encountering centralization--decentralization decisions. Centralized communication links hospital departments giving nurses a unified voice. Decentralization acknowledges the need for diversity and achieves the right balance of uniformity through a responsive communications network.

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

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Pugh, Greg L

2015-01-01

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

The application of hospitality elements in hospitals.

Science.gov (United States)

Wu, Ziqi; Robson, Stephani; Hollis, Brooke

2013-01-01

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

Microbial keratitis in West and East Malaysia

OpenAIRE

Vanitha Ratnalingam; Thiageswari Umapathy; Kala Sumugam; Hanida Hanafi; Shamala Retnasabapathy

2017-01-01

AIM: To evaluate the epidemiological and etiological factors of microbial keratitis seen in tertiary hospitals in West and East Malaysia.METHODS: A total of 207 patients were enrolled. Patients referred for microbial keratitis to Sungai Buloh Hospital and Kuala Lumpur Hospital in West Malaysia and Queen Elizabeth Hospital and Kuching General Hospital in East Malaysia were recruited. Risk factors were documented. Corneal scrapings for microscopy and culture were performed.RESULTS: The most com...

American Hospital Association

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... Central Office-Coding Resources AHA Team Training Health Career Center Health Forum Connect More Regulatory Relief The regulatory burden faced by hospitals is substantial and unsustainable. Read the report . More AHA Opioid Toolkit Stem the Tide: Addressing the Opioid Epidemic More ...

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

OpenAIRE

Alarcon Ruiz, Diego Jesus; Gil Vargas, Luis Fabio

2016-01-01

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

Compliance with the guidelines of prescription writing in a central hospital in the West Bank.

Science.gov (United States)

Tayem, Y I; Ibrahim, M A; Qubaja, M M; Shraim, R K; Taha, O B; Abu Shkhedem, E

2013-09-01

This retrospective, cross-sectional study was carried out to evaluate the quality of 2208 outpatient prescriptions in a central hospital in the West Bank, Palestine. The physicians' handwriting was poorly readable or illegible in one-third of the prescriptions. The prescriber's name and signature and patient's name were mentioned in almost all orders whereas the patient's age was stated in 54.9%. The vast majority of physicians (95.5%) prescribed drugs using their trade (brand) names. Drug strength, quantity and dose/frequency were stated in 61.1%, 76% and 73.8% of prescriptions respectively. Only 33 prescriptions (1.5%) contained full directions for use for all drugs. Correlation analysis revealed that the presence of certain prescription elements was statistically significantly associated with the clinic of origin and the number of drugs prescribed. The overall poor legibility and incompleteness of the prescriptions is of concern.

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

Directory of Open Access Journals (Sweden)

Torbica Aleksandra

2010-05-01

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

A Computerized Hospital Patient Information Management System

Science.gov (United States)

Wig, Eldon D.

1982-01-01

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

The effects of hospital reforms on the management of public hospitals in Tanzania: Challenges and lessons learnt.

Science.gov (United States)

Shwekerela, Byera

2014-01-01

Although hospital reforms are being advocated internationally as part of a solution to hospital management problems in developing countries, studies have shown that they do give rise to some challenges. A study was undertaken that used in-depth interviews, focus group discussion and document review to examine hospital reforms. The article examines the effects of reforms on the management of Level II public hospitals in Tanzania and documents the related challenges and lessons Learnt. It is shown that hospital reforms have mixed effects in resource-strained hospitals, and that hospital reform actions may have replaced the bureaucratic inefficiencies associated with hospitals being managed from the central level (MoHSW) with the equally bureaucratic inefficiencies that characterize the management of these hospitals from a supposedly local level, the office of the Regional Administrative Secretary (RAS). Managing hospitals from this level seems to cause many hospital management problems to be left unattended.

Incidence of thrombosis in children with tunneled central venous access devices versus peripherally inserted central catheters (PICCs).

Science.gov (United States)

Kanin, Maralee; Young, Guy

2013-11-01

The recent proliferation of deep vein thrombosis in children has been attributed to the increased use of central venous catheters, specifically tunneled lines and peripherally inserted central catheters. A formal comparison of the incidence rate for deep vein thrombosis between tunneled lines and peripherally inserted central catheters has not been undertaken. Children inclusion. Data were extracted from the hospital discharge database which includes data on all procedures and up to 20 diagnoses per admission. Diagnoses and procedures were identified by International Classification of Disease, Ninth Revision coding. Patients were excluded if they received more than one central line. Data collected included type of central line, deep vein thrombosis event, and underlying medical illnesses classified according to chronic complex conditions. Over the seven year study period there was an overall rate of 73 deep vein thromboses per 10,000 hospital discharges. Of the 6915 eligible subjects, 181 had a deep vein thrombosis for an overall incidence rate of 2.6%. There were 152 thrombi (2.6%) in subjects with peripherally inserted central catheters and 29 thrombi (3.1%) in subjects with tunneled lines [OR=.83 (0.55, 1.29), p=0.38]. Despite the relative ease and simplicity of use of peripherally inserted central catheters leading to a substantial rise in their use, this study demonstrates that such lines pose a substantial risk for venous thrombosis and no difference in incidence was detected between such lines and tunneled lines. © 2013.

Economic costs and health-related quality of life outcomes of hospitalised patients with high HIV prevalence: A prospective hospital cohort study in Malawi.

Science.gov (United States)

Maheswaran, Hendramoorthy; Petrou, Stavros; Cohen, Danielle; MacPherson, Peter; Kumwenda, Felistas; Lalloo, David G; Corbett, Elizabeth L; Clarke, Aileen

2018-01-01

Although HIV infection and its associated co-morbidities remain the commonest reason for hospitalisation in Africa, their impact on economic costs and health-related quality of life (HRQoL) are not well understood. This information is essential for decision-makers to make informed choices about how to best scale-up anti-retroviral treatment (ART) programmes. This study aimed to quantify the impact of HIV infection and ART on economic outcomes in a prospective cohort of hospitalised patients with high HIV prevalence. Sequential medical admissions to Queen Elizabeth Central Hospital, Malawi, between June-December 2014 were followed until discharge, with standardised classification of medical diagnosis and estimation of healthcare resources used. Primary costing studies estimated total health provider cost by medical diagnosis. Participants were interviewed to establish direct non-medical and indirect costs. Costs were adjusted to 2014 US$ and INT$. HRQoL was measured using the EuroQol EQ-5D. Multivariable analyses estimated predictors of economic outcomes. Of 892 eligible participants, 80.4% (647/892) were recruited and medical notes found. In total, 447/647 (69.1%) participants were HIV-positive, 339/447 (75.8%) were on ART prior to admission, and 134/647 (20.7%) died in hospital. Mean duration of admission for HIV-positive participants not on ART and HIV-positive participants on ART was 15.0 days (95%CI: 12.0-18.0) and 12.2 days (95%CI: 10.8-13.7) respectively, compared to 10.8 days (95%CI: 8.8-12.8) for HIV-negative participants. Mean total provider cost per hospital admission was US$74.78 (bootstrap 95%CI: US$25.41-US$124.15) higher for HIV-positive than HIV-negative participants. Amongst HIV-positive participants, the mean total provider cost was US$106.87 (bootstrap 95%CI: US$25.09-US$106.87) lower for those on ART than for those not on ART. The mean total direct non-medical and indirect cost per hospital admission was US$87.84. EQ-5D utility scores were lower

Granuloma central de células gigantes Giant cells central granuloma

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Ayelén María Portelles Massó

2011-03-01

Full Text Available El granuloma reparativo central de células gigantes es una lesión proliferativa no neoplásica de etiología desconocida. Se presenta un paciente masculino de 40 años de edad, portador de prótesis parcial superior. Fue remitido al Servicio de Cirugía Maxilofacial del Hospital "V. I. Lenin" por presentar aumento de volumen en reborde alveolar superior, de color rojo grisáceo y que provocaba expansión de corticales óseas. Una vez analizados los exámenes clínicos, radiográficos e histopatológicos se diagnosticó un granuloma reparativo central de células gigantes Se realizó exéresis quirúrgica de la lesión y extracción de dientes adyacentes con una evolución satisfactoria sin señales de recidivas luego de tres años del tratamiento. El granuloma reparativo central de células gigantes se presentó como respuesta a un trauma. La correcta interpretación de los datos clínicos, radiográficos e histopatológicos nos permitió llegar al correcto diagnóstico y plan de tratamiento.Giant-cell central reparative granuloma is non neoplastic proliferative lesion of unknown etiology. We report a 40 years old male patient who was admitted at the Maxillofacial Service of the "V. I. Lenin" Hospital. The patient had partial upper prosthesis and was complaining of red-grey volume increase lesion in upper alveolar ridge which led to the expansion of cortical bone. Having analyzed clinical, radiographic and histopathological findings the case was concluded as a giant-cell central reparative granuloma. Surgical exeresis and adjunct tooth extraction were done. After three years of treatment, satisfactory follow up without recurrence is reported.

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

Science.gov (United States)

Anbäcken, O

1994-01-01

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

Unrecognized circulation of SAT 1 foot-and-mouth disease virus in cattle herds around Queen Elizabeth National Park in Uganda

DEFF Research Database (Denmark)

Dhikusooka, Moses Tefula; Ayebazibwe, Chrisostom; Namatovu, Alice

2016-01-01

Foot-and-mouth disease (FMD) is endemic in Uganda in spite of the control measures used. Various aspects of the maintenance and circulation of FMD viruses (FMDV) in Uganda are not well understood; these include the role of the African buffalo (Syncerus caffer) as a reservoir for FMDV. To better...... understand the epidemiology of FMD at the livestock-wildlife-interface, samples were collected from young, unvaccinated cattle from 24 pastoral herds that closely interact with wildlife around Queen Elizabeth National Park in Uganda, and analysed for evidence of FMDV infection. In total, 37 (15 %) of 247...... serum samples had detectable antibodies against FMDV non-structural proteins (NSPs) using a pan-serotypic assay. Within these 37 sera, antibody titres ≥ 80 against the structural proteins of serotypes O, SAT 1, SAT 2 and SAT 3 were detected by ELISA in 5, 7, 4 and 3 samples, respectively, while...

Shrinking risk profiles after deworming of children in Port Elizabeth, South Africa, with special reference to Ascaris lumbricoides and Trichuris trichiura.

Science.gov (United States)

Müller, Ivan; Gall, Stefanie; Beyleveld, Lindsey; Gerber, Markus; Pühse, Uwe; Du Randt, Rosa; Steinmann, Peter; Zondie, Leyli; Walter, Cheryl; Utzinger, Jürg

2017-11-27

Risk maps facilitate discussion among different stakeholders and provide a tool for spatial targeting of health interventions. We present maps documenting shrinking risk profiles after deworming with respect to soil-transmitted helminthiasis among schoolchildren from disadvantaged neighbourhoods in Port Elizabeth, South Africa. Children were examined for soil-transmitted helminth infections using duplicate Kato-Katz thick smears in March 2015, October 2015 and May 2016, and subsequently treated with albendazole after each survey. The mean infection intensities for Ascaris lumbricoides were 9,554 eggs per gram of stool (EPG) in March 2015, 4,317 EPG in October 2015 and 1,684 EPG in March 2016. The corresponding figures for Trichuris trichiura were 664 EPG, 331 EPG and 87 EPG. Repeated deworming shrank the risk of soil-transmitted helminthiasis, but should be complemented by other public health measures.

Teleradiology and PACS - strategy of the Innsbruck University Hospital

International Nuclear Information System (INIS)

Vogl, R.

2005-01-01

Systems for management of digital imaging data are very important and widespread at the Innsbruck University Hospital and constitute a central component of the IT strategies followed by the hospital operating company TILAK (Tyrolean public hospitals). The particular goal is to integrate all imaging data into the electronic medical records and make these available online to each of the approx. 2500 clinic workstations and ensure electronic data exchange with other healthcare services. Teleradiology connections have been established at the University Clinic for Radiology since 1995; these have been continually expanded and linked to the central PACS. An eHealth web portal was recently established to facilitate transfer of images and findings from TILAK hospitals to other healthcare organizations. Registered users can be cleared for a limited time to access all radiological imaging data via this web portal. (orig.) [de

Hospital network performance: a survey of hospital stakeholders' perspectives.

Science.gov (United States)

Bravi, F; Gibertoni, D; Marcon, A; Sicotte, C; Minvielle, E; Rucci, P; Angelastro, A; Carradori, T; Fantini, M P

2013-02-01

Hospital networks are an emerging organizational form designed to face the new challenges of public health systems. Although the benefits introduced by network models in terms of rationalization of resources are known, evidence about stakeholders' perspectives on hospital network performance from the literature is scanty. Using the Competing Values Framework of organizational effectiveness and its subsequent adaptation by Minvielle et al., we conducted in 2009 a survey in five hospitals of an Italian network for oncological care to examine and compare the views on hospital network performance of internal stakeholders (physicians, nurses and the administrative staff). 329 questionnaires exploring stakeholders' perspectives were completed, with a response rate of 65.8%. Using exploratory factor analysis of the 66 items of the questionnaire, we identified 4 factors, i.e. Centrality of relationships, Quality of care, Attractiveness/Reputation and Staff empowerment and Protection of workers' rights. 42 items were retained in the analysis. Factor scores proved to be high (mean score>8 on a 10-item scale), except for Attractiveness/Reputation (mean score 6.79), indicating that stakeholders attach a higher importance to relational and health care aspects. Comparison of factor scores among stakeholders did not reveal significant differences, suggesting a broadly shared view on hospital network performance. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Non-steroidal anti-inflammatory drugs and antibiotics prescription trends at a central west bank hospital.

Science.gov (United States)

Tayem, Yasin I; Qubaja, Marwan M; Shraim, Riyad K; Taha, Omar B; Abu Shkheidem, Imadeddin A; Ibrahim, Murad A

2013-11-01

We aimed to reliably describe the pattern of outpatient prescription of non-steroidal anti-inflammatory drugs (NSAIDs) and antibiotics (ATBs) at a central hospital in the West Bank, Palestine. This was a retrospective, cross-sectional study investigating a cohort of 2,208 prescriptions ordered by outpatient clinics and the emergency room over one year in Beit Jala Hospital in Bethlehem, West Bank. The orders were analysed for the rate and types of NSAIDs and ATBs utilised, and the appropriateness of these drugs to the diagnosis. Of the total prescriptions, 410 contained NSAIDs (18.6%), including diclofenac (40.2%), low dose aspirin (23.9%), ibuprofen (17.8%) and indomethacin (15.1%). A minority of these prescriptions contained a combination of these agents (2.5%). Only one prescription contained cyclooxyeganse-2 inhibitors (0.2%). The appropriateness of NSAID use to the diagnosis was as follows: appropriate (58.3%), inappropriate (14.4%) and difficult to tell (27.3%). The rate of ATB use was 30.3% (669 prescriptions). The ATBs prescribed were amoxicillin (23.3%), augmentin (14.3%), quinolones (12.7%), first and second generation cephalosporins (9.4% and 12.7%, respectively) and macrolides (7.2%). ATB combinations were identified in 9.4%, with the most common being second-generation cephalopsorins and metronidazole (4.3%). Regarding the appropriateness of prescribing ATBs according to the diagnosis, it was appropriate in 44.8%, inappropriate in 20.6% and difficult to tell in 34.6% of the prescriptions. These findings revealed a relatively large number and inappropriate utilisation of ATBs and NSAIDs. An interventional programme needs to be adopted to reinforce physicians' knowledge of the rational prescription of these agents.

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

Science.gov (United States)

Pfäfflin, Frieder; Tufa, Tafese Beyene; Getachew, Million; Nigussie, Tsehaynesh; Schönfeld, Andreas; Häussinger, Dieter; Feldt, Torsten; Schmidt, Nicole

2017-01-01

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

Evaluación del espesor corneal central y su influencia en la presión intraocular en pacientes del Hospital "Dr. Miguel Enríquez" Evaluation of the central corneal thickness and its impact on the intraocular pressure of patients in "Dr. Miguel Enriquez" hospital

Directory of Open Access Journals (Sweden)

María Teresa Arrronte Alarcón

2012-01-01

Full Text Available Objetivo: evaluar el espesor corneal central en sujetos sanos, hipertensos oculares, sospechosos de glaucoma y glaucomatosos, y su influencia en la presión intraocular. Métodos: se realizó un estudio descriptivo y transversal que incluyó 708 ojos de 356 sujetos que acudieron al servicio de oftalmología del Hospital Universitario "Dr. Miguel Enríquez" entre enero y diciembre de 2010. A los pacientes se les midió el espesor corneal central con paquimetría ultrasónica (paquímetro US 4000. El resto de la información se obtuvo a partir de las historias clínicas de los pacientes. Resultados: Los hipertensos oculares presentaron córneas gruesas (p=0,07; el mayor número de casos que tenían diagnóstico de sospecha de glaucoma y de glaucoma primario de ángulo abierto presentaron un grosor corneal delgado (p=0,62 y p=0,08 respectivamente. Si no se hubiese tenido en cuenta el factor de corrección para evaluar la presión intraocular se encontraría 48,1 % de los glaucomatosos y 31,5 % de los hipertensos oculares con diagnóstico inadecuado (pObjective: to evaluate the central corneal thickness in healthy individuals, in persons with ocular hypertension, and in suspected glaucoma and glaucomatous people, and its influence in intraocular pressure. Methods: a cross-sectional and descriptive study was performed in 708 eyes from 356 people who had been seen at ophthalmology service of “Dr. Miguel Enríquez”, university hospital from January to December, 2010. Their central corneal thickness was measured with ultrasonic pachymetry (pachymeter US 4000. The rest of the information came from the clinical histories of the patients. Results: Most of the ocular hypertensives presented thick corneas (p=0,07; a high number of cases that had diagnosis of glaucoma suspicion and primary open-angle glaucoma showed thin corneas (p=0,62 and (p=0,08 respectively. If the correction factor to evaluate the IOP had not been considered, then 48,1 % of the

Calidad del servicio de atención en la Unidad de Laboratorio de Emergencia y Laboratorio Central, Hospital Público de Lima, 2016

OpenAIRE

Castillo Acuña, Marissa Gladys

2016-01-01

La Calidad en el Servicio de Atención de acuerdo a Camarasa (2004) “La Calidad de los servicios de atención constituyen el conjunto de prestaciones y atenciones que el cliente espera recibir de la organización que los presta”. (p.13) Objetivo: Comparar el nivel de calidad del servicio de atención en la unidad de Laboratorio de Emergencia con respecto a la unidad de Laboratorio Central en un Hospital Público de Lima 2016. Metodología: Estudio de Nivel descriptivo comparativo, tr...

75 FR 27227 - Energy Conservation Program: Energy Conservation Standards for Residential Central Air...

Science.gov (United States)

2010-05-14

...-7335. E-mail: Wes.Anderson@ee.doe.gov . Ms. Elizabeth Kohl, U.S. Department of Energy, Office of the... additional information regarding visiting the Resource Room. FOR FURTHER INFORMATION CONTACT: Mr. Wes Anderson, U.S. Department of Energy, Office of Energy Efficiency and Renewable Energy, Building...

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

International Nuclear Information System (INIS)

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

2002-01-01

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

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

International Nuclear Information System (INIS)

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

2002-01-01

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

1995 Emerging Leaders in Healthcare. The new leaders: Gita Budd, Colene Daniel, Elizabeth Gallup, Scott Wordelman.

Science.gov (United States)

Southwick, K

1995-01-01

Fierce pressures for cost containment. Demands for quality improvements. The drive toward patient-centered care. The push for community involvement. Insistent voices of payers, patients, consumers, physicians. Accumulated tensions amid the chaos of change. Balancing all of these demands while inspiring and encouraging the professionals and other workers within the healthcare organization requires a high level of leadership ability. One that insists on the best from everyone involved in a healthcare system--from physicians to staff, nurses to social workers. And then strives for more. The four young executives who are this year's Emerging Leaders in Healthcare have all pushed their systems beyond traditional boundaries into new territory, helping their patients, their employees, their physicians, and their communities rise to new levels of achievement. At the same time, these leaders emphasize teamwork and consensus-style management, so that their co-workers feel like they're participating in the changes, not being victimized by them. Gita Budd, Colene Daniel, Elizabeth Gallup, and Scott Wordelman are winners of the 1995 award from The Healthcare Forum and Korn/Ferry International that honors ¿dynamic, decisive young leaders (under 40) with the proven ability to nurture the growth of the industry.¿ Korn/Ferry International and The Healthcare Forum are proud to present 1995's Emerging Leaders.

THE FEMALE’S MASCULINITIES AGAINST SIAMESE PATRIARCHAL SYSTEMS IN ELIZABETH HAND’S ANNA AND THE KING

Directory of Open Access Journals (Sweden)

Anna Sriastuti

2017-04-01

Full Text Available By not giving voice and value to women‘s opinions, responses and writings, men have therefore suppressed the female, define what it means to be feminine, and therefore devoiced, devalued, and trivialized what it means to be a woman. As femininity is mostly related to women for women are labeled as extensions of men, mirrors of men, devices for showing men off, and also devices for helping men get what they want, women‘s position is inferior to men. This study discusses the female‘s masculinities through the portrayal and life experiences of the main female characteristics, Anna Leonowens, as her protests against the Siamese patriarchal systems that abundant her life as a career woman and also the oppressed lives of Siamese women in Elizabeth Hand‘s novel Anna and the King. Feminism and Deconstructions approaches will be applied to analyze Leonowens‘ actions and reactions regarding to what Siamese patriarchal systems claim to be parts of masculine traits. Leonowens‘ nationality, cultural and educational backgrounds as well as positions play significant roles in the novel. By opposing Leonowens‘ ways of thinking to the King who represents the patriarchal system of Siam, Hand gives a new identity to women in struggling for gender equality in Siam.

Gastric cancers at Kibogora Hospital | Ntakiyiruta | East and Central ...

African Journals Online (AJOL)

East and Central African Journal of Surgery. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 14, No 1 (2009) >. Log in or Register to get access to full text downloads.

Inside the Literature: An Interview with Sally G. Hoskins, 2017 Recipient of the Elizabeth W. Jones Award for Excellence in Education.

Science.gov (United States)

Hoskins, Sally G

2017-12-01

The Genetics Society of America's Elizabeth W. Jones Award for Excellence in Education recognizes significant and sustained impact on genetics education. The 2017 recipient is Sally G. Hoskins, in recognition of her role in developing and promoting the transformative science education method CREATE (Consider, Read, Elucidate hypotheses, Analyze and interpret data, and Think of the next Experiment). This innovative approach uses primary literature to engage students, allowing them to experience for themselves the creativity and challenge of study design, analysis, interpretation, collaboration, and debate. Comprehensive evaluation of CREATE has consistently found that students improve in difficult-to-teach skills like critical thinking and experimental design, while showing improved attitudes and beliefs about science.This is an abridged version of the interview. The full interview is available on the Genes to Genomes blog, at genestogenomes.org/hoskins/. Copyright © 2017 by the Genetics Society of America.

Recensión de: LA LUCHA POR EL PASADO. Cómo construimos la memoria social. Elizabeth Jelin. Ed. Siglo XXI. Buenos Aires. 2017

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Mariana Malet Vázquez

2018-02-01

Full Text Available El 29 de noviembre de 2017, organizada por Extensión de la Universidad de la República, se realizó la presentación de este libro de la socióloga argentina Elizabeth Jelin. A lo largo de su vida se ha dedicado especialmente a la investigación sobre los Derechos Humanos, la represión política y las memorias, junto con el abordaje de otros temas que se vinculan fácilmente con aquéllos, tales como los estudios sobre familia, género y movimientos sociales. De proficua trayectoria, la autora mantiene lazos estrechos con Uruguay, siendo la tutora de varios de nuestros investigadores, lo que propició el clima cálido de la presentación. (...

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

Science.gov (United States)

Tarricone, Rosanna; Torbica, Aleksandra; Franzetti, Fabio; Rosenthal, Victor D

2010-05-10

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

Evaluation of disaster preparedness for mass casualty incidents in private hospitals in Central Saudi Arabia

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Abdullah A. Bin Shalhoub

2017-03-01

Full Text Available Objectives: To identify and describe the hospital disaster preparedness (HDP in major private hospitals in Riyadh, Saudi Arabia. Methods: This is an observational cross-sectional survey study performed in Riyadh city, Saudi Arabia between December 2015 and April 2016. Thirteen major private hospitals in Riyadh with more than 100 beds capacity were included in this investigation. Results: The 13 hospitals had HDP plan and reported to have an HDP committee. In 12 (92.3% hospitals, the HDP covered both internal and external disasters and HDP was available in every department of the hospital. There were agreements with other hospitals to accept patients during disasters in 9 facilities (69.2% while 4 (30.8% did not have such agreement. None of the hospitals conducted any unannounced exercises in previous year. Conclusion: Most of the weaknesses were apparent particularly in the education, training and monitoring of the hospital staff to the preparedness for disaster emergency occasion. Few hospitals had conducted an exercise with casualties, few had drilled evacuation of staff and patients in the last 12 months, and none had any unannounced exercise in the last year.

Competition or coordination in hospital markets with unionised labour.

Science.gov (United States)

Brekke, Kurt R

2004-03-01

This paper study labour market responses to hospital mergers. The market consists of two hospitals providing horizontally and vertically differentiated services. Hospitals compete either in price and quality or just in quality (non-price competition). To provide medical care, hospitals employ health care workers (e.g., physicians, nurses). The workers collectively bargain wages either at a central level, firm level or plant level. Anticipating wage responses, hospitals decide whether or not to merge. The main finding is that the bargaining structure, the nature of competition and the patient copayment rate have a crucial impact on the profitability of hospital mergers.

Patient satisfaction regarding eye care services at tertiary hospital of central India

Directory of Open Access Journals (Sweden)

Anand Sudhan

2011-01-01

Study Design : Descriptive study. Materials and Methods : This study was conducted between September 2005 and June 2006. Patients attending the eye clinic of Sadguru Netra Chikitsalaya, Chitrakoot, Madhya Pradesh, India, and admitted as in-patients in this hospital were our study population. Randomly selected patients were interviewed by trained staff. Close-ended questionnaire was used to conduct these structured interviews. Their responses were grouped into one of five categories and evaluated to determine satisfaction for different components of eye care services. Results : Three hundred and twenty persons were interviewed. The satisfaction was of excellent grade among 77 (48.1% patients attending clinic and 156 (97.5% patients who were admitted in the hospital. The participants expressed dissatisfaction for the long waiting period in clinics, poor cleanliness, and insufficient toilet facilities. Those admitted in the hospital felt that food facilities were less than the expected quality. Child-friendly facilities received high satisfaction scores. Conclusion : Although eye care services both in clinics and in the wards were satisfactory according to the end-users, there are scopes for improvement. Patient satisfaction surveys should be encouraged in hospitals for better accountability and also for strengthening the quality of eye care services.

Awareness and Knowledge of Glaucoma in Central India: A Hospital-Based Study.

Science.gov (United States)

Maharana, Prafulla K; Rai, Vaishali G; Pattebahadur, Rajesh; Singhi, Shipra; Chauhan, Ashish K

2017-01-01

To assess the awareness and knowledge of glaucoma among people attending the ophthalmology outpatient department at a tertiary care hospital in central India. A prospective observational study. A questionnaire-based study was conducted, involving persons aged 18 and above attending the ophthalmology outpatient department from October 2014 to September 2015. Data on awareness and knowledge of glaucoma was collected through a face-to-face interview. Fourteen hundred people participated in the study. The mean age of participants was 43 ± 15 years (range, 18-85). The study participants included 53% men and 47% women. Only 27% (n = 380/1400) of the participants were aware of glaucoma. Age, sex, and presence or type of refractive error had no impact on glaucoma awareness. Awareness level was greater in individuals with higher education levels and those belonging to an upper socioeconomic class (SEC). Multiple logistic regression analysis revealed significantly higher levels of glaucoma awareness among participants belonging to the upper 2 SECs (P = 0.05) and those educated above the high school level (P = 0.001). The most common source of awareness was close acquaintance with relatives, famly members, and friends of glaucoma patients. Awareness of glaucoma in India is low. Lack of education and lower socioeconomic status are the major risk factors for late preentation of glaucoma. Continuous presence of a low level of awareness and the same factors accounting for it warrants the need for an aggressive and refined approach to increase awareness of glaucoma to prevent glaucoma-related blindness. Copyright 2017 Asia-Pacific Academy of Ophthalmology.

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

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Lul Raka

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

Risk of central nervous system defects in offspring of women with and without mental illness.

Science.gov (United States)

Ayoub, Aimina; Fraser, William D; Low, Nancy; Arbour, Laura; Healy-Profitós, Jessica; Auger, Nathalie

2018-02-22

We sought to determine the relationship between maternal mental illness and the risk of having an infant with a central nervous system defect. We analyzed a cohort of 654,882 women aged less than 20 years between 1989 and 2013 who later delivered a live born infant in any hospital in Quebec, Canada. The primary exposure was mental illness during pregnancy or hospitalization for mental illness before pregnancy. The outcomes were neural and non-neural tube defects of the central nervous system in any offspring. We computed risk ratios (RR) and 95% confidence intervals (CI) for the association between mental disorders and risk of central nervous system defects in log-binomial regression models adjusted for age at delivery, total parity, comorbidity, socioeconomic deprivation, place of residence, and time period. Maternal mental illness was associated with an increased risk of nervous system defects in offspring (RR 1.76, 95% CI 1.64-1.89). Hospitalization for any mental disorder was more strongly associated with non-neural tube (RR 1.84, 95% CI 1.71-1.99) than neural tube defects (RR 1.31, 95% CI 1.08-1.59). Women at greater risk of nervous system defects in offspring tended to be diagnosed with multiple mental disorders, have more than one hospitalization for mental disease, or be 17 or older at first hospitalization. A history of mental illness is associated with central nervous system defects in offspring. Women hospitalized for mental illness may merit counseling at first symptoms to prevent central nervous system defects at pregnancy.

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

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Frieder Pfäfflin

2017-01-01

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

77 FR 27869 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

Science.gov (United States)

2012-05-11

... Considered HAC Candidate: Iatrogenic Pneumothorax With Venous Catheterization 3. Present on Admission (POA.... History of Measures Adopted for the Hospital IQR Program b. Maintenance of Technical Specifications for...-Associated Infection (HAI) Measures (A) Proposed Central Line Associated Blood Stream Infections ((CLABSI...

Efficiency and productivity of hospitals in Vietnam.

Science.gov (United States)

Pham, Thuy Linh

2011-01-01

The purpose of this paper is to examine the relative efficiency and productivity of hospitals during the health reform process. Data envelopment analyses method (DEA) with the input-oriented variable-returns-to-scale model was used to calculate efficiency scores. Malmquist total factor productivity index approach was then employed to calculate productivity of hospitals. Data of 101 hospitals was extracted from databases of the Ministry of Health, Vietnam from the years 1998 to 2006. There was evidence of improvement in overall technical efficiency from 65 per cent in 1998 to 76 per cent in 2006. Hospitals' productivity progressed around 1.4 per cent per year, which was mainly due to the technical efficiency improvement. Furthermore, provincial hospitals were more technically efficient than their central counterparts and hospitals located in different regions performed differently. The paper provides an insight in the performance of Vietnamese public hospitals that has been rarely examined before and contributes to the existing literature of hospital performance in developing countries

Car la Lettre tue mais l’Esprit vivifie : une relecture des textes bibliques selon Elizabeth Gaskell For the Letter Killeth, but the Spirit Giveth Life: Elizabeth Gaskell’s Rewriting of the Gospels

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Benjamine Toussaint-Thiriet

2009-10-01

Full Text Available As the anonymous author of “The Hard Church Novel” underlined in his article, “Theology and Literature – the study of God and the study of Man – need to go hand in hand, and are only just beginning to know it”. The links between literature and religion are in fact much older than we might imagine when reading this statement; however, it is a fact that the Victorian period was a time when many authors tried to reconcile secular writing and the Scriptures, to the extent that a new literary genre, the religious novel, was born. Although Elizabeth Gaskell’s works do not belong to this category, she set her heart on reconciling her vocation as a novelist with her beliefs as a Christian. Unlike her husband, she was not a Minister and therefore her own way of preaching the Word of God was to write fiction. She was convinced that the Pharisees had not disappeared with the Advent of Christ and, in her novels, she used her own, sometimes unorthodox, interpretation and rewriting of the Gospels to convert the Pharisees of her own time to the true essence of Christianity. Indeed, her Unitarian education granted her a greater freedom than most of her contemporaries in terms of biblical exegesis, as we can see in many of her works, but most particularly in Ruth, in which the eponymous heroine, a fallen woman, is not only described as a Magdalen but soon turns into a Madonna and then a Christ-like figure.

Central corneal thickness among glaucoma patients attending ...

African Journals Online (AJOL)

AAU_CHS

ocular pressure measurement and is different among different ethnic population and subtypes of glaucoma. The central corneal thickness of different subtypes of glaucoma at Menelik II Hospital ... Intraocular pressure is a key element in the.

Modular organization and hospital performance.

Science.gov (United States)

Kuntz, Ludwig; Vera, Antonio

2007-02-01

The concept of modularization represents a modern form of organization, which contains the vertical disaggregation of the firm and the use of market mechanisms within hierarchies. The objective of this paper is to examine whether the use of modular structures has a positive effect on hospital performance. The empirical section makes use of multiple regression analyses and leads to the main result that modularization does not have a positive effect on hospital performance. However, the analysis also finds out positive efficiency effects of two central ideas of modularization, namely process orientation and internal market mechanisms.

International overview of hospital procurement.

Science.gov (United States)

Ferrier, Maud; Lariviere, David; Laurent, Claire; Roque, Eric

2011-01-01

This article was written by four French hospital director students at the Ecole des Hautes Etudes en Santé Publique (EHESP-School of Public Health) from a study conducted jointly with students at the Grenoble School of Management to present an international overview of hospital procurement methods in ten countries. An analysis of these methods showed that there was a general trend towards group purchasing, with some common aims in terms of costs and performance and some differences in legislation (competition), size of the public sector and centralization or decentralization.

Enterprise resource planning for hospitals

NARCIS (Netherlands)

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

2004-01-01

Integrated hospitals need a central planning and control system to plan patients' processes and the required capacity. Given the changes in healthcare one can ask the question what type of information systems can best support these healthcare delivery organizations. We focus in this review on the

Enterprise resource planning for hospitals

NARCIS (Netherlands)

Merode, van G.G.; Groothuis, S.; Hasman, A.

2004-01-01

Integrated hospitals need a central planning and control system to plan patients’ processes and the required capacity. Given the changes in healthcare one can ask the question what type of information systems can best support these healthcare delivery organizations. We focus in this review on the

The architecture of enterprise hospital information system.

Science.gov (United States)

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

2005-01-01

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

Central line associated sepsis in children receiving parenteral nutrition in Oman.

Science.gov (United States)

Al Lawati, Tawfiq T; Al Jamie, Adawaiya; Al Mufarraji, Nasra

Parenteral Nutrition (PN) is used when gut fails to provide complete nutrition. Central line Associate Blood Stream Infection (CLABSI) a major complication of this therapy. The objective of the study was to report the incidence of CLABSI and associated mortality in children receiving PN in the Royal Hospital and study the indication and duration of PN use. All children from the age of 0-48 months who received TPN outside NICU from the period between 1/1/2011 till 31/12/2014 were included. Data were retrieved from the hospital electronic data base. There were 42 children 27 males and 15 females who used PN through a central line for a total duration of 569 days. The incidence of CLABSI was 14 days per 1000 days catheter and mortality of 556 per 10000. The average duration of TPN was 14.5 days. Most of the patient had CLABSI in the PICU and cardiac related illness or surgery was the most common indication of PN use. The average duration of use was 14 days. Inspite of that short duration use of PN, there is a very high incidence of CLABSI and its related mortality. Bundle policy for central line care is not used in the Royal Hospital and this study calls for urgent implementation of central line care bundle policy in the Royal Hospital. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Echoes of a not so Mythical Past: Memories of Race in Elizabeth Jolley’s The Well

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Cornelis Martin Renes

2009-03-01

Full Text Available Critical discussion of Elizabeth Jolley’s The Well (1986 has largely focused on issues of gender, but little has been said about the racial inscription of the novel. This lack is especially relevant when criticism, despite praising the author’s experimentation with narrative technique and genre, tends to voice dissatisfaction with the novel’s conclusion in medias res, which never solves the tension between a presumed return to the patriarchal norm and the voicing of liberating alternatives. This paper proposes a postcolonial perspective so as to come to terms with this dilemma, and argues that the text signals the impossibility of suppressing the Native from the contemporary Australian land and textscape, whose Gothic articulation in the uncanny shape of the male well-dweller haunts the novel’s engagement with female empowerment. The female protagonist may only start overcoming a crippling gender discourse in the White postcolonial pastoralist setting by inscribing herself into ‘Australianness’. Reconciling her body with the land is significantly staged in terms of an Aboriginal cosmogony, as it is a ‘walkabout’ that allows Hester to start controlling her body and story. Thus, The Well may be understood to be inconclusive because it struggles to map gender across race at a time of Aboriginal-exclusive multiculturalism. Written in the mid 1980s, it announces a point of inflection in thinking about nativenonnative relationships

The Elizabeth Lake paleoseismic site: Rupture pattern constraints for the past ~800 years for the Mojave section of the south-central San Andreas Fault

Science.gov (United States)

Bemis, Sean; Scharer, Katherine M.; Dolan, James F.; Rhodes, Ed

2016-01-01

The southern San Andreas Fault in California has hosted two historic surface-rupturing earthquakes, the ~M7 1812 Wrightwood earthquake and the ~M7.9 1857 Fort Tejon earthquake (e.g., Sieh, 1978; Jacoby et al., 1988). Numerous paleoseismic studies have established chronologies of historic and prehistoric earthquakes at sites along the full length of the 1857 rupture (e.g., Sieh, 1978; Scharer et al., 2014). These studies provide an unparalleled opportunity to examine patterns of recent ruptures; however, at least two significant spatial gaps in high-quality paleoseismic sites remain. At ~100 km long each, these gaps contribute up to 100 km of uncertainty to paleo-rupture lengths and could also permit a surface rupture from an earthquake up to ~M7.2 to go undetected [using scaling relationships of Wells and Coppersmith (1994)]. Given the known occurrence of an ~M7 earthquake on this portion of the SAF (1812), it is critical to fill these gaps in order to better constrain paleo-rupture lengths and to increase the probability of capturing the full spatial record of surface rupturing earthquakes.   In this study, we target a new site within the 100 km long stretch of the San Andreas Fault between the Frazier Mountain and Pallett Creek paleoseismic sites (Figure 1), near Elizabeth Lake, California. Prior excavations at the site during 1998-1999 encountered promising stratigraphy but these studies were hindered by shallow groundwater throughout the site. We began our current phase of investigations in 2012, targeting the northwestern end of a 40 x 350 m fault-parallel depression that defines the site (Figure 2). Subsequent investigations in 2013 and 2014 focused on the southeastern end of the depression where the fault trace is constrained between topographic highs and is proximal to an active drainage. In total, our paleoseismic investigations consist of 10 fault-perpendicular trenches that cross the depression (Figure 2) and expose a >2000 year depositional record

Evaluation of sleep profile in schizophrenia patients treated with extended-release paliperidone: an open-label prospective study in Southeast Asia

OpenAIRE

Kongsakon,Ronnachai; Thavichachart,Nuntika; Chung,Ka Fai; Lim,Leslie; Azucena,Beverly; Rondain,Elizabeth; Go,Benson; Costales,Fe; Nerapusee,Osot

2017-01-01

Ronnachai Kongsakon,1 Nuntika Thavichachart,2 Ka Fai Chung,3 Leslie Lim,4 Beverly Azucena,5 Elizabeth Rondain,6 Benson Go,7 Fe Costales,8 Osot Nerapusee9 1Department of Psychiatry, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; 2Department of Medicine, Division of Psychiatry, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand; 3Department of Psychiatry, University of Hong Kong, Hong Kong, People’s Republic of China; ...

[Munchausen syndrome: need for centralized administrative health-care management].

Science.gov (United States)

Altmark, D; Sigal, M; Gelkopf, M

1991-03-01

The clinical picture of Munchausen syndrome is that of feigned or self-induced illness with the aim of being hospitalized and/or receiving unnecessary medical interventions, peregrination from 1 hospital to another, and disruptive behavior when hospitalized. These patients are a danger to themselves and heavily burden inpatient facilities that care for them. We present a case that illustrates the problems of diagnosing and managing such patients. We stress the need for adequate centralization and distribution of the relevant information concerning these patients.

The Market for Hospital Medicine in Denmark

DEFF Research Database (Denmark)

Hostenkamp, Gisela

2012-01-01

Pharmaceutical expenditure growth has outpaced GDP and healthcare expenditure growth rates in Denmark as in most OECD countries for the last decade. A major part of this increase was due to high growth rates in specialist areas that are typically located in hospital settings. Yet the market...... for hospital medicines and their procurement are still poorly understood. The present paper characterises the market for hospital medicines in Denmark in terms of its organisation and developments between 2005 and 2009. In Denmark hospital medicines are publicly financed and procurement is centrally organised....... 98% of all medicines administered at Danish public hospitals are purchased through a public procurement agency by means of public tenders. Using data on actual contract prices we decompose pharmaceutical expenditure growth into the contributions from newly introduced medicines, price and volume...

Work-Related Accidents and Sharp Injuries in Paramedics-Illustrated with an Example of a Multi-Specialist Hospital, Located in Central Poland.

Science.gov (United States)

Garus-Pakowska, Anna; Szatko, Franciszek; Ulrichs, Magdalena

2017-08-10

(1) Background: An analysis of work-related accidents in paramedics in Poland by presenting the model and trend of accidents, accident rates and by identifying causes and results of accidents; (2) Methods: A retrospective analysis of medical documentation regarding work-related accidents in a multi-specialist hospital, located in central Poland, in the period 2005-2015. The study group included paramedics who had an accident while being on duty; (3) Results: According to hospital records, 88 paramedics were involved in 390 accidents and 265 injuries caused by sharp instruments. The annual accident rate was 5.34/100 employed paramedics. Most of the accidents occurred at night. The most common reason for the accident was careless behaviour of the paramedic, which resulted in joint sprains and dislocations. Injuries accounted for a huge portion of the total number of events. As many as 45% of injuries were not officially recorded; (4) Conclusion: High rates of work-related accidents and injuries caused by sharp instruments in paramedics are a serious public health problem. Further studies should be conducted in order to identify risk factors of accidents, particularly injuries, and to implement preventative programmes, aiming to minimise rates of occupational hazards for paramedics.

Pancreatic Enzyme Replacement Therapy in Children with Severe Acute Malnutrition: A Randomized Controlled Trial

NARCIS (Netherlands)

Bartels, Rosalie H.; Bourdon, Céline; Potani, Isabel; Mhango, Brian; van den Brink, Deborah A.; Mponda, John S.; Muller Kobold, Anneke C.; Bandsma, Robert H.; Boele van Hensbroek, Michael; Voskuijl, Wieger P.

2017-01-01

Objective To assess the benefits of pancreatic enzyme replacement therapy (PERT) in children with complicated severe acute malnutrition. Study design We conducted a randomized, controlled trial in 90 children aged 6-60 months with complicated severe acute malnutrition at the Queen Elizabeth Central

Reason vs Revelation: Feminism, Malthus, and the New Poor Law in Narratives by Harriet Martineau and Charlotte Elizabeth Tonna

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Ella Dzelzainis

2006-04-01

Full Text Available My article examines the profoundly influential presence of eighteenth-century stadial or ‘four stages' theory in industrial fiction of the early Victorian period. Axiomatic within this Enlightenment theory was the assumption that the treatment of women was a reliable index to the civilized status of any society. The two women writers studied here, Harriet Martineau (1802-76 and Charlotte Elizabeth Tonna (1790-1846, took opposing sides in the debate over Malthusian political economy and interpreted stadial theory in correspondingly different ways. Martineau's enthusiastic Malthusianism in the 'Illustrations of Political Economy '(1832-4 foresaw a feminist future brought about by illimitable progress and the spread of reason. With the deliberate aim of countering Martineau's views, the pre-Millenarian Evangelical Tonna asserted the truth of revelation in 'The Wrongs of Woman' (1843-4 and positioned women's domestic subordination as integral to England's continued pre-eminence as a commercial nation. This essay examines the religious, social and political grounds on which these two adversaries staked their arguments, and does so through an analysis of their fictional accounts of the status, role, and treatment of working women in an industrializing society.

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

Energy Technology Data Exchange (ETDEWEB)

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

2016-03-15

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

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

International Nuclear Information System (INIS)

Bouzad, Caroline; Duron, Sandrine; Bousquet, Aurore; Arnaud, François-Xavier; Valbousquet, Laura; Weber-Donat, Gabrielle; Teriitehau, Christophe; Baccialone, Jacques; Potet, Julien

2016-01-01

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

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

Directory of Open Access Journals (Sweden)

Ramona C Dolscheid-Pommerich

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

Implementation of Public-private Partnership Mode in the Re-construction of Public Hospital in Lesotho%PPP模式改建莱索托公立医院的实践

Institute of Scientific and Technical Information of China (English)

肖毅; 曾永强; 田时明; 徐安辉; 项涛; 李舟; 彭健; 闫学军; 邵世文; 钱霜

2016-01-01

Because of the outdated facilities and equipment, and poor operation efficiency in the largest public hospital in Lesotho named Queen Elizabeth II, Lesotho government urgently sought the solution to replace this public hospital for many years. After completing the repair of this hospital, the management of all facilities, equipment and delivery of all clinical services have been totally carried out by a private institutional operator. An independent institution conducts regular assessment of the new hospital and clinics, and the government will pay the bills based on the assessment results. The contract between the government and the private institutional operator lasts for 18 years. The application of this public-private partnerships (PPP) in health service network and the contracting mechanism have increased accountability for health service quality, where the government strengthened its strategic role, and may benefit other public health institutions in Lesotho. If the project can achieve success, the Lesotho government will consider applying PPPs in the reform of other public health institutions.%由于莱索托最大的Queen Elizabeth II公立医院设施、设备陈旧及运行效率低下，莱索托政府多年来迫切寻求可以替代该公立医院的解决方案。对该院进行了修缮，完成后全权由私立机构经营者进行设施、设备的管理和提供医疗服务，由独立机构对新的医院和门诊定期进行评估，政府根据评估的结果来支付费用，政府与私立机构经营者签订的合同为18年。创建政府与私立机构合作（PPP）的卫生服务网络和承包机制增加了对医疗服务质量的问责制，政府在其中加强了其战略性地位，并且这种模式可以让莱索托其他的公共医疗机构受益。如果这个项目能够成功，莱索托政府会考虑将PPPs模式用于其他公共卫生机构的改造。

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

Directory of Open Access Journals (Sweden)

Olugbenga A. Silas

2009-01-01

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

Analysis of the CFTR gene in Venezuelan cystic fibrosis patients, identification of six novel cystic fibrosis-causing genetic variants

OpenAIRE

Sánchez, Karen; De Mendonca,Elizabeth; Matute,Xiorama; Chaustre,Ismenia; Villalon,Marlene; Takiff,Howard

2016-01-01

Karen Sánchez,1 Elizabeth de Mendonca,1 Xiorama Matute,2 Ismenia Chaustre,2 Marlene Villalón,3 Howard Takiff4 1Unit of Genetic and Forensic Studies, Venezuelan Institute for Scientific Research (IVIC), 2Hospital JM de los Ríos, 3Hospital José Ignacio Baldo, Algodonal, National Reference Unit, 4Laboratory of Molecular Genetics, Venezuelan Institute for Scientific Research (IVIC), Caracas, Venezuela. Abstract: The mutations in the CFTR gene found in ...

The role of maintenance pemetrexed in the treatment of non-small-cell lung cancer

OpenAIRE

Rafii, S

2010-01-01

Saeed Rafii, Michael H CullenDepartment of Medical Oncology, Queen Elizabeth Hospital, University Hospital Birmingham, Edgbaston, Birmingham, B15 2TH, United KingdomAbstract: Until recently, the weight of evidence has supported the discontinuation of ­chemotherapy in advanced non-small-cell lung cancer (NSCLC) after 4–6 cycles of induction therapy. This allows patients with limited life expectancy a “treatment holiday.” A minority of cases then go on to r...

Administrative behavior of directors in hospitals: the Israeli case.

Science.gov (United States)

Stern, Z; Schmid, H; Nirel, N

1994-01-01

This article presents research findings on the behavior of directors in hospitals in Israel. According to the findings, hospital directors devote most of their time to internal organization processes and less time to the management of the external organizational environment. The findings also reveal that the orientation of these directors is toward centralization of authority and concentration of the decision-making process.

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

Science.gov (United States)

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

2009-01-01

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

Is the system really the solution? Operating costs in hospital systems.

Science.gov (United States)

Burns, Lawton Robert; McCullough, Jeffrey S; Wholey, Douglas R; Kruse, Gregory; Kralovec, Peter; Muller, Ralph

2015-06-01

Hospital system formation has recently accelerated. Executives emphasize scale economies that lower operating costs, a claim unsupported in academic research. Do systems achieve lower costs than freestanding facilities, and, if so, which system types? We test hypotheses about the relationship of cost with membership in systems, larger systems, and centralized and local hub-and-spoke systems. We also test whether these relationships have changed over time. Examining 4,000 U.S. hospitals during 1998 to 2010, we find no evidence that system members exhibit lower costs. However, members of smaller systems are lower cost than larger systems, and hospitals in centralized systems are lower cost than everyone else. There is no evidence that the system's spatial configuration is associated with cost, although national system hospitals exhibit higher costs. Finally, these results hold over time. We conclude that while systems in general may not be the solution to lower costs, some types of systems are. © The Author(s) 2015.

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

Science.gov (United States)

Dagne, Tesfaye; Beyene, Waju; Berhanu, Negalign

2015-07-01

Motivation is an individual's degree of willingness to exert and maintain an effort towards organizational goals. This study assessed motivational status and factors affecting it among health professionals in public hospitals of West Shoa Zone, Oromia Region. Facility based cross-sectional survey was employed. All health professionals who served at least for 6 months in Ambo, Gedo and Gindeberet hospitals were included. Self-administered Likert scale type questionnaire was used. Data were analyzed using SPSS version 20. Mean motivation calculated as percentage of maximum scale score was used. Bivariate and multiple linear regression analyses were done to see the independent effects of explanatory variables. The overall motivation level of health professionals was 63.63%. Motivation level of health professionals varied among the hospitals. Gindeberet Hospital had lower motivation score as compared to Ambo Hospital (B = -0.54 and 95% CI; -0.08,-0.27). The mean motivation score of health professionals who got monthly financial benefit was significantly higher than those who did not (B = 0.71 and 95% CI; 0.32, 1.10). Environmental factors had higher impact on doctors' motivation compared to nurses' (B = 0.51 and 95% CI; 0.10, 0.92). Supervisor-related factors highly varied in motivation relative to other variables. Motivation of health professionals was affected by factors related to supervisor, financial benefits, job content and hospital location. Efforts should be made to provide financial benefits to health professionals as appropriate especially, to those who did not get any such benefits. Officially recognizing best performance is also suggested.

Numerical investigation of airborne infection in naturally ventilated hospital wards with central-corridor type

DEFF Research Database (Denmark)

Zhou, Qi; Qian, Hua; Liu, Li

2018-01-01

Natural ventilation is believed to control airborne infection due to high ventilation rates while an undesired flow pattern may cause infection transmission in hospital wards. A computational fluid dynamics simulation was carried out in this study to investigate the impact of airflow pattern....... The results not only give direct evidence to strongly support World Health Organization’s recommendation but also suggest required amendment of the Chinese standard GB 51039-2014 to improve ventilation arrangement in general hospital wards in China. Our findings are useful for improving the future design...... of general hospital wards for airborne infection control....

Occurrence, aetiology and challenges in the management of ...

African Journals Online (AJOL)

Introduction: The aim of the study was to investigate the occurrence, the aetiology and the management of congestive heart failure in the cardiac centre of the St. Elizabeth catholic general hospital Shisong in Cameroon. Methods: Between November 2002 and November 2008, a population of 8121 patients was consulted in ...

Impacto económico del tratamiento y gestión de los residuos sólidos producidos por el Hospital Militar Central – Lima

OpenAIRE

Nava Torres, César Augusto; Nava Torres, César Augusto; Loayza Berrocal, Luis Alberto; Nava Torres, César Augusto

2012-01-01

El manejo de los residuos sólidos hospitalarios en nuestro país es uno de los aspectos de la gestión hospitalaria que ha ido tomando importancia e interés en los últimos años. Mediante la presente investigación se pretende evaluar el actual Tratamiento y Gestión de los residuos sólidos en el Hospital Militar Central (HMC) de la ciudad de Lima, analizando los servicios de salud donde los pacientes se hospitalizan y se genere la mayor cantidad de desechos, a fin de determinar las ganancias...

Perceptions of professional nurses regarding introduction of the Batho Pele principles in State hospitals

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Sindiwe James

2015-03-01

Full Text Available Background: The South African health care delivery system has shifted focus to primary health care since 1994. For this purpose the Batho Pele principles were introduced. Nurses claim, however, that since the introduction of these principles patients and their families have been making unnecessary and sometimes impossible demands of nursing staff. This article presents the perceptions of the professional nurses regarding the introduction of the Batho Pele principles in their workplace. Objectives: To describe the perceptions of professional nurses regarding introduction of the Batho Pele principles and to recommend guidelines to facilitate measures to realise the objects of these principles. Method: A qualitative, exploratory, descriptive and contexual research design was used. Six audio-taped focus group discussions and field notes were used to collect data from purposively sampled participants who have worked in the outpatient departments of hospitals in thePort Elizabeth Hospital Complex. Guba’s model of trustworthiness was used to confirm integrity of the study, whilst the participants were kept anonymous, protected from harm and participated voluntarily. Data analysis was done using Tesch’s data analysis spiral and with the involvement of an independent-coder. Results: Three themes emerged, revealing that the professional nurses perceived the objectives of the Batho Pele principles as difficult to uphold due to the inadequate planning prior to their implementation. Inadequacy of human and material resources aggravated this perception. Conclusion: Professional nurses are not happy with how things are in terms of introduction of the Batho Pele principles, but are optimistic of a positive change in the near future.

Perceptions of professional nurses regarding introduction of the Batho Pele principles in State hospitals.

Science.gov (United States)

James, Sindiwe; Miza, Thenjiwe M

2015-03-09

The South African health care delivery system has shifted focus to primary health care since 1994. For this purpose the Batho Pele principles were introduced. Nurses claim, however, that since the introduction of these principles patients and their families have been making unnecessary and sometimes impossible demands of nursing staff. This article presents the perceptions of the professional nurses regarding the introduction of the Batho Pele principles in their workplace. To describe the perceptions of professional nurses regarding introduction of the Batho Pele principles and to recommend guidelines to facilitate measures to realise the objects of these principles. A qualitative, exploratory, descriptive and contexual research design was used. Six audio-taped focus group discussions and field notes were used to collect data from purposively sampled participants who have worked in the outpatient departments of hospitals in the Port Elizabeth Hospital Complex. Guba's model of trustworthiness was used to confirm integrity of the study, whilst the participants were kept anonymous, protected from harm and participated voluntarily. Data analysis was done using Tesch's data analysis spiral and with the involvement of an independent-coder. Three themes emerged, revealing that the professional nurses perceived the objectives of the Batho Pele principles as difficult to uphold due to the inadequate planning prior to their implementation. Inadequacy of human and material resources aggravated this perception. Professional nurses are not happy with how things are in terms of introduction of the Batho Pele principles, but are optimistic of a positive change in the near future.

Work-Related Accidents and Sharp Injuries in Paramedics—Illustrated with an Example of a Multi-Specialist Hospital, Located in Central Poland

Science.gov (United States)

Szatko, Franciszek; Ulrichs, Magdalena

2017-01-01

(1) Background: An analysis of work-related accidents in paramedics in Poland by presenting the model and trend of accidents, accident rates and by identifying causes and results of accidents; (2) Methods: A retrospective analysis of medical documentation regarding work-related accidents in a multi-specialist hospital, located in central Poland, in the period 2005–2015. The study group included paramedics who had an accident while being on duty; (3) Results: According to hospital records, 88 paramedics were involved in 390 accidents and 265 injuries caused by sharp instruments. The annual accident rate was 5.34/100 employed paramedics. Most of the accidents occurred at night. The most common reason for the accident was careless behaviour of the paramedic, which resulted in joint sprains and dislocations. Injuries accounted for a huge portion of the total number of events. As many as 45% of injuries were not officially recorded; (4) Conclusion: High rates of work-related accidents and injuries caused by sharp instruments in paramedics are a serious public health problem. Further studies should be conducted in order to identify risk factors of accidents, particularly injuries, and to implement preventative programmes, aiming to minimise rates of occupational hazards for paramedics. PMID:28796193

Risk Factors for Multidrug-resistant Pseudomonas aeruginosa Among Hospitalized Patients at a Malaysian Hospital

International Nuclear Information System (INIS)

Mohd, N.M.D.; Nurnajwa, M.H.; Lay, J.; Teoh, J.C.; Syafinaz, A.N.; Niazlin, M.T.

2015-01-01

A case-control study was conducted based on medical cases of 100 hospitalized patients with Pseudomonas aeruginosa-isolation at a Malaysian hospital. Cases with 50 multidrug-resistant P. aeruginosa MDRPA and 50 non-multidrug-resistant P. aeruginosa (NMDRPA) were randomly included and compared with socio-demographic and clinical data of the patients, using Chi-square and Fisher's exact tests as the statistical tool. Analysis found no significant association between MDRPA with ages, gender and ethnicity of patients (p>0.050). Other risk factors being investigated were invasive procedure, immunosuppression, bedridden and clinical diagnosis such as central nervous- and respiratory-system disorder, as well as antibiotic exposure during hospitalization and duration of hospital stay with only the last two were found to have significant association (p=0.035 and 0.019, respectively). Some other studies also reported a similar association indicating that the two factors could serve as an important predictive tool for isolation of MDRPA. More studies involving a larger sampling size are warranted to establish the association. (author)

Enterprise resource planning for hospitals.

Science.gov (United States)

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

2004-06-30

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

Performance Measurement in Belgian Hospitals : a state-of-the-art

OpenAIRE

Van Caillie, Didier; Rouhana, Rima; Santin, Sarah

2007-01-01

This communication proposes a global state-of-the-art around the central question : "How is performance measured and controlled in Belgian hospitals. As a first step in a global research project dedicated to the use of Balanced ScoreCard in publics hospitals around the world, it is essentially focused on global economic aspects and on major macroeconomic statistics.

Medical research at the Albert Schweitzer Hospital.

Science.gov (United States)

Issifou, Saadou; Adegnika, Ayola A; Lell, Bertrand

2010-03-01

Built in 1981, the Medical Research Unit is located at the campus of the Albert Schweitzer Hospital. The main scientific activities of this research unit lie on clinical research focusing on antimalarial drugs and vaccines, and basic studies on pathogenesis of infectious diseases. Since 2002 the Medical Research Unit has experience in organising and hosting high quality training in clinical research in collaboration with the Vienna School of Clinical Research and other partners. For the future, this unit is involved as a key partner in the Central African Network on Tuberculosis, HIV/AIDS and Malaria (CANTAM) consortium playing a central role for the excellence in clinical research in Central Africa.

Centralized vs. decentralized child mental health services.

Science.gov (United States)

Adams, M S

1977-09-01

One of the basic tenets of the Community Mental Health Center movement is that services should be provided in the consumers' community. Various centers across the country have attempted to do this in either a centralized or decentralized fashion. Historically, most health services have been provided centrally, a good example being the traditional general hospital with its centralized medical services. Over the years, some of these services have become decentralized to take the form of local health centers, health maintenance organizations, community clinics, etc, and now various large mental health centers are also being broken down into smaller community units. An example of each type of mental health facility is delineated here.

Biological control and surveillance measures for hospital radiopharmacy

International Nuclear Information System (INIS)

Joshi, S.H.; Mehra, K.S.; Ramamoorthy, N.

1997-01-01

The principles and procedures for the surveillance measures and the care required to be observed in hospital radiopharmacy, though much of the aspects are quite valid for centralized and industrial radiopharmacies, are described. 1 tab

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

Directory of Open Access Journals (Sweden)

Yamikani Mastala

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

Job satisfaction and attitudes towards nursing care among nurses working at Mzuzu Central Hospital in Mzuzu, Malawi.

Science.gov (United States)

Nyirenda, Maloni; Mukwato, Patricia

2016-12-01

Job satisfaction is a major determinant of performance at the workplace. Studies have shown that job dissatisfaction can intensify emotional exhaustion, and this can influence nurses to perceive their work as tiresome and repetitive, leading to frustration and discouragement. The purpose of this study was to investigate the relationship between job satisfaction and attitude towards nursing care at Mzuzu Central Hospital in Mzuzu, Malawi. This was a descriptive correlational study. Eighty-nine nurses were selected using simple random sampling. A self-administered questionnaire was used to collect data. Data were analysed using Stata (version 12). Frequencies, means, and standard deviations were used to summarise sociodemographic data and also to determine job satisfaction and attitudes towards nursing care among the participants. Independent t-tests were used to determine if differences in professional qualifications, job title, work experience, or the clinical setting in which the nurses worked were associated with differences in job satisfaction and attitude. Pearson's product-moment correlation was used to determine the relationship between job satisfaction and attitude in the study sample. The nurses who participated in this study generally had positive attitudes towards nursing care and were moderately satisfied with their jobs. There was a significant variation in attitude depending on the amount of time a nurse worked at a particular post (P = 0.0308), as well as the amount of time a nurse had worked at the hospital (P = 0.0012). There was a significant positive relationship between job satisfaction and attitude (r = 0.226, P = 0.033). The nurses in the study sample were moderately satisified with their work and generally had positive attitudes towards nursing care. There was a positive correlation between attitude towards nursing care and job satisfaction. Addressing factors which dissatisfy nurses can promote nurses' attitudes and likely improve performance

SERVICE MARKETING MIX OF INDIAN HOSPITALS: A CRITICAL REVIEW

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Dharmesh, MOTWANI

2014-07-01

Full Text Available Sreenivas, Srinivasarao and Srinivasa (2013 said that “The health care market has become consumer centered and expecting high quality care at a reasonable price. The mushroomed development of corporate hospitals in India, competition is also bringing massive changes in industry structure. In this context, hospital services’ marketing is slowly and surely coming of age and is being woven into the fabric of hospitals planning and public relations programmes.” The essence of any marketing activity is marketing mix, and the central theme of the present paper revolves around the contemporary service marketing mix offered by Indian hospitals. In this paper author has critically reviewed 51 papers to describe elements of hospital service marketing mix; product, price, place, promotion, people, process and physical evidence.

Obituary: Elizabeth Katherine Holmes, 1973-2004

Science.gov (United States)

Beichman, Charles Arnold

2004-12-01

Elizabeth (Beth) K. Holmes died suddenly in Pasadena on March 23, 2004, from the unexpected effects of a long-standing heart condition. She was 30 years old. At the moment of her passing, she was at her computer comparing her theoretical models on the effects of planets on the distribution of zodiacal dust with some of the first observations from the Spitzer Space Telescope. Born on June 24, 1973, in New York City, Beth was the only child of James and Barbara Holmes, who were respectively, a financial manager and a nurse and social worker. Undeterred by numerous treatments and operations to correct a congenital heart condition, Beth developed an interest in math and physics leading to her graduation from MIT in 1995 with a bachelor's degree in Physics. She entered the University of Florida shortly afterwards to begin her PhD studies under the direction of Stanley Dermott. Beth was particularly interested in the dynamics of interplanetary dust, and initially worked on secular perturbations of the zodiacal cloud: how the planets impose warping of the cloud, and how they can force the center of the cloud to be offset from the Sun. Despite the fact that Beth was primarily a theorist, she was keen to include some observing experience in her PhD education. She recently completed an observing program with Harold Butner at the Steward and Palomar Observatories looking for submillimeter and mid-infrared emission around nearby main-sequence stars - a signpost of planetary formation. The results were published last year in the Astronomical Journal. Beth's PhD thesis work, some results of which were recently published in the Astrophysical Journal, focused on dust originating in the Kuiper belt and how some of this dust is expected to be spatially structured due to resonant interactions with Neptune. This phenomenon may be quite common in other planetary systems, with recent images of Epsilon Eridani perhaps providing a prime example of a Kuiper disk analog. After graduating

Central nervous system tuberculomata presenting as internuclear ...

African Journals Online (AJOL)

Central nervous system (CNS) tuberculoma can have variable presentation depending upon the site and number of tuberculomata. We are reporting a rare case of a 15 years old girl who presented to our hospital with binocular diplopia on right gaze. Clinical examination revealed left sided internuclear ophthalmoplegia ...

Epidemiology and Outcomes of Bloodstream Infections in Patients With Solid Tumors in a Central American Population at Mexico Hospital, San Jose, Costa Rica

Directory of Open Access Journals (Sweden)

Jorge Calvo-Lon

2017-12-01

Full Text Available Purpose: Bloodstream infections (BSIs are an important cause of mortality in patients with solid tumors. We conducted a retrospective study to evaluate the epidemiologic profile and mortality of patients with solid tumors who have BSIs and were admitted to Mexico Hospital. This is the first study in Costa Rica and Central America describing the current epidemiologic situation. Methods: We analyzed the infectious disease database for BSIs in patients with solid tumors admitted to Mexico Hospital from January 2012 to December 2014. Epidemiology and mortality were obtained according to microorganism, antibiotic sensitivity, tumor type, and presence of central venous catheter (CVC. Descriptive statistics were used. Results: A total of 164 BSIs were recorded, the median age was 58 years, 103 patients (63% were males, and 128 cases of infection (78% were the result of gram-negative bacilli (GNB. Klebsiella pneumoniae (21%, Escherichia coli (21%, and Pseudomonas aeruginosa (15% were the most common microorganisms isolated. Gram-positive cocci (GPC were found in 36 patients, with the most frequent microorganisms being Staphylococcus aureus (10% and Staphyloccocus epidermidis (6%. With respect to tumor type, BSIs were more frequent in the GI tract (57% followed by head and neck (9% and genitourinary tract (8%. Regarding antibiotic susceptibility, only 17% (GNB expressed extended-spectrum beta-lactamase and 12% (GPC had methicillin resistance. Patients with CVCs (n = 59 were colonized mainly by GNB (78%. Overall the mortality rate at 30 days was about 30%. Conclusion: GNB are the most frequent cause of BSIs in solid tumors and in patients with CVCs. GI cancers had more BSIs than other sites. Mortality and antibiotic sensitivity remained stable and acceptable during this observational period in this Latin American population.

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

Directory of Open Access Journals (Sweden)

Tamara Trelha Gauna

2013-08-01

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

Taiwan's Experience in Hospital Preparedness and Response for Emerging Infectious Diseases.

Science.gov (United States)

Kao, Hui-Yun; Ko, Hai-Yun; Guo, Peng; Chen, Chang-Hsun; Chou, Su-Mei

The Communicable Disease Control Medical Network (CDCMN), established in 2003 after the SARS outbreak in Taiwan, has undergone several phases of modification in structure and activation. The main organizing principles of the CDCMN are centralized isolation of patients with severe highly infectious diseases and centralization of medical resources, as well as a network of designated regional hospitals like those in other countries. The CDCMN is made up of a command system, responding hospitals, and supporting hospitals. It was tested and activated in response to the H1N1 influenza pandemic in 2009-10 and the Ebola outbreak in West Africa in 2014-2016, and it demonstrated high-level functioning and robust capacity. In this article, the history, structure, and operation of the CDCMN is introduced globally for the first time, and the advantages and challenges of this system are discussed. The Taiwanese experience shows an example of a collaboration between the public health system and the medical system that may help other public health authorities plan management and hospital preparedness for highly infectious diseases.

Epidemiology and clinical characteristics of patients hospitalized for ocular trauma in South-Central China.

Science.gov (United States)

Wang, Wanpeng; Zhou, Yalan; Zeng, Jun; Shi, Meng; Chen, Baihua

2017-09-01

Ocular trauma is a major cause of visual loss, but little is known about its epidemiology and clinical characteristics in China. The aim of this study was to determine the prevalence and clinical characteristics of ocular trauma and assess prognostic factors in Changsha, Hunan, located in South-Central China. A retrospective case series (ICD codes: S05) study of ocular trauma in patients was performed at the Second Xiangya Hospital, Central South University, from 1 January 2010 to 31 December 2014. Demographic information, injury causes, ocular trauma types and initial and final visual acuity (VA) were recorded and analysed. The ocular trauma score (OTS) was calculated to assess the extent of the eye injury, prognosis and factors associated with visual impairment. All patient data were collected from the medical records system. Of the 2009 patients presenting during this 5-year period, 1695 (84.4%) were males and 314 (15.6%) were females. The average age of all patients was 37.0 ± 19.3 years (range from 1 to 87 years). The age distribution showed a peak in the ocular trauma population in the 41- to 50-year age group (24%, n = 482), followed by the 51- to 60-year age group (16.9%, n = 339). Overall, open-globe injuries had a higher frequency (70.7%, n = 1420) than closed-globe injuries (28.6%, n = 575) and thermal/chemical injuries (0.7%, n = 14). Of the open-globe injuries, corneal penetration was the most common injury (32.2%, n = 646) followed by rupture (21.5%, n = 432) and an intraocular foreign body (16.2%, n = 325). Overall, the most frequent ocular trauma setting was the workplace (39.6%, n = 795), followed by the home (28.4%, n = 570), and the most frequent activity was ironwork. Firecracker- and firework-associated ocular trauma was significantly higher during the months of January and February than during other months (50.0%, n = 112, p firework-related ocular trauma occurred during the months adjacent to the Chinese New Year

Influence of hospitalization on potentially inappropriate prescribing ...

African Journals Online (AJOL)

Methods: This was a prospective observational study conducted in the multidisciplinary medical and surgical units ... Having a PIM at discharge was associated with the number of discharge medications and the history of .... assess the impact of hospitalization on PIPs in .... Central Nervous System and Psychotropic Drugs.

Improving financial performance by modeling and analysis of radiology procedure scheduling at a large community hospital.

Science.gov (United States)

Lu, Lingbo; Li, Jingshan; Gisler, Paula

2011-06-01

Radiology tests, such as MRI, CT-scan, X-ray and ultrasound, are cost intensive and insurance pre-approvals are necessary to get reimbursement. In some cases, tests may be denied for payments by insurance companies due to lack of pre-approvals, inaccurate or missing necessary information. This can lead to substantial revenue losses for the hospital. In this paper, we present a simulation study of a centralized scheduling process for outpatient radiology tests at a large community hospital (Central Baptist Hospital in Lexington, Kentucky). Based on analysis of the central scheduling process, a simulation model of information flow in the process has been developed. Using such a model, the root causes of financial losses associated with errors and omissions in this process were identified and analyzed, and their impacts were quantified. In addition, "what-if" analysis was conducted to identify potential process improvement strategies in the form of recommendations to the hospital leadership. Such a model provides a quantitative tool for continuous improvement and process control in radiology outpatient test scheduling process to reduce financial losses associated with process error. This method of analysis is also applicable to other departments in the hospital.

[Central diabetes insipidus: diagnostic difficulties].

Science.gov (United States)

Matoussi, N; Aissa, K; Fitouri, Z; Hajji, M; Makni, S; Bellagha, I; Ben Becher, S

2008-06-01

Central diabetes insipidus is rare in children. Characteristic features include polyuria and polydipsia due to arginine vasopressin deficiency. The differential diagnosis of polyuric states may be difficult. Etiologic diagnosis of central diabetes insipidus may be an equally difficult task. To specify the difficulties encountered in the diagnosis of central diabetes insipidus and to point out features of the etiologic work-up and of long-term follow-up of children with idiopathic central diabetes insipidus. A retrospective study of 12 children admitted with a polyuria/polydipsia syndrome to the pediatric - consultation and emergency unit of the children's hospital of Tunis between 1988 and 2005. Children with acquired nephrogenic central diabetes insipidus were excluded. Fourteen-hour fluid restriction test and/or desmopressin test were used without plasma vasopressin measurement. Eight patients were classified as having central diabetes insipidus, which was severe in seven children and partial in one girl. One patient was classified as having primary polydipsia. The diagnosis remains unclear in three patients. The etiological work-up in eight patients with central diabetes insipidus enabled the identification of Langerhan's-cell histiocytosis in two patients and neurosurgical trauma in one. The cause was considered idiopathic in five patients. The median follow-up of the five patients with idiopathic central diabetes insipidus was five years two months plus or minus six years seven months (range five months, 14.5 years). During this follow-up, neither brain magnetic resonance imaging scans findings nor anterior pituitary function have changed. Fluid restriction and desmopressin tests did not enable an accurate distinction between partial diabetes insipidus and primary polydipsia. Regular surveillance is warranted in patients with idiopathic central diabetes insipidus to identify potential etiologies.

Regional cost differences of hospital supply in Germany

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Lauterbach, Karl W.

2005-04-01

Full Text Available The intended adoption of a global reimbursement system for inpatient care in Germany envisions identical payments for identical treatments at different hospitals. This may lead to losses in some hospitals and may cause problems for the supply with health care facilities in the long run if there a important regional cost differences. Cost and performance data of 1112 hospitals in Germany have been analysed for regional differences in 2001: As regional categorizations we used official classification schemes based on centrality. The investigation does not support the postulation of additional payments for selected regions in Germany accounting for level cost-differences between hospitals. Confounding influence factors like ownership and hospital size seem to be more important. We recommend further investigations to evaluate regional cost-differences on the level of medical wards and using more risk-adjusted data. The examination of the individual case is necessary.

"If I only touch her cloak": the Sisters of Charity of St. Joseph in New Orleans hospital, 1834-1860.

Science.gov (United States)

Kong, Hyejung Grace; Kim, Ock-Joo

2015-04-01

This study is about the Sisters of Charity of St. Joseph in New Orleans' Charity Hospital during the years between 1834 and 1860. The Sisters of Charity of St. Joseph was founded in 1809 by Saint Elizabeth Ann Bailey Seton (first native-born North American canonized in 1975) in Emmitsburg, Maryland. Seton's Sisters of Charity was the first community for religious women to be established in the United States and was later incorporated with the French Daughters of Charity of St. Vincent de Paul in 1850. A call to work in New Orleans' Charity Hospital in the 1830s meant a significant achievement for the Sisters of Charity, since it was the second oldest continuously operating public hospitals in the United States until 2005, bearing the same name over the decades. In 1834, Sister Regina Smith and other sisters were officially called to Charity Hospital, in order to supersede the existing "nurses, attendants, and servants," and take a complete charge of the internal management of Charity Hospital. The existing scholarship on the history of hospitals and Catholic nursing has not integrated the concrete stories of the Sisters of Charity into the broader histories of institutionalized medicine, gender, and religion. Along with a variety of primary sources, this study primarily relies on the Charity Hospital History Folder stored at the Daughters of Charity West Center Province Archives. Located in the "Queen city of the South," Charity Hospital was the center of the southern medical profession and the world's fair of people and diseases. Charity Hospital provided the sisters with a unique situation that religion and medicine became intertwined. The Sisters, as nurses, constructed a new atmosphere of caring for patients and even their families inside and outside the hospital, and built their own separate space within the hospital walls. As hospital managers, the Sisters of Charity were put in complete charge of the hospital, which was never seen in other hospitals. By

Incidence and hospital mortality of vascular surgery patients with ...

African Journals Online (AJOL)

Central Hospital (IALCH) intensive care unit (ICU) following vascular surgery between 1 January ... patients have a perioperative myocardial infarction (PMI) and 4.6 .... Emergency surgery was performed in 17.8% of the ..... area is needed.

Trends in diarrhea hospitalizations among infants at three hospitals in Tanzania before and after rotavirus vaccine introduction.

Science.gov (United States)

Lyamuya, Faraja; Michael, Fausta; Jani, Bhavin; Fungo, Yohana; Chambo, Alfred; Chami, Inviolatha; Bulali, Regina; Mpamba, Amina; Cholobi, Happy; Kallovya, Dotto; Kamugisha, Christopher; Mwenda, Jason M; Cortese, Margaret M

2018-04-11

The Tanzania Ministry of Health introduced monovalent human rotavirus vaccine in January 2013, to be administered at ages 6 and 10 weeks. Data suggest there was high vaccine uptake. We used hospital ward registers from 3 hospitals to examine trends in diarrhea hospitalizations among infants before and after vaccine introduction. Ward registers from Dodoma Regional Referral Hospital (Central Tanzania), and two hospitals in Mbeya (Southwest area), Mbeya Zonal Referral Hospital and Mbalizi Hospital, were used to tally admissions for diarrhea among children by age group, month and year. Rotavirus surveillance had started at these hospitals in early 2013; the proportion of infants enrolled and rotavirus-EIA positive were examined by month to determine peak periods of rotavirus disease post-vaccine introduction. Registers were available for 2-4 prevaccine years and 2-3 post introduction years. At Dodoma Regional Referral Hospital, compared with the mean of 2011 and 2012, diarrhea hospitalizations among infants were 26% lower in 2015 and 58% lower in 2016. The diarrhea peak shifted later in the year first by 1 and then by 2-3 months from prevaccine. At the Mbeya hospitals, the number of diarrhea admissions in prevaccine period varied substantially by year. At Mbeya Referral Hospital, diarrhea hospitalizations among infants were lower by 25-37% in 2014 and 11-26% in 2015, while at Mbalizi Hospital, these hospitalizations were 4% lower in 2014 and 14% higher in 2015. Rotavirus testing data demonstrated a lowering of the prevaccine peak, a shift in timing of the peak months and indicated that other diarrheal peaks in post-introduction years were not due to rotavirus. In this ecological evaluation, total diarrhea hospitalizations among infants were lower (≥25% lower in ≥1 year) following introduction in 2 of 3 hospitals. There are challenges in using ward registers to ascertain possible impact of rotavirus vaccine introduction on trends in hospitalizations for

A STUDY ON ADVERSE DRUG REACTIONS INVOLVING CENTRAL NERVOUS SYSTEM, ITS SEVERITY AND CAUSALITY ASSESSMENT IN PEDIATRIC PATIENTS ADMITTED TO A TERTIARY CARE HOSPITAL

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Arati

2015-09-01

Full Text Available A retrospective study was conducted in Department of pediatrics SCB Medical College and SVPPGIP for a period of 2 years i.e. September 2012 to August 2014 . All the patients from birth to 14 years admitted to the pediatric ward in this study were under ADR surveillance. Patients admitted to our hospital with adverse drug reaction o r patients developing adverse drug reaction in our hospital were studied; only those cases where the central nervous system was involved were taken in our study. The cases were compiled and the causality of offending drugs was found using WHO - UMC causality assessment score. The severity of drug reaction in every case was determined by using HARTWIG’s severity scoring scale. Total 350 Adverse reactions were reported in this period with prevalence rate of 2.04% i.e. 20 out of 1000 children faced ADR due to dr ugs, with annual incidence rate of 0.9% and 1.14% over two years. Out of total 350 cases dermatological system was most commonly involved i.e. 207 cases (59.14%. This is followed by involvement of central nervous system 46 number of cases (13.14%. The GI system was involved in 34 cases i.e. (9.71%. Life threatening reactions like anaphylaxis, angioedema and shock like immediate life threatening ADRs were reported in 16 cases. Our study group was the patient in whom the ADR involved the CNS. Out of 46 suc h cases, there were 25 female and 21 male. Various reaction due to drug were encephalopathy , eps, febrile seizure, tremor, head reeling, ototoxicity, persistant cry, pseudotumor cerebri, psychosis, seizure, status epilepticus, toxic amblyopia, tremor, atax ia etc. The most common CNS manifestation was Extra pyramidal side effects (EPS involving 21% of cases. The most common Drug causing CNS manifestation was ATT (HRZE causing blindness, Eps, psychosis , toxic amblyopia blindness etc.

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

African Journals Online (AJOL)

Pathological examination of tissue biopsies with histological confirmation of a correct cancer diagnosis is central to cancer care. Without an accurate and specific ... The oesophagus was the most common biopsied site followed by breast, bladder, bone, prostate, bowel, and cervical lymph node. Malignancies were found in ...

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

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Adem Gul

2014-06-01

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

Images, Dialogue, and Aesthetic Education: Arendt's Response to the Little Rock Crisis

Science.gov (United States)

Pickett, Adrienne

2009-01-01

On September 4, 1957, a crisis occurred at Little Rock Central High School in which a mob of white citizens followed, taunted, and harassed a black student, Elizabeth Eckford, who was attempting to register for classes at the newly desegregated school. In 1959, Hannah Arendt published "Reflections on Little Rock." She argued that…

Process-based organization design and hospital efficiency.

Science.gov (United States)

Vera, Antonio; Kuntz, Ludwig

2007-01-01

The central idea of process-based organization design is that organizing a firm around core business processes leads to cost reductions and quality improvements. We investigated theoretically and empirically whether the implementation of a process-based organization design is advisable in hospitals. The data came from a database compiled by the Statistical Office of the German federal state of Rheinland-Pfalz and from a written questionnaire, which was sent to the chief executive officers (CEOs) of all 92 hospitals in this federal state. We used data envelopment analysis (DEA) to measure hospital efficiency, and factor analysis and regression analysis to test our hypothesis. Our principal finding is that a high degree of process-based organization has a moderate but significant positive effect on the efficiency of hospitals. The main implication is that hospitals should implement a process-based organization to improve their efficiency. However, to actually achieve positive effects on efficiency, it is of paramount importance to observe some implementation rules, in particular to mobilize physician participation and to create an adequate organizational culture.

A quality control exercise of radionuclide calibrators among Belgian hospitals

International Nuclear Information System (INIS)

Reher, D.F.G.; Merlo, P.

1990-01-01

On the initiative of the Belgian Association of Hospital Physicists, eleven Belgian hospitals participated in a quality control of radionuclide calibrators conducted in collaboration with the Central Bureau for Nuclear Measurements of the Commission of the European Communities. For practical reasons the nuclide 57 Co was chosen. The results from 20 different radionuclide calibrators show a fair agreement with a similar comparison carried out in 1980 in the UK. (orig.)

Identifying competitive strategies to improve the performance of hospitals in a competitive environment.

Science.gov (United States)

Chang, Chuan-Hui; Chiao, Yu-Ching; Tsai, Yafang

2017-11-21

This study is based on competitive dynamics theory, and discusses competitive actions (including their implementation requirements, strategic orientation, and action complexity) that influence hospitals' performance, while also meeting the requirements of Taiwan's "global budget" insurance payment policy. In order to investigate the possible actions of hospitals, the study was conducted in two stages. The first stage investigated the actions of hospitals from March 1 to May 31, 2009. Semi-structured questionnaires were used, which included in-depth interviews with senior supervisors of 10 medium- and large-scale hospitals in central Taiwan. This stage collected data related to the types of actions adopted by the hospitals in previous years. The second stage was based on the data collected from the first stage and on developed questionnaires, which were distributed from June 29 to November 1, 2009. The questionnaires were given to 20 superintendents, deputy superintendents, and supervisors responsible for the management of a hospital, and focused on medical centers and regional hospitals in central Taiwan in order to determine the types and number of competitive actions. First, the strategic orientation of an action has a significantly positive influence on subjective performance. Second, action complexity has a significantly positive influence on the subjective and the objective performance of a hospital. Third, the implementation requirements of actions do not have a significantly positive impact on the subjective or the objective performance of a hospital. Managers facing a competitive healthcare environment should adopt competitive strategies to improve the performance of the hospital.

Towards the centralization of digestive oncologic surgery: changes in activity, techniques and outcome

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Cristian Tebé

Full Text Available Aim: The objective of the present study was to examine changes in the activity, surgical techniques and results from the process of centralization of complex digestive oncologic surgery in 2005-2012 as compared to 1996-2000. Material and methods: A retrospective cohort study employing the minimum basic data set of hospital discharge (MBDSHD 1996-2012 from public centers in Catalonia (Spain was performed. The population consisted of individuals aged > 18 who underwent digestive oncologic surgery (esophagus, pancreas, liver, stomach or rectum. Medical centers were divided into low, medium, and high-volume centers (≤ 5, 6-10, and > 10 interventions/year, respectively. The tendency Chi-squared test was used to assess the centralization of patients in high-volume centers and hospital mortality evolution during the study period. Logistic regression was performed to assess the relationship between volume and outcome. Results: A centralization of complex oncologic digestive surgery between 10% (liver and 46% (esophagus was obtained by means of a reduction in the number of hospitals that perform these interventions and a significant rise in the number of patients operated in high-volume centers (all types p ≤ 0.0001, except for esophagus. A significant decrease in mortality was observed, especially in esophagus (from 15% in 1996/2000 to 7% in 2009/12, p = 0.003 and pancreas (from 12% in 1996/2000 to 6% in 2009/12, p trend < 0.0001. Conclusions: A centralization of oncologic digestive surgery in high-volume centers and a reduction of hospital mortality in Catalonia were reported among esophageal and pancreatic cancers. However, no significant changes were found for others cancer types.

Prevalence and determinants of erectile dysfunction among diabetic patients attending in hospitals of central and northwestern zone of Tigray, northern Ethiopia: a cross-sectional study.

Science.gov (United States)

Seid, Awole; Gerensea, Hadgu; Tarko, Shambel; Zenebe, Yosef; Mezemir, Rahel

2017-03-15

The prevalence of erectile dysfunction among diabetic men varies between 35-90%. Although erectile dysfunction is widespread among men with diabetes, the condition often remains undiagnosed and demands appropriate assessment and prompt treatment. Erectile dysfunction can affect all aspects of a patient's life including physical, emotional, social, sexual, and relationships. The main aim of this study is to determine the prevalence and determinants of erectile dysfunction among diabetic patients attending hospitals in the Central and Northwest zone of Tigray, Ethiopia. A hospital based cross-sectional study was conducted on 249 male diabetic patients attending five hospitals in the Central and Northwestern Zone of Tigray, Ethiopia using systematic random sampling. The data was collected from January 1 - February 30, 2016 and was entered and analyzed using SPSS version 20. Correlation and multivariate logistic regression was employed to test associations between independent and outcome variables. The mean age of study participants was 43.39 years and the mean duration of diabetes diagnosis was 6.22 years. The overall prevalence of erectile dysfunction was 69.9%, with 32.9% suffering from mild, 31.7% moderate, and 5.2% severe erectile dysfunction. Multivariate logistic regression revealed that erective dysfunction was significantly predicted by old age (Adjusted Odds Ratio [AOR] =15.013, CI:3.212-70.166), longer duration of diabetes (AOR = 3.77, CI:1.291-11.051), and lower monthly income (AOR = 0.285, CI:0.132-0.615). No association was found with body mass index, co-morbidity, glycemic control, and alcohol consumption. The prevalence of erective dysfunction in this study population was very high. Age, income, and duration of diabetes were the independent predictors of erectile dysfunction. Nearly all of the patients in the sample (97%) had not been screened or treated for erectile dysfunction. Assessment and management of erectile dysfunction in the

Radioactive waste management in a hospital.

Science.gov (United States)

Khan, Shoukat; Syed, At; Ahmad, Reyaz; Rather, Tanveer A; Ajaz, M; Jan, Fa

2010-01-01

Most of the tertiary care hospitals use radioisotopes for diagnostic and therapeutic applications. Safe disposal of the radioactive waste is a vital component of the overall management of the hospital waste. An important objective in radioactive waste management is to ensure that the radiation exposure to an individual (Public, Radiation worker, Patient) and the environment does not exceed the prescribed safe limits. Disposal of Radioactive waste in public domain is undertaken in accordance with the Atomic Energy (Safe disposal of radioactive waste) rules of 1987 promulgated by the Indian Central Government Atomic Energy Act 1962. Any prospective plan of a hospital that intends using radioisotopes for diagnostic and therapeutic procedures needs to have sufficient infrastructural and manpower resources to keep its ambient radiation levels within specified safe limits. Regular monitoring of hospital area and radiation workers is mandatory to assess the quality of radiation safety. Records should be maintained to identify the quality and quantity of radioactive waste generated and the mode of its disposal. Radiation Safety officer plays a key role in the waste disposal operations.

Radioactive Waste Management in A Hospital

Science.gov (United States)

Khan, Shoukat; Syed, AT; Ahmad, Reyaz; Rather, Tanveer A.; Ajaz, M; Jan, FA

2010-01-01

Most of the tertiary care hospitals use radioisotopes for diagnostic and therapeutic applications. Safe disposal of the radioactive waste is a vital component of the overall management of the hospital waste. An important objective in radioactive waste management is to ensure that the radiation exposure to an individual (Public, Radiation worker, Patient) and the environment does not exceed the prescribed safe limits. Disposal of Radioactive waste in public domain is undertaken in accordance with the Atomic Energy (Safe disposal of radioactive waste) rules of 1987 promulgated by the Indian Central Government Atomic Energy Act 1962. Any prospective plan of a hospital that intends using radioisotopes for diagnostic and therapeutic procedures needs to have sufficient infrastructural and manpower resources to keep its ambient radiation levels within specified safe limits. Regular monitoring of hospital area and radiation workers is mandatory to assess the quality of radiation safety. Records should be maintained to identify the quality and quantity of radioactive waste generated and the mode of its disposal. Radiation Safety officer plays a key role in the waste disposal operations. PMID:21475524

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

OpenAIRE

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

2014-01-01

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

Impact on continuity of care of decentralized versus partly centralized mental health care in Northern Norway

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Lars Henrik Myklebust

2011-12-01

Full Text Available Background: The issue of continuity of care is central in contemporary psychiatric services research. In Norway, inpatient admissions are mainly to take place locally, in a system of small bed-units that represent an alternative to traditional central psychiatric hospitals. This type of organization may be advantageous for accessibility and cooperation, but has been given little scientific attention.Aims: To study whether inpatients' utilization of outpatient services differ between an area with a decentralized care model in comparison to an adjacent area with a partly centralized model.  Method: The study was based on data from a one-year registered prevalence sample, drawing on routinely sampled data supplemented with data from medical records. Service-utilization for 247 inpatients was analyzed. The results were controlled for diagnosis, demographic variables, type of service system, localization of inpatient admissions, and length of hospitalization. Results: Most inpatients in the area with the decentralized care model also utilized outpatient consultations, whereas a considerable number of inpatients in the area with a partly centralized model did not enter outpatient care at all. Type of service system, localization of inpatient admission, and length of hospitalization predicted inpatients' utilization of outpatient consultations. The results are discussed in the light of systems integration, particularly management-arrangements and clinical bridging over the transitional phase from inpatient to outpatient care. Conclusion: Inpatients' utilization of outpatient services differed between an area with a decentralized care model in comparison to an adjacent area with a partly centralized care model. In the areas studied, extensive decentralization of the psychiatric services positively affected coordination of inpatient and outpatient services for people with severe psychiatric disorders. Small, local-bed units may therefore represent a

Impact on continuity of care of decentralized versus partly centralized mental health care in Northern Norway

Directory of Open Access Journals (Sweden)

Lars Henrik Myklebust

2011-12-01

Full Text Available Background: The issue of continuity of care is central in contemporary psychiatric services research. In Norway, inpatient admissions are mainly to take place locally, in a system of small bed-units that represent an alternative to traditional central psychiatric hospitals. This type of organization may be advantageous for accessibility and cooperation, but has been given little scientific attention. Aims: To study whether inpatients' utilization of outpatient services differ between an area with a decentralized care model in comparison to an adjacent area with a partly centralized model.   Method: The study was based on data from a one-year registered prevalence sample, drawing on routinely sampled data supplemented with data from medical records. Service-utilization for 247 inpatients was analyzed. The results were controlled for diagnosis, demographic variables, type of service system, localization of inpatient admissions, and length of hospitalization.  Results: Most inpatients in the area with the decentralized care model also utilized outpatient consultations, whereas a considerable number of inpatients in the area with a partly centralized model did not enter outpatient care at all. Type of service system, localization of inpatient admission, and length of hospitalization predicted inpatients' utilization of outpatient consultations. The results are discussed in the light of systems integration, particularly management-arrangements and clinical bridging over the transitional phase from inpatient to outpatient care.  Conclusion: Inpatients' utilization of outpatient services differed between an area with a decentralized care model in comparison to an adjacent area with a partly centralized care model. In the areas studied, extensive decentralization of the psychiatric services positively affected coordination of inpatient and outpatient services for people with severe psychiatric disorders. Small, local-bed units may therefore

Impact on continuity of care of decentralized versus partly centralized mental health care in Northern Norway

Science.gov (United States)

Myklebust, Lars Henrik; Olstad, Reidun; Bjorbekkmo, Svein; Eisemann, Martin; Wynn, Rolf; Sørgaard, Knut

2011-01-01

Background The issue of continuity of care is central in contemporary psychiatric services research. In Norway, inpatient admissions are mainly to take place locally, in a system of small bed-units that represent an alternative to traditional central psychiatric hospitals. This type of organization may be advantageous for accessibility and cooperation, but has been given little scientific attention. Aims To study whether inpatients’ utilization of outpatient services differ between an area with a decentralized care model in comparison to an adjacent area with a partly centralized model. Method The study was based on data from a one-year registered prevalence sample, drawing on routinely sampled data supplemented with data from medical records. Service-utilization for 247 inpatients was analyzed. The results were controlled for diagnosis, demographic variables, type of service system, localization of inpatient admissions, and length of hospitalization. Results Most inpatients in the area with the decentralized care model also utilized outpatient consultations, whereas a considerable number of inpatients in the area with a partly centralized model did not enter outpatient care at all. Type of service system, localization of inpatient admission, and length of hospitalization predicted inpatients’ utilization of outpatient consultations. The results are discussed in the light of systems integration, particularly management-arrangements and clinical bridging over the transitional phase from inpatient to outpatient care. Conclusion Inpatients’ utilization of outpatient services differed between an area with a decentralized care model in comparison to an adjacent area with a partly centralized care model. In the areas studied, extensive decentralization of the psychiatric services positively affected coordination of inpatient and outpatient services for people with severe psychiatric disorders. Small, local-bed units may therefore represent a favourable alternative

Efficiency and hospital effectiveness in improving Hospital Consumer Assessment of Healthcare Providers and Systems ratings.

Science.gov (United States)

Al-Amin, Mona; Makarem, Suzanne C; Rosko, Michael

2016-01-01

Efficiency has emerged as a central goal to the operations of health care organizations. There are two competing perspectives on the relationship between efficiency and organizational performance. Some argue that organizational slack is a waste and that efficiency contributes to organizational performance, whereas others maintain that slack acts as a buffer, allowing organizations to adapt to environmental demands and contributing to organizational performance. As value-based purchasing becomes more prevalent, health care organizations are incented to become more efficient and, at the same time, improve their patients' experiences and outcomes. Unused slack resources might facilitate the timely implementation of these improvements. Building on previous research on organizational slack and inertia, we test whether efficiency and other organizational factors predict organizational effectiveness in improving Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) ratings. We rely on data from the American Hospital Association and HCAHPS. We estimate hospital cost-efficiency by Stochastic Frontier Analysis and use regression analysis to determine whether efficiency, competition, hospital size, and other organizational factors are significant predictors of hospital effectiveness. Our findings indicate that efficiency and hospital size have a significant negative association with organizational ability to improve HCAHPS ratings. Although achieving organizational efficiency is necessary for health care organizations, given the changes that are currently occurring in the U.S. health care system, it is important for health care managers to maintain a certain level of slack to respond to environmental demands and have the resources needed to improve their performance.

Anemia intrahospitalaria y descenso de hemoglobina en pacientes internados Hospital-acquired anemia and decrease of hemoglobin levels in hospitalized patients

Directory of Open Access Journals (Sweden)

Carina V. Gianserra

2011-06-01

estadía hospitalaria prolongada, la presencia de leucocitosis, la hidratación parenteral y colocación de acceso venoso central fueron factores predictivos de descenso de hemoglobina = 2 g/dl.It is common to observe the development of anemia in hospitalized patients, especially in critical cases. Few studies have evaluated its prevalence and associated factors in patients in the general ward. The purpose of this study is to determine the prevalence, characteristics and associated clinical factors of hospital-acquired anemia and the drop of hemoglobin concentration in hospitalized patients. This is a cross-sectional, prospective and descriptive study. A total of 192 consecutive in-patients in the general ward were studied. Associated risk factors to the drop in hemoglobin by = 2g/dl were analyzed; 139 patients (72.4% presented anemia; 89 of them (46.4% had it at admission and 50 (26% developed hospital-acquired anemia, 47 out of 192 showed a drop in hemoglobin = 2 g/dl(24.48%. They also presented lower values of hematocrite and hemoglobin at discharge (p = 0.01, parenteral hydration at a higher volume (p = 0.01, and lengthier hospitalizations (p = 0.0001. In the univariate analysis, the following variables were statistically significant risk factors: leukocytosis = 11 000 mm³ (OR; IC95%: 2,02; 1.03-4; p = 0.01, hospitalization days = 7 (OR; IC95%:3.39; 1.62-7.09; p = 0.0006, parenteral hydration = 1500 ml/day (OR; IC95%: 2.47; 1.06-6.4; p = 0.01, central venous access (OR; IC95%:10.29; 1.75-108.07; p = 0.003 and hospital-acquired anemia (OR; IC95%: 7.06; 3.41-15.83; p = 0.00000004. In the multivariate analysis, the following variables were independent predictive factors of the hemoglobin decrease = 2 g/dl: leukocytosis = 11 000 mm³ (OR; IC95%: 2.45; 1.14-5,27; p = 0.02, hospitalization days = 7 (OR; IC95%:5.15; 2.19-12.07; p = 0.0002, parenteral hydration = 1500 ml/day (OR; IC95%: 2.95; 1.13-7.72; p = 0.02, central venous access (OR; IC95%:8.82; 1.37-56.82; p = 0

A preliminary investigation of tuberculosis and other diseases in African buffalo (Syncerus caffer in Queen Elizabeth National Park, Uganda

Directory of Open Access Journals (Sweden)

G. Kalema-Zikusoka

2005-09-01

Full Text Available A survey to determine the prevalence of bovine tuberculosis caused by Mycobacterium bovis and certain other infectious diseases was conducted on 42 free-ranging African buffaloes, (Syncerus caffer from May to June 1997 in the Queen Elizabeth National Park, Uganda. Using the gamma interferon test, exposure to M. bovis was detected in 21.6 % of the buffaloes. One dead buffalo and an emaciated warthog (Phacochoerus aethiopicus that was euthanased, were necropsied; both had miliary granulomas from which M. bovis was isolated. None of the buffaloes sampled in Sector A of the park, which has no cattle interface, tested positive for bovine tuberculosis (BTB exposure. The prevalence and distribution of BTB does not appear to have changed significantly since the 1960s, but this may be due to fluxes in the buffalo population. Serological testing for foot-and-mouth disease (FMD demonstrated positive exposure of 57.1% of the buffaloes sampled, with types A, O and SAT 1-3, which is the first known report of FMD antibodies to A and O types in free ranging African buffaloes. Foot-and-mouth disease virus types SAT 1 and SAT 3 were isolated from buffalo probang samples. Two percent of the buffaloes had been exposed to brucellosis. None of the buffaloes tested had antibodies to rinderpest, leptospirosis or Q fever.

Potential gains from hospital mergers in Denmark.

Science.gov (United States)

Kristensen, Troels; Bogetoft, Peter; Pedersen, Kjeld Moeller

2010-12-01

The Danish hospital sector faces a major rebuilding program to centralize activity in fewer and larger hospitals. We aim to conduct an efficiency analysis of hospitals and to estimate the potential cost savings from the planned hospital mergers. We use Data Envelopment Analysis (DEA) to estimate a cost frontier. Based on this analysis, we calculate an efficiency score for each hospital and estimate the potential gains from the proposed mergers by comparing individual efficiencies with the efficiency of the combined hospitals. Furthermore, we apply a decomposition algorithm to split merger gains into technical efficiency, size (scale) and harmony (mix) gains. The motivation for this decomposition is that some of the apparent merger gains may actually be available with less than a full-scale merger, e.g., by sharing best practices and reallocating certain resources and tasks. Our results suggest that many hospitals are technically inefficient, and the expected "best practice" hospitals are quite efficient. Also, some mergers do not seem to lower costs. This finding indicates that some merged hospitals become too large and therefore experience diseconomies of scale. Other mergers lead to considerable cost reductions; we find potential gains resulting from learning better practices and the exploitation of economies of scope. To ensure robustness, we conduct a sensitivity analysis using two alternative returns-to-scale assumptions and two alternative estimation approaches. We consistently find potential gains from improving the technical efficiency and the exploitation of economies of scope from mergers.

RCRA corrective measures using a permeable reactive iron wall US Coast Guard Support Center, Elizabeth City, North Carolina

International Nuclear Information System (INIS)

Schmithors, W.L.; Vardy, J.A.

1997-01-01

A chromic acid release was discovered at a former electroplating shop at the U.S. Coast Guard Support Center in Elizabeth City, North Carolina. Initial investigative activities indicated that chromic acid had migrated into the subsurface soils and groundwater. In addition, trichloroethylene (TCE) was also discovered in groundwater during subsequent investigations of the hexavalent chromium (Cr VI) plume. Corrective measures were required under the Resource Conservation and Recovery Act (RCRA). The in-situ remediation method, proposed under RCRA Interim Measures to passively treat the groundwater contaminants, uses reactive zero-valent iron to reductively dechlorinate the chlorinated compounds and to mineralize the hexavalent chromium. A 47 meter by 0.6 meter subsurface permeable iron wall was installed downgradient of the source area to a depth of 7 meters using a direct trenching machine. The iron filings were placed in the ground as the soils were excavated from the subsurface. This is the first time that direct trenching was used to install reactive zero-valent iron filings. Over 250 metric tons of iron filings were used as the reactive material in the barrier wall. Installation of the iron filings took one full day. Extensive negotiations with regulatory agencies were required to use this technology under the current facility Hazardous Waste Management Permit. All waste soils generated during the excavation activities were contained and treated on site. Once contaminant concentrations were reduced the waste soils were used as fill material

Media and Attention, Cognition, and School Achievement

Science.gov (United States)

Schmidt, Marie Evans; Vandewater, Elizabeth A.

2008-01-01

Marie Evans Schmidt and Elizabeth Vandewater review research on links between various types of electronic media and the cognitive skills of school-aged children and adolescents. One central finding of studies to date, they say, is that the content delivered by electronic media is far more influential than the media themselves. Most studies, they…

Blood lactate as a predictor for in-hospital mortality in patients admitted acutely to hospital: A systematic review

DEFF Research Database (Denmark)

Kruse, Ole; Grunnet, Niels; Barfod, Charlotte

2011-01-01

to the hospital, or serial lactate measurements. Furthermore there is no consensus whether the sample should be drawn from arterial, peripheral venous, or capillary blood. The aim of this review was: 1) To examine whether blood lactate levels are predictive for in-hospital mortality in patients in the acute...... setting, i.e. patients assessed pre-hospitally, in the trauma centre, emergency department, or intensive care unit. 2) To examine the agreement between arterial, peripheral venous, and capillary blood lactate levels in patients in the acute setting. METHODS: We performed a systematic search using Pub......Med, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and CINAHL up to April 2011. 66 articles were considered potentially relevant and evaluated in full text, of these ultimately 33 articles were selected. RESULTS AND CONCLUSION: The literature reviewed supported blood...

Importancia, evolución y organización de un Servicio de Esterilización Central

OpenAIRE

Rothamel, Alicia

1986-01-01

La Central de Esterilización Hospitalaria es el lugar donde se decontaminan, lavan, preparan, acondicionan y esterilizan los materiales de uso en el Hospital. La gran responsabilidad profesional y técnica que caracterizan su rol en el Hospital exigen que el Servicio esté estrictamente organizado, contando con una estructura física, equipamiento, plantel de personal y estructura técnico-administrativa conforme a las Normas de Esterilización en vigencia. La Central de Esterilización en un Hospi...

Integrating centralized and decentralized organization structures: an education and development model.

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Sheriff, R; Banks, A

2001-01-01

Organization change efforts have led to critically examining the structure of education and development departments within hospitals. This qualitative study evaluated an education and development model in an academic health sciences center. The model combines centralization and decentralization. The study results can be used by staff development educators and administrators when organization structure is questioned. This particular model maximizes the benefits and minimizes the limitations of centralized and decentralized structures.

Low-grade central osteosarcoma in proximal humerus: a rare entity

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Tang F

2017-10-01

Full Text Available Fan Tang,1,2 Li Min,1,2 Yong Zhou,1 Yi Luo,1 Chongqi Tu1 1Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, People’s Republic of China; 2Sarcoma Biology Laboratory, Center for Sarcoma and Connective Tissue Oncology, Massachusetts General Hospital, Boston, MA, USA Abstract: Low-grade central osteosarcoma is a rare subtype of tumor with low-grade malignancy. Currently, wide resection with negative resection margin is the standard treatment for this disease. The role of neoadjuvant chemotherapy in low-grade central osteosarcoma was controversial and was mostly considered for tumors containing high-grade focal areas. Local tumor recurrences often exhibited a tumor with higher histologic grade or differentiation with the potential for metastases. In low-grade central osteosarcoma, timely wide resection after definite diagnosis can result in 5-year survival for almost 90%. However, the relatively nonspecific radiological and pathological findings make diagnosis very difficult. MDM2 and CDK4 are specific and provide sensitive markers for the diagnosis of low-grade central osteosarcoma, helping to differentiate low-grade central osteosarcoma from some benign lesions, including fibrous dysplasia, bone giant cell tumor, and chondrosarcoma. Here, we report the case of a 19-year-old woman with low-grade central osteosarcoma located at the proximal humerus. The affected site was rare, but the sensitive biomarkers CDK4 and MDM2 were positive. The patient recovered well after wide tumor resection following a proximal humerus endoprosthesis replacement. Our case highlighted the management strategies in low-grade central osteosarcoma. Being familiar with radiographic features, understanding the biological characteristics, and mastering diagnostic biomarkers can help oncologists avoid embarrassing situations in treatment when this rare tumor is highly suspected, even when located at an uncommon site. The discussion in this report

Clinical protein science developments for patient monitoring in hospital central laboratories.

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Malm, Johan; Marko-Varga, György

2016-12-01

Patient care relies heavily on standardized tests performed in hospital laboratories, typically including clinical chemistry, pathology and microbiology. With the introduction of personalized medicine tremendous efforts have been made to identify new biomarkers of disease with various omics technologies, often including mass spectrometry. In order to validate new biomarkers and perform clinical studies high quality biobank samples are of key importance. In this editorial different aspects of mass spectrometry in future personalized medicine are discussed.

Difference and proliferation: race in the poetry of Elizabeth Bishop = Diferença e proliferação: o conceito de raça na poesia de Elizabeth Bishop

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Terry Caesar

2010-01-01

Full Text Available The current paper deals with the whole imagination of race in the work of a major American poet. The very subject of race intersects with the question of national identity, also neglected in Bishop’s work, although not in the same way. The aim of the discussion is to align the racial text with the national text. How can we understand Bishop’s consistent interest in race throughout her poetry, and what effect can be observed in it as a result of her exposure to racial constructs in Brazil that are so different from those of her native United States? We can see this effect manifest even in the controversy over her 1965 magazine article on the quatercentenary of Rio de Janeiro. What does this controversy demonstrate, finally, but that national experience with respect to race turns out to be mutually exclusive? One cannot be in this respect both Brazilian and American—in prose. In poetry, however, it is quite another matter. The subject of race is all of a piece, and has been all along conducted in Bishop’s work according to a logic ultimately apart fromnational construction. Analisa-se a imaginação de raça na obra de Elizabeth Bishop, uma poetisa importante da literatura estadunidense. O assunto ‘raça’ cruza com o problema da identidade nacional, também negligenciado na obra de Bishop, embora de modo diferente. A presente discussão alinha o texto racial ao texto nacional. Como pode-se compreender o seu interesse constante sobre ‘raça’ e quais são os efeitos em sua poesia como resultado de sua exposição às construções raciais no Brasil, as quais são tão diferentes daquelas nos Estados Unidos? Este efeito manifesta-se também em seu artigo numa revista de 1965 referente ao quatrocentenário do Rio de Janeiro. Esta controvérsia parece mostrar que a experiência nacional sobre ‘raça’ é mutuamente exclusiva. Na prosa não se pode ser brasileiro ou estadunidense ao mesmo tempo. Na poesia, parece que os parâmetros s

Challenges for the surgical capacity building of township hospitals among the Central China: a retrospective study.

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Li, Zhong; Yang, Jian; Wu, Yue; Pan, Zijin; He, Xiaoqun; Li, Boyang; Zhang, Liang

2018-05-02

China's rapid transition in healthcare service system has posed considerable challenges for the primary care system. Little is known regarding the capacity of township hospitals (THs) to deliver surgical care in rural China with over 600 million lives. We aimed to ascertain its current performance, barriers, and summary lessons for its re-building in central China. This study was conducted in four counties from two provinces in central China. The New Rural Cooperative Medical System (NRCMS) claim data from two counties in Hubei province was analyzed to describe the current situation of surgical care provision. Based on previous studies, self-administered questionnaire was established to collect key indicators from 60 THs from 2011 to 2015, and social and economic statuses of the sampling townships were collected from the local statistical yearbook. Semi-structured interviews were conducted among seven key administrators in the THs that did not provide appendectomy care in 2015. Determinants of appendectomy care provision were examined using a negative binominal regression model. First, with the rapid increase in inpatient services provided by the THs, their proportion of surgical service provision has been nibbled by out-of-county facilities. Second, although DY achieved a stable performance, the total amount of appendectomy provided by the 60 THs decreased to 589 in 2015 from 1389 in 2011. Moreover, their proportion reduced to 26.77% in 2015 from 41.84% in 2012. Third, an increasing number of THs did not provide appendectomy in 2015, with the shortage of anesthesiologists and equipment as the most mentioned reasons (46.43%). Estimation results from the negative binomial model indicated that the annual average per capita disposable income and tightly integrated delivery networks (IDNs) negatively affected the amount of appendectomy provided by THs. By contrast, the probability of appendectomy provision by THs was increased by performance-related payment (PRP). Out

Fact-finding survey of nosocomial infection control in hospitals in Vietnam and application to training programs.

Science.gov (United States)

Ohara, Hiroshi; Hung, Nguyen Viet; Thu, Truong Anh

2009-12-01

Nosocomial infection control is crucial for improving the quality of medical care. It is also indispensable for implementing effective control measures for severe acute respiratory syndrome (SARS) and the possible occurrence of a human influenza pandemic. The present authors, in collaboration with Vietnamese hospital staff, performed a fact-finding survey of nosocomial infection control in hospitals in northern Vietnam and compared the results with those of a survey conducted 4 years previously. Remarkable improvement was recognized in this period, although there were considerable differences between the central hospitals in Hanoi and local hospitals. In the local hospitals, basic techniques and the systems for infection control were regarded as insufficient, and it is necessary to improve these techniques and systems under the guidance of hospitals in the central area. Based on the results of the survey, programs were prepared and training courses were organized in local hospitals. Evaluation conducted after the training courses showed a high degree of satisfaction among the trainees. The results of the survey and the training courses conducted during the study period are expected to contribute to the improvement of nosocomial infection control in remote areas of Vietnam.

Errors, medicine and the law

National Research Council Canada - National Science Library

Merry, Alan; Smith, R. Alexander McCall

2001-01-01

... anonymous, but immensely helpful, reviewer in the USA. We were enabled to spend several periods working together in Canada thanks to the hospitality of Barbara Parker and Iona and John Copping of Vancouver, and of Douglas and Nadia Parker of Toronto, during which, and other times, Dr Sally Merry and Dr Elizabeth McCall Smith provided unstinting support for the proj...

Triple Gestations in Two University Teaching Hospitals in Yaounde ...

African Journals Online (AJOL)

3Department of Obstetrics & Gynecology, Central Hospital Yaounde/Faculty of Medicine and Biomedical Sciences,. University of Yaounde I, BP 337, Yaounde, Cameroon. Address correspondence to E. Nkwabong, enkwabong@yahoo.fr. Received 27 November 2010; Accepted 19 January 2011. Abstract The frequency of ...

Participatory simulation in hospital work system design

DEFF Research Database (Denmark)

Andersen, Simone Nyholm

When ergonomic considerations are integrated into the design of work systems, both overall system performance and employee well-being improve. A central part of integrating ergonomics in work system design is to benefit from emplo y-ees’ knowledge of existing work systems. Participatory simulation...... (PS) is a method to access employee knowledge; namely employees are involved in the simulation and design of their own future work systems through the exploration of models representing work system designs. However, only a few studies have investigated PS and the elements of the method. Yet...... understanding the elements is essential when analyzing and planning PS in research and practice. This PhD study investigates PS and the method elements in the context of the Danish hospital sector, where PS is applied in the renewal and design of public hospitals and the work systems within the hospitals...

Drawing the eczema aesthetic: the psychological effects of chronic skin disease as depicted in the works of John Updike, Elizabeth Bishop, and Zelda Fitzgerald.

Science.gov (United States)

Tatum, Karen E

2010-06-01

How might the psycho-social effects of chronic skin disease, its treatments (and discontents) be figuratively expressed in writing and painting? Does the art reveal common denominators in experience and representation? If so, how do we understand the cryptic language of these expressions? By examining the works of artists with chronic skin diseases--John Updike, Elizabeth Bishop, and Zelda Fitzgerald--some common features can be noted. Chronically broken skin can fracture the ego or self-perception, resulting in a disturbed body image, which leads to personality disorders and co-morbid affective disorders such as anxiety and depression. The vertiginous feeling that results can be noted in the paradoxical characters, figures, and psyches portrayed in the works of these artists. This essay will examine the more specific ways in which artists disclose and/or conceal their experiences and the particular ways in which these manifest in their works. While certain nuances exist, the common denominators give us a starting point for developing an eczema aesthetic, a code for interpreting the ways in which artists' experiences with skin disease manifest in their works.

Healthcare reform. Is the NHS ready for US business guru's strategy?

Science.gov (United States)

Cavendish, Will; Edwards, Nigel; Swindells, Matthew; Henke, Nicolaus; Robinson, Edna; Smith, Richard

2006-12-07

The central argument of the new book by renowned US academics Michael Porter and Elizabeth Olmsted Teisberg is that the US health system is broken because rather than improving quality and efficiency, it focuses on budgetary battles. HSJ gathered together six leading healthcare insiders to discuss whether his diagnosis is applicable to the NHS. Nick Edwards was there.

The effect of eradicating Helicobacter pylori on idiopathic central serous chorioretinopathy patients

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Dang Y

2013-09-01

Full Text Available Yalong Dang,1,2,* Yalin Mu,2,* Manli Zhao,2 Lin Li,3 Yaning Guo,4 Yu Zhu1,2 1Department of Ophthalmology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People's Republic of China; 2Department of Ophthalmology and Visual Science, Yellow River Hospital of Henan University of Science and Technology, Sanmenxia City, Henan, People's Republic of China; 3Department of Ophthalmology, The First Affiliated Hospital of Henan University of Science and Technology, Luoyang City, Henan, People's Republic of China; 4Gu-Cheng Eye Hospital, Xi'an City, Shanxi, People's Republic of China *These authors contributed equally to this work Purpose: To evaluate the effect of Helicobacter pylori (H. pylori eradication on the remission of acute idiopathic central serous chorioretinopathy (ICSCR. Study design: A prospective, randomized, placebo-controlled study of 53 participants. Main outcome measure: Twenty-seven acute ICSCR patients tested positive for H. pylori were given an eradication H. pylori therapy, and another 26 patients with the same diagnosis received matching placebo medication. All participants were tested for the following items: (1 disappearance rate of subretinal fluid (SRF; (2 best-corrected visual acuity (BCVA; and (3 central retinal sensitivity at baseline, 2 weeks, 4 weeks, 8 weeks, and 12 weeks after treatment. The difference between the two groups was analyzed by PASW statistics version 18.0. Results: At each follow-up, the disappearance rate of SRF in the active treatment group seemed slightly better than in the control group, but no statistically significant differences were observed (P > 0.05 at each follow-up. The BCVA between the two groups also did not demonstrate statistically significant differences (P > 0.05 at each follow-up. Unlike the BCVA and the disappearance rate of SRF, we compared the change in central retinal sensitivity at 12 weeks after treatment; a statistical difference was observed (P = 0

Misdiagnosis of acute peripheral vestibulopathy in central nervous ischemic infarction.

Science.gov (United States)

Braun, Eva Maria; Tomazic, Peter Valentin; Ropposch, Thorsten; Nemetz, Ulrike; Lackner, Andreas; Walch, Christian

2011-12-01

Vertigo is a very common symptom at otorhinolaryngology (ENT), neurological, and emergency units, but often, it is difficult to distinguish between vertigo of peripheral and central origin. We conducted a retrospective analysis of a hospital database, including all patients admitted to the ENT University Hospital Graz after neurological examination, with a diagnosis of peripheral vestibular vertigo and subsequent diagnosis of central nervous infarction as the actual cause for the vertigo. Twelve patients were included in this study. All patients with acute spinning vertigo after a thorough neurological examination and with uneventful computed tomographic scans were referred to our ENT department. Nine of them presented with horizontal nystagmus. Only 1 woman experienced additional hearing loss. The mean diagnostic delay to the definite diagnosis of a central infarction through magnetic resonance imaging was 4 days (SD, 2.3 d). A careful otologic and neurological examination, including the head impulse test and caloric testing, is mandatory. Because ischemic events cannot be diagnosed in computed tomographic scans at an early stage, we strongly recommend to perform cranial magnetic resonance imaging within 48 hours from admission if vertigo has not improved under conservative treatment.

Infection and natural history of emergency department-placed central venous catheters.

Science.gov (United States)

LeMaster, Christopher H; Schuur, Jeremiah D; Pandya, Darshan; Pallin, Daniel J; Silvia, Jennifer; Yokoe, Deborah; Agrawal, Ashish; Hou, Peter C

2010-11-01

Central line-associated bloodstream infection (CLABSI, hereafter referred to in this paper as "bloodstream infection") is a leading cause of hospital-acquired infection. To our knowledge, there are no previously published studies designed to determine the rate of bloodstream infection among central venous catheters placed in the emergency department (ED). We design a retrospective chart review methodology to determine bloodstream infection and duration of catheterization for central venous catheters placed in the ED. Using hospital infection control, administrative, and ED billing databases, we identified patients with central venous catheters placed in the ED between January 1, 2007, and December 31, 2008, at one academic, urban ED with an annual census of 57,000. We performed a structured, explicit chart review to determine duration of catheterization and confirm bloodstream infection. We screened 4,251 charts and identified 656 patients with central venous catheters inserted in the ED, 3,622 catheter-days, and 7 bloodstream infections. The rate of bloodstream infection associated with central venous catheters placed in the ED was 1.93 per 1,000 catheter-days (95% confidence interval 0.50 to 3.36). The mean duration of catheterization was 5.5 days (median 4; range 1 to 29 days). Among infected central venous catheters, the mean duration of catheterization was 8.6 days (median 7; range 2 to 19 days). A total of 667 central venous catheters were placed in the internal jugular (392; 59%), subclavian (145; 22%), and femoral (130; 19%) veins. The sensitivity of using ED procedural billing code for identifying ED-placed central venous catheters among patients subsequently admitted to any ICU was 74.9% (95% confidence interval 71.4% to 78.3%). The rate of ED bloodstream infection at our institution is similar to current rates in ICUs. Central venous catheters placed in the ED remain in admitted patients for a substantial period. Copyright © 2010 American College of

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

International Nuclear Information System (INIS)

Della Valle, A; Santander G; Camejo, N; Spera, G.

2010-01-01

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

Impact of morphologic characteristics of central pulmonary thromboemboli in massive pulmonary embolism.

Science.gov (United States)

Podbregar, Matej; Krivec, Bojan; Voga, Gorazd

2002-09-01

To assess the impact of morphologically different central pulmonary artery thromboemboli in patients with massive pulmonary emboli (MPEs) on short-term outcome. A prospective registry of consecutive patients. An 11-bed closed medical ICU at a 860-bed community general hospital Forty-seven patients with shock or hypotension due to MPE and central pulmonary thromboemboli detected by transesophageal echocardiography who were treated with thrombolysis between January 1994 and April 2000. Patients were divided into two groups according to the following characteristics of the detected thromboemboli: group 1, thrombi with one or more long, mobile parts; and group 2, immobile thrombi. Right heart catheterization was performed. The incidence of both types of thromboemboli was comparable. Groups 1 and 2 showed no differences in demographic data, risk factors for pulmonary embolism, length of preceding clinical symptoms, percentage of patients in shock, hemodynamic variables, serum lactate levels on hospital admission, and treatment. Seven fatal cases due to obstructive shock and right heart failure were present in group 2, but none were present in group 1 (7 of 23 patients vs 0 of 24 patients, respectively; p < 0.05). At 12 h, the cardiac index was lower in group 2 than in group 1 (2.6 +/- 1.0 vs 3.1 +/- 0.9 L/min/m(2), respectively; p < 0.05), and the central venous pressure (15.0 +/- 6.2 vs 12.5 +/- 3.7 mm Hg, respectively; p < 0.05) and total pulmonary resistance (12.9 +/- 5.9 vs 8.6 +/- 2.7 mm Hg/L/min/m(2), respectively; p < 0.001) were higher in group 2 compared to group 1. On hospital admission, inclusion in group 2 (p < 0.03; hazard ratio, 9.53; 95% confidence interval [CI], 1.19 to 76.47) and preexisting chronic medical or neurologic disease (p < 0.01; hazard ratio, 16.4; 95% CI, 1.97 to 136.3) were independent predictors of 30-day mortality. On hospital admission, morphology of the thromboemboli and the presence of pre-existing chronic medical or neurologic disease

Primary cerebral angitis of the central nervous | Das | East African ...

African Journals Online (AJOL)

Various medications like intravenous immunoglobulin, antibiotics, acyclovir, methyl prednisolone and management for raised intracranial pressure were instituted. She rapidly deteroriated and died on tenth hospital day. Only at autopsy was the diagnosis of primary angitis of central nervous system established. East African ...

Recentralization within decentralization: County hospital autonomy under devolution in Kenya

Science.gov (United States)

Manyara, Anthony M.; Molyneux, Sassy; Tsofa, Benjamin

2017-01-01

Background In 2013, Kenya transitioned into a devolved system of government with a central government and 47 semi-autonomous county governments. In this paper, we report early experiences of devolution in the Kenyan health sector, with a focus on public county hospitals. Specifically, we examine changes in hospital autonomy as a result of devolution, and how these have affected hospital functioning. Methods We used a qualitative case study approach to examine the level of autonomy that hospitals had over key management functions and how this had affected hospital functioning in three county hospitals in coastal Kenya. We collected data by in-depth interviews of county health managers and hospital managers in the case study hospitals (n = 21). We adopted the framework proposed by Chawla et al (1995) to examine the autonomy that hospitals had over five management domains (strategic management, finance, procurement, human resource, and administration), and how these influenced hospital functioning. Findings Devolution had resulted in a substantial reduction in the autonomy of county hospitals over the five key functions examined. This resulted in weakened hospital management and leadership, reduced community participation in hospital affairs, compromised quality of services, reduced motivation among hospital staff, non-alignment of county and hospital priorities, staff insubordination, and compromised quality of care. Conclusion Increasing the autonomy of county hospitals in Kenya will improve their functioning. County governments should develop legislation that give hospitals greater control over resources and key management functions. PMID:28771558

Early discharge hospital at home.

Science.gov (United States)

Gonçalves-Bradley, Daniela C; Iliffe, Steve; Doll, Helen A; Broad, Joanna; Gladman, John; Langhorne, Peter; Richards, Suzanne H; Shepperd, Sasha

2017-06-26

Early discharge hospital at home is a service that provides active treatment by healthcare professionals in the patient's home for a condition that otherwise would require acute hospital inpatient care. This is an update of a Cochrane review. To determine the effectiveness and cost of managing patients with early discharge hospital at home compared with inpatient hospital care. We searched the following databases to 9 January 2017: the Cochrane Effective Practice and Organisation of Care Group (EPOC) register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, and EconLit. We searched clinical trials registries. Randomised trials comparing early discharge hospital at home with acute hospital inpatient care for adults. We excluded obstetric, paediatric and mental health hospital at home schemes.   DATA COLLECTION AND ANALYSIS: We followed the standard methodological procedures expected by Cochrane and EPOC. We used the GRADE approach to assess the certainty of the body of evidence for the most important outcomes. We included 32 trials (N = 4746), six of them new for this update, mainly conducted in high-income countries. We judged most of the studies to have a low or unclear risk of bias. The intervention was delivered by hospital outreach services (17 trials), community-based services (11 trials), and was co-ordinated by a hospital-based stroke team or physician in conjunction with community-based services in four trials.Studies recruiting people recovering from strokeEarly discharge hospital at home probably makes little or no difference to mortality at three to six months (risk ratio (RR) 0.92, 95% confidence interval (CI) 0.57 to 1.48, N = 1114, 11 trials, moderate-certainty evidence) and may make little or no difference to the risk of hospital readmission (RR 1.09, 95% CI 0.71 to 1.66, N = 345, 5 trials, low-certainty evidence). Hospital at home may lower the risk of living in institutional setting at six months (RR 0.63, 96% CI

Hospital decentralisation in Romania: stakeholders' perspectives in the newsprint media.

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Popa, Adela Elena

2014-01-01

In the summer of 2010, Romania undertook a process of hospital decentralisation as part of the reform in the healthcare sector. The national newsprint media covered the process thoroughly. This paper is a study of how key stakeholders' views, attitudes, beliefs and attitudes towards decentralisation are represented in print media. 106 articles, published between June and September 2010, retrieved from the online databases of six leading national dailies were analysed. A mixed methodology was used in the data analysis stage. The qualitative data exploration identified five voices belonging to stakeholders involved directly or indirectly in the process: the representatives of central government, the local authorities (district and local councils, municipal mayors), health professionals (managers and physicians in hospitals), the media (journalists, analysts) and finally voices from civil society, professional associations and advocacy groups. These were the main actors negotiating the subjective meanings of the decentralisation process. An imbalance between these key actors were observed in the frequency, content and tone of the messages delivered in media during the four months. Central government and the local authorities were the most active voices, but the respective discourses differed significantly. An analysis of the accounts identified three main themes: the financial problem (hospitals liabilities and future spending), human resource in hospitals (the impact of decentralisation upon it) and the political character of the decentralisation. Copyright © 2013 John Wiley & Sons, Ltd.

National trends in heart failure hospitalization rates in Slovenia 2004-2012.

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Omersa, Daniel; Farkas, Jerneja; Erzen, Ivan; Lainscak, Mitja

2016-11-01

Heart failure (HF) hospitalization rates are decreasing in western Europe, but little is known about trends in central and east European countries. We analysed the Slovenian national hospitalization database to determine the burden of HF hospitalization. The Slovenian National Hospital Discharge Registry was searched for HF hospitalizations between 2004 and 2012 in patients aged ≥20 years. A total of 55 531 main HF hospitalizations (43 636 first HF hospitalizations) in 34 406 patients (median age 78 years, 55% female) were recorded. The most common co-morbidities were arterial hypertension (54.3%), atrial fibrillation (40.6%), diabetes mellitus (24.5%), and ischaemic heart disease (21.9%). The number of age-standardized main and first HF hospitalizations per 100 000 population decreased from 249 to 232 (7.1%, P = 0.002) and from 467 to 435 (6.8%, P = 0.074), respectively. Crude main and first HF hospitalization rates increased from 249 to 298 (19.8%, P Slovenia, standardized HF hospitalization rates have decreased but the crude HF hospitalization burden has increased. Readmissions were associated with established cardiovascular risk factors. © 2016 The Authors. European Journal of Heart Failure © 2016 European Society of Cardiology.

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

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Longhua Hu

2016-08-01

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

A RETROSPECTIVE ANALYSIS OF ACUTE APPENDICITIS, RUPTURED APPENDICITIS AND THE LEVEL OF LEUKOCYTOSIS IN PAEDIATRIC SURGICAL PATIENTS OF NELSON MANDELA CENTRAL HOSPITAL.

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Mtimba, L; Dhaffala, A; Molaoa, S Z

2017-06-01

Appendicectomy is the most commonly performed operation worldwide. The diagnosis is predominantly based on clinical findings. Some patients will clinically be unclear if ruptured or acute inflamed appendicitis; the level of white cell count has been used as the predictor for ruptured appendicitis. This was a retrospective chart review of paediatric surgical patients admitted at Nelson Mandela Central Hospital, Mthatha South Africa. A total of 214 patients with a diagnosis of acute appendicitis. Overall, the ruptured appendicitis was 62% and 38% were inflamed appendicitis. Nature of the acute appendicitis: White cell count, Inflamed, Ruptured, Total p-value 30 0 4 4. This study has demonstrated that in patients who are diagnosed with acute appendicitis clinically, the normal white cell count does not necessarily rule out ruptured acute appendicitis. But the risks of ruptured acute appendicitis increase with the increase level of white cell count.

Reinventing the Hospital – A Study of Lost Synergies in Danish Healthcare

DEFF Research Database (Denmark)

Bekdik, Baris; Thuesen, Christian

2016-01-01

The purpose of this study is to identify the effects of inter organizational relationships in construction projects by investigating how complexities are manifested in variance and repetitions across projects. The case is a set of 27 hospital projects in Denmark including new buildings as well...... project. This lead us to the conclusion that the hospital is reinvented in each project leaving behind unrealized potential for leveraging similarity across the projects. This could have been achieved by a stronger central coordination, thinking of super hospitals as programs and portfolios rather than...

Clinical and radiological characteristics of central pulmonary adenocarcinoma: a comparison with central squamous cell carcinoma and small cell lung cancer and the impact on treatment response

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Wang Z

2018-05-01

Full Text Available Zhe Wang,1,2 Minghuan Li,2 Yong Huang,3 Li Ma,3 Hui Zhu,2 Li Kong,2 Jinming Yu2 1School of Medicine, Shandong University, Jinan, Shandong, China; 2Department of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Jinan, Shandong, China; 3Department of Radiology, Shandong Cancer Hospital Affiliated to Shandong University, Jinan, Shandong, China Purpose: The proportion of central pulmonary adenocarcinoma (ADC in central-type lung cancer has been gradually increasing due to the overall increasing incidence of pulmonary ADC. But the clinical and radiological characteristics of central ADCs remain unclear. In this study, we compared the clinical and radiological characteristics of central ADCs with those of small cell lung cancers (SCLCs and squamous cell carcinomas (SQCCs and investigated the impact of these characteristics on patients’ treatment response. Patients and methods: The medical records of 302 consecutive patients with central lung cancer from July 2014 to September 2016 were retrospectively reviewed. There were 99 patients with ADC, 95 with SQCC and 108 with SCLC. Computed tomography images were interpreted by two radiologists. Treatment response was determined by Response Evaluation Criteria In Solid Tumors 1.1. Results: Univariate analyses found that younger age, female sex, no history of smoking, higher levels of carcinoembryonic antigen (CEA, contralateral hilum lymphadenopathy, contralateral lung metastasis, pleural nodules and pleural metastasis to the interlobular fissure were significantly correlated with central ADC. Multivariate logistic regression analyses revealed that compared with central SQCC, female sex, younger age, no history of smoking, higher levels of CEA and contralateral hilum lymphadenopathy were the significantly independent indicators of central pulmonary ADC. Furthermore, compared with central SCLC, younger age, higher levels of CEA and cytokeratin 19 fragment (Cyfra21-1, lower

Portable Sleep Monitoring for Diagnosing Sleep Apnea in Hospitalized Patients With Heart Failure.

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Aurora, R Nisha; Patil, Susheel P; Punjabi, Naresh M

2018-04-21

Sleep apnea is an underdiagnosed condition in patients with heart failure. Efficient identification of sleep apnea is needed, as treatment may improve heart failure-related outcomes. Currently, use of portable sleep monitoring in hospitalized patients and those at risk for central sleep apnea is discouraged. This study examined whether portable sleep monitoring with respiratory polygraphy can accurately diagnose sleep apnea in patients hospitalized with decompensated heart failure. Hospitalized patients with decompensated heart failure underwent concurrent respiratory polygraphy and polysomnography. Both recordings were scored for obstructive and central disordered breathing events in a blinded fashion, using standard criteria, and the apnea-hypopnea index (AHI) was determined. Pearson's correlation coefficients and Bland-Altman plots were used to examine the concordance among the overall, obstructive, and central AHI values derived by respiratory polygraphy and polysomnography. The sample consisted of 53 patients (47% women) with a mean age of 59.0 years. The correlation coefficient for the overall AHI from the two diagnostic methods was 0.94 (95% CI, 0.89-0.96). The average difference in AHI between the two methods was 3.6 events/h. Analyses of the central and obstructive AHI values showed strong concordance between the two methods, with correlation coefficients of 0.98 (95% CI, 0.96-0.99) and 0.91 (95% CI, 0.84-0.95), respectively. Complete agreement in the classification of sleep apnea severity between the two methods was seen in 89% of the sample. Portable sleep monitoring can accurately diagnose sleep apnea in hospitalized patients with heart failure and may promote early initiation of treatment. Copyright © 2018 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

Centralized vs. Decentralized Nursing Stations: An Evaluation of the Implications of Communication Technologies in Healthcare.

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Bayramzadeh, Sara; Alkazemi, Mariam F

2014-01-01

This study aims to explore the relationship between the nursing station design and use of communication technologies by comparing centralized and decentralized nursing stations. The rapid changes in communication technologies in healthcare are inevitable. Communication methods can change the way occupants use a space. In the meantime, decentralized nursing stations are emerging as a replacement for the traditional centralized nursing stations; however, not much research has been done on how the design of nursing stations can impact the use of communication technologies. A cross sectional study was conducted using an Internet-based survey among registered nurses in a Southeastern hospital in the United States. Two units with centralized nursing stations and two units with decentralized nursing stations were compared in terms of the application of communication technologies. A total of 70 registered nurses completed the survey in a 2-week period. The results revealed no significant differences between centralized and decentralized nursing stations in terms of frequency of communication technologies used. However, a difference was found between perception of nurses toward communication technologies and perceptions of the use of communication technologies in decentralized nursing stations. Although the study was limited to one hospital, the results indicate that nurses hold positive attitudes toward communication technologies. The results also reveal the strengths and weaknesses of each nursing station design with regard to communication technologies. Hospital, interdisciplinary, nursing, technology, work environment.

The association of debt financing with not-for-profit hospitals' provision of uncompensated care.

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Magnus, Stephen A; Smith, Dean G; Wheeler, John R C

2004-01-01

Not-for-profit hospitals undertook unprecedented amounts of debt in the mid to late 1990s. Corporate finance theory and the literature on hospital financing suggest that debt may constrain hospitals' capacity to deliver uncompensated care. Using data from audited financial statements for a sample of hospitals, this article explores whether debt financing is associated with hospitals' provision of uncompensated care, an output central to many hospitals' service missions. Contrary to expectations, our analysis finds that higher debt is associated with higher levels of uncompensated care. However, the results may reflect the unusual economic and stock-market conditions prevailing in the mid 1990s, and they are consistent with the views of hospital financial managers and other practitioners whom we interviewed.

Pattern and Management of Priapism in a Tertiary Hospital of North ...

African Journals Online (AJOL)

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COSECSA/ASEA Publication --East & Central African Journal of Surgery 2017; Vol. 22 (1) ... Hospital of North- Western Nigeria ... In Western world, ischaemic priapism is .... This difference can be accounted for by the late presentation in.

Pancreatic Enzyme Replacement Therapy in Children with Severe Acute Malnutrition: A Randomized Controlled Trial.

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Bartels, Rosalie H; Bourdon, Céline; Potani, Isabel; Mhango, Brian; van den Brink, Deborah A; Mponda, John S; Muller Kobold, Anneke C; Bandsma, Robert H; Boele van Hensbroek, Michael; Voskuijl, Wieger P

2017-11-01

To assess the benefits of pancreatic enzyme replacement therapy (PERT) in children with complicated severe acute malnutrition. We conducted a randomized, controlled trial in 90 children aged 6-60 months with complicated severe acute malnutrition at the Queen Elizabeth Central Hospital in Malawi. All children received standard care; the intervention group also received PERT for 28 days. Children treated with PERT for 28 days did not gain more weight than controls (13.7 ± 9.0% in controls vs 15.3 ± 11.3% in PERT; P = .56). Exocrine pancreatic insufficiency was present in 83.1% of patients on admission and fecal elastase-1 levels increased during hospitalization mostly seen in children with nonedematous severe acute malnutrition (P Children who died had low fecal fatty acid split ratios at admission. Exocrine pancreatic insufficiency was not improved by PERT, but children receiving PERT were more likely to be discharged with every passing day (P = .02) compared with controls. PERT does not improve weight gain in severely malnourished children but does increase the rate of hospital discharge. Mortality was lower in patients on PERT, a finding that needs to be investigated in a larger cohort with stratification for edematous and nonedematous malnutrition. Mortality in severe acute malnutrition is associated with markers of poor digestive function. ISRCTN.com: 57423639. Copyright © 2017 Elsevier Inc. All rights reserved.

Factors driving physician-hospital alignment in orthopaedic surgery.

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Page, Alexandra E; Butler, Craig A; Bozic, Kevin J

2013-06-01

The relationships between physicians and hospitals are viewed as central to the proposition of delivering high-quality health care at a sustainable cost. Over the last two decades, major changes in the scope, breadth, and complexities of these relationships have emerged. Despite understanding the need for physician-hospital alignment, identification and understanding the incentives and drivers of alignment prove challenging. Our review identifies the primary drivers of physician alignment with hospitals from both the physician and hospital perspectives. Further, we assess the drivers more specific to motivating orthopaedic surgeons to align with hospitals. We performed a comprehensive literature review from 1992 to March 2012 to evaluate published studies and opinions on the issues surrounding physician-hospital alignment. Literature searches were performed in both MEDLINE(®) and Health Business™ Elite. Available literature identifies economic and regulatory shifts in health care and cultural factors as primary drivers of physician-hospital alignment. Specific to orthopaedics, factors driving alignment include the profitability of orthopaedic service lines, the expense of implants, and issues surrounding ambulatory surgery centers and other ancillary services. Evolving healthcare delivery and payment reforms promote increased collaboration between physicians and hospitals. While economic incentives and increasing regulatory demands provide the strongest drivers, cultural changes including physician leadership and changing expectations of work-life balance must be considered when pursuing successful alignment models. Physicians and hospitals view each other as critical to achieving lower-cost, higher-quality health care.

Central African Journal of Medicine - Vol 61, No 1-4 (2015)

African Journals Online (AJOL)

Etiology and risk factors of meningitis in patients admitted at a Central Hospital ... rupture of the Achilles tendon in a rat model · EMAIL FULL TEXT EMAIL FULL TEXT ... An echocardiography audit to determine and characterise rheumatic heart ...

Tuberculosis patients hospitalized in the Albert Schweitzer Hospital, Lambaréné, Gabon-a retrospective observational study.

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Stolp, S M; Huson, M A M; Janssen, S; Beyeme, J O; Grobusch, M P

2013-11-01

Epidemiological data on tuberculosis in Central Africa are limited. We performed a retrospective observational study on clinical characteristics of 719 hospitalized tuberculosis patients in Lambaréné, Gabon. Human immunodeficiency virus (HIV) co-infection rate was high (34%) and in-hospital mortality was significantly higher in HIV-positive patients (10% versus 2%). Long-term information on patient outcome was limited; however, from 2008 to 2011, loss to follow up was noted in 28% of cases. Our data illustrate the high burden of TB in Gabon, where loss to follow up and emerging drug resistance are important problems for which comprehensive data are still lacking. © 2013 The Authors Clinical Microbiology and Infection © 2013 European Society of Clinical Microbiology and Infectious Diseases.

Evaluation of Etiology and Treatment Methods for Epistaxis: A Review at a Tertiary Care Hospital in Central Nepal

Science.gov (United States)

2015-01-01

Introduction. Epistaxis is one of the most common emergencies in Otorhinolaryngology. It is usually managed with simple conservative measures but occasionally it is a life threatening condition. Identification of the cause is important, as it reflects the management plan being followed. Aims and Objectives. To analyze the etiology and treatment methods for patients with epistaxis. Methods. A retrospective study was done in a tertiary care hospital in central Nepal. The study period was from May 2014 to April 2015. Results. A total of 84 patients had epistaxis; 52 were males and 32 were females. The most common cause of epistaxis was idiopathic (38.09%) followed by hypertension (27.38%), trauma (15.47%), and coagulopathy (8.33%). Regarding treatment methods, most (52.38%) of our patients required anterior nasal packing. Chemical cautery was sufficient to stop bleeding in 14.28% of patients while electrocautery and posterior nasal packing were performed in 2.38% and 16.66% patients, respectively. Two (2.38%) patients required endoscopic sphenopalatine arterial ligation. Conclusion. Hypertension, trauma and coagulopathy were the most common etiological factors among the patients in whom etiology was found although in most of the patients etiology could not be found. Anterior nasal packing was the most common treatment method applied to these patients. PMID:26346242

Evaluation of Etiology and Treatment Methods for Epistaxis: A Review at a Tertiary Care Hospital in Central Nepal.

Science.gov (United States)

Parajuli, Ramesh

2015-01-01

Introduction. Epistaxis is one of the most common emergencies in Otorhinolaryngology. It is usually managed with simple conservative measures but occasionally it is a life threatening condition. Identification of the cause is important, as it reflects the management plan being followed. Aims and Objectives. To analyze the etiology and treatment methods for patients with epistaxis. Methods. A retrospective study was done in a tertiary care hospital in central Nepal. The study period was from May 2014 to April 2015. Results. A total of 84 patients had epistaxis; 52 were males and 32 were females. The most common cause of epistaxis was idiopathic (38.09%) followed by hypertension (27.38%), trauma (15.47%), and coagulopathy (8.33%). Regarding treatment methods, most (52.38%) of our patients required anterior nasal packing. Chemical cautery was sufficient to stop bleeding in 14.28% of patients while electrocautery and posterior nasal packing were performed in 2.38% and 16.66% patients, respectively. Two (2.38%) patients required endoscopic sphenopalatine arterial ligation. Conclusion. Hypertension, trauma and coagulopathy were the most common etiological factors among the patients in whom etiology was found although in most of the patients etiology could not be found. Anterior nasal packing was the most common treatment method applied to these patients.

Evaluation of Etiology and Treatment Methods for Epistaxis: A Review at a Tertiary Care Hospital in Central Nepal

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Ramesh Parajuli

2015-01-01

Full Text Available Introduction. Epistaxis is one of the most common emergencies in Otorhinolaryngology. It is usually managed with simple conservative measures but occasionally it is a life threatening condition. Identification of the cause is important, as it reflects the management plan being followed. Aims and Objectives. To analyze the etiology and treatment methods for patients with epistaxis. Methods. A retrospective study was done in a tertiary care hospital in central Nepal. The study period was from May 2014 to April 2015. Results. A total of 84 patients had epistaxis; 52 were males and 32 were females. The most common cause of epistaxis was idiopathic (38.09% followed by hypertension (27.38%, trauma (15.47%, and coagulopathy (8.33%. Regarding treatment methods, most (52.38% of our patients required anterior nasal packing. Chemical cautery was sufficient to stop bleeding in 14.28% of patients while electrocautery and posterior nasal packing were performed in 2.38% and 16.66% patients, respectively. Two (2.38% patients required endoscopic sphenopalatine arterial ligation. Conclusion. Hypertension, trauma and coagulopathy were the most common etiological factors among the patients in whom etiology was found although in most of the patients etiology could not be found. Anterior nasal packing was the most common treatment method applied to these patients.

HOW COULD HOSPITALS ACT IN AN AGEING SOCIETY?

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Leuca Mirela

2011-12-01

Full Text Available The demographic changes are of great importance for all European societies. Their impact and effects have multiple, deep facets. Each European healthcare and welfare system will be facing considerable changes in the new demographic context. The hospital sector plays an important role in each health system. This paper focuses on the impact of the demographic changes on hospitals, presents and analyzes statistical data for the German hospitals sector in order to underline the importance of the older age groups for the number of the hospital inpatient cases, the provided range of medical services and disciplines and for the hospital disease costs. The paper also reveals main findings from 30 interviews conducted in 2010 with German health experts (from hospitals, health insurance companies, universities, institutes and regional healthcare policy makers that accepted to answer questions referring to the demographic impact on the German healthcare system and hospital sector. The results of the interviews show that hospitals will have to act and react to the demographic changes. German hospitals might play different roles in the healthcare service provision for older people when engaging in new models of integrated care that will have to be developed. Processes, structures, human resources expertise, hospital service provision and medical departments will undergo major changes in response to the demographic challenges. Networks, centres of excellence for older persons and integrated care will probably be indispensable structures of the German healthcare system in the future. Strategic partnerships with pre- and post-hospital healthcare service providers are considered to be top priorities for German hospitals when facing the demographic challenge. Central case management and process optimization can be essential factors of success in the hospital care of the older, multimorbid patients. Acute geriatric medicine will be a main quality feature for the

The market for hospital medicine in Denmark

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Gisela Hostenkamp

2011-11-01

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

Drug adherence behavior among hypertensive out-patients at a tertiary health institution in Manicaland province, Zimbabwe, 2011

OpenAIRE

Mukora-Mutseyekwa, Fadzai NN; Chadambuka, Elizabeth M

2013-01-01

Fadzai NN Mukora-Mutseyekwa, Elizabeth M ChadambukaFaculty of Health Sciences, Africa University, Mutare, ZimbabweObjectives: This study investigated the level of drug adherence among hypertensive outpatients at a tertiary hospital in Zimbabwe. Specific objectives included measurement of blood pressure (BP) control achievement, estimating prevalence of drug adherence behavior, and establishing the association between drug adherence behavior and achievement of BP control.Methods and materials:...

Using central venous catheter for suprapubic catheterization in cardiac surgery

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Bilehjani E

2017-01-01

Full Text Available Eissa Bilehjani,1 Solmaz Fakhari2 1Department of Cardiovascular Anesthesia, Tabriz University of Medical Sciences, Madani Heart Hospital, 2Department of Anesthesiology, Tabriz University of Medical Sciences, Madani Heart Hospital, Tabriz, Iran Abstract: Suprapubic catheterization is an alternative method for urinary drainage that is used when transurethral catheterization fails. Traditionally, inserted large-bore suprapubic catheters may cause fatal complications. During the past decade, we used a small central venous catheter (CVC suprapubicly in 16 male patients for the purpose of urinary drainage, when transurethral catheterization failed. The procedure is performed in no more than 10 minutes. Success rate was 100% and this approach did not lead to any complications. In conclusion, placing a CVC for suprapubic drainage is a safe method with a high success rate and we recommend it in patients with failed transurethral catheterization after a few attempts (2–3 attempts. Keywords: suprapubic catheterization complication, urethral catheterization, central venous catheter, Seldinger’s technique, cardiac surgery

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

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Graziella Gasparotto Baiocco

2010-12-01

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

Varicella-related Primary Health-care Visits, Hospitalizations and Mortality in Norway, 2008-2014.

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Mirinaviciute, Grazina; Kristensen, Erle; Nakstad, Britt; Flem, Elmira

2017-11-01

Norway does not currently implement universal varicella vaccination in childhood. We aimed to characterize health care burden of varicella in Norway in the prevaccine era. We linked individual patient data from different national registries to examine varicella vaccinations and varicella-coded primary care consultations, hospitalizations, outpatient hospital visits, deaths and viral infections of central nervous system in the whole population of Norway during 2008-2014. We estimated health care contact rates and described the epidemiology of medically attended varicella infection. Each year approximately 14,600 varicella-related contacts occurred within primary health care and hospital sector in Norway. The annual contact rate was 221 cases per 100,000 population in primary health care and 7.3 cases per 100,000 in hospital care. Both in primary and hospital care, the highest incidences were observed among children 1 year of age: 2,654 and 78.1 cases per 100,000, respectively. The annual varicella mortality was estimated at 0.06 deaths per 100,000 and in-hospital case-fatality rate at 0.3%. Very few (0.2-0.5%) patients were vaccinated against varicella. Among hospitalized varicella patients, 22% had predisposing conditions, 9% had severe-to-very severe comorbidities and 5.5% were immunocompromised. Varicella-related complications were reported in 29.3% of hospitalized patients. Varicella zoster virus was the third most frequent virus found among 16% of patients with confirmed viral infections of central nervous system. Varicella causes a considerable health care burden in Norway, especially among children. To inform the policy decision on the use of varicella vaccination, a health economic assessment of vaccination and mathematical modeling of vaccination impact are needed.

The effect of centralization of health care services on travel time and its equality.

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Kobayashi, Daisuke; Otsubo, Tetsuya; Imanaka, Yuichi

2015-03-01

To analyze the regional variations in travel time between patient residences and medical facilities for the treatment of ischemic heart disease and breast cancer, and to simulate the effects of health care services centralization on travel time and equality of access. We used medical insurance claims data for inpatients and outpatients for the two target diseases that had been filed between September 2008 and May 2009 in Kyoto Prefecture, Japan. Using a geographical information system, patient travel times were calculated based on the driving distance between patient residences and hospitals via highways and toll roads. Locations of residences and hospital locations were identified using postal codes. We then conducted a simulation analysis of centralization of health care services to designated regional core hospitals. The simulated changes in potential spatial access to care were examined. Inequalities in access to care were examined using Gini coefficients, which ranged from 0.4109 to 0.4574. Simulations of health care services centralization showed reduced travel time for most patients and overall improvements in equality of access, except in breast cancer outpatients. Our findings may contribute to the decision-making process in policies aimed at improving the potential spatial access to health care services. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

The mission of the well-managed community hospital.

Science.gov (United States)

Griffith, J R

1988-07-01

The well-managed community hospital as an organization is in dynamic equilibrium with its geographic community and with other communities providing finance, physicians, nurses, other professionals and resources necessary to meet local health care needs. The hospital is "well-managed" when it develops an equilibrium that permits all of its various constituencies to be satisfied. Growth in market share results from good management. The hospital's ability to attract and satisfy the needs of health care professionals while simultaneously meeting the needs of patients and their families at competitive prices allows it to flourish. Its financial success allows it to reward its medical staff and employees in ways that attract the best of each work group. A central problem in achieving good management is communication. Hospitals must communicate their goals convincingly to a large number of doctors and employees. "The Well-Managed Community Hospital," winner of the James A. Hamilton Hospital Administration Book Award, argues that a well-structured mission statement is the essential first step in the communications process. According to the book, final responsibility for the mission statement lies with the governing board and is one of five non-delegable functions of the board. The nature of the mission setting function as described in the book follows.

Learning to deal with psychosocial strains at hospitals

DEFF Research Database (Denmark)

Hvid, Helge Søndergaard; Hagedorn-Rasmussen, Peter; Lund, Henrik Lambrecht

This paper examines the psychosocial work environment in the hospital sector from a learning perspective. The paper is based on case studies in the Danish hospital system, characterized by professionalism, centralized management and constant organizational change. In all cases, the psychosocial...... and employees in the individual departments must learn to cope with the stress imposed. Learning-related concepts are found to be suitable for analysing how they actually do cope locally. However, these concepts not only pave the way for an analysis. They also open for reflection, interpretations and learning...... at the work site as a result of the incremental practice intervention. This might have a positive effect in reducing psychosocial stress. The paper focuses on one of the cases – a specialized hospital section with approx. 400 employees. It is investigated how learning-related activities, studied through three...

East and Central African Journal of Surgery http://www.bioline.org.br ...

African Journals Online (AJOL)

Patrick

populations in Asia, far-east, and North America. By far reported cases ... Zomba Central hospital with long standing history of a giant scalp cutenous horn for about 28 years .Excision ... educative pathologies goes under reported. Case Report.

Risk factors for common cancers among patients at Kamuzu Central ...

African Journals Online (AJOL)

Background: Little is known about risk factors for different cancers in Malawi. This study aimed to assess risk factors for and epidemiologic patterns of common cancers among patients treated at Kamuzu Central Hospital (KCH) in Lilongwe, and to determine the prevalence of Human Immunodeficiency Virus (HIV) infection in ...

Relationship between organizational structure and creativity in teaching hospitals.

Science.gov (United States)

Rezaee, Rita; Marhamati, Saadat; Nabeiei, Parisa; Marhamati, Raheleh

2014-07-01

Organization structure and manpower constitute two basic components of anorganization and both are necessary for stablishing an organization. The aim of this survey was to investigate the type of the organization structure (mechanic and organic) from viewpoint of senior and junior managers in Shiraz teaching hospitals and creativity in each of these two structures. In this cross-sectional and descriptive-analytic study, organization structure and organizational creation questionnaires were filled out by hospital managers. According to the statistical consultation and due to limited target population, the entire study population was considered as sample. Thus, the sample size in this study was 84 (12 hospitals and every hospital, n = 7). For data analysis, SPSS 14 was used and Spearman correlation coefficient and t-test were used. RESULTS showed that there is a negative association between centralization and complexity with organizational creation and its dimensions. Also there was a negative association between formalization and 4 organizational creation dimensions: reception change, accepting ambiguity, abet new view and less control outside (p=0.001). The results of this study showed that the creation in hospitals with organic structure is more than that in hospitals with mechanic structure.

Construction and Application of a Refined Hospital Management Chain.

Science.gov (United States)

Yi, Lihua; Hao, Aimin; Hu, Minmin; Huang, Pei; Yuan, Huikang; Xing, Ming

2015-05-01

Gaining large scale success was quite common in the later period of industrialization for hospitals in China. Today, Chinese hospital management face such problems as service inefficiency, high human resources cost, and low rate of capital use. This study analyzes the refined management chain of the Wuxi No. 2 People's Hospital. This consists of six gears namely "organizational structure, clinical practice, outpatient service, medical technology, and nursing care and logistics" used to achieve maximum scale and benefits. The gears are based on "flat management system targets, chief of medical staff, centralized outpatient service, intensified medical examinations, vertical nursing management and socialized logistics". The hospital took innovative measures. The "one doctor-one patient-one clinic" was well accepted; "one dispensary" shorten the waiting time by 20 min. The 168 rear service hot line "made patients' lives easier; and a red wrist ribbon" for seriously ill patient was implemented to prioritize medical treatment. The core concepts of refined hospital management are optimizing flow process, reducing waste, improving efficiency, saving costs, and taking good care of patients as most important.

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

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Tamar Akhvlediani

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

Etiologic Agents of Central Nervous System Infections among Febrile Hospitalized Patients in the Country of Georgia

Science.gov (United States)

Akhvlediani, Tamar; Bautista, Christian T.; Shakarishvili, Roman; Tsertsvadze, Tengiz; Imnadze, Paata; Tatishvili, Nana; Davitashvili, Tamar; Samkharadze, Tamar; Chlikadze, Rusudan; Dvali, Natia; Dzigua, Lela; Karchava, Mariam; Gatserelia, Lana; Macharashvili, Nino; Kvirkvelia, Nana; Habashy, Engy Emil; Farrell, Margaret; Rowlinson, Emily; Sejvar, James; Hepburn, Matthew; Pimentel, Guillermo; Dueger, Erica; House, Brent; Rivard, Robert

2014-01-01

Objectives There is a large spectrum of viral, bacterial, fungal, and prion pathogens that cause central nervous system (CNS) infections. As such, identification of the etiological agent requires multiple laboratory tests and accurate diagnosis requires clinical and epidemiological information. This hospital-based study aimed to determine the main causes of acute meningitis and encephalitis and enhance laboratory capacity for CNS infection diagnosis. Methods Children and adults patients clinically diagnosed with meningitis or encephalitis were enrolled at four reference health centers. Cerebrospinal fluid (CSF) was collected for bacterial culture, and in-house and multiplex RT-PCR testing was conducted for herpes simplex virus (HSV) types 1 and 2, mumps virus, enterovirus, varicella zoster virus (VZV), Streptococcus pneumoniae, HiB and Neisseria meningitidis. Results Out of 140 enrolled patients, the mean age was 23.9 years, and 58% were children. Bacterial or viral etiologies were determined in 51% of patients. Five Streptococcus pneumoniae cultures were isolated from CSF. Based on in-house PCR analysis, 25 patients were positive for S. pneumoniae, 6 for N. meningitidis, and 1 for H. influenzae. Viral multiplex PCR identified infections with enterovirus (n = 26), VZV (n = 4), and HSV-1 (n = 2). No patient was positive for mumps or HSV-2. Conclusions Study findings indicate that S. pneumoniae and enteroviruses are the main etiologies in this patient cohort. The utility of molecular diagnostics for pathogen identification combined with the knowledge provided by the investigation may improve health outcomes of CNS infection cases in Georgia. PMID:25369023

Evidence of tuberculosis among children in medieval (13th–15th century Wrocław: A case study of hip joint tuberculosis in a juvenile skeleton excavated from the crypt of the St. Elizabeth church

Directory of Open Access Journals (Sweden)

Cieślik Agata Izabela

2017-06-01

Full Text Available Paleopathological examinations of the skeletal remains of people who died centuries ago are material source of knowledge about health and diseases in the past. In this article, a case of skeletal tuberculosis from historical (13th-15th c. Wrocław, Poland has been presented. The juvenile skeleton excavated from grave No 93, from the crypt located under the church of St. Elizabeth, displayed pathological lesions within the right hip joint resulting from a chronic inflammation, which might have been assigned to signs typical for skeletal tuberculosis. The results of macroscopic and radiological analyses appeared to be consistent, and allowed to determine a reliable diagnosis of this paleopathological case.

Comparison of blood loss between using non central part cutting knee prosthesis and distal central part cutting.

Science.gov (United States)

Malairungsakul, Anan

2014-12-01

Patients who undergo knee replacement surgery may need to receive a blood transfusion due to blood loss during the operation. Therefore it was important to improve the design of knee implant operative procedures in an attempt to reduce the rate of blood loss. The present study aimed to compare the blood loss between two types of knee replacement surgery. This is a retrospective study in which 78 patients received cemented knee replacements in Phayao Hospital between October 2010 and March 2012. There were two types of surgical procedure: 1) using an implant position covering the end of the femoral bone without cutting into the central part of the distal femoral, 2) using an implant position covering the end of the femoral bone cutting the central part of the distal femoral. Blood loss, blood transfusion, hemoglobin and hematocrit were recorded preoperatively, immediately postsurgery and 48 hours after surgery. Findings revealed that the knee replacement surgery using the implant position covering the end of the femoral bone without cutting the central part of the distal femoral significantly lowered the rate of blood loss when compared to using the implant position covering the end of the femoral bone with central cutting of the distal femor. The average blood loss during the operation without cutting at the central part of distal femoral was 49.50 ± 11.11 mL; whereas the operation cutting the central part of the distal femoral was 58.50 ± 11.69 mL. As regards blood loss, the knee replacement surgery using the implant position covering the end ofthefemoral bone without cutting the central part of distal femor was better than using the implant position covering the end of the femoral bone cutting at the central part of the distal femor.

Cells in the Body Politic: Social identity and hospital construction in Peronist Argentina

Directory of Open Access Journals (Sweden)

J Hagood

2012-09-01

Full Text Available This article examines the critical role played by social identity in the construction of hospitals in the Argentine health care sector during the 1940s and 1950s by uncovering the way in which the “jungle” of hospitals withstood attempts by the state to apply some sense of order, purpose, and centralized organization. The first section examines how physicians envisioned the “modern” hospital they hoped to construct. The second section reveals the important antecedents of nationalized hospitalization schemes found in the collaboration between physicians’ unions and the state. In the third section, an analysis of political speeches illuminates how Juan and Evita Perón packaged new hospitals as gifts to the people from their leader. The fourth section outlines specific plans to increase the number of hospital beds. The final section surveys examples of hospital construction to demonstrate how sub-national identities were instrumental to fragmenting both Argentine society and its hospital infrastructure.

Fecundity as a biomarker of health? - Semen quality and subsequent hospitalization

DEFF Research Database (Denmark)

Lindahl-Jacobsen, Rune; Latif, Tabassam; Skakkebæk, Niels Erik

. Men with a low total sperm count had a 50% higher risk of first hospitalization from all causes of disease (95%CI: 1.4-1.6). The higher risk of hospitalization was robust across disease categories and not confined to specific diseases. A man with low sperm concentration (0-10 mill/ml) had an average...... Hospital Discharge Registry for hospitalizations and the Central Person Registry to obtain information on vital status and childhood status. A clear dose - response relationship between semen quality (total sperm count, sperm concentration or sperm motility) and survival was observed in both cohorts...... data from two unique Danish cohorts; The Copenhagen Sperm Analysis Laboratory and the Fertility Clinic - Frederiksberg Hospital. In total, semen samples from 51,543 and 4,712 men from the two cohorts respectively for the period 1963-2010 was used for the analysis. The data was linked to the Danish...

Using database reports to reduce workplace violence: Perceptions of hospital stakeholders.

Science.gov (United States)

Arnetz, Judith E; Hamblin, Lydia; Ager, Joel; Aranyos, Deanna; Essenmacher, Lynnette; Upfal, Mark J; Luborsky, Mark

2015-01-01

Documented incidents of violence provide the foundation for any workplace violence prevention program. However, no published research to date has examined stakeholders' preferences for workplace violence data reports in healthcare settings. If relevant data are not readily available and effectively summarized and presented, the likelihood is low that they will be utilized by stakeholders in targeted efforts to reduce violence. To discover and describe hospital system stakeholders' perceptions of database-generated workplace violence data reports. Eight hospital system stakeholders representing Human Resources, Security, Occupational Health Services, Quality and Safety, and Labor in a large, metropolitan hospital system. The hospital system utilizes a central database for reporting adverse workplace events, including incidents of violence. A focus group was conducted to identify stakeholders' preferences and specifications for standardized, computerized reports of workplace violence data to be generated by the central database. The discussion was audio-taped, transcribed verbatim, processed as text, and analyzed using stepwise content analysis. Five distinct themes emerged from participant responses: Concerns, Etiology, Customization, Use, and Outcomes. In general, stakeholders wanted data reports to provide ``the big picture,'' i.e., rates of occurrence; reasons for and details regarding incident occurrence; consequences for the individual employee and/or the workplace; and organizational efforts that were employed to deal with the incident. Exploring stakeholder views regarding workplace violence summary reports provided concrete information on the preferred content, format, and use of workplace violence data. Participants desired both epidemiological and incident-specific data in order to better understand and work to prevent the workplace violence occurring in their hospital system.

The central Iowa project.

Science.gov (United States)

Allen, H M

1994-10-01

This project developed and tested a population-based survey, the HS Form, to examine health and health care in the Central Iowa community. Data from this new collection of proven sets of items were used to compare competing health plans, doctor offices, hospitals, and to develop preliminary norms of the community's insured, in two areas: system performance and health burden. The results showed that the survey: (1) was both feasible and efficient in delivering a comprehensive and generic assessment of consumers and patients; (2) revealed consistent, noteworthy differences between plans and between providers across both sets of criteria; and (3) indicated that there is substantial room for improvement in Central Iowa's health care delivery system from the public's perspective. Recommendations for next steps include: (1) following through on the June 1993 community forum (held to discuss the project's methods and results with local decision makers); (2) broadening the evaluation design to increase sample representativeness; and (3) implementing a pre/post approach to measure changes in plan and provider performance.

Central de producción de calor - Madrid – España

Directory of Open Access Journals (Sweden)

Laorden Jiménez, J.

1973-10-01

Full Text Available The Heat Production Station of the University City Hospital in Madrid is described, after several years operation. The Station is equipped for an output of 13,000,000 kcal/hr, for heating; 1,000,000 kcal/hr, for hospital hot water, and 3,200,000 kcal/hr, for steam at 5 kp/cm2. The different alternatives are presented and the general outline of the solution chosen, as well as a comprehensive list of the materials used.Se describe la Central de Producción de Calor del Hospital Clínico de la Ciudad Universitaria de Madrid, después de algunos años de funcionamiento. La Central está preparada para una producción de 13.000.000 de kcal/h, para calefacción; 1.000.000 de kilocalorías/h, para agua caliente sanitaria, y 3.200.000 kcal/h, para vapor a 5 kp/cm2. Se presentan las diversas alternativas y el esquema general de la solución elegida, así como una extensa relación de ios materiales empleados.

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

Science.gov (United States)

Giraldes, Maria Do Rosário

2007-01-01

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

Audit of appendicectomies at Frere Hospital | Rogers | South African ...

African Journals Online (AJOL)

Objective. We sought to evaluate the surgical service in the central part of the Eastern Cape Province by reviewing the practice of appendicectomy at Frere Hospital. Specifically, it was our aim to compare the service to those patients who reside in and outside the East London metropolitan area and the outcomes of patients ...

Repurposing Waste Streams: Lessons on Integrating Hospital Food Waste into a Community Garden.

Science.gov (United States)

Galvan, Adri M; Hanson, Ryan; George, Daniel R

2018-04-06

There have been increasing efforts in recent decades to divert institutional food waste into composting programs. As major producers of food waste who must increasingly demonstrate community benefit, hospitals have an incentive to develop such programs. In this article, we explain the emerging opportunity to link hospitals' food services to local community gardens in order to implement robust composting programs. We describe a partnership model at our hospital in central Pennsylvania, share preliminary outcomes establishing feasibility, and offer guidance for future efforts. We also demonstrate that the integration of medical students in such efforts can foster systems thinking in the development of programs to manage hospital waste streams in more ecologically-friendly ways.

Outsourced central archiving: an information bridge in a multi-IMAC environment

Science.gov (United States)

Gustavsson, Staffan; Tylen, Ulf; Carlsson, Goeran; Angelhed, Jan-Erik; Wintell, Mikael; Helmersson, Roger; Norrby, Clas

2001-08-01

In 1998 three hospitals merged to form the Sahlgrenska University Hospital. The total radiology production became 325 000 examinations per year. Two different PACS and RIS with different and incompatible archiving solutions were used since 1996. One PACS had commercial origin and the other was developed inhouse. Together they managed 1/3 of the total production. Due to differences in standard compliance and system architecture the communication was unsatisfactory. In order to improve efficiency, communication and the service level to our customers the situation was evaluated. It was decided to build a transparent virtual radiology department based on a modular approach. A common RIS and a central DICOM image archive as the central nodes in a star configured system were chosen. Web technique was chosen as the solution for distribution of images and reports. The reasons for the decisions as well as the present status of the installation are described and discussed is this paper.

Loiasis in a Japanese Traveler Returning from Central Africa

Science.gov (United States)

Kobayashi, Tetsuro; Hayakawa, Kayoko; Mawatari, Momoko; Itoh, Makoto; Akao, Nobuaki; Yotsu, Rie R.; Sugihara, Jun; Takeshita, Nozomi; Kutsuna, Satoshi; Fujiya, Yoshihiro; Kanagawa, Shuzo; Ohmagari, Norio; Kato, Yasuyuki

2015-01-01

We encountered a probable case of loiasis in a returned traveler from Central Africa. A 52-year-old Japanese woman presented to our hospital complaining of discomfort in her eyes and skin. She reported having frequently visited Central Africa over many years and having been extensively exposed to the rainforest climate and ecosystem. Although no microfilariae were found in her blood, there was an elevated level of IgG antibodies against the crude antigens of Brugia pahangi, which have cross-reactivity with Loa loa. She was treated with albendazole for 21 days, after which the antigen-specific IgG level decreased and no relapse occurred. PMID:26161033

Access to facility delivery and caesarean section in north-central Liberia: a cross-sectional community-based study

Science.gov (United States)

Gartland, Matthew G; Taryor, Victor D; Norman, Andy M; Vermund, Sten H

2012-01-01

Objective Rural north-central Liberia has one of the world's highest maternal mortality ratios. We studied health facility birthing service utilisation and the motives of women seeking or not seeking facility-based care in north-central Liberia. Design Cross-sectional community-based structured interviews and health facility medical record review. Setting A regional hospital and the surrounding communities in rural north-central Liberia. Participants A convenience sample of 307 women between 15 and 49 years participated in structured interviews. 1031 deliveries performed in the regional hospital were included in the record review. Primary outcomes Delivery within a health facility and caesarean delivery rates were used as indicators of direct utilisation of care and as markers of availability of maternal health services. Results Of 280 interview respondents with a prior childbirth, only 47 (16.8%) delivered their last child in a health facility. Women who did not use formal services cited cost, sudden labour and family tradition or religion as their principal reasons for home delivery. At the regional hospital, the caesarean delivery rate was 35.5%. Conclusions There is an enormous unmet need for maternal health services in north-central Liberia. Greater outreach and referral services as well as community-based education among women, family members and traditional midwives are vital to improve the timely utilisation of care. PMID:23117566

High Tech for Milady's Makeup

Science.gov (United States)

1985-01-01

"Elizabeth," a computerized beauty analysis system marketed by Elizabeth Arden, is based upon an ARAC data base search of technologies measuring skin profiles. * "Elizabeth" is no longer commercially available.

Knowledge, Attitude, and Perception of Barriers for Eye Care among Diabetic Persons Registered at Employee Health Department of a Tertiary Eye Hospital of Central Saudi Arabia

Science.gov (United States)

Al-Alawi, Abeer; Al-Hassan, Arif; Chauhan, Deepti; Al-Futais, Muneera; Khandekar, Rajiv

2016-01-01

Purpose: To evaluate the level of knowledge, attitudes, and barriers to diabetic retinopathy (DR) screening among diabetic healthcare staff at a tertiary eye hospital in central Saudi Arabia. Methods: This was a descriptive survey using a closed-ended questionnaire. A. 5-grade. Likert scale was used for responses to each question. Data were collected on patient demographics and the status of diabetes. Survey responses related to knowledge, attitude, and barriers were grouped. Results: The study sample was comprised of 45 diabetics employed at the hospital. The mean age was 49 ± 11 years and 33 diabetics were males. One-third of the study population was referred to the eye clinic for DR screening. DR screening was performed in 25% of diabetics over the previous year. Twenty-nine (64%; 95% confidence intervals: 50–78) participants had excellent knowledge of eyecare for diabetic complications. Thirteen percent of participants had a positive attitude toward periodic eye checkups. Travel distance to an eyecare unit, no referral from family physicians for annual eye checkups and the lack of availability of gender-specific eyecare professionals were the main perceived barriers. Conclusion: Annual DR screening needs to be promoted to primary healthcare providers and diabetic patients. Barriers should be addressed to improve the uptake of DR screening. PMID:26957842

Knowledge, Attitude, and Perception of Barriers for Eye Care among Diabetic Persons Registered at Employee Health Department of a Tertiary Eye Hospital of Central Saudi Arabia.

Science.gov (United States)

Al-Alawi, Abeer; Al-Hassan, Arif; Chauhan, Deepti; Al-Futais, Muneera; Khandekar, Rajiv

2016-01-01

To evaluate the level of knowledge, attitudes, and barriers to diabetic retinopathy (DR) screening among diabetic healthcare staff at a tertiary eye hospital in central Saudi Arabia. This was a descriptive survey using a closed-ended questionnaire. A. 5-grade. Likert scale was used for responses to each question. Data were collected on patient demographics and the status of diabetes. Survey responses related to knowledge, attitude, and barriers were grouped. The study sample was comprised of 45 diabetics employed at the hospital. The mean age was 49 ± 11 years and 33 diabetics were males. One-third of the study population was referred to the eye clinic for DR screening. DR screening was performed in 25% of diabetics over the previous year. Twenty-nine (64%; 95% confidence intervals: 50-78) participants had excellent knowledge of eyecare for diabetic complications. Thirteen percent of participants had a positive attitude toward periodic eye checkups. Travel distance to an eyecare unit, no referral from family physicians for annual eye checkups and the lack of availability of gender-specific eyecare professionals were the main perceived barriers. Annual DR screening needs to be promoted to primary healthcare providers and diabetic patients. Barriers should be addressed to improve the uptake of DR screening.

Using data from a multi-hospital clinical network to explore prevalence of pediatric rickets in Kenya

Science.gov (United States)

Karuri, Stella W.; Murithi, Maureen K.; Irimu, Grace; English, Mike

2017-01-01

Background: Nutritional rickets is a public health concern in developing countries despite tropical climates and a re-emerging issue in developed countries. In this study, we reviewed pediatric admission data from the Clinical Information Network (CIN) to help determine hospital and region based prevalence of rickets in three regions of Kenya (Central Kenya, Western Kenya and Nairobi County). We also examine the association of rickets with other diagnosis, such as malnutrition and pneumonia, and study the effect of rickets on regional hospital stays. Methods: We analyzed discharge records for children aged 1 month to 5 years from county (formerly district) hospitals in the CIN, with admissions from February 1 st 2014 to February 28 th 2015. The strength of the association between rickets and key demographic factors, as well as with malnutrition and pneumonia, was assessed using odds ratios. The Fisher exact test was used to test the significance of the estimated odd ratios. Kaplan-Meier curves were used to analyze length of hospital stays. Results: There was a marked difference in prevalence across the three regions, with Nairobi having the highest number of cases of rickets at a proportion of 4.01%, followed by Central Region at 0.92%. Out of 9756 admissions in the Western Region, there was only one diagnosis of rickets. Malnutrition was associated with rickets; this association varied regionally. Pneumonia was found to be associated with rickets in Central Kenya. Children diagnosed with rickets had longer hospital stays, even when cases of malnutrition and pneumonia were excluded in the analysis. Conclusion: There was marked regional variation in hospital based prevalence of rickets, but in some regions it is a common clinical diagnosis suggesting the need for targeted public health interventions. Factors such as maternal and child nutrition, urbanization and cultural practices might explain these differences. PMID:29062911

A social network typology and sexual risk-taking among men who have sex with men in Cape Town and Port Elizabeth, South Africa.

Science.gov (United States)

de Voux, Alex; Baral, Stefan D; Bekker, Linda-Gail; Beyrer, Chris; Phaswana-Mafuya, Nancy; Siegler, Aaron J; Sullivan, Patrick S; Winskell, Kate; Stephenson, Rob

2016-01-01

Despite the high prevalence of HIV among men who have sex with men in South Africa, very little is known about their lived realities, including their social and sexual networks. Given the influence of social network structure on sexual risk behaviours, a better understanding of the social contexts of men who have sex with men is essential for informing the design of HIV programming and messaging. This study explored social network connectivity, an understudied network attribute, examining self-reported connectivity between friends, family and sex partners. Data were collected in Cape Town and Port Elizabeth, South Africa, from 78 men who have sex with men who participated in in-depth interviews that included a social network mapping component. Five social network types emerged from the content analysis of these social network maps based on the level of connectivity between family, friends and sex partners, and ranged from disconnected to densely connected networks. The ways in which participants reported sexual risk-taking differed across the five network types, revealing diversity in social network profiles. HIV programming and messaging for this population can greatly benefit from recognising the diversity in lived realities and social connections between men who have sex with men.

Metaphors of Postmodernism in Neo-Victorian Fiction: “The Trial of Elizabeth Cree” by Peter Ackroyd and “The Decorator” by Boris Akunin

Directory of Open Access Journals (Sweden)

Olga A. Baratova

2017-11-01

Full Text Available One of the features that characterizes postmodern fiction is an intense interest in the past, and especially so – in Victorian period, chiefly in its sensational aspects. Therefore we witness a revival of Victorian crime novel and this tendency can be traced not only in recent English literature, but in other literatures as well, Russian in particular. This gave birth to the term “neo-Victorian novel”, referring to the pieces, which recreate the atmosphere of the period, introduce a lot of intertextual allusions and references to the well-known Victorian novels and exploit most popular subjects of the 19th century literature. However as we will argue in this essay the authors often use these plots as implicit metaphors of postmodern art as such. It will be demonstrated on the example of two Neo-Victorian novels – “The Trial of Elizabeth Cree” by Peter Ackroyd (1995 and “The Decorator” by Boris Akunin; for the latter Ackroyd’s novel can be also regarded as one of the precedent texts. Both novels give their versions of the story of Jack the Ripper but what is more important in our case – employ akin plot structures, images and artistic devices, which in fact become metaphoric actualization of postmodern techniques.

Designing for Economies of Scale vs. Economies of Focus in Hospital Departments

NARCIS (Netherlands)

Vanberkel, Peter T.; Boucherie, Richardus J.; Hans, Elias W.; Hurink, Johann L.; Litvak, Nelli

2010-01-01

Subject/Research problem: Hospitals traditionally segregate resources into centralized functional departments such as diagnostic departments, ambulatory care centres, and nursing wards. In recent years this organizational model has been challenged by the idea that higher quality of care and

Curriculum-Making in School and College: The Case of Hospitality

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Edwards, Richard; Miller, Kate; Priestley, Mark

2009-01-01

Drawing upon research in the curriculum of hospitality, this article explores the contrasting ways in which the prescribed curriculum is translated into the enacted curriculum in school and college contexts. It identifies organisational culture and teacher and student backgrounds and dispositions as central to the emerging contrasts. It uses this…

Paediatric utilisation of a teaching hospital and a community health ...

African Journals Online (AJOL)

to Red Cross Children's Hospital (RXH) that could be more ... better access and perceived quality. S Atr Med ... tertiary resources, low levels of efficiency and staff ... However, central to improved patterns of utilisation is the .... the modei were: (/) age of the child; (it) duration of residence ... There was no significant association.

Corporate and philanthropic models of hospital governance: a taxonomic evaluation.

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Weiner, B J; Alexander, J A

1993-08-01

We assess the theoretical integrity and practical utility of the corporate-philanthropic governance typology frequently invoked in debates about the appropriate form of governance for nonprofit hospitals operating in increasingly competitive health care environments. Data were obtained from a 1985 national mailed survey of nonprofit hospitals conducted by the American Hospital Association (AHA) and the Hospital Research and Educational Trust (HRET). A sample 1,577 nonprofit community hospitals were selected for study. Representativeness was assessed by comparing the sample with the population of non-profit community hospitals on the dimensions of bed size, ownership type, urban-rural location, multihospital system membership, and census region. Measurement of governance types was based on hospital governance attributes conforming to those cited in the literature as distinguishing corporate from philanthropic models and classified into six central dimensions of governance: (1) size, (2) committee structure and activity, (3) board member selection, (4) board composition, (5) CEO power and influence, and (6) bylaws and activities. Cluster analysis and ANCOVA indicated that hospital board forms adhered only partially to corporate and philanthropic governance models. Further, board forms varied systematically by specific organizational and environmental conditions. Boards exhibiting more corporate governance forms were more likely to be large, privately owned, urban, and operating in competitive markets than were hospitals showing more philanthropic governance forms. Findings suggest that the corporate-philanthropic governance distinction must be seen as an ideal rather than an actual depiction of hospital governance forms. Implications for health care governance are discussed.

Management of hospitals solid waste in Khartoum State.

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Saad, Suhair A Gayoum

2013-10-01

This research had been conducted during year 2012 to review existing data on hospital waste management for some of Khartoum town hospitals and to try to produce appropriate proposals acceptable for waste management and final treatment methods. The overall status of hospital waste management in Khartoum has been assessed through direct visits and designated questionnaires. Eight main hospitals were covered in the study with an overall bed capacity of 2,978. The current waste management practice observed at all studied hospitals was that most of waste, office, general, food, construction debris, and hazardous chemical materials were all mixed together as they are generated, collected, and finally disposed of. Only a small portion of waste in some hospitals (part of potentially infectious, body parts, and sharps) are collected separately and treated in a central incinerator. The estimated value of per bed generation rate in the studied hospitals was found to be 0.87 kg/day, which lies within the range for the low-income countries. In all studied hospitals, it was found that workers were working under very poor unsafe conditions with very low salaries ($35 to $45 per month on average). About 90 % were completely illiterate or had very low education levels. At the national level, no laws considering hospital waste, or even hazardous waste, were found; only some federal general environmental regulations and some procedures from town and city localities for controlling general municipal waste exist. At the hospital level, no policies or rules were found, except in the radiotherapy center, where they manage radioactive wastes under the laws of the Sudanese Atomic Agency. Urgent actions are needed for the remediation and prevention of hazards associated with this type of waste.

Mental Hospitals in India: Reforms for the future.

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Daund, Muktesh; Sonavane, Sushma; Shrivastava, Amresh; Desousa, Avinash; Kumawat, Sanjay

2018-02-01

Mental hospitals are an integral part of mental health services in India. It is an interesting story how mental hospitals have responded to the challenges of contemporary period they were built in. It is beyond doubt that it is a progressive journey along with advances in mental health both in India and internationally. As in other countries, mental hospitals in India have responded to the social challenges, disparities, and poor resources of workforce and fiscal investment. Historically, there have been changes and three major reforms are needed, namely attempt to facilitate discharge and placing patients back into the family, introducing teaching and research in mental hospitals, and accountability to civil rights as per the requirements of the National Human Rights Commission. In this review, we explore the brief history of mental hospitals in India and examine the reforms in the clinical, administrative, and psychosocial areas of these hospitals and progress in teaching and research. We finally summarize and conclude the necessity and the relevance of mental hospitals in India akin to modern psychiatric practice. We believe that mental hospitals have an important and perhaps a central role in mental health services in India. Its modernization to address issues of long-term stay, burden on caregivers, stigma, research and teaching including undergraduate and postgraduate training, new curriculum, and training for nonpsychiatric professionals and primary care physicians are necessary components of the role of mental hospitals and responsibilities of both government and nongovernmental sectors. Last but not the least, it is obligatory for mental hospitals to ensure that evidence-based treatments are implemented and that the standard of care and respect of civil and human rights of the patients and families are provided while involving the people's participation in its functioning.

Errors in the administration of intravenous medication in Brazilian hospitals.

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Anselmi, Maria Luiza; Peduzzi, Marina; Dos Santos, Claudia Benedita

2007-10-01

To verify the frequency of errors in the preparation and administration of intravenous medication in three Brazilian hospitals in the State of Bahia. The administration of intravenous medications constitutes a central activity in Brazilian nursing. Errors in performing this activity may result in irreparable damage to patients and may compromise the quality of care. Cross-sectional study, conducted in three hospitals in the State of Bahia, Brazil. Direct observation of the nursing staff (nurse technicians, auxiliary nurses and nurse attendants), preparing and administering intravenous medication. When preparing medication, wrong patient error did not occur in any of the three hospitals, whereas omission dose was the most frequent error in all study sites. When administering medication, the most frequent errors in the three hospitals were wrong dose and omission dose. The rates of error found are considered low compared with similar studies. The most frequent types of errors were wrong dose and omission dose. The hospitals studied showed different results with the smallest rates of errors occurring in hospital 1 that presented the best working conditions. Relevance to clinical practice. Studies such as this one have the potential to improve the quality of care.

Hospital ownership: a risk factor for nosocomial infection rates?

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Schröder, C; Behnke, M; Geffers, C; Gastmeier, P

2018-03-26

In some countries, a relationship between hospital ownership and the occurrence of healthcare-associated infection (HCAI) rates has been described. To investigate the association between hospital ownership and occurrence of HCAI in Germany. Five different components of the German national nosocomial infection surveillance system were analysed with regard to the influence of hospital ownership in the period 2014-2016. Endpoints included ventilator-associated pneumonia, central-venous-catheter-associated bloodstream infections, urinary-catheter-associated urinary tract infections, surgical site infections (SSI) following hip prosthesis and colon surgery, meticillin-resistant Staphylococcus aureus (MRSA), Clostridium difficile infections (CDI) and hand rub consumption per 1000 patient-days. Three hospital ownership types (public, non-profit and private) were analysed using univariate and multi-variate methods. The distribution of hospitals according to the three ownership types was similar in all components. In total, 661 intensive care units (ICUs), 149 departments performing colon procedures, and 349 departments performing hip prosthesis were included. In addition, 568 hospitals provided their MRSA rates and 236 provided their CDI rates, and 1833 ICUs and 12,934 non-ICUs provided their hand rub consumption data. In general, the differences between the hospital types were rather small and not significant for the ICUs. In the multi-variate analysis, public hospitals had a lower SSI rate following hip prosthesis (odds ratio 0.80, 95% confidence interval 0.65-0.99). Hospital ownership was not found to have a major influence on the incidence of HCAI in Germany. Copyright © 2018 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Demand-driven care and hospital choice. Dutch health policy toward demand-driven care: results from a survey into hospital choice.

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Lako, Christiaan J; Rosenau, Pauline

2009-03-01

In the Netherlands, current policy opinion emphasizes demand-driven health care. Central to this model is the view, advocated by some Dutch health policy makers, that patients should be encouraged to be aware of and make use of health quality and health outcomes information in making personal health care provider choices. The success of the new health care system in the Netherlands is premised on this being the case. After a literature review and description of the new Dutch health care system, the adequacy of this demand-driven health policy is tested. The data from a July 2005, self-administered questionnaire survey of 409 patients (response rate of 94%) as to how they choose a hospital are presented. Results indicate that most patients did not choose by actively employing available quality and outcome information. They were, rather, referred by their general practitioner. Hospital choice is highly related to the importance a patient attaches to his or her physician's opinion about a hospital. Some patients indicated that their hospital choice was affected by the reputation of the hospital, by the distance they lived from the hospital, etc. but physician's advice was, by far, the most important factor. Policy consequences are important; the assumptions underlying the demand-driven model of patient health provider choice are inadequate to explain the pattern of observed responses. An alternative, more adequate model is required, one that takes into account the patient's confidence in physician referral and advice.

First step to reducing infection risk as a system: evaluation of infection prevention processes for 71 hospitals.

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Fakih, Mohamad G; Heavens, Michelle; Ratcliffe, Carol J; Hendrich, Ann

2013-11-01

Hospitals can better focus their efforts to prevent health care-associated infections (HAIs) if they identify specific areas for improvement. We administered a 96-question survey to infection preventionists at 71 Ascension Health hospitals to evaluate opportunities for the prevention of catheter-associated urinary tract infection, central line-associated bloodstream infection, ventilator-associated pneumonia, and surgical site infection. Seventy-one (100%) infection preventionists completed the survey. The majority of hospitals had established policies for urinary catheter placement and maintenance (55/70, 78.6%), central venous catheter maintenance (68/71, 95.8%), and care for the mechanically ventilated patient (62/66, 93.9%). However, there was variation in health care worker practice and evaluation of competencies and outcomes. When addressing device need, 55 of 71 (77.5%) hospitals used a nurse-driven evaluation of urinary catheter need, 26 of 71 (36.6%) had a team evaluation for central venous catheters on transfer out of intensive care, and 53 of 57 (93%) assessed daily ventilator support for continued need. Only 19 of 71 (26.8%) hospitals had annual nursing competencies for urinary catheter placement and maintenance, 29 of 71 (40.8%) for nursing venous catheter maintenance, and 38 of 66 (57.6%) for appropriate health care worker surgical scrubbing. We suggest evaluating infection prevention policies and practices as a first step to improvement efforts. The next steps include implementing spread of evidence-based practices, with focus on competencies and feedback on performance. Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.

Findings in young adults at colonoscopy from a hospital service database audit.

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Wong, Stephanie; Lidums, Ilmars; Rosty, Christophe; Ruszkiewicz, Andrew; Parry, Susan; Win, Aung Ko; Tomita, Yoko; Vatandoust, Sina; Townsend, Amanda; Patel, Dainik; Hardingham, Jennifer E; Roder, David; Smith, Eric; Drew, Paul; Marker, Julie; Uylaki, Wendy; Hewett, Peter; Worthley, Daniel L; Symonds, Erin; Young, Graeme P; Price, Timothy J; Young, Joanne P

2017-04-19

Colorectal cancer (CRC) diagnosed at young adults. The aim of this work was to document the prevalence and histological subtype of lesions seen in patients aged <50 years, and any associated clinical features. An audit of the colonoscopy database at The Queen Elizabeth Hospital in Adelaide, South Australia over a 12-month period was undertaken. Findings were recorded from both colonoscopy reports and corresponding histological examination of excised lesions. Data were extracted from colonoscopies in 2064 patients. Those aged <50 comprised 485 (24%) of the total. CRC precursor lesions (including sessile serrated adenoma/polyps (SSA/P), traditional serrated adenomas, tubular adenomas ≥10 mm or with high-grade dysplasia, and conventional adenomas with villous histology) were seen in 4.3% of patients aged <50 and 12.9% of patients aged ≥50 (P <0.001). Among colonoscopies yielding CRC precursor lesions in patients under 50 years, SSA/P occurred in 52% of procedures (11/21), compared with 27% (55/204) of procedures in patients aged 50 and older (P = 0.02). SSA/P were proximally located in (10/11) 90% of patients aged under 50, and 80% (43/54) of those aged 50 and older (P = 0.46). SSA/P were the most frequently observed CRC precursor lesions in patients aged <50. Most CRCs in this age group are known to arise in the distal colon and rectum suggesting that lesions other than SSA/P may serve as the precursor for the majority of early-onset CRC.

Antibiotic sensitivity pattern of bacteria from diabetic foot infections Haji Adam Malik central general hospital

Science.gov (United States)

Bulolo, B. A.; Pase, M. A.; Ginting, F.

2018-03-01

Increasing rate of Diabetic Foot Infections (DFIs) caused by multi-drug-resistance pathogens plays a huge role in the duration of hospitalization, morbidity, and mortality of diabetic patients. The aim of the study is to assess the antibiotic sensitivity pattern of bacteria in DFIs and causative microorganisms. Using cross-sectional retrospective study, data were collected from medical records of DFIs patients previously hospitalized atHaji Adam Malik Hospital, Medan from January to July 2017. 33 patients met the criteria and got enrolled in the study. The classification of DFIs was evaluated according to Wagner’s Classification. Evaluation of antibiotic sensitivity and identification of causative microorganisms were performed in standard microbiologic methods. The most common grade of DFIs was Grade-4 (48.5%), followed by Grade-3 (39.4%) and Grade-5 (9.1%). A total of 12 pathogens were identified. The most common infecting microorganism isolated on pus cultures was Klebsiella pneumonia (33.3%), followed by Escherichia coli (24.2%), Acinetobacter baumanni (12.1%), and Staphylococcus aureus (9.1%). Frequent susceptible antibiotics were Amikacin (88.8%), Imipenem (87%), Meropenem (84.6%), Erythromycin (75%), and Cefoperazone/Sulbactam (68.9%). DFIs are polymicrobial infections in this study K. pneumonia was the most common cause microorganism.

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

Directory of Open Access Journals (Sweden)

Amar M. Taksande

2015-11-01

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

[Impact of HIV infection in hospital environment].

Science.gov (United States)

Martínez Avilés, P; López Benito, I; Berbegal Serra, J

1998-12-01

Retrospective study to review the admissions at the Hospital Marina Alta due to infection for HIV or its complications and look for risk factors. Clinical charts of patients admitted at the hospital from 1989 to 1996 were analyzed. From 11,932 admissions, 199 (1.7%) were due to patients with infection from HIV, resulting in the 2.4% of the total stay. The medium stays were higher (8.6 +/- 7.4 vs 6 +/- 4.5) more re-admissions (42.7% vs 25.5%) and higher mortality (11% vs 7.8%). The parasitic infestations of the nervous central system and cardiovascular were the most numerous number of admissions and also the longer stays. Throughout the years we saw a increase in the patients at the outpatient clinic with HIV infection and a paradogic decrease in the inpatient admissions, and also a decrease in the media stay and total stays. There is a decrease in the admissions at the inpatient level in contrast with a increment of the prevalence in the outpatients with HIV infection. The improved treatments, the experience of the physicians, the use of the Day Hospital and the use of the service of Home Care Hospitalization allows to keep more patients with less admissions and more outpatient visits.

PHARMACOEPIDEMIOLOGIC ANALYSIS OF ST-ELEVATION MYOCARDIAL INFARCTION REPERFUSION THERAPY AT SARATOV REGION HOSPITALS OF DIFFERENT TYPES

Directory of Open Access Journals (Sweden)

O. V. Reshetko

2016-01-01

Full Text Available Aim. To evaluate the real practice of thrombolytic therapy of patients with ST-elevation myocardial infarction (STEMI at cardiological departments of Saratov and Saratov region hospitals.Material and methods. Retrospective pharmacoepidemiologic study was carried out. Case histories of STEMI patients discharged from cardiologic departments of several central district hospitals (CDH of Saratov region, cardiologic department of one of Saratov general municipal hospitals (MH and urgent cardiology department of Saratov clinical hospital (CH in 2006 were analyzed.Results. In CH all patients received thrombolytic therapy given they did not have contraindications and were admitted to the hospital timely. Few patients received thrombolytic therapy in MH and CDH in 2006.Conclusion. Correlation between hospital type and quality of STEMI management has been revealed.

[The Jewish Hospital in Budapest under the Nazi occupation (1944-1945)].

Science.gov (United States)

Weisskopf, Varda

2008-01-01

On March 19, 1944 the German army invaded and occupied Hungary. The Waffen-SS soldiers captured the buildings of the Jewish community in Budapest, including the famous and important Jewish hospital on Szabolcs Street, founded in 1802. The Jewish hospital moved into a school belonging to the Jewish community on 44 Wesselényi Street. The hospital personnel managed to smuggle out medical equipment, and operating rooms were transferred into this central, temporary medical location. Other hospitals were founded, some inside the ghetto, others outside. The Judenrat supplied these hospitals with medical equipment obtained through contributions from Jews. The temporary hospitals admitted sick patients and a great number of those injured as a result of the war in Budapest. These hospitals operated with poor equipment. Surgeries were sometimes performed on kitchen tables, and medical equipment was sterilized by burning the synagogue's benches and library books. As of December 1944, there was no electricity in the hospitals. Thus doctors were forced to operate by the light of candles and flashlights. Nevertheless, they managed to save numerous lives. In spite of the terrible conditions under which the medical staff worked, they were committed to their mission, and their courage deserves appreciation. Ghetto Budapest was liberated by the Red army on 18th January, 1945. Thousands of Jews were released from the temporary hospitals.

Factors associated with intention to exclusive breastfeed in central women's hospital, Yangon, Myanmar.

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Hmone, Myat Pan; Li, Mu; Agho, Kingsley; Alam, Ashraful; Dibley, Michael J

2017-01-01

Under-nutrition is a public health problem in Myanmar. Despite current efforts, the exclusive breastfeeding rate (EBF) for children under six months is only 24%. Intention to breastfeed is a strong predictor for long-term breastfeeding, however, little is known about pregnant women's breastfeeding intentions in Myanmar. We, therefore, aimed to identify the factors associated with women's intention to EBF. Data in this article was collected in a baseline survey for a randomized controlled trial, which aimed to assess the impact of mobile text messages on the breastfeeding practices of women in Yangon, Myanmar. A total of 353 pregnant women at 28-34 weeks of gestation, recruited into the trial from the antenatal clinics of the Central Women's Hospital, Yangon, Myanmar, responded to the baseline survey questions, which included background information and breastfeeding related characteristics. To determine factors associated with women's intention to EBF logistic regression was used to analyse individual demographic, household economic and breastfeeding characteristics. In-depth interviews were performed with a sub-sample of 24 women who participated in the survey, to gain a further understanding of these associated factors. After adjusting for potential confounders, working women were less likely to intend to EBF (adjusted odds ratio (AOR) = 0.30, CI 0.17-0.53). Women from rich households (AOR = 2.43, CI 1.08-5.47) and middle income households (AOR = 1.79, CI 1.01-3.16); those who had high (AOR = 10.19, CI 3.43-30.23) and medium (AOR = 5.46, CI 1.79-16.72) breastfeeding knowledge levels, and received information from health professionals (AOR = 2.29, CI 1.29-4.03) and mobile internet (AOR 3.62, CI 2.04-6.41) had a higher intention to EBF. These findings were supported by qualitative analysis, which revealed that returning to work was the main barrier; health staff and printed media are reliable sources and; women with higher knowledge had high intentions

Central nervous system complications after liver transplantation.

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Kim, Jeong-Min; Jung, Keun-Hwa; Lee, Soon-Tae; Chu, Kon; Roh, Jae-Kyu

2015-08-01

We investigated the diversity of central nervous system complications after liver transplantation in terms of clinical manifestations and temporal course. Liver transplantation is a lifesaving option for end stage liver disease patients but post-transplantation neurologic complications can hamper recovery. Between 1 January 2001 and 31 December 2010, patients who had undergone liver transplantation at a single tertiary university hospital were included. We reviewed their medical records and brain imaging data and classified central nervous system complications into four categories including vascular, metabolic, infectious and neoplastic. The onset of central nervous system complications was grouped into five post-transplantation intervals including acute (within 1 month), early subacute (1-3 months), late subacute (3-12 months), chronic (1-3 years), and long-term (after 3 years). During follow-up, 65 of 791 patients (8.2%) experienced central nervous system complications, with 30 occurring within 1 month after transplantation. Vascular etiology was the most common (27 patients; 41.5%), followed by metabolic (23; 35.4%), infectious (nine patients; 13.8%), and neoplastic (six patients). Metabolic encephalopathy with altered consciousness was the most common etiology during the acute period, followed by vascular disorders. An initial focal neurologic deficit was detected in vascular and neoplastic complications, whereas metabolic and infectious etiologies presented with non-focal symptoms. Our study shows that the etiology of central nervous system complications after liver transplantation changes over time, and initial symptoms can help to predict etiology. Copyright © 2015 Elsevier Ltd. All rights reserved.

Lessons learned from early implementation of option B+: the Elizabeth Glaser Pediatric AIDS Foundation experience in 11 African countries.

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Kieffer, Mary Pat; Mattingly, Meghan; Giphart, Anja; van de Ven, Roland; Chouraya, Caspian; Walakira, Moses; Boon, Alexandre; Mikusova, Silvia; Simonds, R J

2014-12-01

"Option B+" is a World Health Organization-recommended approach to prevent mother-to-child HIV transmission whereby all HIV-positive pregnant and lactating women initiate lifelong antiretroviral therapy (ART). This review of early Option B+ implementation experience is intended to inform Ministries of Health and others involved in implementing Option B+. This implementation science study analyzed data from 11 African countries supported by the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) to describe early experience implementing Option B+. Data are from 4 sources: (1) national guidelines for prevention of mother-to-child HIV transmission and Option B+ implementation plans, (2) aggregated service delivery data between January 2013 and March 2014 from EGPAF-supported sites, (3) field visits to Option B+ implementation sites, and (4) relevant EGPAF research, quality improvement, and evaluation studies. Rapid adoption of Option B+ led to large increases in percentage of HIV-positive pregnant women accessing ART in antenatal care. By the end of 2013, most programs reached at least 50% of HIV-positive women in antenatal care with ART, even in countries using a phased approach to implementation. Scaling up Option B+ through integrating ART in maternal and child health settings has required expansion of the workforce, and task shifting to allow nurse-led ART initiation has created staffing pressure on lower-level cadres for counseling and community follow-up. Complex data collection needs may be impairing data quality. Early experiences with Option B+ implementation demonstrate promise. Continued program evaluation is needed, as is specific attention to counseling and support around initiation of lifetime ART in the context of pregnancy and lactation.

THE IMPACT OF CENTRALIZATION, CORRUPTION AND INSTITUTIONAL QUALITY ON PROCUREMENT PRICES: AN APPLICATION TO PHARMACEUTICAL PURCHASING IN ITALY

OpenAIRE

Simona, Baldi; Davide, Vannoni

2014-01-01

This paper deals with the open issue about the choice between a centralized versus a decentralized public procurement strategy. Using a unique dataset on tender prices of selected drugs for hospital usage awarded by a sample of 52 Italian local health service providers (ASLs) between 2009 and 2012, we test which procurement system (centralized, decentralized or hybrid) performs better. Controlling for several covariates, we always find that centralized and hybrid procurers pay lower prices as...

Dental trauma that require fixation in a children's hospital.

Science.gov (United States)

Bruns, Timothy; Perinpanayagam, Hiran

2008-02-01

Children and adolescents who suffer traumatic injuries often seek emergency treatment at a Children's Hospital. Complex injuries to permanent teeth and their periodontium require immediate repositioning and stabilization. Many of these emergencies are treated by pediatric dental residents at the Women and Children's Hospital of Buffalo, Buffalo, New York. The purpose of this study was to characterize these complex injuries of permanent teeth that require emergency treatment in a Children's Hospital. All of the cases of dental trauma which had involved permanent teeth and which had been treated with a splint in 2001 and 2002 were reviewed. There were 79 patients that were between 5 and 19 years of age with twice as many males (54) as females (25). The number of males increased from childhood (5-10 years) to early adolescence (11-15 years) and then decreased rapidly in late adolescence (16-19 years), whereas the number of females decreased steadily with age. Most of the incidents occurred during the summer months (72%), particularly in June and July (42%), and Fridays and Saturdays were the busiest days of the week. Most of the injuries were caused by organized and recreational sporting activities (39%) and accidental falls (33%), followed by interpersonal violence (15%) and a few motor vehicle accidents (7%). The 173 permanent tooth injuries were mostly luxations (62%) or avulsions (20%), with only a few fractures of the alveolar bone (5%) or tooth root (1%). Most of the displacements were lateral luxations (40%) or extrusions (18%) with only a few intrusions (3%). These injuries most commonly afflicted the maxillary central incisors (54%), followed by the maxillary laterals (18%) and mandibular centrals (17%). The emergency treatment that was provided at the Children's Hospital included replantation and repositioning, and the placement of a semi-rigid or flexible splint.

[Burnout syndrome in pre-hospital and hospital emergency. Cognitive study in two cohorts of nurses].

Science.gov (United States)

Cicchitti, Chiara; Cannizzaro, Giorgia; Rosi, Fabrizio; Maccaroni, Roberto; Menditto, Vincenzo G

2014-01-01

Burnout syndrome (BOS) associated with stress has been documented in health care professionals in many specialties. The emergency department and the pre-hospital healthcare services are highly stressful environments. Little is known about the BOS in critical care nursing staff. The objective of the study is to compare the incidence of BOS and its three domains, namely, emotional exhaustion, depersonalization and reduced professional accomplishment, in two cohorts of critical care nurses: a pre-hospital and a hospital emergency service. A survey using a questionnaire (the Maslach Burnout Inventory-General Survey, MBI-GS), among nurses of two Italian emergency services has been performed: a hospital emergency service (HES, Emergency Department or "Pronto Soccorso") and a pre-hospital emergency service (PHES, territorial healthcare service or "Centrale Operativa 118"). All 60 nurses surveyed (82% female) filled the questionnaires. BOS-related symptoms have been identified in at least 50% of the nurses in the HES: 50% suffered a medium-high emotional exhaustion, 75% had a medium-high depersonalization and 92.5% had a medium-high reduced professional accomplishment. Among the PEHS nurses, BOS-related symptoms have been identified in at least 60% of the respondents: 60% had a medium-high emotional exhaustion, 70% had a medium-high depersonalization and 95% had a medium-high reduced professional accomplishment. Moreover, the likelihood that a nurse has a severe BOS, that is at least one degree of high burnout or ≥2 degrees of medium burnout, is significantly higher in the group of the PHES than in the HES (90% vs 60%, p nursing staff had a severe BOS. The incidence of BOS appeared to be similar among PHES and HES nurses with a higher trend for the former. Further interventional studies are needed to investigate the determinants of BOS among critical care nurses and the potentially preventive strategies.

Occurrence of Organic Compounds and Trace Elements in the Upper Passaic and Elizabeth Rivers and Their Tributaries in New Jersey, July 2003 to February 2004: Phase II of the New Jersey Toxics Reduction Workplan for New York-New Jersey Harbor

Science.gov (United States)

Wilson, Timothy P.; Bonin, Jennifer L.

2008-01-01

Samples of surface water and suspended sediment were collected from the Passaic and Elizabeth Rivers and their tributaries in New Jersey from July 2003 to February 2004 to determine the concentrations of selected chlorinated organic and inorganic constituents. This sampling and analysis was conducted as Phase II of the New York-New Jersey Harbor Estuary Workplan?Contaminant Assessment and Reduction Program (CARP), which is overseen by the New Jersey Department of Environmental Protection. Phase II of the New Jersey Workplan was conducted to define upstream tributary and point sources of contaminants in those rivers sampled during Phase I work, with special emphasis on the Passaic and Elizabeth Rivers. Samples were collected from three groups of tributaries: (1) the Second, Third, and Saddle Rivers; (2) the Pompton and upper Passaic Rivers; and (3) the West Branch and main stem of the Elizabeth River. The Second, Third, and Saddle Rivers were sampled near their confluence with the tidal Passaic River, but at locations not affected by tidal flooding. The Pompton and upper Passaic Rivers were sampled immediately upstream from their confluence at Two Bridges, N.J. The West Branch and the main stem of the Elizabeth River were sampled just upstream from their confluence at Hillside, N.J. All tributaries were sampled during low-flow discharge conditions using the protocols and analytical methods for organic constituents used in low-flow sampling in Phase I. Grab samples of streamflow also were collected at each site and were analyzed for trace elements (mercury, methylmercury, cadmium, and lead) and for suspended sediment, particulate organic carbon, and dissolved organic carbon. The measured concentrations and available historical suspended-sediment and stream-discharge data (where available) were used to estimate average annual loads of suspended sediment and organic compounds in these rivers. Total suspended-sediment loads for 1975?2000 were estimated using rating

Zolpidem prescribing and adverse drug reactions in hospitalized general medicine patients at a Veterans Affairs hospital.

Science.gov (United States)

Mahoney, Jane E; Webb, Melissa J; Gray, Shelly L

2004-03-01

Zolpidem is prescribed for sleep disruption in hospitalized patients, but data on the incidence of adverse drug reactions (ADRs) are based largely on outpatient studies. Thus, the incidence of ADRs in hospitalized patients may be much higher. The goal of this study was to describe prescribing patterns of zolpidem for hospitalized medical patients aged 50 years, the incidence of ADRs possibly and probably associated with its use, and the factors associated with central nervous system (CNS) ADRs. This case series was conducted in 4 general medicine wards at a Veterans Affairs hospital and was a consecutive sample of patients aged 50 years who were hospitalized between 1993 and 1997 and received zolpidem as a hypnotic during hospitalization, but had not received it in the previous 3 months. Chart review was conducted by 2 evaluators. Data extracted from the medical records included admission demographic characteristics, medications, comorbidities, and levels of function in performing basic and instrumental activities of daily living. The main outcome measure was ADRs possibly or probably related to zolpidem use. The association between zolpidem and the occurrence of CNS ADRs (eg, confusion, dizziness, daytime somnolence) was analyzed separately. The review included 119 medical patients aged > or =50 years who had newly received zolpidem for sleep disruption during hospitalization. The median age of the population was 70 years; 86 (72.3%) patients were aged 65 years. The initial zolpidem dose was 5 mg in 42 patients (35.3%) and 10 mg in 77 patients (64.7%). Twenty-three patients had a respective 16 and 10 ADRs possibly and probably related to zolpidem use (19.3% incidence). Of a total of 26 ADRs, 21 (80.8%) were CNS ADRs, occurring with both zolpidem 5 mg (10.8% of users) and 10 mg (18.3% of users). On univariate analyses, the only factor significantly associated with a CNS ADR was functional impairment at baseline (P = 0.003). Zolpidem was discontinued in 38.8% of

A selective review of glutamate pharmacological therapy in obsessive–compulsive and related disorders

OpenAIRE

Grados, Marco; Atkins,Elizabeth; Kovacikova,Gabriela Ika; McVicar,Erin

2015-01-01

Marco A Grados,1 Elizabeth B Atkins,2 Gabriela I Kovacikova,3 Erin McVicar4 1Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, 2Department of Psychology, Smith College, Northampton, MA, 3Department of Psychology, Wellesley College, Wellesley, MA, 4Susquehanna University, Selinsgrove, PA, USA Abstract: Glutamate, an excitatory central nervous system neurotransmitter, is emerging as a potential alternative pharmacological treatment when co...

Hospital Presbiteriano Valley

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Luckman, Charles

1964-12-01

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

Building patient-centeredness: hospital design as an interpretive act.

Science.gov (United States)

Bromley, Elizabeth

2012-09-01

Hospital designs reflect the sociocultural, economic, professional, and aesthetic priorities prevalent at a given time. As such, hospital buildings concretize assumptions about illness, care and healing, patienthood, and medical providers' roles. Trends in hospital design have been attributed to the increasing influence of consumerism on healthcare, the influx of business-oriented managers, and technological changes. This paper describes the impact of the concept of patient-centeredness on the design of a new hospital in the USA. Data come from 35 interviews with planners, administrators, and designers of the new hospital, as well as from public documents about the hospital design. Thematic content analysis was used to identify salient design principles and intents. For these designers, administrators, and planners, an interpretation of patient-centeredness served as a heuristic, guiding the most basic decisions about space, people, and processes in the hospital. I detail the particular interpretation of patient-centeredness used to build and manage the new hospital space and the roles and responsibilities of providers working within it. Three strategies were central to the implementation of patient-centeredness: an onstage/offstage layout; a concierge approach to patients; and the scripting of communication. I discuss that this interpretation of patient-centeredness may challenge medical professionals' roles, may construct medical care as a product that should sate the patient's desire, and may distance patients from the realities of medical care. By describing the ways in which hospital designs reflect and reinforce contemporary concepts of patienthood and caring, this paper raises questions about the implementation of patient-centeredness that deserve further empirical study by medical social scientists. Copyright © 2012 Elsevier Ltd. All rights reserved.

[in-hospital mortality in patient with acute ischemic and hemorrhagic stroke].

Science.gov (United States)

Sadamasa, Nobutake; Yoshida, Kazumichi; Narumi, Osamu; Chin, Masaki; Yamagata, Sen

2011-09-01

There is a lack of evidence to compare in-hospital mortality with different types of stroke. The purpose of this study was to elucidate the in-hospital mortality after acute ischemic/hemorrhagic stroke and compare the factors associated with the mortality among stroke subtypes. All patients admitted to Kurashiki Central Hospital in Japan between January 2009 and December 2009, and diagnosed with acute ischemic/hemorrhagic stroke were included in this study. Demographics and clinical data pertaining to the patients were obtained from their medical records. Out of 738 patients who had an acute stroke, 53 (7.2%) died in the hospital. The in-hospital mortality was significantly lower in the cerebral infarction group than in the intracerebral hemorrhage and subarachnoid hemorrhage group (3.5%, 15.1%, and 17.9%, respectively; Phemorrhage group than in the other 2 groups. With regard to past history, diabetes mellitus was significantly found to be a complication in mortality cases of intracranial hemorrhage. Further investigation is needed to clarify the effect of diabetes on mortality after intracranial hemorrhage.

Racial/Ethnic Pay Disparities among Registered Nurses (RNs) in U.S. Hospitals: An Econometric Regression Decomposition.

Science.gov (United States)

Moore, Jean; Continelli, Tracey

2016-04-01

To detect the presence of racial and ethnic pay disparities between minority and white hospital RNs using a national sample. The National Sample Survey of Registered Nurses, 2008, which is representative at both the state and national level. Cross-sectional data were analyzed using multivariate regression and regression decomposition. Differences between groups were decomposed into differences in the possession of characteristics and differences in the value of the same characteristic between different groups, the latter being a commonly used measure of wage discrimination. As the majority of minority hospital RNs are employed within the most densely populated (central) counties of metropolitan statistical areas (MSAs), only hospital RNs employed in the central counties of MSAs were selected. Regression decomposition found that black and Hispanic RNs earned less than whites and Asians, while Asian RNs earned more than white RNs. The majority of pay variation between white RNs, versus Asian, black, or Hispanic RNs was due to unexplained differences in the value of the same characteristic between groups. Differences in earnings between underrepresented and overrepresented hospital RNs is suggestive of discrimination. © Health Research and Educational Trust.

Tratamiento antimicrobiano en la meningoencefalitis, Hospital Militar Central "Dr. Luis Díaz Soto", 2004-2011

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María del Carmen Jiménez Martínez

Full Text Available Introducción: las meningoencefalitis constituyen un grupo de gran importancia dentro de las enfermedades infecciosas, en las cuales la introducción de los antibióticos hizo posible que fuese curable, pero la morbilidad y la mortalidad de esta enfermedad continúan siendo inaceptablemente altas. Objetivo: identificar la terapia antimicrobiana usada en las meningoencefalitis. Métodos: estudio descriptivo, observacional y retrospectivo. Se estudiaron 150 pacientes con diagnóstico de meningoencefalitis viral o meningoencefalitis bacteriana confirmada por cuadro clínico, estudio citoquímico del líquido cefalorraquídeo o identificación del agente etiológico. Todos se atendieron en el período comprendido entre los años 2004 y primer semestre del 2011, en los servicios de Medicina y Pediatría del Hospital Militar Central "Dr. Luis Díaz Soto". Se empleó el diseño de un estudio de utilización de medicamentos que hace uso de la indicación-prescripción y el esquema terapéutico para este tipo de paciente. Resultados: se utilizó terapia antimicrobiana en el 18,67 % de pacientes con meningoencefalitis viral (23,93 % de 117 y el 22 % con bacteriana (100 % de 33 casos. Las antibioticoterapias más usadas fueron la ceftriaxona (como único antibiótico en la meningoencefalitis viral, y asociada (ceftriaxona más vancomicina en la meningoencefalitis bacteriana. El patógeno más aislado (Streptococcus pneumoniae fue tratado en la mayoría de los casos con ceftriaxona más vancomicina. La generalidad de los tratamientos para la meningoencefalitis bacteriana duró menos de 21 días. Conclusiones: se evidenció el uso de terapia antimicrobiana en pacientes con meningoencefalitis viral y la coincidencia entre la terapia empírica y la específica en la meningoencefalitis bacteriana.

Preliminary Characterization of the Liquid Discharge of the Mexico Hospital; Caracterizacion Preliminar de la Descarga Liquida del Hospital Mexico

Energy Technology Data Exchange (ETDEWEB)

Hernandez Rojas, A

2001-07-01

The generation and wrong handling of hospital waste constitutes a serious problem at national level. In this work, a preliminary characterization of the discharge it liquidates of the Mexico Hospital is carried out. For it, different pouring points were analyzed inside the institution; they are: Laundry, Central Kitchen, Clinical Laboratory, X-Rays, Laboratory of Biomass, Morgue, and the final discharge of the hospital. This with the purpose of knowing the handling of the liquid waste in the health center, the sanitary quality of these liquids and their influence in the raw waters of the Mexico Hospital in the receiving body. For this study, we first coordinated with the personnel of each department to know about the handling and type of liquid residuals that are discharged to the system of pipes. Later on the physical-chemical and biological tests were carried out with base in two compound samplings done the days October 26 and November 4 1998. Among the carried out tests we have: pH, DBO, DQO, SAAM, Fatty and Oils, Temperature, Nitrogen and Faecal Coniforms, depending on the characteristics of their origin point. At the end of the study, the obtained results were evaluated for each studied pouring point, and then the influence of these focuses on the quality of the raw waters of the hospital that discharge in a gulch located to the northwest side of the facilities was analyzed. The obtained results allow to preliminarily know the characterization of the liquid discharge of the Mexico Hospital and it was classified as a source of contamination. The Hospital requires of a biological treatment plant for those biodegradable poured liquids, and of a system of chemical treatment for that type of products used in the processes characteristic of each department. It is also required to take into account measures of reduction of contamination that diminish the quantity of waste from the source. (Author) [Spanish] La generacion y mal manejo de desechos hospitalarios

[The establishment of the hospital-system in the Byzantine Empire].

Science.gov (United States)

Józsa, László

2011-01-01

Byzantine hospitals developed out of Christian institutions for the poor and homeless. Philanthropy provided the initial impulse to create hospices (xenons) and to expand these institutions into specialized medical centers (iatreons or nosokomeions). However the Byzantine nosocomeions resemble more closely modern hospitals than they do any of the institutions of Greek-Roman antiquity or any of the houses of charity in the Latin West during the Middle Ages. Since the 4th century the Byzantine hospitals have stressed the central position of the nosocomeion in Byzantine society at the intersection of state, ecclesiastical and professional interest. In the great cities and in the capital, more than hundred hospitals worked in the East-Roman Empire. The Byzantine hospital rules guaranted patients private beds, required physicians to wash their hands after each examination and arranged the physical plant to keep all the sick warm. The Byzantine hospitals had separate sections (in modern terms: surgery-trauma surgery, internal medicine, ophthalmology, etc.) and at the beginning of the sixth century a separate institution for women. From the sixth century at least, bathing facilities normally adjoined Byzantine nosocomeia. By the twelfth century Byzantine hospitals also set aside a room or perhaps a separate building to treat outpatients. In addition to the main dormitories the surgery, baths and outpatient clinic, the large parts of hospitals also had separate rooms (or adjoining buildings) for library, for lecture hall, for administrative functions and record keeping for storage and for other services.

Abnormal intrinsic functional hubs in alcohol dependence: evidence from a voxelwise degree centrality analysis

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Luo X

2017-07-01

Full Text Available Xiaoping Luo,1,2 Linghong Guo,1 Xi-Jian Dai,3 Qinglai Wang,2 Wenzhong Zhu,2 Xinjun Miao,2 Honghan Gong1 1Department of Radiology, The First Affiliated Hospital of Nanchang University, Nangchang, Jiangxi, People’s Republic of China; 2Department of Radiology, Wenzhou Chinese Medicine Hospital, Wenzhou, Zhejiang, People’s Republic of China; 3Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, People’s Republic of China Objective: To explore the abnormal intrinsic functional hubs in alcohol dependence using voxelwise degree centrality analysis approach, and their relationships with clinical features.Materials and methods: Twenty-four male alcohol dependence subjects free of medicine (mean age, 50.21±9.62 years and 24 age- and education-matched male healthy controls (mean age, 50.29±8.92 years were recruited. The alcohol use disorders identification test and the severity of alcohol dependence questionnaire (SADQ were administered to assess the severity of alcohol craving. Voxelwise degree centrality approach was used to assess the abnormal intrinsic functional hubs features in alcohol dependence. Simple linear regression analysis was performed to investigate the relationships between the clinical features and abnormal intrinsic functional hubs.Results: Compared with healthy controls, alcohol dependence subjects exhibited significantly different degree centrality values in widespread left lateralization brain areas, including higher degree centrality values in the left precentral gyrus (BA 6, right hippocampus (BA 35, 36, and left orbitofrontal cortex (BA 11 and lower degree centrality values in the left cerebellum posterior lobe, bilateral secondary visual network (BA 18, and left precuneus (BA 7, 19. SADQ revealed a negative linear correlation with the degree centrality value in the left precentral gyrus (R2=0.296, P=0.006.Conclusion: The specific abnormal intrinsic functional hubs appear

Radiology integration in a multi-hospital system.

Science.gov (United States)

Welch, D

1999-01-01

In 1989, Salt Lake City's Intermountain Health Care (IHC) began a process to reduce costs and streamline processes. Divided into four geographic regions, IHC consists of 24 hospitals and 100 clinics, a 400-member practitioner-physician group, and a staff of 23,000. IHC determined that three Salt Lake Valley hospitals, part of its Urban Central Region, must become one entity with shared management and a reduced staff to cover operations at all three hospitals. Management of the three radiology departments were charged with creating an integration process for the three hospitals. Two directors were selected to manage radiology and meet the outlined goals. Difficulty arose when one director needed to make changes in a facility managed by the other. The directors found that structuring by modality allowed them to plan for all three facilities, standardize equipment purchases and create integrated rather than departmental programs. As consolidation was taking place in top management, employees worried what the resulting changes meant for their jobs. Many were unfamiliar with the concepts of team structure and continuous quality improvement. Various courses and meetings were held to educate staff members and bring them up to new standards. Most successful were the meetings that allowed staff from different facilities to come together and share ideas. Although travel was an issue, these meetings quickly helped move the integration processes forward as peer relationships were developed. Employees were recruited for cross-training and new staff worked wherever needed. As they began to share data, the three hospitals identified best-practice and internal benchmarks. IHC is now ready to hire a single director to manage the radiology departments at the three Salt Lake Valley hospitals.

Leptospirosis following a major flood in Central Queensland, Australia.

Science.gov (United States)

Smith, J K G; Young, M M; Wilson, K L; Craig, S B

2013-03-01

Throughout December 2010 and January 2011, Queensland experienced widespread flooding due to unusually protracted and heavy rainfalls. In mid-January 2011, four individuals from a small community in Central Queensland were hospitalized with leptospirosis. A further five cases were subsequently identified from around Central Queensland, bringing the total to nine. Microscopic agglutination testing found that serovar Arborea (Leptospira borgpetersenii serovar Arborea) was presumptively responsible for leptospirosis in seven of nine confirmed cases. Serovars Hardjo and Australis were identified in samples from two remaining cases. All cases had exposure to flood water. No single exposure source was identified. This is the first reported outbreak of leptospirosis in Central Queensland and the first report of leptospirosis cases associated with flood water inundation in Queensland. Public health authorities should continue to promote awareness of leptospirosis in flood-affected populations. Healthcare providers must maintain a high level of suspicion for leptospirosis during and after flood events.

[Hospital governance: between crisis management and implementation of public health policy].

Science.gov (United States)

Bréchat, Pierre-Henri; Antoine, Leenhardt; Mathieu-Grenouilleau, Marie-Christine; Rymer, Roland; Matisse, François; Baraille, Denis; Beaufils, Philippe

2010-01-01

The implementation of the recent act to amend the law on hospitals, patient health and territories (HPST Law) completes the reform of the organization and governance of health facilities, which was announced in 2002 by the "Hospital 2007" plan. What kind of assessments and perspectives can be considered and envisaged for these Hospital Activity Poles? We compared our experience with a review of the professional and scientific literature in order to stimulate answers to these questions for advocacy purposes prior to the Act's implementation. The hospital's cluster of activities should reinforce--not call into question the core activities and the financial stability of the facility, while respecting the contract on agreed objectives and the necessary means and resources to meet the health needs of the catchment population as well as national priorities. Although significant, but limited, successes exist, five obstacles to hospital reorganization can be identified. These include, for example: lack of delegation of management and centralization of decisions, the heterogeneity of numerous Hospital Activity Poles or problems related to timing. These obstacles may cause strain, or put the Hospital Activity Poles and the health facilities in a difficult situation with respect to their dynamics. This may show that the State and social health insurance should steer and direct public health policy and that the delegation of management roles and responsibilities to the Hospital Activity Poles should be addressed.

In-hospital mortality, 30-day readmission, and length of hospital stay after surgery for primary colorectal cancer: A national population-based study.

Science.gov (United States)

Pucciarelli, S; Zorzi, M; Gennaro, N; Gagliardi, G; Restivo, A; Saugo, M; Barina, A; Rugge, M; Zuin, M; Maretto, I; Nitti, D

2017-07-01

The simultaneous assessment of multiple indicators for quality of care is essential for comparisons of performance between hospitals and health care systems. The aim of this study was to assess the rates of in-hospital mortality and 30-day readmission and length of hospital stay (LOS) in patients who underwent surgical procedures for colorectal cancer between 2005 and 2014 in Italy. All patients in the National Italian Hospital Discharge Dataset who underwent a surgical procedure for colorectal cancer during the study period were included. The adjusted odd ratios for risk factors for in-hospital mortality, 30-day readmission, and LOS were calculated using multilevel multivariable logistic regression. Among the 353 941 patients, rates of in-hospital mortality and 30-day readmission were 2.5% and 6%, respectively, and the median LOS was 13 days. High comorbidity, emergent/urgent admission, male gender, creation of a stoma, and an open approach increased the risks of all the outcomes at multivariable analysis. Age, hospital volume, hospital geographic location, and discharge to home/non-home produced different effects depending on the outcome considered. The most frequent causes of readmission were infection (19%) and bowel obstruction (14.6%). We assessed national averages for mortality, LOS and readmission and related trends over a 10-year time. Laparoscopic surgery was the only one that could be modified by improving surgical education. Higher hospital volume was associated with a LOS reduction, but our findings only partially support a policy of centralization for colorectal cancer procedures. Surgical site infection was identified as the most preventable cause of readmission. Copyright © 2017 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

75 FR 34186 - Self-Regulatory Organizations; BATS Exchange, Inc.; EDGA Exchange, Inc.; EDGX Exchange, Inc...

Science.gov (United States)

2010-06-16

... Bar Association Business Law Section to Elizabeth M. Murphy, Secretary, Commission, dated June 3, 2010... of Business, to Elizabeth M. Murphy, Secretary, Commission, dated May 26, 2010 (``Harris Letter...''); Letter from Alexander M. Cutler, Business Roundtable to Elizabeth M. Murphy, Secretary, Commission, dated...

Early weaning and hospitalization with alcohol-related diagnoses in adult life

DEFF Research Database (Denmark)

Sørensen, Holger J; Mortensen, Erik L; Reinisch, June M

2006-01-01

hospitalizations with alcohol-related diagnoses according to ICD-8 or ICD-10 were identified in the Danish Psychiatric Central Register in 1999. Nine potential confounders were included as covariates: gender of the cohort member, maternal age, parental social status, maternal prenatal smoking, unwanted pregnancy...... of early weaning was 1.47. Elevated relative risks were also associated with maternal smoking during pregnancy (1.52) and unwanted pregnancy status (1.59). Other independent predictors were male gender, maternal psychiatric hospitalization with alcohol-related diagnosis, and low parental social status......OBJECTIVE: This study attempted to determine whether lack of breast-feeding or a short duration of breast-feeding during infancy is associated with an elevated risk of hospitalization with alcohol-related diagnoses in adult life. METHOD: The study was a prospective longitudinal birth cohort design...

The Rural Inpatient Mortality Study: Does Urban-Rural County Classification Predict Hospital Mortality in California?

Science.gov (United States)

Linnen, Daniel T; Kornak, John; Stephens, Caroline

2018-03-28

Evidence suggests an association between rurality and decreased life expectancy. To determine whether rural hospitals have higher hospital mortality, given that very sick patients may be transferred to regional hospitals. In this ecologic study, we combined Medicare hospital mortality ratings (N = 1267) with US census data, critical access hospital classification, and National Center for Health Statistics urban-rural county classifications. Ratings included mortality for coronary artery bypass grafting, stroke, chronic obstructive pulmonary disease, heart attack, heart failure, and pneumonia across 277 California hospitals between July 2011 and June 2014. We used generalized estimating equations to evaluate the association of urban-rural county classifications on mortality ratings. Unfavorable Medicare hospital mortality rating "worse than the national rate" compared with "better" or "same." Compared with large central "metro" (metropolitan) counties, hospitals in medium-sized metro counties had 6.4 times the odds of rating "worse than the national rate" for hospital mortality (95% confidence interval = 2.8-14.8, p centers may contribute to these results, a potential factor that future research should examine.

Incidence rates of in-hospital carpal tunnel syndrome in the general population and possible associations with marital status

OpenAIRE

Melani Carla; Fateh-Moghadam Pirous; dell'Omo Marco; de Giacomi Giovanna; Bena Antonella; Cooke Robin MT; Curti Stefania; Baldasseroni Alberto; Mattioli Stefano; Biocca Marco; Buiatti Eva; Campo Giuseppe; Zanardi Francesca; Violante Francesco S

2008-01-01

Abstract Background Carpal tunnel syndrome (CTS) is a socially relevant condition associated with biomechanical risk factors. We evaluated age-sex-specific incidence rates of in-hospital cases of CTS in central/northern Italy and explored relations with marital status. Methods Seven regions were considered (overall population, 14.9 million) over 3–6-year periods between 1997 and 2002 (when out-of-hospital CTS surgery was extremely rare). Incidence rates of in-hospital cases of CTS were estima...

100 Years of Accumulated Deformation at Depth Observed in the Elizabeth Lake Tunnel, Southern San Andreas Fault

Science.gov (United States)

Telling, J. W.; Tayyebi, A.; Hudnut, K. W.; Davis, C. A.; Glennie, C. L.

2017-12-01

The Elizabeth Lake Tunnel was completed in 1911 to convey water from the Owens Valley to Los Angeles, CA. The tunnel is approximately 8-km long and crosses the San Andreas Fault (SAF) at a depth of 90 m below the surface, measured near the tunnel mid-point. If present, a tectonic signal recorded by warping or offset of this tunnel could provide an opportunity to examine the deformation at depth in this location during the 100 years since the tunnel was constructed. A temporary closure of the tunnel for inspection and repair allowed the entire 8-km length to be surveyed using terrestrial laser scanning, providing a complete high-resolution 3D model of the tunnel. Since a high-resolution survey of the tunnel after its construction is not available for comparison, we assume that the tunnel was originally straight; this assumption is substantiated by records that indicate that the two halves of the tunnel, dug from opposite ends, met within 2.9 cm in the XY-plane and 1.6 cm in the Z-direction, at an off-fault location. Our results show 20 cm of right-lateral horizontal deformation near the estimated location of the tunnel's intersection with SAF, which agrees with the SAF sense of motion. The zone of deviation is approximately 300 m south of the SAF surface trace, and is about 350 m south of where the two tunneling crews met. This observed offset is consistent with either steady-state creep of about 2 mm/yr or possibly residual afterslip following the 1857 earthquake (that may be negligible at present). The full tectonic strain accumulation at this location would be five to ten times higher than observed, so clearly the observed deformation is only part of the expected full tectonic signal. In addition to the 20 cm short-wavelength deflection, we are examining for possible subtle longer wavelength deformation of the tunnel. The lidar model also shows significantly higher density of apparent cracking in the tunnel walls near this intercept point.

Nutrient-enriched formula milk versus human breast milk for preterm infants following hospital discharge.

Science.gov (United States)

Henderson, G; Fahey, T; McGuire, W

2007-10-17

Preterm infants are often growth-restricted at hospital discharge. Feeding infants after hospital discharge with nutrient-enriched formula milk instead of human breast milk might facilitate "catch-up" growth and improve development. To determine the effect of feeding nutrient-enriched formula compared with human breast milk on growth and development of preterm infants following hospital discharge. The standard search strategy of the Cochrane Neonatal Review Group was used. This included searches of the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 2, 2007), MEDLINE (1966 - May 2007), EMBASE (1980 - May 2007), CINAHL (1982 - May 2007), conference proceedings, and previous reviews. Randomised or quasi-randomised controlled trials that compared feeding preterm infants following hospital discharge with nutrient-enriched formula compared with human breast milk. The standard methods of the Cochrane Neonatal Review Group were used, with separate evaluation of trial quality and data extraction by two review authors. No eligible trials were identified. There are no data from randomised controlled trials to determine whether feeding preterm infants following hospital discharge with nutrient-enriched formula milk versus human breast milk affects growth and development. Mothers who wish to breast feed, and their health care advisors, would require very clear evidence that feeding with a nutrient-enriched formula milk had major advantages for their infants before electing not to feed (or to reduce feeding) with maternal breast milk. If evidence from trials that compared feeding preterm infants following hospital discharge with nutrient-enriched versus standard formula milk demonstrated an effect on growth or development, then this might strengthen the case for undertaking trials of nutrient-enriched formula milk versus human breast milk.

Splenectomy for hematological diseases: The Qatif Central HospitalExperience

International Nuclear Information System (INIS)

Al-Salem, Ahmed H.; Naserullah, Z.; Qaisaruddin, S.; Al-Dabbous, I.; Al-Abkari, H.; Al-Jama, A.; Al-Faraj, A.; Yassin, Yassin M.

1999-01-01

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

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

Directory of Open Access Journals (Sweden)

Susan J. Armstrong

2015-05-01

Full Text Available Background: Improving the quality of health care is central to the proposed health care reforms in South Africa. Nursing unit managers play a key role in coordinating patient care activities and in ensuring quality care in hospitals. Objective: This paper examines whether the activities of nursing unit managers facilitate the provision of quality patient care in South African hospitals. Methods: During 2011, a cross-sectional, descriptive study was conducted in nine randomly selected hospitals (six public, three private in two South African provinces. In each hospital, one of each of the medical, surgical, paediatric, and maternity units was selected (n=36. Following informed consent, each unit manager was observed for a period of 2 hours on the survey day and the activities recorded on a minute-by-minute basis. The activities were entered into Microsoft Excel, coded into categories, and analysed according to the time spent on activities in each category. The observation data were complemented by semi-structured interviews with the unit managers who were asked to recall their activities on the day preceding the interview. The interviews were analysed using thematic content analysis. Results: The study found that nursing unit managers spent 25.8% of their time on direct patient care, 16% on hospital administration, 14% on patient administration, 3.6% on education, 13.4% on support and communication, 3.9% on managing stock and equipment, 11.5% on staff management, and 11.8% on miscellaneous activities. There were also numerous interruptions and distractions. The semi-structured interviews revealed concordance between unit managers’ recall of the time spent on patient care, but a marked inflation of their perceived time spent on hospital administration. Conclusion: The creation of an enabling practice environment, supportive executive management, and continuing professional development are needed to enable nursing managers to lead the provision

Evaluation of hospital medication inventory policies.

Science.gov (United States)

Gebicki, Marek; Mooney, Ed; Chen, Shi-Jie Gary; Mazur, Lukasz M

2014-09-01

As supply chain costs constitute a large portion of hospitals' operating expenses and with $27.7 billion spent by the US hospitals on drugs alone in 2009, improving medication inventory management provides a great opportunity to decrease the cost of healthcare. This study investigates different management approaches for a system consisting of one central storage location, the main pharmacy, and multiple dispensing machines located in each department. Each medication has a specific unit cost, availability from suppliers, criticality level, and expiration date. Event-driven simulation is used to evaluate the performance of several inventory policies based on the total cost and patient safety (service level) under various arrangements of the system defined by the number of drugs and departments, and drugs' criticality, availability, and expiration levels. Our results show that policies that incorporate drug characteristics in ordering decisions can address the tradeoff between patient safety and cost. Indeed, this study shows that such policies can result in higher patient safety and lower overall cost when compared to traditional approaches. Additional insights from this study allow for better understanding of the medication inventory system's dynamics and suggest several directions for future research in this topic. Findings of this study can be applied to help hospital pharmacies with managing their inventory.

Magnetic resonance imaging features of neuroinfections in patients with AIDS. Pablo Tobon Hospital, Medellin (2008-2009)

International Nuclear Information System (INIS)

Pulgarin R, Luis G; Gomez R, Susana; Sanchez Z, Jonathan A; Abreo L, Diego F; Hernandez J, Andres F; Donado G, Jorge H.

2010-01-01

Our purpose is to describe the clinical and magnetic resonance imaging (MRI) features of the central nervous system (CNS ) most common infectious diseases in patients with human immunodeficiency virus (HIV) and / or acquired immunodeficiency syndrome (AIDS ) that consulted to the Hospital Pablo Tobon Uribe in the period 2008-2009. We included four adult patients with HIV and / or AIDS from Hospital Pablo Tobon Uribe database, who were diagnosed having central nervous system infections by MRI and diagnostic microbiological tests. The most common MRI patterns of CNS infections in AIDS patients in our institution were irregular multifocal intra-axial space-occupying lesions with heterogeneous and variable signals on T1, T2 and FLAI R, with perilesional edema and rim postcontrast enhancement.

75 FR 34183 - Self-Regulatory Organizations; Financial Industry Regulatory Authority, Inc.; Order Granting...

Science.gov (United States)

2010-06-16

... Bar Association Business Law Section to Elizabeth M. Murphy, Secretary, Commission, dated June 3, 2010... Harris, USC Marshall School of Business, to Elizabeth M. Murphy, Secretary, Commission, dated May 26... Ameritrade Letter''); Letter from Alexander M. Cutler, Business Roundtable to Elizabeth M. Murphy, Secretary...

Ultrafine and Fine Particles and Hospital Admissions in Central Europe Results from the UFIREG Study

Czech Academy of Sciences Publication Activity Database

Lanzinger, S.; Schneider, A.; Breitner, S.; Stafoggia, M.; Erzen, I.; Dostál, Miroslav; Pastorková, Anna; Bastian, S.; Cyrys, J.; Zscheppang, A.; Kolodnitská, T.; Peters, A.

2016-01-01

Roč. 194, č. 10 (2016), s. 1233-1241 ISSN 1073-449X Institutional support: RVO:68378041 Keywords : ultrafine particles * particulate matter * hospital admissions * respiratory Subject RIV: DN - Health Impact of the Environment Quality Impact factor: 13.204, year: 2016

[Centralization in obstetrics: pros and cons].

Science.gov (United States)

Roemer, V M; Ramb, S

1996-01-01

Possible advantages and disadvantages of a general centralization of German obstetric facilities are analysed in the study. The need for centralization of risk cases, especially premature births (regionalization) is pointed out. Centralization appears appropriate, since every fifth maternity unit in Germany (19.78%) has 300 or fewer deliveries per year. This one fifth of perinatal clinics accounts for 6.3% of all deliveries (N = 49450). There are appreciable differences between the old and new federal states (Bundesländer): in the recently acceded federal states, 48.7% of all perinatal clinics have deliveries of 300 and less per year. This group of perinatal clinics accounts for 29% of all deliveries in the new federal states. We have carried out a survey of the mother's attitude to centralization: out of 416 patients in the Detmold women's hospital whose mean age was 29.0 +/- 4.2 years, 90.4% were not in favor of general centralization of obstetrics. 43% were also against a centralization of risk cases (regionalization). 75% of the women surveyed objected to centralized obstetrics because of the 'possible absence of the family', the 'possible absence of students and trainees' (44.9%), the 'unfamiliarity with staff and premises' (41.8%) and 'fear of anonymity' (44.5%). The majority of all women (84.1%) did not want to have a drive more than 20 km to an obstetrics center. Fear of 'delivery in a taxi'(78.6%), the 'fear that the husband will come too late to the delivery' (65.4%) and that the 'overall course of the delivery might not be adequate for reasons of time'. The presence of a pediatrics department in conjunction with the perinatal clinic was rated very positively (93%). It is concluded from the data and further juridical considerations that centralization of risk cases (regionalization) is indispensable in the near future and that somewhat more further into the future decentralization should be carried out by closing obstetrics departments with substantially

Impact of centralization of pancreatoduodenectomy on reported radical resections rates in a nationwide pathology database.

Science.gov (United States)

Onete, Veronica G; Besselink, Marc G; Salsbach, Chanielle M; Van Eijck, Casper H; Busch, Olivier R; Gouma, Dirk J; de Hingh, Ignace H; Sieders, Egbert; Dejong, Cornelis H; Offerhaus, Johan G; Molenaar, I Quintus

2015-08-01

Centralization of a pancreatoduodenectomy (PD) leads to a lower post-operative mortality, but is unclear whether it also leads to improved radical (R0) or overall resection rates. Between 2004 and 2009, pathology reports of 1736 PDs for pancreatic and peri-ampullary neoplasms from a nationwide pathology database were analysed. Pre-malignant lesions were excluded. High-volume hospitals were defined as performing ≥ 20 PDs annually. The relationship between R0 resections, PD-volume trends, quality of pathology reports and hospital volume was analysed. During the study period, the number of hospitals performing PDs decreased from 39 to 23. High-volume hospitals reported more R0 resections in the pancreatic head and distal bile duct tumours than low-volume hospitals (60% versus 54%, P = 0.035) although they operated on more advanced (T3/T4) tumours (72% versus 58%, P < 0.001). The number of PDs increased from 258 in 2004 to 394 in 2009 which was partly explained by increased overall resection rates of pancreatic head and distal bile duct tumours (11.2% in 2004 versus 17.5% in 2009, P < 0.001). The overall reported R0 resection rate of pancreatic head and distal bile duct tumours increased (6% in 2004 versus 11% in 2009, P < 0.001). Pathology reports of low-volume hospitals lacked more data including tumour stage (25% versus 15%, P < 0.001). Centralization of PD was associated with both higher resection rates and more reported R0 resections. The impact of this finding on overall survival should be further assessed. © 2015 International Hepato-Pancreato-Biliary Association.

An audit of hospital based outpatient infusions and a pilot program of community-based monoclonal antibody infusions.

LENUS (Irish Health Repository)

Doran, J-P

2012-02-01

INTRODUCTION: Infliximab, a chimeric monoclonal antibody to tumour necrosis factor alpha, is administered as an intravenous infusion requiring a costly hospital day case or inpatient admission. METHODS: An audit of all current therapies given by intravenous infusions in an outpatient setting in St Vincent\\'s University Hospital (SVUH) was undertaken. Furthermore, in conjunction with TCP homecare, we established in a general practise health clinic, the first Irish community infusion centre for the administration of infliximab in August 2006. RESULTS: All outpatient departments indicated that they would favour a centralized hospital infusion unit. There were no adverse events and the mean global satisfaction improved in the community infliximab infusion pilot programme of seven patients. CONCLUSION: This study suggests efficiencies in providing centralized infusion facilities, while the community based infusion of infliximab is feasible and safe in this small cohort and identifies the community infusion unit as a viable and cost efficient alternative for administration of infliximab.

Risk factors for hospital-associated venous thromboembolism in critically ill children following cardiothoracic surgery or therapeutic cardiac catheterisation.

Science.gov (United States)

Atchison, Christie M; Amankwah, Ernest; Wilhelm, Jean; Arlikar, Shilpa; Branchford, Brian R; Stock, Arabela; Streiff, Michael; Takemoto, Clifford; Ayala, Irmel; Everett, Allen; Stapleton, Gary; Jacobs, Marshall L; Jacobs, Jeffrey P; Goldenberg, Neil A

2018-02-01

Paediatric hospital-associated venous thromboembolism is a leading quality and safety concern at children's hospitals. The aim of this study was to determine risk factors for hospital-associated venous thromboembolism in critically ill children following cardiothoracic surgery or therapeutic cardiac catheterisation. We conducted a retrospective, case-control study of children admitted to the cardiovascular intensive care unit at Johns Hopkins All Children's Hospital (St. Petersburg, Florida, United States of America) from 2006 to 2013. Hospital-associated venous thromboembolism cases were identified based on ICD-9 discharge codes and validated using radiological record review. We randomly selected two contemporaneous cardiovascular intensive care unit controls without hospital-associated venous thromboembolism for each hospital-associated venous thromboembolism case, and limited the study population to patients who had undergone cardiothoracic surgery or therapeutic cardiac catheterisation. Odds ratios and 95% confidence intervals for associations between putative risk factors and hospital-associated venous thromboembolism were determined using univariate and multivariate logistic regression. Among 2718 admissions to the cardiovascular intensive care unit during the study period, 65 met the criteria for hospital-associated venous thromboembolism (occurrence rate, 2%). Restriction to cases and controls having undergone the procedures of interest yielded a final study population of 57 hospital-associated venous thromboembolism cases and 76 controls. In a multiple logistic regression model, major infection (odds ratio=5.77, 95% confidence interval=1.06-31.4), age ⩽1 year (odds ratio=6.75, 95% confidence interval=1.13-160), and central venous catheterisation (odds ratio=7.36, 95% confidence interval=1.13-47.8) were found to be statistically significant independent risk factors for hospital-associated venous thromboembolism in these children. Patients with all three

PACS in Töölö hospital.

Science.gov (United States)

Kinnunen, J; Pohjonen, H

2001-07-01

A 3-year PACS project was started in 1997 and completed in 1999 with filmless radiology and surgery. An efficient network for transferring images provides the infrastructure for integration of different distributed imaging systems and enables efficient handling of all patient-related information on one display station. Because of the need for high-speed communications and the massive amount of image data transferred in radiology, ATM (25, 155 Mbit/s) was chosen to be the main technology used. Both hardware and software redundancy of the system have been carefully planned. The size of the Dicom image library utilizing MO discs is currently 1.2 TB with 300 GB RAID capacity. For the increasing amount of teleradiologic consultations, a special Dicom gateway is planned. It allows a centralized and resilient handling and routing of received images around the hospital. Hospital-wide PACS has already improved the speed and quality of patient care by providing instant access to diagnostic information at multiple locations simultaneously. The benefits of PACS are considered from the viewpoint of the entire hospital: PACS offers a method for efficiently transporting patient-related images and reports to the referring physicians.

Characteristics of HIV-infected childbearing women in Barbados Características de las mujeres con infección por VIH que dan a luz en Barbados

OpenAIRE

Alok Kumar; Valmay Bent

2003-01-01

OBJECTIVE: To describe the demographic profile, social and family characteristics, and life style traits of HIV-infected childbearing women in the Caribbean nation of Barbados in comparison to a control group of HIV-negative women. METHODS: Data for this report were drawn from the Pediatrics HIV Surveillance Program of the Queen Elizabeth Hospital in Barbados. The data covered all HIV-infected women in the country who delivered between 1986-2000, with similar data coming from a control group ...

Hospital staffing and hospital costs.

Science.gov (United States)

Andrew, R R

1976-08-07

A comparative study of costs per bed per day in teaching hospitals affiliated with Monash University compared with large non-teaching metropolitan hospitals (1964 to 1974) shows they are much higher in teaching hospitals. There is no evidence that this is due to the additional costs arising from the clinical schools. Research in the teaching hospitals and the accompanying high professional standards and demands on services are major factors accounting for the difference. Over the decade studied, the resident staff have increased by 77% and other salaried staff by 24%. The index of expenditure for the three teaching hospitals in the decade has increased by 386%.

Association between value-based purchasing score and hospital characteristics

Directory of Open Access Journals (Sweden)

Borah Bijan J

2012-12-01

Full Text Available Abstract Background Medicare hospital Value-based purchasing (VBP program that links Medicare payments to quality of care will become effective from 2013. It is unclear whether specific hospital characteristics are associated with a hospital’s VBP score, and consequently incentive payments. The objective of the study was to assess the association of hospital characteristics with (i the mean VBP score, and (ii specific percentiles of the VBP score distribution. The secondary objective was to quantify the associations of hospital characteristics with the VBP score components: clinical process of care (CPC score and patient satisfaction score. Methods Observational analysis that used data from three sources: Medicare Hospital Compare Database, American Hospital Association 2010 Annual Survey and Medicare Impact File. The final study sample included 2,491 U.S. acute care hospitals eligible for the VBP program. The association of hospital characteristics with the mean VBP score and specific VBP score percentiles were assessed by ordinary least square (OLS regression and quantile regression (QR, respectively. Results VBP score had substantial variations, with mean score of 30 and 60 in the first and fourth quartiles of the VBP score distribution. For-profit status (vs. non-profit, smaller bed size (vs. 100–199 beds, East South Central region (vs. New England region and the report of specific CPC measures (discharge instructions, timely provision of antibiotics and beta blockers, and serum glucose controls in cardiac surgery patients were positively associated with mean VBP scores (p Conclusions Although hospitals serving the poor and the elderly are more likely to score lower under the VBP program, the correlation appears small. Profit status, geographic regions, number and type of CPC measures reported explain the most variation among scores.

Using the Theory of Planned Behavior to explore hospital-based nurses' intention to use peripherally inserted central catheter (PICC): a survey study.

Science.gov (United States)

Bertani, Laura; Carone, Maria; Caricati, Luca; Demaria, Serena; Fantuzzi, Silvia; Guarasci, Alessandro; Pirazzoli, Luca

2016-11-22

The peripherally inserted central catheters (PICC) have become an alternative to the traditional CVC. PICCs are usually inserted by trained nurses who decided to attend and complete a special training on PICC insertion and management. The present work aimed to investigate the intention of using PICC in a sample of hospital-based nurses using the theory of planned behavior as theoretical framework. A cross-sectional design was used in which a questionnaire was delivered to 199 nurses. According to the theory of planned behavior, the attitude toward the use of PICC, subjective norms and perceived self-efficacy predicted the intention to use PICC. Contrary to the expectations, the effect of subjective norms on intention to use PICC was mediated by attitude and self-efficacy. Finally, age of participants was negatively related to the intention to use the PICC. The theory of planned behavior offers a useful framework to explain nurses' intention to use PICC. Shared norms favoring the use of PICC seem to increase both nurse's positive attitudes and self-efficacy whit respect to the use of these devices. Thus, it appears that to train professionals individually does not necessarily results in an increased use of PICC.

The definition, selection and implementation of a new Clinical Information System to prepare the hospital for the electronic future : an example of project-based education

NARCIS (Netherlands)

Spil, Antonius A.M.; van de Meeberg, Henk J.; Sikkel, Nicolaas

The software supplier of a large hospital has been taken over. The hospital gets notice that the central hospital information system (HIS) will no longer be maintained, starting next year. This problem, not uncommon in business today, is used as a real-life case in a project-based course for first

Hospitality within hospital meals—Socio-material assemblages

DEFF Research Database (Denmark)

Justesen, Lise; Gyimóthy, Szilvia; Mikkelsen, Bent E.

2016-01-01

Hospital meals and their role in nutritional care have been studied primarily from a life and natural science perspective. This article takes a different approach and explores the idea of hospitality inspired by Jacques Derrida’s work on the ontology of hospitality. By drawing on ethnographic fie...... and management involved in hospital food service and in nutritional care to work more systematically with the environment for improved hospital meal experiences in the future......Hospital meals and their role in nutritional care have been studied primarily from a life and natural science perspective. This article takes a different approach and explores the idea of hospitality inspired by Jacques Derrida’s work on the ontology of hospitality. By drawing on ethnographic...

Hospital Prices Increase in California, Especially Among Hospitals in the Largest Multi-hospital Systems

Directory of Open Access Journals (Sweden)

Glenn A. Melnick PhD

2016-06-01

Full Text Available A surge in hospital consolidation is fueling formation of ever larger multi-hospital systems throughout the United States. This article examines hospital prices in California over time with a focus on hospitals in the largest multi-hospital systems. Our data show that hospital prices in California grew substantially (+76% per hospital admission across all hospitals and all services between 2004 and 2013 and that prices at hospitals that are members of the largest, multi-hospital systems grew substantially more (113% than prices paid to all other California hospitals (70%. Prices were similar in both groups at the start of the period (approximately $9200 per admission. By the end of the period, prices at hospitals in the largest systems exceeded prices at other California hospitals by almost $4000 per patient admission. Our study findings are potentially useful to policy makers across the country for several reasons. Our data measure actual prices for a large sample of hospitals over a long period of time in California. California experienced its wave of consolidation much earlier than the rest of the country and as such our findings may provide some insights into what may happen across the United States from hospital consolidation including growth of large, multi-hospital systems now forming in the rest of the rest of the country.

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

Science.gov (United States)

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

1989-01-01

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

Evaluation of real-time location systems in their hospital contexts.

Science.gov (United States)

Fisher, Jill A; Monahan, Torin

2012-10-01

The purpose of the research was to assess real-time location systems (RTLS) that have been implemented in U.S. hospitals. We examined the type of uses to which RTLS have been put, the degree of functionality of the various technologies and software, and the organizational effects of implementing RTLS. The project was a 3-year qualitative study of 23 U.S. hospitals that had implemented RTLS for the purpose of tracking assets, personnel, and/or patients. We observed the systems in use and conducted 80 semi-structured interviews with hospital personnel and vendors. In order to protect the confidentiality of the hospitals and vendors in our sample, we conducted an aggregate analysis of our findings rather than providing evaluations of specific technologies or hospital case studies. The most important findings from our research were (1) substandard functionality of most real-time location systems in use and (2) serious obstacles to effective deployment of the systems due to the material and organizational constraints of the hospitals themselves. We found that the current best use of RTLS is for asset tracking, but importantly it requires whole-hospital deployment as well as centralized control of the system, preferably by materials management or biomedical engineering departments. There are serious technological, material, and organizational barriers to the implementation of RTLS, and these barriers need to be overcome if hospitals are to maximize the potential benefits of these systems. In addition to considering the available technological options, hospitals must assess their unique environments, including the myriad material and organizational constraints that will affect the success of RTLS implementation. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Comparison amount of air microbial pollution in the hospital of two different towns in Gilan Province, Iran

International Nuclear Information System (INIS)

Arani, A.; Mosahab, R.

2008-01-01

Nosocomial infections are known as infections which are acquired during patients hospitalization in hospitals. It has long history and causes to increase both therapy costs and problems of patient treatments. This study is for comparison of air microbial pollution in hospitals of towns (A) and (B) in Iran. This study is a descriptive-analytic type. Blood Agar culture was used for determining of microbial pollution. Statistic tests (central and scattering criterions) have been used for data analysis. Findings show that the most epidemical pathogen in view of air pollution in different parts of hospitals is non-urease Staphylococcus. It seems that because of using UV radiation, proper air ventilation and many facilities, air pollution in town (B) hospitals is less than town (A). (author)

Cost of treatment for breast cancer in central Vietnam

Directory of Open Access Journals (Sweden)

Nguyen Hoang Lan

2013-02-01

Full Text Available Background: In recent years, cases of breast cancer have been on the rise in Vietnam. To date, there has been no study on the financial burden of the disease. This study estimates the direct medical cost of a 5-year treatment course for women with primary breast cancer in central Vietnam. Methods: Retrospective patient-level data from medical records at the Hue Central Hospital between 2001 and 2006 were analyzed. Cost analysis was conducted from the health care payers’ perspective. Various direct medical cost categories were computed for a 5-year treatment course for patients with breast cancer. Costs, in US dollars, discounted at a 3% rate, were converted to 2010 after adjusting for inflation. For each cost category, the mean, standard deviation, median, and cost range were estimated. Median regression was used to investigate the relationship between costs and the stage, age at diagnosis, and the health insurance coverage of the patients. Results: The total direct medical cost for a 5-year treatment course for breast cancer in central Vietnam was estimated at $975 per patient (range: $11.7–$3,955. The initial treatment cost, particularly the cost of chemotherapy, was found to account for the greatest proportion of total costs (64.9%. Among the patient characteristics studied, stage at diagnosis was significantly associated with total treatment costs. Patients at later stages of breast cancer did not differ significantly in their total costs from those at earlier stages however, but their survival time was much shorter. The absence of health insurance was the main factor limiting service uptake. Conclusion: From the health care payers’ perspective, the Government subsidization of public hospital charges lowered the direct medical costs of a 5-year treatment course for primary breast cancer in central Vietnam. However, the long treatment course was significantly influenced by out-of-pocket payments for patients without health insurance.

Implementation of a Personnel Management System "Beaufort": Successes and failures at a Dutch Hospital

NARCIS (Netherlands)

Bondarouk, Tatiana; Khosrow-Pour, M.

2004-01-01

This case describes a project concerning the implementation of a personnel management system - Beaufort - in Medinet, one of the larger regional general hospitals in The Netherlands. The project plan included two sequential phases: firstly, the introduction of Beaufort to the central personnel and

Does autonomy for public hospitals in developing countries increase performance? Evidence-based case studies.

Science.gov (United States)

De Geyndt, Willy

2017-04-01

Governments in middle and low income countries have sought ways for the past decades to make their public hospitals more performing. The objectives of this assessment are to: (a) synthesize the experience of eleven countries at granting autonomy to their public hospitals and the obstacles encountered; (b) deduce which autonomy policies have or have not been effective documenting successes and failures; and (c) propose evidence-based recommendations to policy makers. Data for five countries are derived from the author's participation in the autonomy process augmented by current updates provided by national colleagues. Data for the other six countries are derived from publications available in the literature. Policies granting autonomy to public hospitals have had limited success. In all cases Boards of Directors have been created. Governance of autonomized hospitals by Boards however is obstructed by the resistance of central level entities to have their authority diminished. The Ministry of Finance tends to maintain control over revenues and expenditures. The Public Service Commission resists abdicating its role to hire, promote, transfer and dismiss government employees. The Ministry of Health attempts to keep its authority to appoint hospital staff, procure medical supplies and equipment; it may do so directly or indirectly by selecting and appointing Board members. Management information systems continue to collect activity measures to be aggregated at the national level for statistical purposes and do not provide financial and clinical data useful for decision making by the Boards and by senior management. Decentralizing decision making to the operational level has had limited success. Stakeholders at the central level devise strategies to maintain their power. Two main obstacles are delegating authority over human resources and finances that are sine qua non conditions for governing and increasing the performance of public hospitals. Copyright © 2017 Elsevier

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

NARCIS (Netherlands)

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

2009-01-01

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

Evaluation Of Prescription Pattern And Medication Adherence Of Antihypertensive Drugs In Stage 1 Essential Hypertensive Patients At Rural Tertiary Care Teaching Hospital Of Central India.

Directory of Open Access Journals (Sweden)

Chetan S. Urade

2016-09-01

Full Text Available Objectives- To study the prescription pattern of antihypertensive drugs and analyze the medication adherence to antihypertensive drugs at rural tertiary care teaching hospital.Materials and Methods- Prospective, observational, 12 weeks, questionnaire based study, conducted in rural tertiary care teaching hospital of central India. 214 antihypertensive prescriptions were analyzed by Morisky medication adherence scale. Statistical analysis was done by MS Excel and Graph pad prism 6.0.Results- 28.03% patients were not aware about the medicines taken, 29.90% patients were unacquainted about dose and route of administration whereas 32.71% patients were unfamiliar about frequency of administration of medicines. 53.27% patients were unaware about precautions to be taken while consuming medicines.  58.68% & 12.67% patients consumed amlodipine & atenolol respectively. In 16.43% patients, atenolol + amlodipine combination therapy was prescribed.  Amongst 214 patients 12, 58 & 144 showed high, medium & low adherence respectively.  No significant difference was found on gender basis at any level of adherence.Conclusion- In this study, physicians given preference to amlodipine than other antihypertensive drugs. However, thiazide is a first line drug in stage 1 hypertension, recommended by JNC VII guideline. This indicates that there is need of creating awareness about current management of hypertension to clinicians by organizing various workshops. We observed only 5.60% patients showed high adherence to antihypertensive therapy. Therefore educational strategies must be carried out for physicians focusing on causes for nonadherence to antihypertensive medications. Also raising patient trust in their physicians may improve patient motivation to prescribed medication. 

A comprehensive approach to improving patient flow in our hospitals--the 'left to right, over and under' concept.

Science.gov (United States)

Ardagh, Michael

2015-08-21

It is essential we manage the capacity of our hospitals so that acute demand can be accommodated without developing queues for care and backlogs of work. This paper presents a comprehensive model for improving patient flow in our hospitals by attending carefully to both the demand and capacity states of the hospital and maximising efficient flow of our acute patient journeys. The model includes attention to the patient journey as the central focus, with an overarching governance structure and an underpinning sophisticated operations structure.

Senior Friendly Hospitals: Development and Application of Criteria: A Descriptive Study.

Science.gov (United States)

Rashmi, M R; Kasthuri, Arvind; Rodrigues, Rashmi J

2016-01-01

The world's population is rapidly aging. Between 2000 and 2050, the proportion of the world's population over the age of 60 will double from about 11% to 22%; more so in the developing countries. The prevalence of frailty and morbidity among the elderly is high. There is a need to assess the "preparedness" of the health care system including hospitals to respond to the needs of the elderly. 1. To develop criteria for a senior friendly hospital and 2. To assess the feasibility of application of these criteria. A descriptive study was done at Bangalore, India, involving 100 subjects sampled by purposive sampling. Study population consisted of senior citizens, their caretakers, physicians, hospital support staff, nurses, geriatricians, hospital administrators, and architects. They were interviewed using a validated translated interview schedule. The study consisted of two phases; Phase 1: Developing a checklist to assess senior friendliness of a hospital by using modified Delphi technique. Phase 2: Application of the checklist thus developed to selected hospitals in order to assess the feasibility of administration. The data was then analyzed using Statistical Package for the Social Sciences (SPSS) for frequencies, proportions, central tendency and dispersion, interclass reliability, intraclass reliability, and Cronbach's alpha. A checklist containing 44 items to assess the senior friendliness of a hospital was developed. The checklist was found feasible and easy to administer. The checklist thus developed to assess senior friendliness of a hospital has wider application as it has a potential to be considered for framing senior friendly hospital guidelines/policies.

Expression of CD40 is a positive prognostic factor of diffuse large B-cell lymphoma treated with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone

Directory of Open Access Journals (Sweden)

Song G

2016-06-01

Full Text Available Guoqi Song,1 Huiyun Ni,1 Linqing Zou,2 Shukui Wang,3 Fuliang Tian,4 Hong Liu,1 William C Cho5 1Department of Hematology, Affiliated Hospital of Nantong University, Nantong, 2Department of Human Anatomy, Nantong University, Nantong, 3Central Laboratory of Nanjing First Hospital, Nanjing Medical University, Nanjing, 4Maternal and Child Health Hospital of Lianyungang, Lianyungang, Jiangsu, People’s Republic of China; 5Department of Clinical Oncology, Queen Elizabeth Hospital, Kowloon, Hong Kong Objectives: The objective of this study was to investigate the expression level of CD40 and its role in the prognosis of patients with diffuse large B-cell lymphoma (DLBCL who were treated with rituximab-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone.Design and methods: The immunohistochemical expressions of CD40 in 186 well-characterized DLBCL patients were evaluated by tissue microarrays, thereby revealing the relationship of the molecule CD40 with known tumor, patient-related variables, and survival rates.Results: The results showed that CD40 expressions were not statistically different between the germinal center B-cell-like (GCB type and the non-GCB type. We also analyzed the relationships of CD40 expression with overall survival (OS and progression-free survival (PFS in DLBCL patients who were uniformly treated with R-CHOP. A low expression of CD40 compared to high expression is related to poor OS and PFS. Conclusion: Our findings indicate that the CD40 level at onset acts as an independent prognostic predictor of DLBCL patients treated with R-CHOP. Keywords: CD40, diffuse large B-cell lymphoma, R-CHOP, prognostic factor

Hospital waste management in El-Beheira Governorate, Egypt.

Science.gov (United States)

Abd El-Salam, Magda Magdy

2010-01-01

This study investigated the hospital waste management practices used by eight randomly selected hospitals located in Damanhour City of El-Beheira Governorate and determined the total daily generation rate of their wastes. Physico-chemical characteristics of hospital wastes were determined according to standard methods. A survey was conducted using a questionnaire to collect information about the practices related to waste segregation, collection procedures, the type of temporary storage containers, on-site transport and central storage area, treatment of wastes, off-site transport, and final disposal options. This study indicated that the quantity of medical waste generated by these hospitals was 1.249tons/day. Almost two-thirds was waste similar to domestic waste. The remainder (38.9%) was considered to be hazardous waste. The survey results showed that segregation of all wastes was not conducted according to consistent rules and standards where some quantity of medical waste was disposed of with domestic wastes. The most frequently used treatment method for solid medical waste was incineration which is not accepted at the current time due to the risks associated with it. Only one of the hospitals was equipped with an incinerator which is devoid of any air pollution control system. Autoclaving was also used in only one of the selected hospitals. As for the liquid medical waste, the survey results indicated that nearly all of the surveyed hospitals were discharging it in the municipal sewerage system without any treatment. It was concluded that the inadequacies in the current hospital waste management practices in Damanhour City were mainly related to ineffective segregation at the source, inappropriate collection methods, unsafe storage of waste, insufficient financial and human resources for proper management, and poor control of waste disposal. The other issues that need to be considered are a lack of appropriate protective equipment and lack of training and

Hospital Geriátrico Ellesmere Gran Bretaña

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Stow, Derek

1980-11-01

Full Text Available This center was designed to serve as a prototype for geriatric hospitals, in accordance with the program drawn up by the health authorities of the southeast area of the Thames; for this reason, its design had to be such that it could be reused in different hospital complexes. It consists of a pavilion with an infirmary equipped with different clinical, therapeutical and social services for senior citizens. In order to render possible the realization of the prototype on locations with different conditioning factors —in this case the unit was built on the grounds of an important medical center—, the auxiliary and service premises were designed separately, thus facilitating a different implementation with respect to the central nucleus, in accordance with varying circumstances

Este centro se concibió para que sirviera como prototipo de hospital geriátrico, de acuerdo con el programa confeccionado por las autoridades sanitarias del suroeste del Támesis; por ello su diseño debía hacerle capaz de ser reutilizado en distintos complejos hospitalarios. Consta de un pabellón con ambulatorio equipado con distintos servicios clínicos, terapéuticos y de tipo social dirigidos a la tercera edad. Con el fin de posibilitar la realización del prototipo en parcelas sometidas a distintos condicionantes —en este caso, la unidad se construyó en los terrenos de un importante centro médico—, los locales auxiliares y de servicio fueron objeto de un diseño independiente facilitando, por tanto, su distinta implantación respecto al núcleo central, de acuerdo con las diferentes circunstancias.

Market Orientation Impact on Radical and Incremental Marketing Innovation: A Study of Saudi Arabia Hospital Marketing Efforts

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Alshahry Abdullah saeed A; Wang Aimin

2015-01-01

We conducted an empirical study to measure influence of market orientation on marketing innovation in hospitals in Saudi Arabia. The sample includes 109 hospital workers that have been identified as having an adequate knowledge of the subject of research. In particular we explain the impact of customer orientation, inter-functional orientation and competitor orientation on marketing innovation. Furthermore the moderating effects of centralization and formalization on those relationships are e...

Centralization of politrauma. Study of Ferrara’s reality and simulation of an agreed-upon protocol

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Luigi Melcarne

2011-09-01

Full Text Available In a time in which everybody’s asked a big effort to use hospitals, resources and emergency departments in a rational way, the Centralization – that is sending the right patient to the right hospital at the right time – allows an optimization of the resources and a better management of medical patients. In this study we examined the actual state of Centralization in the city of Ferrara where an experimental protocol of “centralization” has been introduced. This study has the purpose of simulating reality if the protocol had been introduced in the years 2008/2009. The results confirm not only that an important number of patients that were meant to be sent to the CTZ of Ferrara where instead sent to the PST but also that, on the contrary, patients from the suburbs that didn’t require advanced treatments were sent to the Sant’Anna hospital of Ferrara. So if medical literature already points out the advantages of a correct Centralization for patients with polytraumas; the study, based on the reality in Ferrara , shows how the creation of an agreed protocol with the goal to guide health workers at sending polytrauma patients to the right destination , instead of creating an excessive flow th the main hub, can improve the overall organization of health services, with an equal distribution between hub and spoke. When considering First Aid not always speed and rapidity guarantee survival; this is so much more real in the case of patients with polytrauma, where quality of cures assumes more importance than time.

Using real-time problem solving to eliminate central line infections.

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Shannon, Richard P; Frndak, Diane; Grunden, Naida; Lloyd, Jon C; Herbert, Cheryl; Patel, Bhavin; Cummins, Daniel; Shannon, Alexander H; O'Neill, Paul H; Spear, Steven J

2006-09-01

An estimated 200,000 Americans suffer central line-associated bloodstream infections (CLABs) each year, with 15%-20% mortality. Two intensive care units (ICUs) redefined the processes of care through system redesign to deliver reliable outcomes free of the variations that created the breeding ground for infection. The ICUs, comprising 28 beds at Allegheny General Hospital, employed the principles of the Toyota Production System adapted to health care--Perfecting Patient Care--and applied them to central line placement and maintenance. Intensive observations, which revealed multiple variances from established practices, and root cause analyses of all CLABs empowered the workers to implement countermeasures designed to eliminate the defects in the processes of central line placement and maintenance. New processes were implemented within 90 days. Within a year CLABs decreased from 49 to 6 (10.5 to 1.2 infections/1,000 line-days), and mortalities from 19 to 1 (51% to 16%), despite an increase in the use of central lines and number of line-days. These results were sustained during a 34-month period. CLABs are not an inevitable product of complex ICU care but the result of highly variable and therefore unreliable care delivery that predisposes to infection.

Central retinal artery occlusion in the 9 years old girl (Clinical case report

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E. Yu. Markova

2013-01-01

Full Text Available 9 years old girl was admitted to the Ophthalmological Department of Morozov Pediatric City Clinical Hospital with sudden persistent painless loss of vision of the left eye. Other organs and systems were without any changes. After ophthalmological examination (OS — white edema of central and peripapillar retina, a cherry red spot at the fovea the diagnosis of central retinal artery occlusion OS was formed, and treatment was started immediately. CRAO practically does not occur in pediatric ophthalmological practice. Therefore this clinical case can be of interest to clinicians and pediatric ophthalmologists.

Central retinal artery occlusion in the 9 years old girl (Clinical case report

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E. Yu. Markova

2014-07-01

Full Text Available 9 years old girl was admitted to the Ophthalmological Department of Morozov Pediatric City Clinical Hospital with sudden persistent painless loss of vision of the left eye. Other organs and systems were without any changes. After ophthalmological examination (OS — white edema of central and peripapillar retina, a cherry red spot at the fovea the diagnosis of central retinal artery occlusion OS was formed, and treatment was started immediately. CRAO practically does not occur in pediatric ophthalmological practice. Therefore this clinical case can be of interest to clinicians and pediatric ophthalmologists.

A novel system to tackle hospital acquired pressure ulcers.

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Renganathan, B S; Preejith, S P; Nagaiyan, Sridhar; Joseph, Jayaraj; Sivaprakasam, Mohanasankar

2016-08-01

Hospital acquired pressure ulcers (HAPUs) is a major problem that affects around one in twenty patients who are admitted in hospital with sudden illness. These ulcers often occur when patients have limited mobility and cannot change positions in bed on their own. Traditionally, the occurrence of HAPUs has been minimized by turning the patient every 2 hours to alternating lateral and supine positions, and by using pressure redistributing mattresses. In many healthcare facilities, such a patient repositioning schedule is not always maintained owing to low caregiver compliance to turning protocols. Difficulty in monitoring patient position continuously, lack of turn reminders/alerts and suboptimal caregiver staffing ratio increases the occurrence of HAPUs. A novel method to address the need for improved pressure ulcer prevention is presented. The proposed method consists of a wearable device which continuously monitors the patient's position and communicates wirelessly with a tablet which enables alerts to be sent to the caregiver when a patient turn is due in accordance with the protocol adopted by the hospital. The patient's position is continuously monitored and the turning procedure carried out is logged and updated on the hospital's cloud system, thereby enabling centralized monitoring. Under a controlled setting, system was able to continuously monitor patient's position and can accurately detect standard patient positions.

Geographic variations and temporal trends of Salmonella-associated hospitalization in the U.S. elderly, 1991-2004: a time series analysis of the impact of HACCP regulation.

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Chui, Kenneth K H; Webb, Patrick; Russell, Robert M; Naumova, Elena N

2009-12-03

About 1.4 million Salmonella infections, a common food-borne illness, occur in the U.S. annually; the elderly (aged 65 or above) are most susceptible. In 1997, the USDA introduced the Pathogen Reduction and Hazard Analysis and Critical Control Points Systems (PR/HACCP) which demands regular Salmonella testing in various establishments processing meat products, such as broiler chickens. Impact evaluations of PR/HACCP on hospitalizations related to Salmonella are lacking. Hospitalization records of the U.S. elderly in 1991-2004 were obtained from the Centers of Medicare and Medicaid Services. Harmonic regression analyses were performed to evaluate the long-term trends of Salmonella-related hospitalizations in pre- and post-HACCP periods. Seasonal characteristics of the outcome in the nine Census divisions of the contiguous U.S. were also derived and contrasted. Predicted rates decreased in most divisions after 1997, except South Atlantic, East South Central, and West South Central. These three divisions also demonstrated higher overall hospitalization rates, pronounced seasonal patterns, and consistent times to peak at about 32nd to 34th week of the year. The impact of HACCP was geographically different. South Atlantic, East South Central, and West South Central divisions should be targeted in further Salmonella preventive programs. Further research is needed to identify the best program type and timing of implementation.

Job satisfaction and turnover intent among hospital social workers in the United States.

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Pugh, Greg L

2016-08-01

Feelings of job satisfaction and turnover intentions among social workers affect work quality for both social workers and the people for whom they provide services. Existing literature on job satisfaction among hospital social workers is limited, and is overly focused on issues of compensation. There is job satisfaction research with hospital nurses available for comparison. Other informative social work research on job satisfaction and turnover exists in mental health and generally, across settings. Research on turnover intent in social work is primarily from child welfare settings and may not generalize. The literature notes gaps and contradictions about predictors of job satisfaction and turnover intent. Using a large national dataset of hospital social workers, this research clarifies and fills gaps regarding hospital social workers, and explores how Herzberg's theory of work can clarify the difference between sources of job dissatisfaction and job satisfaction. Findings include hospital social workers reporting high job satisfaction and that demographics do not contribute to the predictive models. The findings do support centralized social work departments and variety in the job functions of hospital social workers, and are consistent with the theoretical framework.

Can hospitals compete on quality? Hospital competition.

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

2015-09-01

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

The risk of bloodstream infection associated with peripherally inserted central catheters compared with central venous catheters in adults: a systematic review and meta-analysis.

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Chopra, Vineet; O'Horo, John C; Rogers, Mary A M; Maki, Dennis G; Safdar, Nasia

2013-09-01

Peripherally inserted central catheters (PICCs) are associated with central line-associated bloodstream infection (CLABSI). The magnitude of this risk relative to central venous catheters (CVCs) is unknown. To compare risk of CLABSI between PICCs and CVCs. MEDLINE, CinAHL, Scopus, EmBASE, and Cochrane CENTRAL were searched. Full-text studies comparing the risk of CLABSI between PICCs and CVCs were included. Studies involving adults 18 years of age or older who underwent insertion of a PICC or a CVC and reported CLABSI were included in our analysis. Studies were evaluated using the Downs and Black scale for risk of bias. Random effects meta-analyses were used to generate summary estimates of CLABSI risk in patients with PICCs versus CVCs. Of 1,185 studies identified, 23 studies involving 57,250 patients met eligibility criteria. Twenty of 23 eligible studies reported the total number of CLABSI episodes in patients with PICCs and CVCs. Pooled meta-analyses of these studies revealed that PICCs were associated with a lower risk of CLABSI than were CVCs (relative risk [RR], 0.62; 95% confidence interval [CI], 0.40-0.94). Statistical heterogeneity prompted subgroup analysis, which demonstrated that CLABSI reduction was greatest in outpatients (RR [95% CI], 0.22 [0.18-0.27]) compared with hospitalized patients who received PICCs (RR [95% CI], 0.73 [0.54-0.98]). Thirteen of the included 23 studies reported CLABSI per catheter-day. Within these studies, PICC-related CLABSI occurred as frequently as CLABSI from CVCs (incidence rate ratio [95% CI], 0.91 [0.46-1.79]). Only 1 randomized trial met inclusion criteria. CLABSI definition and infection prevention strategies were variably reported. Few studies reported infections by catheter-days. Although PICCs are associated with a lower risk of CLABSI than CVCs in outpatients, hospitalized patients may be just as likely to experience CLABSI with PICCs as with CVCs. Consideration of risks and benefits before PICC use in inpatient

Hospital Variation in Utilization of Life-Sustaining Treatments among Patients with Do Not Resuscitate Orders.

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Walkey, Allan J; Weinberg, Janice; Wiener, Renda Soylemez; Cooke, Colin R; Lindenauer, Peter K

2018-06-01

To determine between-hospital variation in interventions provided to patients with do not resuscitate (DNR) orders. United States Agency of Healthcare Research and Quality, Healthcare Cost and Utilization Project, California State Inpatient Database. Retrospective cohort study including hospitalized patients aged 40 and older with potential indications for invasive treatments: in-hospital cardiac arrest (indication for CPR), acute respiratory failure (mechanical ventilation), acute renal failure (hemodialysis), septic shock (central venous catheterization), and palliative care. Hierarchical logistic regression to determine associations of hospital "early" DNR rates (DNR order placed within 24 hours of admission) with utilization of invasive interventions. California State Inpatient Database, year 2011. Patients with DNR orders at high-DNR-rate hospitals were less likely to receive invasive mechanical ventilation for acute respiratory failure or hemodialysis for acute renal failure, but more likely to receive palliative care than DNR patients at low-DNR-rate hospitals. Patients without DNR orders experienced similar rates of invasive interventions regardless of hospital DNR rates. Hospitals vary widely in the scope of invasive or organ-supporting treatments provided to patients with DNR orders. © Health Research and Educational Trust.

The saw-tooth sign as a clinical clue for intrathoracic central airway obstruction

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Nakajima Akira

2012-07-01

Full Text Available Abstract Background The saw-tooth sign was first described by Sanders et al in patients with obstructive sleep apnea syndrome as one cause of extrathoracic central airway obstruction. The mechanism of the saw-tooth sign has not been conclusively clarified. The sign has also been described in various extrathoracic central airway diseases, such as in burn victims with thermal injury to the upper airways, Parkinson’s disease, tracheobronchomalacia, laryngeal dyskinesia, and pedunculated tumors of the upper airway. Case presentation A 61-year-old man was referred to our hospital with a two-month history of persistent dry cough and dyspnea. He was diagnosed with lung cancer located in an intrathoracic central airway, which was accompanied by the saw-tooth sign on flow-volume loops. This peculiar sign repeatedly improved and deteriorated, in accordance with the waxing and waning of central airway stenosis by anti-cancer treatments. Conclusion This report suggests that the so-called saw-tooth sign may be found even in intrathoracic central airway obstruction due to lung cancer.

Propuesta de implementación de una guía de procedimientos para mejorar la eficiencia en los procesos de la Central de Esterilización del Hospital "Dr. Teodoro Maldonado Carbo" de la ciudad de Guayaquil.

OpenAIRE

Payez Freire, Eva Cristina

2015-01-01

La presente investigación se desarrolló en la central de esterilización del Hospital Teodoro Maldonado Carbo de la ciudad de Guayaquil, perteneciente al Instituto Ecuatoriano de Seguridad Social, con la finalidad de evaluar el nivel de aplicación de los procedimientos obligatorios de esterilización y su relación con el nivel de eficiencia en los resultados obtenidos. Para el logro de los objetivos planteados se desarrolló una investigación de campo aplicando encuestas y entrevistas al...

Branding Icarus: The Construction of Identity and Diversity at The United States Air Force Academy

Science.gov (United States)

2015-06-01

in the RAAF, Australia’s Sex Discrimina- tion Commissioner Elizabeth Broderick provided further insight into the construction of these five critical...Weber. 60 Unpublished statement by Elizabeth Broderick at Chief of Air Force New Horizon Call, RAAF... Broderick , Elizabeth. Unpublished Statement at Chief of Air Force New Horizon Call, Royal Australian Air Force Base Glenbrook, August 2013

Cloud-based hospital information system as a service for grassroots healthcare institutions.

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Yao, Qin; Han, Xiong; Ma, Xi-Kun; Xue, Yi-Feng; Chen, Yi-Jun; Li, Jing-Song

2014-09-01

Grassroots healthcare institutions (GHIs) are the smallest administrative levels of medical institutions, where most patients access health services. The latest report from the National Bureau of Statistics of China showed that 96.04 % of 950,297 medical institutions in China were at the grassroots level in 2012, including county-level hospitals, township central hospitals, community health service centers, and rural clinics. In developing countries, these institutions are facing challenges involving a shortage of funds and talent, inconsistent medical standards, inefficient information sharing, and difficulties in management during the adoption of health information technologies (HIT). Because of the necessity and gravity for GHIs, our aim is to provide hospital information services for GHIs using Cloud computing technologies and service modes. In this medical scenario, the computing resources are pooled by means of a Cloud-based Virtual Desktop Infrastructure (VDI) to serve multiple GHIs, with different hospital information systems dynamically assigned and reassigned according to demand. This paper is concerned with establishing a Cloud-based Hospital Information Service Center to provide hospital information software as a service (HI-SaaS) with the aim of providing GHIs with an attractive and high-performance medical information service. Compared with individually establishing all hospital information systems, this approach is more cost-effective and affordable for GHIs and does not compromise HIT performance.

Identifying maternity services in public hospitals in rural and remote Australia.

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Longman, Jo; Pilcher, Jennifer M; Donoghue, Deborah A; Rolfe, Margaret; Kildea, Sue V; Kruske, Sue; Oats, Jeremy J N; Morgan, Geoffrey G; Barclay, Lesley M

2014-06-01

This paper articulates the importance of accurately identifying maternity services. It describes the process and challenges of identifying the number, level and networks of rural and remote maternity services in public hospitals serving communities of between 1000 and 25000 people across Australia, and presents the findings of this process. Health departments and the national government's websites, along with lists of public hospitals, were used to identify all rural and remote Australian public hospitals offering maternity services in small towns. State perinatal reports were reviewed to establish numbers of births by hospital. The level of maternity services and networks of hospitals within which services functioned were determined via discussion with senior jurisdictional representatives. In all, 198 rural and remote public hospitals offering maternity services were identified. There were challenges in sourcing information on maternity services to generate an accurate national picture. The nature of information about maternity services held centrally by jurisdictions varied, and different frameworks were used to describe minimum requirements for service levels. Service networks appeared to be based on a combination of individual links, geography and transport infrastructure. The lack of readily available centralised and comparable information on rural and remote maternity services has implications for policy review and development, equity, safety and quality, network development and planning. Accountability for services and capacity to identify problems is also compromised.

Long-term performance monitoring for a permeable reactive barrier at the U.S. Coast Guard Support Center, Elizabeth City, North Carolina.

Science.gov (United States)

Puls, R W; Blowes, D W; Gillham, R W

1999-08-12

A continuous hanging iron wall was installed in June, 1996, at the U. S. Coast Guard (USCG) Support Center near Elizabeth City, NC, United States, to treat overlapping plumes of chromate and chlorinated solvent compounds. The wall was emplaced using a continuous trenching machine whereby native soil and aquifer sediment was removed and the iron simultaneously emplaced in one continuous excavation and fill operation. To date, there have been seven rounds (November 1996, March 1997, June 1997, September 1997, December 1997, March 1998, and June 1998) of performance monitoring of the wall. At this time, this is the only full-scale continuous 'hanging' wall installed as a permeable reactive barrier to remediate both chlorinated solvent compounds and chromate in groundwater. Performance monitoring entails the following: sampling of 10-5 cm PVC compliance wells and 15 multi-level samplers for the following constituents: TCE, cis-dichloroethylene (c-DCE), vinyl chloride, ethane, ethene, acetylene, methane, major anions, metals, Cr(VI), Fe(II), total sulfides, dissolved H(2), Eh, pH, dissolved oxygen, specific conductance, alkalinity, and turbidity. Electrical conductivity profiles have been conducted using a Geoprobe to verify emplacement of the continuous wall as designed and to locate upgradient and downgradient wall interfaces for coring purposes. Coring has been conducted in November, 1996, in June and September, 1997, and March, 1998, to evaluate the rate of corrosion on the iron surfaces, precipitate buildup (particularly at the upgradient interface), and permeability changes due to wall emplacement. In addition to several continuous vertical cores, angled cores through the 0.6-m thick wall have been collected to capture upgradient and downgradient wall interfaces along approximate horizontal flow paths for mineralogic analyses.

Why Are There So Few Ethics Consults in Children's Hospitals?

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Carter, Brian; Brockman, Manuel; Garrett, Jeremy; Knackstedt, Angie; Lantos, John

2017-10-03

In most children's hospitals, there are very few ethics consultations, even though there are many ethically complex cases. We hypothesize that the reason for this may be that hospitals develop different mechanisms to address ethical issues and that many of these mechanisms are closer in spirit to the goals of the pioneers of clinical ethics than is the mechanism of a formal ethics consultation. To show how this is true, we first review the history of collaboration between philosophers and physicians about clinical dilemmas. Then, as a case-study, we describe the different venues that have developed at one children's hospital to address ethical issues. At our hospital, there are nine different venues in which ethical issues are regularly and explicitly addressed. They are (1) ethics committee meetings, (2) Nursing Ethics Forum, (3) ethics Brown Bag workshops, (4) PICU ethics rounds, (5) Grand Rounds, (6) NICU Comprehensive Care Rounds, (7) Palliative Care Team (PaCT) case conferences, (8) multidisciplinary consults in Fetal Health Center, and (9) ethics consultations. In our hospital, ethics consults account for only a tiny percentage of ethics discussions. We suspect that most hospitals have multiple and varied venues for ethics discussions. We hope this case study will stimulate research in other hospitals analyzing the various ways in which ethicists and ethics committees can build an ethical environment in hospitals. Such research might suggest that ethicists need to develop a different set of "core competencies" than the ones that are needed to do ethics consultations. Instead, they should focus on their skills in creating multiple "moral spaces" in which regular and ongoing discussion of ethical issues would take place. A successful ethicist would empower everyone in the hospital to speak up about the values that they believe are central to respectful, collaborative practice and patient care. Such a role is closer to what the first hospital philosophers set

Conservation of Peary caribou based on a recalculation of the 1961 aerial survey on the Queen Elizabeth Islands, Arctic Canada

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Frank L. Miller

2005-05-01

Full Text Available The estimate of 25 845 Peary caribou (Rangifer tarandus pearyi on the Queen Elizabeth Islands (QEI in the Canadian High Arctic in summer 1961 is the only nearly range-wide 'benchmark' for the past number of caribou. No variances or confidence intervals were calculated for this estimate and no estimates were calculated for Peary caribou on the three major islands of Ellesmere, Devon, and Axel Heiberg. We reexamined the 1961 raw data by grouping the QEI into five island-complexes ('eco-units' and calculating, for each unit, the estimated number of caribou and the standard error, and the 95% confidence interval of the estimate, using a 'bootstrap' technique with 100 000 replications. Our goal was to provide an ecological basis for evaluating subsequent changes in numbers rather than relying on single-island evaluations. Our bootstrap reanalysis produced an estimate of 28 288 ± 2205 SE with a 95% CI of 20 436—37 031 Peary caribou on the QEI in summer 1961. Substantial differences in density were apparent among the five eco-units, with about a 50-fold difference from 0.01 caribou • km-2 in the Eastern eco-unit to 0.5 caribou • km-2 in the Northwestern eco-unit. The 1961 findings, with our subsequent reexamination, are crucial to any evaluation of trends for the number of Peary caribou on the QEI and the relative importance of individual eco-units for these animals. These findings also allow a more accurate evaluation of the magnitude of the subsequent decline of Peary caribou on the QEI during the last four decades and may help predict future potential levels for caribou in each of the five eco-units.

Using data from a multi-hospital clinical network to explore prevalence of pediatric rickets in Kenya [version 1; referees: 2 approved

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Stella W. Karuri

2017-08-01

Full Text Available Background: Nutritional rickets is a public health concern in developing countries despite tropical climates and a re-emerging issue in developed countries. In this study, we reviewed pediatric admission data from the Clinical Information Network (CIN to help determine hospital and region based prevalence of rickets in three regions of Kenya (Central Kenya, Western Kenya and Nairobi County. We also examine the association of rickets with other diagnosis, such as malnutrition and pneumonia, and study the effect of rickets on regional hospital stays. Methods: We analyzed discharge records for children aged 1 month to 5 years from county (formerly district hospitals in the CIN, with admissions from February 1st 2014 to February 28th 2015. The strength of the association between rickets and key demographic factors, as well as with malnutrition and pneumonia, was assessed using odds ratios. The Fisher exact test was used to test the significance of the estimated odd ratios. Kaplan-Meier curves were used to analyze length of hospital stays. Results: There was a marked difference in prevalence across the three regions, with Nairobi having the highest number of cases of rickets at a proportion of 4.01%, followed by Central Region at 0.92%. Out of 9756 admissions in the Western Region, there was only one diagnosis of rickets. Malnutrition was associated with rickets; this association varied regionally. Pneumonia was found to be associated with rickets in Central Kenya. Children diagnosed with rickets had longer hospital stays, even when cases of malnutrition and pneumonia were excluded in the analysis. Conclusion: There was marked regional variation in hospital based prevalence of rickets, but in some regions it is a common clinical diagnosis suggesting the need for targeted public health interventions. Factors such as maternal and child nutrition, urbanization and cultural practices might explain these differences.

Using data from a multi-hospital clinical network to explore prevalence of pediatric rickets in Kenya [version 2; referees: 2 approved

Directory of Open Access Journals (Sweden)

Stella W. Karuri

2017-11-01

Full Text Available Background: Nutritional rickets is a public health concern in developing countries despite tropical climates and a re-emerging issue in developed countries. In this study, we reviewed pediatric admission data from the Clinical Information Network (CIN to help determine hospital and region based prevalence of rickets in three regions of Kenya (Central Kenya, Western Kenya and Nairobi County. We also examine the association of rickets with other diagnosis, such as malnutrition and pneumonia, and study the effect of rickets on regional hospital stays. Methods: We analyzed discharge records for children aged 1 month to 5 years from county (formerly district hospitals in the CIN, with admissions from February 1st 2014 to February 28th 2015. The strength of the association between rickets and key demographic factors, as well as with malnutrition and pneumonia, was assessed using odds ratios. The Fisher exact test was used to test the significance of the estimated odd ratios. Kaplan-Meier curves were used to analyze length of hospital stays. Results: There was a marked difference in prevalence across the three regions, with Nairobi having the highest number of cases of rickets at a proportion of 4.01%, followed by Central Region at 0.92%. Out of 9756 admissions in the Western Region, there was only one diagnosis of rickets. Malnutrition was associated with rickets; this association varied regionally. Pneumonia was found to be associated with rickets in Central Kenya. Children diagnosed with rickets had longer hospital stays, even when cases of malnutrition and pneumonia were excluded in the analysis. Conclusion: There was marked regional variation in hospital based prevalence of rickets, but in some regions it is a common clinical diagnosis suggesting the need for targeted public health interventions. Factors such as maternal and child nutrition, urbanization and cultural practices might explain these differences.

Nurses' Perceptions of Patient Safety Culture in Three Hospitals in Saudi Arabia.

Science.gov (United States)

Alquwez, Nahed; Cruz, Jonas Preposi; Almoghairi, Ahmed Mohammed; Al-Otaibi, Raid Salman; Almutairi, Khalid Obaid; Alicante, Jerico G; Colet, Paolo C

2018-05-14

To assess the present patient safety culture of three general hospitals in Saudi Arabia, as perceived by nurses. This study utilized a descriptive, cross-sectional design. A convenience sample of 351 nurses working in three general hospitals in the central region of Saudi Arabia was surveyed in this study using the Hospital Survey of Patients' Safety Culture (HSOPSC) from October 2016 to April 2017. From the 12 composites of the HSOPSC, the nurses perceived only the following two patient safety areas as strengths: teamwork within units and organizational learning-continuous improvement. Six areas of patient safety were identified as weaknesses, namely overall perception of patient safety, handoffs and transitions, communication openness, staffing, frequency of events reported, and nonpunitive response to errors. Nationality, educational attainment, hospital, length of service in the hospital, work area or unit, length of service in the current work area or unit, current position, and direct patient contact or interaction were significant predictors of the nurses' perceived patient safety culture. The findings in this study clarify the current status of patient safety culture in three hospitals in the Kingdom of Saudi Arabia. The present findings should be considered by policymakers, hospital leaders, and nurse executives in creating interventions aimed at improving the patient safety culture in hospitals. A multidimensional network intervention targeting the different dimensions of patient safety culture and involving different organizational levels should be implemented to improve patient safety. © 2018 Sigma Theta Tau International.

Individual and hospital-specific factors influencing medical graduates' time to medical specialization.

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Johannessen, Karl-Arne; Hagen, Terje P

2013-11-01

Previous studies of gender differences in relation to medical specialization have focused more on social variables than hospital-specific factors. In a multivariate analysis with extended Cox regression, we used register data for socio-demographic variables (gender, family and having a child born during the study period) together with hospital-specific variables (the amount of supervision available, efficiency pressure and the type of teaching hospital) to study the concurrent effect of these variables on specialty qualification among all 2474 Norwegian residents who began specialization in 1999-2001. We followed the residents until 2010. A lower proportion of women qualified for a specialty in the study period (67.9% compared with 78.7% of men, p specialization qualification (p specialization: working at university hospitals (regional) or central hospitals was associated with a reduction in the time taken to complete the specialization, whereas an increased patient load and less supervision had the opposite effect. Multivariate analysis showed that the smaller proportion of women who qualified for a specialty was explained principally by childbirth and by the number of children aged under 18 years. Copyright © 2013 Elsevier Ltd. All rights reserved.