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Sample records for france regional hospital

  1. Regional variation in hospital admission rates in the Netherlands, Belgium, Northern France and Nordrhein-Westfalen.

    NARCIS (Netherlands)

    Noordt, M. van; Zee, J. van der; Groenewegen, P.P.

    1992-01-01

    For the analysis of regional variations in hospital admission rates a model was set up, including both supply and demand indicators. Data were gathered for regions in four health care systems (the Dutch, Belgian, French and German), for 1982, 1979, 1974 (France 1982 only). Hospital bed supply proved

  2. [Computerization of hospital blood banks in France].

    Science.gov (United States)

    Daurat, G; Py, J-Y

    2012-11-01

    In France, most blood products are delivered by the établissement francais du sang, directly to the recipients, and hospital blood banks deliver a minor part, but are independent from it. However that may be, hospital blood banks are hazardous activities regarding to recipients, blood products, blood supply of the hospital and regional blood supply. Because of the high risk level, a computerized information system is compulsory for all hospital blood banks, except for those only devoted to vital emergency transfusion. On the field, the integration of computerization in the different processes is very heterogeneous. So, it has been decided to publish guidelines for computerizing hospital blood banks information systems and production management. They have been built according to risk assessment and are intended to minimize those risks. The principle is that all acquisition and processing of data about recipients or blood products and tracking, must be fully computerized and that the result of all manual processes must be checked by computer before proceeding to the next step. The guidelines list the different processes and, for each of them, the functions the software must play. All together, they form the basic level all hospital blood banks should reach. Optional functions are listed. Moreover, the guidelines are also aimed to be a common tool for regional health authorities who supervise hospital blood banks.

  3. Hospital based ethics, current situation in France: between "Espaces" and committees.

    Science.gov (United States)

    Guerrier, M

    2006-09-01

    Unlike research ethics committees, which were created in 1988, the number of functioning hospital based ethical organisations in France, such as clinical ethics committees, is unknown. The objectives of such structures are diverse. A recent law created regional ethical forums, the objectives of which are education, debate, and research in relation to healthcare ethics. This paper discusses the current situation in France and the possible evolution and conflicts induced by this law. The creation of official healthcare ethics structures raises several issues.

  4. Hospital planning in France and the Federal Republic of Germany.

    Science.gov (United States)

    Altenstetter, C

    1980-01-01

    This article on hospital planning programs in France and North-Rhine Westfalia (a state in the Federal Republic of Germany), assembles information on the formal building blocks of inter-organizational relations in the formulation and implementation process. Because these planning programs are embedded in past social policy developments and institution-building, it is necessary to first compare the two countries' compulsory health insurance schemes. This is followed by a general profile of each health care system. A third section examines the formulation and implementation of the countries' hospital planning programs and participation patterns. Based on this comparison, inferences are drawn that are relevant to policy and research. The analysis yields three major conclusions. First, despite abundant legal and administrative controls at the disposal of central health bureaucracies, the capability of the national leadership to influence the hospital system through innovative planning is limited by jurisdictional, institutional, functional and territorial fragmentation, and differentiation of control and public responsibility in health. However, the diverse goal orientations of participants may provide the necessary tension to allow for some change in otherwise highly structured political and administrative systems. Second, despite differences in historical, political and administrative developments, the decision making systems for health care policies in France and the Federal Republic, with the exception of health insurance, are strikingly similar to the fragmented decision making system in the United States. Third, the effect of government-mandated participation is empirically uncertain. Opening up the circle of participants seems to have reinforced alliances between public bureaucracies and corporate vested interests. Hospital planning continues to be carried out for rather than with the consumer and citizen. Hospital planning which is a mixture of goal and process

  5. Regionalization procedures for hydrological drought assessment in Cevennes region, France

    Science.gov (United States)

    Dewaele, Helene; Vasiliades, Lampros; Esteves, Michel; Loukas, Athanasios

    2014-05-01

    Nowadays, low flow characteristics have been extensively studied for the design of hydrotechnical projects and water resources planning and management. Information on the magnitude and frequency of low flows is very important for hydrological drought analysis at operational level in public water supply systems. In this study, several low flow characteristics are derived and analysed for hydrological drought assessment at 26 watersheds located at Cevennes area, Southern France. The reliability of two statistical regionalisation techniques (the Principal Component Analysis and the L-moment approach) is tested on low flows characteristics for defining homogeneous regions in the study area and application of the methods to ungauged watersheds. The Threshold Level Method (TLM) is applied to estimate duration and deficit of the main hydrological drought events derived from flow duration curves at the study hydrometric stations using daily streamflow data for the period 1988 to 2008. Furthermore, the two regionalisation techniques are also applied in two other low flows indices, the annual minimum 7-days flow and the annual minimum 30-days flow. Finally, a regional analysis is performed in order to understand better the hydrological behavior of each watershed and the possible interactions between the hydrological regime and the descriptive hydrogeomorphologic characteristics.

  6. Regional approaches to hospital preparedness.

    Science.gov (United States)

    Maldin, Beth; Lam, Clarence; Franco, Crystal; Press, David; Waldhorn, Richard; Toner, Eric; O'Toole, Tara; Inglesby, Thomas V

    2007-03-01

    This article describes issues related to the engagement of hospitals and other community partners in a coordinated regional healthcare preparedness and response effort. The report is based on interviews with public health and hospital representatives from 13 regions or states across the country. It aims to identify key ingredients for building successful regional partnerships for healthcare preparedness as well as critical challenges and policy and practical recommendations for their development and sustainability.

  7. Regional variations in quinolone use in France and associated factors.

    Science.gov (United States)

    Gallini, A; Taboulet, F; Bourrel, R

    2012-11-01

    The purpose of this study was to investigate geographic variations in the use of quinolones in France and their associated factors. All reimbursement claims of antimicrobials were collected for 90 % of the French population for the year 2007. Dispensed quantities were then converted into defined daily doses (DDD) and adjusted for the age structure of the national population. Correlations between quinolone use and total antimicrobial use and some morbidity and socio-economic factors were studied using Spearman's rank correlation coefficients. On average, 2.05 DDD of quinolones per 1,000 inhabitants per day (DID) were dispensed in 2007 in France, accounting for 10.2 % of the total antimicrobial consumption in adults. A 40 % variation was observed between the regions with the lowest (1.73 DID) and the highest use (2.44 DID). This variation was more important for anti-pneumococcal quinolones than for quinolones directed against urinary tract infections (coefficients of variation: 26 vs. 6 %). Quinolone use was correlated with some regional socio-economic factors (unemployment, growth domestic product, health expenditures) and physician density, but was independent of the total antimicrobial use. After adjustment for age, large variations in quantitative and qualitative quinolone use were observed across French regions, especially for anti-pneumococcal fluoroquinolones. These results, though not controlled for potential epidemics variations, argue in favour of a possible improvement in quinolone prescribing to be achieved in some regions.

  8. France.

    Science.gov (United States)

    1993-02-10

    Taxes on cigarettes in France have been increased by 15 per cent, the first of an overall rise of 30 per cent. Part of the revenue raised will help subsidise motor racing which lost its sponsors following a recent national ban on cigarette advertising. The remainder will go to the social security service.

  9. France

    Science.gov (United States)

    2002-01-01

    Every July, the world's best cyclists race more than 3500 km around France, and sometimes the surrounding countries, in the Tour de France. This image from the Moderate resolution Imaging Spectroradiometer (MODIS) shows the varied terrain which challenges the riders. The race started in western France at Futuroscope, and headed toward Brittany. In these mostly flat 'stages' (as each day's race is called) sprinting specialists usually dash for the finish out of the main pack of riders. The race then moved to the Pyrenees mountains, in southern France along the border with Spain. Climbers and the overall favorites shine in the mountains, often gaining 10 minutes or more on their rivals. Only a few days after the Pyrenees climbs the race was again in the mountains. First Mont Ventoux, an extinct volcano in Provence, and then the massive Alps, with altitudes as high as 2,645 meters, challenged the racers. Finally the race headed toward Paris and a July 23rd finish in Paris. Go Lance! To learn more about MODIS, visit the MODIS web. Image by Jacques Descloitres, MODIS Land group, NASA GSFC

  10. Regional action in France for the mastery of energy

    Energy Technology Data Exchange (ETDEWEB)

    Schiele, P.

    1986-01-01

    Regional authorities in France have often been described as playing a second rate role. However, they draw their strength and their originality from their capacity to encourage, to innovate, to attempt and to succeed in new fields which other collective authorities do not quite grasp. This is the case for energy problems as the regions have proved their capacity to act in this field. They've also shown that they can work in symbiosis with State and municipal authorities and that they can produce high performance results. Such results are obtained by flexibility in intervention regulations on the psychological level - the perception of problems linked to energy - in strictly economic affairs by using the multiplying effects of invested credits and in the field of employment by the opening of new markets. As interesting as all this might be, the field of energy in this case is merely an example of what the French regions can do. At a time when decentralization processes have given the regions major management duties, it is important that the regions don't fall into the trap of creating supplementary and sterile administrative structures. It is also important for the regions not to forget their essential role which is to encourage innovation.

  11. Travel industry as a focus on regional development: Case study of the Mediterranean France

    OpenAIRE

    Terzić Aleksandra; Petrović Marko; Vuković Darko

    2015-01-01

    This paper presents a regionalization of the Mediterranean France with regard to tourism, as well as basic economic sectors present in the region. The study included three administrative regions of this part of France: Provence - Alpes - Cote d'Azur, Languedoc - Roussillon and the Island of Corsica, where the travel industry is defined as dominant. The subject of this research is to study the area of the Mediterranean France, primarily from the aspect of tourism. Special attention is focused ...

  12. History of psychosurgery at Sainte-Anne Hospital, Paris, France, through translational interactions between psychiatrists and neurosurgeons.

    Science.gov (United States)

    Zanello, Marc; Pallud, Johan; Baup, Nicolas; Peeters, Sophie; Turak, Baris; Krebs, Marie Odile; Oppenheim, Catherine; Gaillard, Raphael; Devaux, Bertrand

    2017-09-01

    Sainte-Anne Hospital is the largest psychiatric hospital in Paris. Its long and fascinating history began in the 18th century. In 1952, it was at Sainte-Anne Hospital that Jean Delay and Pierre Deniker used the first neuroleptic, chlorpromazine, to cure psychiatric patients, putting an end to the expansion of psychosurgery. The Department of Neuro-psychosurgery was created in 1941. The works of successive heads of the Neurosurgery Department at Sainte-Anne Hospital summarized the history of psychosurgery in France. Pierre Puech defined psychosurgery as the necessary cooperation between neurosurgeons and psychiatrists to treat the conditions causing psychiatric symptoms, from brain tumors to mental health disorders. He reported the results of his series of 369 cases and underlined the necessity for proper follow-up and postoperative re-education, illustrating the relative caution of French neurosurgeons concerning psychosurgery. Marcel David and his assistants tried to follow their patients closely postoperatively; this resulted in numerous publications with significant follow-up and conclusions. As early as 1955, David reported intellectual degradation 2 years after prefrontal leucotomies. Jean Talairach, a psychiatrist who eventually trained as a neurosurgeon, was the first to describe anterior capsulotomy in 1949. He operated in several hospitals outside of Paris, including the Sarthe Psychiatric Hospital and the Public Institution of Mental Health in the Lille region. He developed stereotactic surgery, notably stereo-electroencephalography, for epilepsy surgery but also to treat psychiatric patients using stereotactic lesioning with radiofrequency ablation or radioactive seeds of yttrium-90. The evolution of functional neurosurgery has been marked by the development of deep brain stimulation, in particular for obsessive-compulsive disorder, replacing the former lesional stereotactic procedures. The history of Sainte-Anne Hospital's Neurosurgery Department sheds

  13. Hospital use in France and the United States.

    Science.gov (United States)

    Kozak, L J; McCarthy, E; Mizrahi, A; Mizrahi, A; Sandier, S

    1989-01-01

    This report presents national statistics on hospital use from the U.S. National Hospital Discharge Survey conducted by the National Center for Health Statistics and the national survey of hospitalization conducted by CREDES, Centre de Recherche d'Etude et de Documentation en Economie de la Santé, previously the Medical Economics Division of CREDOC. The use statistics compared between the two countries include rates and percent distributions of discharges and days of care and average lengths of stay. These statistics are shown by sex, age, diagnostic category, and other hospital and patient characteristics. The similarities and differences between the two countries in population characteristics, causes of death, health care systems, and hospital systems are also described.

  14. [Strategic management of hospitals in France: balance and perspectives].

    Science.gov (United States)

    Crémadez, Michel

    2010-08-01

    The strategic management was introduced in French hospitals in the late 80s, in a context of inefficiency and the need to control healthcare expenditure. This concept has inspired a series of government reforms, the organization and dynamics of hospitals and the mode of regulating the French health system, assuming a real change of professional culture. The changes in the economic context and in the finance of hospitals, the behavior of users, the population aging, the development of chronic diseases and increased competition, are the new challenges to be faced. The involvement of stakeholders is crucial and the strategic management, based on mobilizing these actors, is today, a method of administration particularly well adapted to the health area. This article aims to present the impact of the concept of strategic management in the evolution of French hospitals and the consequences of these developments on the outlook for the dissemination of strategic management in the health sector. To do so, it is examined the evolution of the French context until 2010, the new challenges that French hospitals must face and, finally, the consequences of these challenges on how to design services, manage the relationships between the actors of the health system and organize the operational functioning of hospitals.

  15. Clinical and molecular epidemiology of hospital Enterococcus faecium isolates in eastern France. Members of Réseau Franc-Comtois de Lutte contr les Infections Nosocomiales.

    Science.gov (United States)

    Bertrand, X; Thouverez, M; Bailly, P; Cornette, C; Talon, D

    2000-06-01

    We carried out a surveillance study of Enterococcus faecium isolates in the Franche-Comtéregion of France over three years. Clinical and epidemiological strains were characterized by antibiotype and genotype (pulsed field gel electrophoresis, PFGE). Three case-control studies were performed to identify risk factors for colonization/infection with three defined resistant phenotypes (amoxycillin, high-level gentamicin and high-level kanamycin). The crude incidence of colonization/infection was 0.156%, and 68.8% of cases were classified as hospital-acquired. Incidence did not differ according to the type of hospitalization (middle term or acute care). The urinary tract was the major site of infection. Resistance rates were: 45.8% (amoxycillin), 18.7% (high-level gentamicin), 61.4% (high-level kanamycin) and 3.1% (vancomycin). No isolate produced b-lactamase and one isolate carried the vanA gene. PFGE revealed two major epidemic patterns each including resistant strains isolated in different hospitals and during different periods in the study. Previous antimicrobial treatment was not identified as a risk factor for colonization/infection with any resistant phenotype. Despite the low frequency of vancomycin-resistant isolates in this study, resistant strains were widely disseminated and had characteristics enabling them to persist and spread. If these strains acquired the vanA gene, the risk of an outbreak would be large. So, the prevalence of vancomycin-resistant E. faecium in hospitals should be carefully monitored in the future.

  16. Travel industry as a focus on regional development: Case study of the Mediterranean France

    Directory of Open Access Journals (Sweden)

    Terzić Aleksandra

    2015-01-01

    Full Text Available This paper presents a regionalization of the Mediterranean France with regard to tourism, as well as basic economic sectors present in the region. The study included three administrative regions of this part of France: Provence - Alpes - Cote d'Azur, Languedoc - Roussillon and the Island of Corsica, where the travel industry is defined as dominant. The subject of this research is to study the area of the Mediterranean France, primarily from the aspect of tourism. Special attention is focused on the identification of economic and socioeconomic importance that tourism has on the overall economic development of the region, in order to enable the implementation of tourism regionalization. In order to tourism regionalization of this area carried out, it is necessary to include research components, such as geographic environment, tourist motives and attractions that are located in this area, as well as other elements relevant to the separation of the region from the neighboring regions of France.

  17. Healing the Empire: Indian Hospitals in Britain and France during the First World War.

    Science.gov (United States)

    Jarboe, Andrew Tait

    2015-01-01

    Desperate for soldiers to stem the German onrush in late 1914, the British deployed some 135,000 Indian riflemen--known as sepoys--to the trenches of France and Belgium. Between October 1914 and December 1915, these soldiers fought at the battles of Ypres, Festubert, Givenchy, Neuve Chapelle, Second Ypres, and Loos, suffering some 34,252 casualties. This article looks to the experiences of these men at segregated hospitals in France and England from 1914 to 1915. These hospitals served many of the same dual purposes facilitated by hospitals for English soldiers: namely, they sustained the war-making capacity of the Indian battalions. The Indian hospitals also functioned as sites of propaganda, reaffirming the ideologies and racial hierarchies of imperial rule for audiences at home, abroad, and within the hospital wards. But as this article demonstrates, wounded Indian sepoys were rarely, if ever, mere pawns on the imperial chessboard. Hospital authorities were committed to two policies: returning sepoys to the front and protecting White prestige. Sepoys successfully resisted both. In so doing, Indian hospitals became what British hospital administrators hoped they would not: spaces where imperial subjects contested and even reshaped some of the policies and ideologies of imperial rule.

  18. Hospital-based health technology assessment in France: A focus on medical devices.

    Science.gov (United States)

    Martelli, Nicolas; Puc, Cyril; Szwarcensztein, Karine; Beuscart, Régis; Coulonjou, Hélène; Degrassat-Théas, Albane; Dutot, Camille; Epis de Fleurian, Anne-Aurélie; Favrel-Feuillade, Florence; Hounliasso, Iliona; Lechat, Philippe; Luigi, Emmanuel; Mairot, Laurent; Nguyen, Thao; Piazza, Laurent; Roussel, Christophe; Vienney, Cécile

    2017-02-01

    Hospital-based health technology assessment (HTA) guides decisions as to whether new healthcare products should be made available within hospital structures. Its extension to medical devices (MDs) makes it possible to analyse several relevant aspects of these healthcare products in addition to their clinical value, and such evaluations are of interest to national health authorities, other healthcare establishments and industry. The aim of this work was to formulate several recommendations for a blueprint for hospital-based HTA for MDs in France. Five themes based on the work of the European Adopting hospital-based HTA in the EU (AdHopHTA) project were defined. Each member of the roundtable was then allocated a documentation task based on their experience of the theme concerned, and a literature review was carried out. An inventory of hospital-based HTA was performed and six recommendations aiming to strengthen and improve this approach were put forward: (1) encouragement of the spread of the hospital-based HTA culture and participation in communications and the promotion of this approach to hospital decision-makers; (2) adaptation of hospital-based HTA to the needs of decision-makers, taking into account the financial timetable and strategic objectives of the healthcare establishment; (3) harmonisation of the dossiers requested from industry between healthcare establishments, based on a common core; (4) promotion of the sharing of hospital-based HTA data under certain conditions, with data dissociable from the HTA report and the use of a validated methodology for the literature review; (5) creation of a composite indicator reflecting data production effort and the sharing of HTA activities, to be taken into account in the distribution of funds allocated for teaching, research and innovation missions considered of general interest; (6) the transmission of information directly from local to national level by pioneering centres. This work highlights the major issues

  19. Vaccine Knowledge in Students in Paris, France, and surrounding Regions

    Directory of Open Access Journals (Sweden)

    Guillaume Mellon

    2014-01-01

    Full Text Available INTRODUCTION: In France, young adults are legally freed from parental authority at the age of 18 years and are, thus, responsible for their own vaccine record. This young adult population is more frequently exposed to vaccine-preventable infectious diseases.

  20. US hospital payment adjustments for innovative technology lag behind those in Germany, France, and Japan.

    Science.gov (United States)

    Hernandez, John; Machacz, Susanne F; Robinson, James C

    2015-02-01

    Medicare pioneered add-on payments to facilitate the adoption of innovative technologies under its hospital prospective payment system. US policy makers are now experimenting with broader value-based payment initiatives, but these have not been adjusted for innovation. This article examines the structure, processes, and experience with Medicare's hospital new technology add-on payment program since its inception in 2001 and compares it with analogous payment systems in Germany, France, and Japan. Between 2001 and 2015 CMS approved nineteen of fifty-three applications for the new technology add-on payment program. We found that the program resulted in $201.7 million in Medicare payments in fiscal years 2002-13-less than half the level anticipated by Congress and only 34 percent of the amount projected by CMS. The US program approved considerably fewer innovative technologies, compared to analogous technology payment mechanisms in Germany, France and Japan. We conclude that it is important to adjust payments for new medical innovations within prospective and value-based payment systems explicitly as well as implicitly. The most straightforward method to use in adjusting value-based payments is for the insurer to retrospectively adjust spending targets to account for the cost of new technologies. If CMS made such retrospective adjustments, it would not financially penalize hospitals for adopting beneficial innovations. Project HOPE—The People-to-People Health Foundation, Inc.

  1. Faecal carriage of carbapenemase-producing Gram-negative bacilli in hospital settings in southern France.

    Science.gov (United States)

    Pantel, A; Marchandin, H; Prère, M-F; Boutet-Dubois, A; Brieu-Roche, N; Gaschet, A; Davin-Regli, A; Sotto, A; Lavigne, J-P

    2015-05-01

    The emergence of carbapenemase-producing Gram-negative bacilli is a worldwide problem. To date, no study has evaluated the prevalence of faecal carriage of carbapenemase-producing and carbapenem-resistant Gram-negative bacilli (CR GNB) in France. From 1 February to 30 April 2012, we conducted a prospective, multicentre study in three University Hospitals and four General Hospitals in the south of France. The carriage of carbapenemase-producing Enterobacteriaceae (CPE) and other CR GNB was screened by both cultivation on chromID® CARBA and chromID® OXA-48 media (bioMérieux) and molecular tools [multiplex polymerase chain reaction (PCR) and NucliSENS EasyQ® KPC (bioMérieux)]. The genetic relationship between isolates was assessed by rep-PCR (DiversiLab, bioMérieux) or multilocus sequence typing (MLST). The prevalences of CR GNB and carbapenemase-producing bacteria were 2.4 % (27/1,135) and 0.4 % (n = 5), respectively. Two strains corresponded to OXA-23-producing Acinetobacter baumannii and belonged to the widespread sequence type (ST) 2/international clone II, whereas one strain was an ST15 OXA-48-producing Klebsiella pneumoniae. Two OXA-48-producers were detected exclusively by PCR. This first French study revealed the very low dissemination of carbapenemase-producing bacteria in patients attending hospitals in southern France during a non-outbreak situation. However, the increasing description of epidemic cases in this area must reinforce the use of hygiene procedures to prevent diffusion of these multidrug-resistant microorganisms.

  2. Hospital staffing and local pay: an investigation into the impact of local variations in the competitiveness of nurses' pay on the staffing of hospitals in France.

    Science.gov (United States)

    Combes, Jean-Baptiste; Delattre, Eric; Elliott, Bob; Skåtun, Diane

    2015-09-01

    Spatial wage theory suggests that employers in different regions may offer different pay rates to reflect local amenities and cost of living. Higher wages may be required to compensate for a less pleasant environment or a higher cost of living. If wages in a competing sector within an area are less flexible and therefore less competitive this may lead to an inability to employ staff. This paper considers the market for nursing staff in France where there is general regulation of wages and public hospitals compete for staff with the private hospital and non-hospital sectors. We consider two types of nursing staff, registered and assistant nurses and first establish the degree of spatial variation in the competitiveness of pay of nurses in public hospitals. We then consider whether these spatial variations are associated with variation in the employment of nursing staff. We find that despite regulation of pay in the public and private sector, there are substantial local variations in the competitiveness of nurses' pay. We find evidence that the spatial variations in the competitiveness of pay are associated with relative numbers of assistant nurses but not registered nurses. While we find the influence of the competitiveness of pay is small, it suggests that nonpay conditions may be an important factor in adjusting the labour market as might be expected in such a regulated market.

  3. Regional factors interact with educational and income tax levels to influence food intake in France.

    Science.gov (United States)

    Wyndels, K; Dallongeville, J; Simon, C; Bongard, V; Wagner, A; Ruidavets, J-B; Arveiler, D; Ferrières, J; Amouyel, P; Dauchet, L

    2011-09-01

    The goal of the present study was to assess whether geographic factors affect the relationship between socioeconomic indicators and adherence to the French National Nutritional Health Programme (Programme National Nutrition Santé (PNNS)) guidelines. The MONA LISA-NUT study (2005-2007) is a cross-sectional survey of a representative sample from northern, northeastern and southwestern France. Educational level and household income tax were recorded by trained interviewers. Food intake was assessed with a 3-day food diary in 3188 subjects aged from 35-64 years. Adherence to the PNNS guidelines was assessed with a validated score (the French score of indicators of the PNNS objective (FSIPO)). Multivariate analyses were adjusted for gender, age, marital status, body mass index, energy intake and medically prescribed diets. The FSIPO score was higher in southwestern France than in the two other regions (P<0.0001). The FSIPO score was correlated with the educational level in northern and northeastern France (P<0.0001) but not in southwestern France (region-education interaction: P<0.001). This interaction was accounted for by fruit and vegetable (P<0.0001), calcium (P=0.03), saturated fatty acid (P<0.0001), and fibre (P=0.0001) components of the FSIPO score. In contrast, the income tax level and the FSIPO score were positively correlated (P<0.0001) to a similar extent in all three regions (region × income tax interaction: P=0.09). The relationship between educational level and adherence to the national nutritional health guidelines differs from one region of France to another, suggesting that nutrition education programmes should perhaps be adapted on a regional basis. In contrast, guideline adherence is correlated with income tax level independently of geographical factors, suggesting that financial constraints on food choices are uniform across France.

  4. [Best practice agreement: implementation of best practice guidelines in HCL hospitals in Lyon, France].

    Science.gov (United States)

    Hédoux, S; Armoiry, X; Dode, X; Stamm, C; Chamouard, V; Pivot, C; Souquet, P-J; Aulagner, G

    2010-05-01

    Since 2004, the Hospices Civils de Lyon (HCL) hospitals are committed to comply with best practice guidelines for healthcare products that are reimbursed in addition to diagnosis related groups' (DRGs) tariffs in France, and that, even before the publication of the law concerning best practice agreement. It has been necessary to adapt national drugs best practice guidelines to every-day practice. A working group, COPIL RBU, has been created in HCL hospitals to manage the best practice guidelines locally. This group has two main activities: it conducts a scientific and regulatory information watch and follows up emerging indications at HCL. The group's best practice guidelines contain a classification of indications into three categories: approved indications (market authorization and temporary protocol of treatment), currently-assessed indications and contra-indications. Our best practice guidelines are more than a rewriting of national guidelines since they include emerging indications validated by prescribing physicians at HCL hospitals. A scientific argumentation is made for each emerging indication that is classified in our guidelines, based on the level of scientific evidence available. The practical use of our best practice guidelines is made through a best practice prescription that enables the traceability of drugs from the prescription to the administration to the patient. These prescriptions are accompanied with best practice guidelines made by medical and pharmaceutical professional groups. Audits will then be conducted to assess the indications' conformity to our guidelines and to have a better knowledge of current medical practice.

  5. Cost-effectiveness of energy efficiency programmes. Evaluating the impacts of a regional programme in France

    Energy Technology Data Exchange (ETDEWEB)

    Suerkemper, F.; Thomas, S. [Wuppertal Institute for Climate, Environment and Energy, Doeppersberg 19, 42103 Wuppertal (Germany); Osso, D. [EDF-R and D, Site des Renardieres-Avenue des Renardieres, Ecuelles, 77818 Moret-sur-Loing cedex (France); Baudry, P. [EDF-R and D, 1, Avenue du General de Gaulle, 92141 Clamart Cedex (France)

    2012-01-15

    This paper presents the evaluation of a regional energy efficiency programme implemented in two 'departements' of France. Electricite de France (EDF), a French energy company, provides refurbishment advice and financial incentives to end-users in the residential sector as well as specific training courses and certification to local installation contractors and building firms. Refurbishment measures analysed in this paper are efficient space heating equipment (condensing boilers, heat pumps and wood stoves or boilers), solar water heating systems and the installation of double-glazed windows. A billing analysis based on a survey of programme participants' energy consumption is used to calculate the energy savings attributed to the programme. In order to receive an economic feedback of this demonstration programme, the evaluation of both saved energy and programme costs is of importance. Detailed knowledge of the programme's cost-effectiveness is essential for EDF to achieve the saving obligations imposed by the French White Certificate scheme at the lowest cost. Results of this evaluation can support the development and implementation of further energy efficiency programmes with similar characteristics in other regions of France. The cost-effectiveness is determined from the perspective of the programme participant and the society as well as the energy company in charge of the programme. All cost and benefit components are calculated in Euro per kilowatt-hour, which allows a direct comparison of levelized costs of conserved energy with the avoidable costs of the energy supply system.

  6. Impacts of climate change on wind energy resources in France: a regionalization study; Impacts du changement climatique sur le potentiel eolien en France: une etude de regionalisation

    Energy Technology Data Exchange (ETDEWEB)

    Najac, J.

    2008-11-15

    In this work, we study the impact of climate change on surface winds in France and draw conclusions concerning wind energy resources. Because of their coarse spatial resolution, climate models cannot properly reproduce the spatial variability of surface winds. Thus, 2 down-scaling methods are developed in order to regionalize an ensemble of climate scenarios: a statistical method based on weather typing and a statistic-dynamical method that resorts to high resolution mesoscale modelling. By 2050, significant but relatively small changes are depicted with, in particular, a decrease of the wind speed in the southern and an increase in the northern regions of France. The use of other down-scaling methods enables us to study several uncertainty sources: it appears that most of the uncertainty is due to the climate models. (author)

  7. The social representations of suicide in France: An inter-regional study in Alsace and Brittany.

    Science.gov (United States)

    Kopp-Bigault, Céline; Walter, Michel; Thevenot, Anne

    2016-12-01

    Suicide is a major worldwide public health issue. Various studies showed that individual attitudes toward suicide change in a region with high suicide rate. Attitudes are one of the components of a global and complex system: social representations (SRs). In France, the Brittany region has an abnormally high death rate due to suicides. Our research focuses on the SRs of suicide in this region. The hypothesis underlying this project is that suicide SRs are different between an area with a high suicide rate and a region less affected by suicide. A comparative study between the Brittany and Alsace regions, with the latter showing a statistically much lower suicide rate. The persons polled responded to a three-word free-association task around the question 'For you, suicide is …?' An analysis of word frequency and evocation rank was then carried out. In confirmation of our hypothesis, SRs were different between Brittany and the control region. The study's results open new avenues of research, specific to Brittany, in terms of the collective or individual effects of suicides, in terms of psycho-pathological conditions - essentially on depression, and in terms of training, on the stereotypes associated with suicide. © The Author(s) 2016.

  8. Conservation and promotion of the geological heritage in the «Ile-de-France» region (France): Establishment of a decision support-tool based on inventory

    Science.gov (United States)

    Auberger, Elise; Gély, Jean-Pierre; De Wever, Patrick; Merle, Didier

    2017-04-01

    Based on an initiative by the "Regional Commission of Geological Patrimony" (CRPG), the French state and the regional government of Ile-de-France co-financed the setting up of an inventory with the aim of safeguarding geological sites of patrimonial interest. This project forms part of larger scale policies, at the national and European level. Geological studies in the Paris region began as early as the 18th century, in the fields of cartography and paleontology. Later on, prominent scientists like G. Cuvier, A. Brongniart and A. d'Orbigny established the first concepts in sedimentology and stratigraphy through the description of Cenozoic fossil sites that rank amongst the richest in the world and geological formations in the Paris Basin. Eventually, later on, five historical stratotypes were established in the Ile-de-France region. Yet, at present, this geological heritage is constantly threatened by expanding urbanisation. To conserve this diverse geological patrimony, we have set up a protocol composed of 4 main actions: i) The exhaustive and objective referencing of geological sites in Ile-de-France. This information is centralised in a database, which currently comprises 639 sites (mainly of anthropic nature such as quarries) ii) The pre-selection of sites (298 out of the initial 639) based on sufficient accessibility and potential geological interest. iii) The use of a method of description and hierarchisation - following the guidelines of the National Geological Heritage Inventory Program (INPG) - on the pre-selected sites. iv) Establishment of a schedule specifying actions of geo-conservation which will take into account the patrimonial value of the sites, but also their threats, their juridical status and the socio-economic context of the region. The purpose of this program is to conserve a collection of geological sites that reflect the totality of the regional geology in Ile-de-France. The results of this study will be released to the general public and

  9. Promoting Regional Disaster Preparedness among Rural Hospitals

    Science.gov (United States)

    Edwards, Janine C.; Kang, JungEun; Silenas, Rasa

    2008-01-01

    Context and Purpose: Rural communities face substantial risks of natural disasters but rural hospitals face multiple obstacles to preparedness. The objective was to create and implement a simple and effective training and planning exercise to assist individual rural hospitals to improve disaster preparedness, as well as to enhance regional…

  10. Improving microcystin monitoring relevance in recreative waters: A regional case-study (Brittany, Western France, Europe).

    Science.gov (United States)

    Pitois, Frédéric; Vezie, Chantal; Thoraval, Isabelle; Baurès, Estelle

    2016-05-01

    Cyanobacteria and their toxins are known as a health hazard in recreative and distributed waters. Monitoring data from 2004 to 2011 were collected at regional scale to characterize exposition parameters to microcystins in Brittany (Western France). The data show that cyanobacteria populations are experiencing a composition shift leading to a longer duration of cell densities higher than WHO alert levels 2 and 3. Microcystins however appear to be more frequently detected with subacute concentrations in low cell density samples than in high cell density samples or during bloom episodes. Positive relations are described between microcystin concentrations, detection frequencies and cyanobacteria biovolumes, allowing for a novel definition of alert levels and decision framework following WHO recommendations. Copyright © 2015 Elsevier GmbH. All rights reserved.

  11. Determinants of geographic inequalities in HPV vaccination in the most populated region of France

    Science.gov (United States)

    2017-01-01

    Background In France, there are recommendations and reimbursements for human papillomavirus (HPV) vaccination but no HPV vaccination programs. Therefore, vaccination is largely determined by parents’ initiative, which can lead to inequalities. The objective of this study was to determine the factors associated with poorer vaccination coverage rates in the most populated region of France. Methods The data of this study were obtained from the National Health Insurance between 2011 and 2013. Correlations between vaccination initiation rate (at least 1 dose reimbursed) and socio-demographic/cultural factors were assessed using Pearson’s product-moment correlation coefficient. Multivariate analyses were performed using logistic regression. Results In total, 121,636 girls received at least one HPV vaccine dose. The vaccination rate for girls born from 1996 to 1999 was 18.7%. Disparities in vaccination coverage rates were observed between the 8 departments of the region, ranging from 12.9% to 22.6%. At the department level, unemployment, proportion of immigrants and foreigners, and coverage by CMU health insurance (“Couverture Maladie Universelle”, a health insurance plan for those who are not otherwise covered through business or employment and who have a low income) were significantly inversely correlated with vaccination rates, whereas urban residence, medical density, income and use of medical services were not related to coverage. In the multivariate model, only the percentage of foreigners remained independently associated with lower vaccination coverage. At the individual level, the use of medical services was a strong driver of HPV vaccination initiation. Conclusion We observed geographic disparities in HPV vaccination initiation coverage. Even if no clear factor was identified as a vaccination determinant, we observed a failure of vaccination only based on parents’ initiative. Therefore, an organized policy on HPV vaccination, such as school

  12. Regional cost differences of hospital supply in Germany

    Directory of Open Access Journals (Sweden)

    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.

  13. Regional Development and Vocational Training. The Problems of Evaluation. Colloquium (Limoges, France, June 18-19, 1990).

    Science.gov (United States)

    Pierret, M.

    1990-01-01

    This paper summarizes the proceedings of a conference held to discuss evaluation in vocational education. The agenda included welcome speeches and the introductory address by Robert Savy, President of the Regional Council of Limousin (France); an opening session with statements from representatives of the Commission of the European Communities…

  14. [Medication administration practices in elderly residential facilities in Ile de France Region in 2014: findings and room for improvement].

    Science.gov (United States)

    de Saunière, Anne; Bonneau, Laetitia; Donio, Valérie; Godinot, Valérie; Flouzat, Jean-Philippe; Bensasson, Géraldine; Code, Christelle; Galay, Guillaume; Pige, Dominique

    2016-11-25

    The institutions expressed great interest in medication administration systems and tools designed to monitor all stages of medication administration. A dozen simple and pragmatic improvement actions were identified and listed in the Ile-de-France Regional Health Agency action plan to improve medication administration management of in EHPAD..

  15. Roles of infection control nurses in regional hospitals.

    Science.gov (United States)

    Kananitaya, Thamolwan; Senarat, Wilawan; Moongtui, Wanchai; Tantisiriwat, Warapot; Danchaivijitr, Somwang

    2005-12-01

    To evaluate the roles of infection control nurses (ICNs) in regional hospitals and to detect problems, obstacles in practice and needs for support. A descriptive study by interview and questionnaire survey of 16 ICNs from regional hospitals appling for HA. From February to April 2002, a study by interview and questionnaires was done in 16 ICNs from 10 regional hospitals applying for HA. Most of the ICNs practised IC roles according to HA criteria except for hospital employee health, NI surveillance and research. The major problems and obstacles included the lack of IC positions, inadequate ICNs, lack of support from hospital administrative personnel, too heavy work load, lack of: IC experts, budget for IC, equipment, IC research data and education material. The present study suggested that roles of ICNs in hospital employee health, NI surveillance and research were inadequate because of the lack of full time ICNs, too heavy a work load, lack of: IC consultants supply and administrative support.

  16. Assessment of the water balance over France using regionalized Turc-Pike formula

    Science.gov (United States)

    Le Lay, Matthieu; Garçon, Rémy; Gailhard, Joël; Garavaglia, Federico

    2016-04-01

    With extensive use of hydrological models over a wide range of hydro-climatic contexts, bias in hydro-climatic data may lead to unreliable models and thus hydrological forecasts and projections. This issue is particularly pregnant when considering mountainous areas with great uncertainties on precipitations, or when considering complex unconservative catchments (e.g. karstic systems). The Turc-Pike water balance formula, analogous to the classical Budyko formula, is a simple and efficient mathematical formulation relating long-term average streamflow to long-term average precipitation and potential evaporation. In this study, we propose to apply this framework to assess and eventually adjust the water-balance before calibrating an operational hydrologic model (MORDOR model). Considering a large set of 350 french catchments, the Turc-Pike formula is regionalized based on ecohydrologic criterions to handle various hydro-climatic contexts. This interannual regional model is then applied to assess the water-balance over numerous catchments and various conditions, such as karstic, snow-driven or glaciarized and even anthropized catchments. Results show that it is possible to obtain pretty realistic corrections of meteorological inputs (precipitations, temperature or potential evaporation) or hydrologic surface (or runoff). These corrections can often be confirmed a posteriori by exogenous information. Positive impacts on hydrologic model's calibration are also demonstrated. This methodology is now operational for hydrologic applications at EDF (Electricité de France, French electric utility company), and therefore applied on hundreds of catchments.

  17. Assessment of the Water Balance Over France Using Regionalized Turc-Pike Formula for Operational Hydrology

    Science.gov (United States)

    LE Lay, M.; Garcon, R.; Gailhard, J.; Garavaglia, F.

    2015-12-01

    With extensive use of hydrological models over a wide range of hydro-climatic contexts, bias in hydro-climatic data may lead to unreliable models and thus hydrological forecasts and projections. This issue is particularly pregnant when considering mountainous areas with great uncertainties on precipitations, or when considering complex unconservative catchments (e.g. karstic systems). The Turc-Pike water balance formula, analogous to the classical Budyko formula, is a simple and efficient mathematical formulation relating long-term average streamflow to long-term average precipitation and potential evaporation. In this study, we propose to apply this framework to assess and eventually adjust the water-balance before calibrating an operational hydrologic model (MORDOR model). Considering a large set of 350 french catchments, the Turc-Pike formula is regionalized based on ecohydrologic criterions to handle various hydro-climatic contexts. This interannual regional model is then applied to assess the water-balance over numerous catchments and various conditions, such as karstic, snow-driven or glaciarized and even anthropized catchments. Results show that it is possible to obtain pretty realistic corrections of meteorological inputs (precipitations, temperature or potential evaporation) or hydrologic surface (or runoff). These corrections can often be confirmed a posteriori by exogenous information. Positive impacts on hydrologic model's calibration are also demonstrated. This methodology is now operational for hydrologic applications at EDF (Electricité de France, French electric utility company), and therefore applied on hundreds of catchments.

  18. Early and Middle Pleistocene vegetation history of the Médoc region, southwest France

    Science.gov (United States)

    O'Brien, C. E.; Jones, R. L.

    2003-09-01

    Pleistocene deposits, together with their pollen, plant macrofossil, foraminiferal, dinoflagellate and coleopteran remains, from five sites along the Atlantic coast of the Médoc Peninsula are described and discussed. Sediments making up the Négade Formation are shown to have been laid down under either estuarine or lagoonal conditions when closed Quercus-Pinus-Tsuga canadensis regional woodland existed. Comparison with plant records from The Netherlands indicates that these deposits are most likely attributable to either the Early Pleistocene Bavel Interglacial (marine oxygen isotope stage (MIS) 31), or an interglacial of the Waalian (MIS 37-49) or Tiglian (MIS 63-79). In addition, clays assigned to the Argiles du Gurp sensu stricto, were similarly deposited in either an estuary or lagoon, which subsequently was cut off from the sea. A freshwater lake with vegetation dominated by Azolla filiculoides then developed. This was succeeded by reedswamp and an organic mud (termed Lignite in the corresponding French stratigraphical records) formed. Regional Quercus-Abies woodland was replaced by one with Pinus dominant and Pterocarya a minor component. Comparison with plant records from France and other parts of Europe suggest that the clays and organic mud might be correlated with the Holsteinian (Praclaux) Interglacial (MIS 11c). Copyright

  19. Family history of immigration from a tuberculosis endemic country and low family income are associated with a higher BCG vaccination coverage in Ile-de-France region, France.

    Science.gov (United States)

    Guthmann, Jean-Paul; Chauvin, Pierre; Le Strat, Yann; Soler, Marion; Fonteneau, Laure; Lévy-Bruhl, Daniel

    2013-11-19

    After withdrawal of multipuncture BCG device from the French market in January 2006, vaccination coverage (VC) with the intradermal device has dropped and since remained sub-optimal in Ile-de-France, the only region of mainland France where BCG is recommended to all children. We conducted a cross-sectional study to identify socio-economic factors associated with BCG VC in children of Paris metropolitan area born after January 2006. Two-stage random sampling was used to include 425 children up to 5 years old from Paris and its suburbs. Information was collected through face-to-face interviews and vaccination status confirmed by a vaccination document. Poisson regression analyzed the association between VC and potential determinants. VC of children from families with the lowest incomes (first quartile of family income/consumption unit (CU) (history of immigration, regardless of family income, are correctly identified as being at high risk of tuberculosis and properly vaccinated with BCG in this area.

  20. Climatology of observed rainfall in Southeast France at the Regional Climate Model scales

    Science.gov (United States)

    Froidurot, Stéphanie; Molinié, Gilles; Diedhiou, Arona

    2016-04-01

    In order to provide convenient data to assess rainfall simulated by Regional Climate Models, a spatial database (hereafter called K-REF) has been designed. This database is used to examine climatological features of rainfall in Southeast France, a study region characterized by two mountain ranges of comparable altitude (the Cévennes and the Alps foothill) on both sides of the Rhône valley. Hourly records from 1993 to 2013 have been interpolated to a 0.1° × 0.1° latitude-longitude regular grid and accumulated over 3-h periods in K-REF. The assessment of K-REF relatively to the SAFRAN daily rainfall reanalysis indicates consistent patterns and magnitudes between the two datasets even though K-REF fields are smoother. A multi-scale analysis of the occurrence and non-zero intensity of rainfall is performed and shows that the maps of the 50th and 95th percentiles of 3- and 24-h rain intensity highlight different patterns. The maxima of the 50th and 95th percentiles are located over plain and mountainous areas respectively. Moreover, the location of these maxima is not the same for the 3- and 24-h intensities. To understand these differences between median and intense rainfall on the one hand and between the 3- and 24-h rainfall on the other hand, we analyze the statistical distributions and the space-time structure of occurrence and intensity of the 3-h rainfall in two classes of days, defined as median and intense. This analysis illustrates the influence of two factors on the triggering and the intensity of rain in the region: the solar cycle and the orography. The orographic forcing appears to be quite different for the two ranges of the domain and is much more pronounced over the Cévennes.

  1. Time scales of regional circulation of saline fluids in continental aquifers (Armorican massif, Western France

    Directory of Open Access Journals (Sweden)

    A. Armandine Les Landes

    2014-06-01

    Full Text Available In recent decades, saline fluids have been sampled worldwide at great depths in continental basements. Although some of them have been attributed to marine transgressions the mechanisms allowing their circulation is not understood. In this paper, we describe the horizontal and vertical distribution of moderately saline fluids (60 to 1400 mg L−1 sampled at depths ranging from 41 to 200 m in aquifers at the regional scale of the Armorican Massif (northwestern France. The horizontal and vertical distributions of high chloride concentrations are in good agreement with both the altitudinal and vertical limits and succession of the three major transgressions between the Mio-Pliocene and Pleistocene ages. The mean chloride concentration for each transgression area is exponentially related to the time spanned until present. It defines the potential laws of leaching of marine waters by fresh meteoric waters. The results of the Armorican aquifers provide the first observed constraints for the time scales of seawater circulation in the continental basement and the subsequent leaching by fresh meteoric waters. The general trend of increasing chloride concentration with depth and the time frame for the flushing process provide useful information to develop conceptual models of the paleo-functionning of Armorican aquifers.

  2. Larval trematode infections in Lymnaea glabra populations living in the Brenne Regional Natural Park, central France.

    Science.gov (United States)

    Rondelaud, Daniel; Vignoles, Philippe; Dreyfuss, Gilles

    2015-01-01

    Lymnaea glabra is known to be a natural intermediate host of two flukes, Calicophoron daubneyi and Fasciola hepatica, in central France. But it can also sustain larval development of other digeneans. Adult snails were thus collected from 206 habitats in 2014 and 2015 to identify parasite species and determine the prevalence of each digenean infection in relation to the five types of snail habitats. Seven digenean species were noted in 321 infected snails (out of 17,647 L. glabra). Snails with F. hepatica or C. daubneyi were found in 14.5% and 12.6% of habitats, respectively. Percentages were lower for snails with Opisthoglyphe ranae (5.8%), Haplometra cylindracea (5.3%) and were less than 5% for those infected with Echinostoma revolutum, Notocotylus sp. or Plagiorchis sp. Prevalence noted for each parasite species varied with the type of habitat. The number of species in L. glabra was lower than that found in G. truncatula from the same region (7 instead of 10). The distribution and prevalence of each digenean species were thus dependent on the type and location of each snail habitat. © D. Rondelaud et al., published by EDP Sciences, 2015.

  3. Larval trematode infections in Lymnaea glabra populations living in the Brenne Regional Natural Park, central France

    Directory of Open Access Journals (Sweden)

    Rondelaud Daniel

    2015-01-01

    Full Text Available Lymnaea glabra is known to be a natural intermediate host of two flukes, Calicophoron daubneyi and Fasciola hepatica, in central France. But it can also sustain larval development of other digeneans. Adult snails were thus collected from 206 habitats in 2014 and 2015 to identify parasite species and determine the prevalence of each digenean infection in relation to the five types of snail habitats. Seven digenean species were noted in 321 infected snails (out of 17,647 L. glabra. Snails with F. hepatica or C. daubneyi were found in 14.5% and 12.6% of habitats, respectively. Percentages were lower for snails with Opisthoglyphe ranae (5.8%, Haplometra cylindracea (5.3% and were less than 5% for those infected with Echinostoma revolutum, Notocotylus sp. or Plagiorchis sp. Prevalence noted for each parasite species varied with the type of habitat. The number of species in L. glabra was lower than that found in G. truncatula from the same region (7 instead of 10. The distribution and prevalence of each digenean species were thus dependent on the type and location of each snail habitat.

  4. A new challenge for hospitals in southeast France: monitoring local populations of Aedes albopictus to prevent nosocomial transmission of dengue or chikungunya.

    Science.gov (United States)

    Cotteaux-Lautard, Christelle; Berenger, Jean-Michel; Fusca, François; Chardon, Hubert; Simon, Fabrice; Pagès, Frederic

    2013-03-01

    Aedes albopictus was first identified in southern France in 2004, inducing an emerging risk for autochthonous transmission around imported cases of dengue or chikungunya, and also for mosquito-borne nosocomial transmission in hospitals. Aedes albopictus has been present in Marseille since September 2009 and in Aix-en-Provence since August 2010. Because of the possible admission of viremic patients with dengue or chikungunya in the hospitals of these cities, a mosquito survey was conducted in 2011 in 2 of the hospitals, with the use of mosquito traps. Aedes albopictus was detected with Eisenhans II traps and egg traps in both hospitals during the warm season.

  5. Ecology and spatiotemporal dynamics of sandflies in the Mediterranean Languedoc region (Roquedur area, Gard, France)

    OpenAIRE

    Prudhomme, Jorian; Rahola, Nil; Toty, Céline; Cassan, Cécile; Roiz, David; Vergnes, Baptiste; Thierry, Magali; Rioux, Jean-Antoine; Alten, Bulent; Sereno, Denis; Bañuls, Anne-Laure

    2015-01-01

    Background: Phlebotomine sandflies are hematophagous insects widely present in Western Mediterranean countries and known for their role as Leishmania vectors. During the last ten years, the risk of leishmaniasis re-emergence has increased in France. However, sandfly biology and ecology in the South of France remain poorly known because the last detailed study on their spatiotemporal dynamics was performed over 30 years ago. The aim of the present study was to update our knowledge on sandfly e...

  6. Does hospital ownership influence hospital referral region health rankings in the United States.

    Science.gov (United States)

    Hamadi, Hanadi; Apatu, Emma; Spaulding, Aaron

    2017-07-21

    Extensive evidence demonstrates that a hospital's organizational ownership structure impacts its overall performance, but little is known concerning the influence of hospital structure on the health of its community. This paper explores the association between US hospital referral region (HRR) health rankings and hospital ownership and performance. Data from the 2016 Commonwealth Fund Scorecard on Local Health System Performance, the American Hospital Association dataset, and the Hospital Value-Based Purchasing dataset are utilized to conduct a cross-sectional analysis of 36 quality measures across 306 HRRs. Multivariate regression analysis was used to estimate the association among hospital ownership, system performance measures-access and affordability, prevention and treatment, avoidable hospital use and cost, and healthy lives-and performance as measured by value-based purchasing total performance scores. We found that indicators of access and affordability, as well as prevention and treatment, were significantly associated across all 3 hospitals' organizational structures. Hospital referral regions with a greater number of not-for-profit hospitals demonstrated greater indications of access and affordability, as well as better prevention and treatment rankings than for-profit and government hospitals. Hospital referral regions with a greater number of government, nonfederal hospitals had worse scores for healthy lives. Furthermore, the greater the total performance scores score, the better the HRR score on prevention and treatment rankings. The greater the per capita income, the better the score across all 4 dimensions. As such, this inquiry supports the assertion that performance of a local health system is dependent on its community's resources of health care delivery entities and their structure. Copyright © 2017 John Wiley & Sons, Ltd.

  7. [Health of immigrant population of consultants at the Baudelaire outpatient clinic in Saint-Antoine hospital in Paris, France].

    Science.gov (United States)

    Kaoutar, B; Mathieu-Zahzam, L; Lebas, J; Chauvin, P

    2012-05-01

    Social and health data on the immigrant population remain scarce in France, especially concerning those in irregular situation. The Baudelaire outpatient clinic in Saint- Antoine hospital in Paris (PASS, i.e. specific free medicosocial care for the poor, the uninsured or the undocumented patients) treats a majority of immigrants, a lot of them being in an irregular residence status. The objectives of this study were to describe the social and health status of the immigrant consultants, to compare regular and undocumented migrants and to describe their main reasons for migration. A cross-sectional, descriptive, survey among the immigrant consultants has been performed among this outpatient clinic in April and May 2009. In total, 536 patients were included. Their age mean was 45 years, 62% are male, 49% are in an irregular situation and they have been in France for 12 years in average (19 years for the regular immigrants and 5 years for the undocumented). More than 20% had no health insurance. A majority (55%) of patients were suffering from a chronic disease. The more frequent ones were hypertension (20%), type 2 diabetes (11.6%), chronic infectious diseases - HIV, HBV, HCV - (7%). Reasons for immigration were mostly economical (39%), family (19%) and political (17%). Health reasons were at the 4th rank and concerned 9% of the patients. The main chronic diseases observed among this population are similar to those of the general population of consultants in primary health care, except for the chronic infectious diseases, which are more frequent. Immigration for health reasons represents only a small proportion of all immigration reasons. For this population, free clinics like the one investigated here constitute unique, irreplaceable, access points in the French healthcare system.

  8. Snow covers detection using terrestrial photography. Application to a mountain catchment in Alps region (France).

    Science.gov (United States)

    Barth, Thierry; Saulnier, Georges-Marie; Malet, Emmanuel

    2010-05-01

    In August 2005, a significant mudflow leaded to major impacts damages at the Sainte-Agnes village located downstream the Vorz torrent (35 km2, elevations ranging from 1248m and 2977m, Alps region, France). To meet the demand of populations and civil authorities a research program was launched to both monitor and model these regions to help to quantify water resources and vulnerability to such hazardous events, including their probable evolutions do to climatic changes. This communication focuses on one of the several forcing variables of the water cycle in mountainous regions: the snow covering. Indeed, its controls a significant part of the future available water resources and may strongly interact with liquid precipitations during snow melting season. Usual sensors such as remote sensing cannot easily quantify accurately the snow covering for small mountainous catchment at hydrological models spatial and temporal resolutions (typically Dx fog, clouds, etc.) taking into account for the very various luminosity and cloud covers conditions. To make the 2D to 3D conversion, the camera referential needs to be replaced in the catchment referential by geometrical transformations. This operation is automatically realized by automatic recognition of geo referenced ground points (particular DTM points) within the camera pictures and resolution of a matrix system. Solving this inverse matrix problem raises numerous mathematical difficulties that will be discussed in the presentation. When successfully solved, every picture pixel can then be dropped on the DTM taking into account classical problems such as hidden faces. The automatically detection of the snow pixels in each picture is then achieved. The recurrent problem is the changing of luminosity and cloud cover of the catchment. It is often very difficult to distinguish between white clouds and snow within the picture by automatic algorithm. Difficulties also arise when shading effects fade colours of the compressed

  9. Spatial prediction of soil texture in region Centre (France) from summary data

    Science.gov (United States)

    Dobarco, Mercedes Roman; Saby, Nicolas; Paroissien, Jean-Baptiste; Orton, Tom G.

    2015-04-01

    Soil texture is a key controlling factor of important soil functions like water and nutrient holding capacity, retention of pollutants, drainage, soil biodiversity, and C cycling. High resolution soil texture maps enhance our understanding of the spatial distribution of soil properties and provide valuable information for decision making and crop management, environmental protection, and hydrological planning. We predicted the soil texture of agricultural topsoils in the Region Centre (France) combining regression and area-to-point kriging. Soil texture data was collected from the French soil-test database (BDAT), which is populated with soil analysis performed by farmers' demand. To protect the anonymity of the farms the data was treated by commune. In a first step, summary statistics of environmental covariates by commune were used to develop prediction models with Cubist, boosted regression trees, and random forests. In a second step the residuals of each individual observation were summarized by commune and kriged following the method developed by Orton et al. (2012). This approach allowed to include non-linear relationships among covariates and soil texture while accounting for the uncertainty on areal means in the area-to-point kriging step. Independent validation of the models was done using data from the systematic soil monitoring network of French soils. Future work will compare the performance of these models with a non-stationary variance geostatistical model using the most important covariates and summary statistics of texture data. The results will inform on whether the later and statistically more-challenging approach improves significantly texture predictions or whether the more simple area-to-point regression kriging can offer satisfactory results. The application of area-to-point regression kriging at national level using BDAT data has the potential to improve soil texture predictions for agricultural topsoils, especially when combined with

  10. Mediterranean region`s LNG industry. Algeria and Libya to Spain, France, Italy and Turkey; Chichukai chiiki no LNG sangyo. Arujeria, Ribia kara Supein, Furansu, Itaria, Toruko e

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-08-10

    Since LNG is used along with gas supply in mediterranean region, the amount of LNG use in that region is very small in comparison with total demand. However imported LNG for peak use during winter and use as industrial raw materials occupies very important part in Spain, France etc., and other importing countries. From this, further increase of LNG trade is expected. Information regarding operating conditions of plants and liquefaction ability, present conditions of base plant construction and its special features, history of oil/gas fields and LNG supply contracts with importing countries is provided for LNG exporting countries like Libya and Algeria in mediterranean region. Storage base`s scale (site area, tank capacity and ship logging`s load capacity) and period until operation starts are reported along with information before import for importing countries like Spain, France, Italy and Turkey. Further trend of base storage for Greece and Turkey will be surveyed here after.

  11. Practice of Regional Economic Intelligence in France%法国区域经济情报的实践

    Institute of Scientific and Technical Information of China (English)

    祝碧衡

    2012-01-01

    As a major highlight of the economic intelligence in France ,the regional economic intelligence is relevant with the public policy for local government and private,in particular innovators in the SMEs to collaborate. Under the guidance of the Department of E- conomic Intelligence Coordination of France( SCIE), head of the Prefet de region, the regional economic intelligence system have been established since 2005 in most regions in France. They provide information to support services for regional economic development strategy, particularly in key industry gathering areas for the French the competitive clusters, to help them to increase the competitiveness of enterprises, promote the regional economy and enhance the regional influence.%法国区域经济情报是法国国家经济情报体系中的一大亮点,相关工作主要是围绕公共政策,为政府和私人,尤其是中小企业的创新者搭建协作的桥梁。2005年以来,在法国国家经济情报协调署的指导下,在各大区区长的牵头下,法国各大区相继建立区域经济情报体系,为地区经济发展战略,尤其是为法国重点产业集聚区——竞争力集群的发展提供情报支持服务,以期达到提升企业竞争力、振兴地区经济和提高地区影响力之目的。

  12. Assessment of commuters' daily exposure to flash flooding over the roads of the Gard region, France

    Science.gov (United States)

    Debionne, Samuel; Ruin, Isabelle; Shabou, Saif; Lutoff, Céline; Creutin, Jean-Dominique

    2016-10-01

    Flash floods are responsible for a majority of natural disaster fatalities in the USA and Europe and most of them are vehicle-related. If human exposure to flood is generally assessed through the number of inhabitants per buildings located in flood prone zone, it is clear that this number varies dramatically throughout the day as people move from place to place to follow their daily program of activities. Knowing the number of motorists exposed on flood prone road sections or the factors determining their exposure would allow providing a more realistic evaluation of the degree of exposure. In order to bridge this gap and provide emergency managers with methods to assess the risk level for motorists, this paper describes two methods, a simple rough-and-ready estimate and a traffic attribution method, and applies both of them on datasets of the Gard département, an administrative region of Southern France with about 700 000 inhabitants over 5875 km2. The first method to obtain an overall estimation of motorists flood exposure is to combine (i) the regional density of roads and rivers to derive a count of potential road cuts and (ii) the average daily kilometers driven by commuters of the study area to derive the number of people passing these potential cuts. If useful as a first approximation, this method fails to capture the spatial heterogeneities introduced by the geometry of river and road networks and the distribution of commuters' itineraries. To address this point, this paper (i) uses a pre-established detailed identification of road cuts (Naulin et al., 2013) and (ii) applies a well-known traffic attribution method to existing and freely available census datasets. Both methods indicate that commuters' exposure is much larger than the number of commuters itself, illustrating the risk amplification effect of mobility. Comparing the results from both methods shows that (i) the road network geometry plays a significant role in reducing the risk of river

  13. Travel Time to Hospital for Childbirth: Comparing Calculated Versus Reported Travel Times in France.

    Science.gov (United States)

    Pilkington, Hugo; Prunet, Caroline; Blondel, Béatrice; Charreire, Hélène; Combier, Evelyne; Le Vaillant, Marc; Amat-Roze, Jeanne-Marie; Zeitlin, Jennifer

    2017-08-05

    Objectives Timely access to health care is critical in obstetrics. Yet obtaining reliable estimates of travel times to hospital for childbirth poses methodological challenges. We compared two measures of travel time, self-reported and calculated, to assess concordance and to identify determinants of long travel time to hospital for childbirth. Methods Data came from the 2010 French National Perinatal Survey, a national representative sample of births (N = 14 681). We compared both travel time measures by maternal, maternity unit and geographic characteristics in rural, peri-urban and urban areas. Logistic regression models were used to study factors associated with reported and calculated times ≥30 min. Cohen's kappa coefficients were also calculated to estimate the agreement between reported and calculated times according to women's characteristics. Results In urban areas, the proportion of women with travel times ≥30 min was higher when reported rather than calculated times were used (11.0 vs. 3.6%). Longer reported times were associated with non-French nationality [adjusted odds ratio (aOR) 1.3 (95% CI 1.0-1.7)] and inadequate prenatal care [aOR 1.5 (95% CI 1.2-2.0)], but not for calculated times. Concordance between the two measures was higher in peri-urban and rural areas (52.4 vs. 52.3% for rural areas). Delivery in a specialised level 2 or 3 maternity unit was a principal determinant of long reported and measured times in peri-urban and rural areas. Conclusions for Practice The level of agreement between reported and calculated times varies according to geographic context. Poor measurement of travel time in urban areas may mask problems in accessibility.

  14. [Results and lessons after 10 years of universal neonatal hearing screening in the Champagne-Ardenne region of France].

    Science.gov (United States)

    Chays, André; Labrousse, Marc; Makeieff, Marc

    2014-01-01

    In France, universal newborn hearing screening has been mandatory since April23rd, 2012, but it began in the Champagne-Ardenne region on January 15th 2004. More than 99 % of 160 196 newborns have since been systematically screened in this region. Bilateral hearing impairment was thus identified in 116 infants when they were around 3.5 months old. Earlier diagnosis improves the outcome of deafness, which is only diagnosed around age 20 months without screening. The authors report their experience and the lessons learnt.

  15. Development prospects and challenges for organic farming in the Midi-Pyrénées region of France

    OpenAIRE

    MONDY, B.; Terrieux, A.; Gafsi, M.; HEMPTINNE, J.L.

    2009-01-01

    With 67,000 ha and 1,200 organic farms (OF), the Midi-Pyrénées region is the biggest agricultural area in France and second only to the Pays de Loire region in number of farms. Organic farming has developed rapidly over the past 15 years due to the steep increase in the demand for organic products. However, this was not always the case due to several factors linked to technical difficulties: market access, wide use of imports, a trend towards industrialisation, difficulties in mastering t...

  16. [Phlebotomus perniciosus Newstead, 1911 naturally infected by promastigotes in the region of Nice (France)].

    Science.gov (United States)

    Izri, M A; Marty, P; Rahal, A; Lelièvre, A; Ozon, C; Baldelli, G; Presiozo, J; Haas, P; Le Fichoux, Y

    1992-01-01

    The authors report the results of investigations in Nice from July, 16 to August, 3, 1991. The 2,098 phlebotomes captured represent three species: Phlebotomus perniciosus, Phlebotomus ariasi and Sergentomyia minuta. Two species: P. perniciosus and P. ariasi are infected with promastigotes. About 4% of dissected females are parasited. This is the first description in France of P. perniciosus infected.

  17. Provision of general paediatric surgical services in a regional hospital.

    LENUS (Irish Health Repository)

    Zgraj, O

    2012-01-31

    BACKGROUND: In Ireland, specialist paediatric surgery is carried out in paediatric hospitals in Dublin. General surgeons\\/consultants in other surgical specialities provide paediatric surgical care in regional centres. There has been a failure to train general surgeons with paediatric skills to replace these surgeons upon retirement. AIM: To assess paediatric surgical workload in one regional centre to focus the debate regarding the future provision of general paediatric surgery in Ireland. METHODS: Hospital in-patient enquiry (HIPE) system was used to identify total number of paediatric surgical admissions and procedures. Cases assessed requiring hospital transfer. RESULTS: Of 17,478 surgical patients treated, 2,584 (14.8%) were under 14 years. A total of 2,154 procedures were performed. CONCLUSION: Regional centres without dedicated paediatric surgeons deliver care to large numbers of paediatric patients. The demand for care highlights the need for formal paediatric services\\/appropriate surgical training for general surgical trainees.

  18. [Obstetric and neonatal outcomes of adolescent pregnancies: a cohort study in a hospital in Seine-Saint-Denis France].

    Science.gov (United States)

    Debras, E; Revaux, A; Bricou, A; Laas, E; Tigaizin, A; Benbara, A; Carbillon, L

    2014-09-01

    The aim of this study was to describe the characteristics, monitoring, obstetrical complications, childbirth and neonatal outcomes of pregnancies among minors in a cohort of adolescents from Seine-Saint-Denis (France). This is a retrospective, cohort, comparative study, conducted from January 1, 1996 to July 31, 2011, made from the database of Jean-Verdier hospital in Seine-Saint-Denis. Three groups were established: patients aged less than 16 years old, patients aged over 16 years old and under 18 years old compared to a group consisting of older primiparas from 18 to 25 years old. The criteria considered were the characteristics of pregnancy, terms of delivery, neonatal outcome and conduct of post-partum. Minor patients were statistically more likely to be single, student, smoking and anemia compared to young adults. The obstetrical care was lower for minor compared to the control group with a number of consultations and ultrasounds lower (P Adolescentes under 16 years old had a higher preterm delivery risk in multivariate analysis (RR = 0.33 CI 95% [0.12; 0.90] P = 0.03). Adolescents had fewer cesarean and instrumental deliveries (P < 0.05). Teenage pregnancy remains an important managing issue for maternities, particularly from a social standpoint. On the medical side, one preterm delivery appears to be more common among these adolescents. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  19. [Gastric cancer in the Honorio Delgado Regional Hospital in Arequipa].

    Science.gov (United States)

    Estremadoyro, O; Alvarez de Trillo, Y; Estremadoyro Stagnaro, L; Gamero Tejada, D

    1995-01-01

    We present the study of 120 cases of gastric carcinoma, observed in the Hospital Regional Honorio Delgado from Arequipa Peru, in 2683 gastroscopies, with 4.5% of incidence. We offer date of age, sex, race, occupation, antecedents, social-economic conditions, clinics, diagnosis, pathologies aspects and mortality.

  20. Driving hospital transformation with SLMTA in a regional hospital in Cameroon

    Directory of Open Access Journals (Sweden)

    Laura T. Eno

    2014-09-01

    Full Text Available Background: Inspired by the transformation of the Regional Hospital Buea laboratory through implementation of the Strengthening Laboratory Management Toward Accreditation (SLMTA programme, hospital management adapted the SLMTA toolkit to drive hospital wide quality improvement.Objective: This paper describes changes in the hospital following the quality improvement activities in hygiene and sanitation, the outpatient waiting area and the surgical and maternity wards.Methods: In March 2011, hospital management established a quality improvement task force and created a hospital-wide quality improvement roadmap, following the SLMTA model. The roadmap comprised improvement projects, accountability plans, patient feedback forms and log books to track quality indicators including patient wait time, satisfaction level, infectionrates, birth outcomes and hospital revenue.Results: There was steady improvement in service delivery during the 11 months after the introduction of the quality improvement initiatives: patient wait time at the reception was reduced from three hours to less than 30 minutes and patient satisfaction increased from 15% to 60%. Treatment protocols were developed and documented for various units, infrastructure and workflow processes were improved and there was increased staff awareness of the importance of providing quality services. Maternal infection rates dropped from 3% to 0.5% and stillbirths from 5% to < 1%. The number of clients increased as a result of improvedservices, leading to a 25% increase in hospital revenue.Conclusion: The SLMTA approach was adapted successfully to meet the needs of the entire hospital. Such a programme has the potential to impact positively on hospital quality systems; consideration should be made for development of a formal SLMTA-like programmefor hospital quality improvement.

  1. Bacterial lymphadenitis at a major referral hospital in France from 2008 to 2012.

    Science.gov (United States)

    Safont, Marion; Angelakis, Emmanouil; Richet, Hervé; Lepidi, Hubert; Fournier, Pierre-Edouard; Drancourt, Michel; Raoult, Didier

    2014-04-01

    Lymph node enlargement is a common medical problem, and in a large number of patients, the causes of lymphadenopathy remain undiagnosed. We report a thorough microbiological analysis of 1,688 lymph node biopsy specimens collected in our bartonellosis reference center. We studied lymph node biopsy samples from patients with suspected regional infectious lymph node enlargement from January 2008 to December 2012. To evaluate a useful strategy for the diagnosis of infectious lymphadenitis, specimens were cultured and subjected to molecular assays. Histologic analysis was done when possible. A total of 642 (38%) biopsy specimens were infected with a bacterial agent, and quantitative PCR (qPCR) was significantly better than 16S rRNA gene PCR (rrs) for the detection of Bartonella henselae (P = 0.05), Mycobacterium tuberculosis (P = 0.05), and Mycobacterium avium (P = 0.007). Molecular assays were significantly better than bacterial cultures for the diagnosis of Francisella tularensis (P = 0.017) but were less effective for detecting M. tuberculosis (P = 0.004) and M. avium (P = 0.001). Histologic analysis was done for 412 lymph nodes, and 20% of these were compatible with an infectious lymphadenitis, whereas a neoplasm was found in 29% of these lymph nodes. M. tuberculosis was detected significantly more in female than in male patients (P = 0.01), and patients with cat scratch disease (CSD) were younger than patients with M. tuberculosis, Tropheryma whipplei, and F. tularensis. Negative rrs PCR does not exclude the diagnosis of infectious lymphadenitis. Histologic analysis of lymph node biopsy specimens is critical, as a diagnosis of infectious lymphadenitis does not preclude other concurrent diseases.

  2. Regional hospital solid waste assessment using the evidential reasoning approach.

    Science.gov (United States)

    Abed-Elmdoust, Armaghan; Kerachian, Reza

    2012-12-15

    Hospital solid waste assessment is regularly characterized by a large number of known criteria that are both qualitative and quantitative in nature. The qualitative criteria can only be assessed by human judgments, which predictably engage a variety of uncertainties such as fuzziness and ignorance. Therefore, hospital solid waste assessments need to be analyzed and modeled using approaches that can handle uncertainties. The evidential reasoning (ER) approach can be utilized for such an analysis. In this paper, perhaps for the first time, the ER approach is applied to regional hospital solid waste assessment. The assessment criteria are characterized by a set of assessment grades assumed to be commonly exclusive and communally exhaustive. All assessment information, incomplete or complete, qualitative or quantitative, and imprecise or precise, are modeled using a cohesive belief structure. The ER approach will be used to aggregate multiple hospital solid waste assessment criteria, resulting in distributed assessment for each alternative. The proposed methodology is applied for regional hospital solid waste assessment in the province of Khuzestan, Iran.

  3. Tourism and Sustainable Regional Development in Romania and France: an Approach from the Perspective of New Economic Geography

    Directory of Open Access Journals (Sweden)

    Gabriela Carmen Pascariu

    2014-11-01

    Full Text Available The issue of sustainable tourism and its potential contribution to regional development and convergence within the EU has been, in recent years, one of the primary research themes and a constant concern in European policies. However, currently, the European tourism industry is facing a loss in competitiveness at the global level due to a reduction in its share in world tourism and lower average revenues, many regions being in decline and the geographical flows being redirected. Based on these aspects, the present study proposes an analysis from the New Economic Geography perspective, considering two EU countries, a developed one (France, but situated in a tourist sub-region with a declining share in the total international tourist arrivals (Western Europe and a developing one (Romania, from a growing tourism sub-region (Central/Eastern Europe. Using a comparative analysis at regional level, with three categories of functions - a function of impact (economic, social, environmental, a function of stability and a function of convergence - combined into a matrix model, we achieved an integrated research on the contribution that tourism brings in the two countries in terms of development and regional convergence. Then, we proposed a classification of regions according to the tourism index (mature tourist destinations, less attractive or in the early stage, the conclusions of the paper outlining several action lines for improving competitiveness of tourism in developing regions.

  4. Modelling LAI at a regional scale with ISBA-A-gs: comparison with satellite-derived LAI over southwestern France

    Directory of Open Access Journals (Sweden)

    A. Brut

    2009-08-01

    Full Text Available A CO2-responsive land surface model (the ISBA-A-gs model of Météo-France is used to simulate photosynthesis and Leaf Area Index (LAI in southwestern France for a 3-year period (2001–2003. A domain of about 170 000 km2 is covered at a spatial resolution of 8 km. The capability of ISBA-A-gs to reproduce the seasonal and the interannual variability of LAI at a regional scale, is assessed with satellite-derived LAI products. One originates from the CYCLOPES programme using SPOT/VEGETATION data, and two products are based on MODIS data. The comparison reveals discrepancies between the satellite LAI estimates and between satellite and simulated LAI values, both in their intensity and in the timing of the leaf onset. The model simulates higher LAI values for the C3 crops than the satellite observations, which may be due to a saturation effect within the satellite signal or to uncertainties in model parameters. The simulated leaf onset presents a significant delay for C3 crops and mountainous grasslands. In-situ observations at a mid-altitude grassland site show that the generic temperature response of photosynthesis used in the model is not appropriate for plants adapted to the cold climatic conditions of the mountainous areas. This study demonstrates the potential of LAI remote sensing products for identifying and locating models' shortcomings at a regional scale.

  5. Modelling LAI at a regional scale with ISBA-A-gs: comparison with satellite-derived LAI over southwestern France

    Directory of Open Access Journals (Sweden)

    A. Brut

    2009-04-01

    Full Text Available A CO2-responsive land surface model (the ISBA-A-gs model of Météo-France is used to simulate photosynthesis and Leaf Area Index (LAI in southwestern France for a 3-year period (2001–2003. A domain of about 170 000 km2 is covered at a spatial resolution of 8 km. The capability of ISBA-A-gs to reproduce the seasonal and the inter-annual variability of LAI at a regional scale, is assessed with two satellite-derived LAI products. One originates from the CYCLOPES programme using SPOT/VEGETATION data, and the second is based on MODIS data. The comparison reveals discrepancies between the two satellite LAI estimates and between satellite and simulated LAI values, both in their intensity and in the timing of the leaf onset. The model simulates higher LAI values for the C3 crops and coniferous trees than the satellite observations, which may be due to a saturation effect within the satellite signal. The simulated leaf onset presents a significant delay for mountainous grasslands. In-situ observations at a mid-altitude grassland site show that the generic temperature response of photosynthesis used in the model is not appropriate for plants adapted to the cold climatic conditions of the mountainous areas. This study demonstrates the potential of LAI remote sensing products for identifying and locating models' shortcomings at a regional scale.

  6. Modelling LAI at a regional scale with ISBA-A-gs: comparison with satellite-derived LAI over southwestern France

    Science.gov (United States)

    Brut, A.; Rüdiger, C.; Lafont, S.; Roujean, J.-L.; Calvet, J.-C.; Jarlan, L.; Gibelin, A.-L.; Albergel, C.; Le Moigne, P.; Soussana, J.-F.; Klumpp, K.

    2009-04-01

    A CO2-responsive land surface model (the ISBA-A-gs model of Météo-France) is used to simulate photosynthesis and Leaf Area Index (LAI) in southwestern France for a 3-year period (2001-2003). A domain of about 170 000 km2 is covered at a spatial resolution of 8 km. The capability of ISBA-A-gs to reproduce the seasonal and the inter-annual variability of LAI at a regional scale, is assessed with two satellite-derived LAI products. One originates from the CYCLOPES programme using SPOT/VEGETATION data, and the second is based on MODIS data. The comparison reveals discrepancies between the two satellite LAI estimates and between satellite and simulated LAI values, both in their intensity and in the timing of the leaf onset. The model simulates higher LAI values for the C3 crops and coniferous trees than the satellite observations, which may be due to a saturation effect within the satellite signal. The simulated leaf onset presents a significant delay for mountainous grasslands. In-situ observations at a mid-altitude grassland site show that the generic temperature response of photosynthesis used in the model is not appropriate for plants adapted to the cold climatic conditions of the mountainous areas. This study demonstrates the potential of LAI remote sensing products for identifying and locating models' shortcomings at a regional scale.

  7. [Ragweed in France and the Rhône-Alpes region (Lyon, Bourgoin, Grenoble, Roussillon].

    Science.gov (United States)

    Thibaudon, M; Lachasse, C; Finet, F

    2003-03-01

    Ragweed in France is a rather recent pollen which causes strong allergies on the populations concerned. This pollen, mainly located in the area Rhone-Alpes, extend more and more on totality of France. Indeed, the pollinic data highlight the presence of ragweed on all the territory with very low, as for Brittany, to several hundreds grains in the area of Rhone-Alpes. So four towns of this area have followed closely the extend of this pollen during the year 2002 through five pollen-traps (2 for the town of Lyon). The trap of Lyon I (Gerland) made it possible to follow temporal the extend of ragweed from 1987 to 2002 and the increase of the number of grains as that of the number of days with a significant allergic risk. The study shows also the differences in quantity of pollens, the differences between the daily allergic risks of the five sites, as well as the differences, between the cities, of the number of days when the allergic risk is significant. It is necessary that pollen of ragweed can be followed closely because of its strong allergenic capacity, in the area of Rhone-Alpes, where the plant prevails mainly, but also on the totality of the own territory, this to supervise its evolution and the speed of proliferation of the plant.

  8. COMPARATIVE SOCIAL AND ECONOMIC STUDY OF YOUTH PRO-NATALIST POLICY IN THE REGIONS OF GERMANY, FRANCE AND RUSSIA

    Directory of Open Access Journals (Sweden)

    Olga Vladimirovna Gokova

    2017-06-01

    Full Text Available This article analyzes the results of three empirical studies conducted in Russia, Germany and France, which reveal value orientations of contemporary young people of these countries, the nature of their social behavior in the demographic context, as well as economic factors influencing it. The objectives of the study are the need to identify and systematize the factors that influence the reproductive behavior of today’s youth from typical regions of these countries, as well as the evaluation of the experience of the organization and implementation of the pro-natalist policy accumulated by these three states. In the process of the questionnaire survey of young people in three countries, we formed an information database for the comparative analysis of young respondents’ views on the issues of identifying their behaviour and value orientations in family life. We also use materials of the state statistics of these countries and the secondary analysis of the materials of sociological studies. On the basis of the conducted research and experience of implementation of pro-natalist policy in Germany and France, we have developed a number of measures of the Russian youth pro-natalist policy. The development of the labor market has a strong influence on the formation of the family value system of today’s youth in Germany, France and Russia. It specifies the need to achieve a balance between creating a family, birth of children and the desire to create oneself as a professional. The possibility of achieving such life harmony must be ensured and supported by government measures in the framework of the effective pro-natalist policy.

  9. Comparison between seismic and domestic risk in moderate seismic hazard prone region: the Grenoble City (France test site

    Directory of Open Access Journals (Sweden)

    F. Dunand

    2012-02-01

    Full Text Available France has a moderate level of seismic activity, characterized by diffuse seismicity, sometimes experiencing earthquakes of a magnitude of more than 5 in the most active zones. In this seismicity context, Grenoble is a city of major economic and social importance. However, earthquakes being rare, public authorities and the decision makers are only vaguely committed to reducing seismic risk: return periods are long and local policy makers do not have much information available. Over the past 25 yr, a large number of studies have been conducted to improve our knowledge of seismic hazard in this region. One of the decision-making concerns of Grenoble's public authorities, as managers of a large number of public buildings, is to know not only the seismic-prone regions, the variability of seismic hazard due to site effects and the city's overall vulnerability, but also the level of seismic risk and exposure for the entire city, also compared to other natural or/and domestic hazards. Our seismic risk analysis uses a probabilistic approach for regional and local hazards and the vulnerability assessment of buildings. Its applicability to Grenoble offers the advantage of being based on knowledge acquired by previous projects conducted over the years. This paper aims to compare the level of seismic risk with that of other risks and to introduce the notion of risk acceptability in order to offer guidance in the management of seismic risk. This notion of acceptability, which is now part of seismic risk consideration for existing buildings in Switzerland, is relevant in moderately seismic-prone countries like France.

  10. Characteristics and patterns of elective admissions to for-profit and not-for-profit hospitals in France in 2009 and 2010.

    Science.gov (United States)

    Weeks, William B; Jardin, Marie; Paraponaris, Alain

    2015-05-01

    In the mid 2000s, in an effort to increase competition among hospitals in France - and thereby reduce hospital care costs - policymakers implemented a prospective payment system and created incentives to promote use of for-profit hospitals. But such policies might incentivize 'upcoding' to higher-reimbursed procedures or overuse of preference-sensitive elective procedures, either of which would offset anticipated cost savings. To explore either possibility, we examined the relative use and costs of admissions for ten common preference-sensitive elective surgical procedures to French not-for profit and for-profit sector hospitals in 2009 and 2010. For each admission type, we compared sector-specific hospitalization characteristics and mean per-admission reimbursement and sector-specific relative rates of lower- and higher-reimbursed procedures. We found that, despite having substantially fewer beds, for-profit hospitals captured a large portion of market for these procedures; further, for-profit admissions were shorter and less expensive, even after adjustment for patient demographics, hospital characteristics, and patterns of admission to different reimbursement categories. While French for-profit hospitals appear to provide more efficient care, we found coding inconsistencies across for-profit and not-for-profit hospitals that may suggest supplier-induced demand and upcoding in for-profit hospitals. Future work should examine sector-specific changes in relative use and billing practices of for elective surgeries, the degree to which these elective surgeries are justified in either sector, and whether outcomes differ according to sector used. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Regional inequalities of hospital morbidity and associations with mortality in Lithuania

    Directory of Open Access Journals (Sweden)

    Skirmantė Jurevičiūtė

    2015-11-01

    Conclusions: Despite national efforts to decrease hospital care, our study detected the failure of hospitalization reduction and revealed an increase of hospitalization with the existing regional inequalities in Lithuania.

  12. Basque: The Basque Language in Education in France. Second Edition. Regional Dossiers Series

    Science.gov (United States)

    Sanchez, Daniel

    2007-01-01

    This regional dossier aims to provide concise, descriptive information and basic educational statistics about minority language education in a specific region of Europe--the Northern Basque country. Aspects that are addressed include features of the education system, recent educational policies, main actors, legal arrangements, and support…

  13. Three-year follow-up of attitudes and smoking behaviour among hospital nurses following enactment of France's national smoke-free workplace law.

    Science.gov (United States)

    Fathallah, Nadia; Maurel-Donnarel, Elodie; Baumstarck-Barrau, Karine; Lehucher-Michel, Marie-Pascale

    2012-07-01

    This study evaluated among hospital nurses the smoking status, knowledge and attitudes regarding smoking cessation services, and smoking behaviour 3years after the implementation of smoke-free workplace law (decree no. 2006-1386). A descriptive study was undertaken in a public referral hospital in the South of France. Between February and April 2010, a questionnaire was distributed to the nurses. Data on demographic information, smoking status, behaviour and attitudes regarding smoking addiction, and knowledge regarding smoking cessation services were collected. Changes in nurses' smoking habits were studied through a former study conducted in this hospital a year after the law had come into effect. Three years after the enactment of the smoking ban, 30% (30% in 2008) reported themselves as current smokers, 26% (25% in 2008) as ex-smokers and 44% (45% in 2008) as non-smokers. Among smokers, 72% (68% in 2008) declared they had decreased tobacco consumption during working hours and 50% (29% in 2008) daily cigarette consumption. The majority of nurses (88%) supported the smoke-free law. A higher percentage of smokers than non smokers have knowledge of smoking cessation services. The smoking prevalence among hospital nurses seemed to have remained constant between 2008 and 2010 despite a better compliance with the law. France's national smoke-free workplace law is associated with a reduction in tobacco consumption and exposure to second-hand smoke in nurses but not smoking prevalence. The other measures of the MPOWER package have to be reinforced. Copyright © 2012 Elsevier Ltd. All rights reserved.

  14. [The beginnings of the nursing profession : the complementary relationship between secular caregivers and hospital nuns in France in the 17th and 18th centuries].

    Science.gov (United States)

    Diebolt, Evelyne

    2013-06-01

    The words used for designating the caregivers are ambiguous. Little by little, the word "nurse" becomes widely used, mainly in the feminine form due to the need of specialized staff. Health care structures are developing in the 17th and 18 centuries, the remains of which you can find in today hospitals (Salpêtrière hospital, Hôtel-Dieu hospital in Paris). The government of Louis XIV cares for the poor sick people, the vagabonds and the beggars. It opens new general hospitals as it will be the case later in all Europe. In the 17th century, the staff of the general hospital in Paris is entirely secular. The Paris general hospital is headed by the magistrates of Paris Parliament. The healthcare institutions employ both secular and religious staff for example the Hotel Dieu in Paris and the one in Marseilles. In the 17th century, there are 2000 secular caregivers in France. The order of the "Filles de la Charité" (grey sisters) is not submitted to the rule of enclosure. They renew their vows every year. For their founders Vincent de Paul and Louise de Marcillac, their monastery should be the cells of the sick, their cloister should be the rooms of the hospitals or the streets of the town. The secular or religious caregivers are excellent in the apothecary and they open a network of small dispensaries. It improves the health of the French population and allows fighting against the epidemics. This activity allowed some women to have a rewarding activity and a social status of which they were apparently satisfied.

  15. Ecological Study on Hospitalizations for Cancer, Cardiovascular, and Respiratory Diseases in the Industrial Area of Etang-de-Berre in the South of France

    Directory of Open Access Journals (Sweden)

    Laurence Pascal

    2013-01-01

    Full Text Available The Etang-de-Berre area is a large industrialized area in the South of France, exposing 300,000 inhabitants to the plumes of its industries. The possible associated health risks are of the highest concern to the population, who asked for studies investigating their health status. A geographical ecological study based on standardized hospitalizations ratios for cancer, cardiovascular, and respiratory diseases was carried out over the 2004–2007 period. Exposure to air pollution was assessed using dispersion models coupled with a geographic information system to estimate an annual mean concentration of sulfur dioxide (SO2 for each district. Results showed an excess risk of hospitalization for myocardial infarction in women living in districts with medium or high SO2 exposure, respectively, 38% [CI 95% 4 : 83] and 54% [14 : 110] greater than women living in districts at the reference level exposure. A 26% [2 : 57] excess risk of hospitalization for myocardial infarction was also observed in men living in districts with high SO2 levels. No excess risk of hospitalization for respiratory diseases or for cancer was observed, except for acute leukemia in men only. Results illustrate the impact of industrial air pollution on the cardiovascular system and call for an improvement of the air quality in the area.

  16. Transfers to acute care hospitals at the end of life: do rural/remote regions differ from urban regions?

    Science.gov (United States)

    Menec, Verena H; Nowicki, Scott; Kalischuk, Alison

    2010-01-01

    In population-based studies, transfers into hospitals and hospital deaths are typically considered to be indicators of potentially inappropriate care settings at the end of life. Despite a plethora of research into where people die, few studies have examined whether hospital transfers at the end of life differ in rural versus urban areas. In the present study hospitalizations in the last month before death in one mid-Western Canadian province were examined. The study had three main objectives, to: (1) compare hospitalizations in rural/remote with urban regions; (2) examine the role of healthcare resources in hospitalizations; and (3) explore more specifically whether day-to-day patterns of hospitalization shortly before death differ between rural/remote and urban areas. The source of data was administrative healthcare records, with the study including all adults (aged over 19 years; excluding nursing home residents) who died in the province of Manitoba in 2003-2004 (n = 6523). Whether the decedents were hospitalized in the 30 days before death was determined from hospital files. The number of hospital days incurred was counted. Region of residence was defined along regional health authority boundaries, with 7 regions identified as rural/remote and 2 as urban. Healthcare resources were measured in terms of the number of: physicians, hospital beds, nursing home beds, and home care services per 1000 population. Age, sex and trajectory groups, which categorized decedents according to their cause of death, were included in all analyses. Residents of 4 of the 7 rural/remote regions had increased odds of being hospitalized relative to the comparison, the larger urban region (adjusted odds ratios [AOR] ranged from 1.25 to 1.70). Hospital days did not differ across regions. Further analyses showed that having more physicians (AOR = .75) and more hospital beds per 1000 population (AOR = .95) both significantly reduced the odds of being hospitalized. Nursing home beds and

  17. Physical fitness levels of adolescents in the Ile de France region: comparisons with European standards and relevance for future cardiovascular risk.

    Science.gov (United States)

    Vanhelst, Jérémy; Fardy, Paul S; Chapelot, Didier; Czaplicki, Grégory; Ulmer, Zekya

    2016-11-01

    The aim was to assess physical fitness in French schoolchildren in the region of Ile de France and to compare the results with European countries. The relationship between physical fitness and future health profile was of particular interest. Participants were 1851 French youth in the Ile de France region. Cardiorespiratory fitness, muscular endurance, speed, flexibility and speed agility were tested. Independent t-tests were used to compare differences between different variables. Spearman's rho correlation coefficients assessed the relationship between body mass index, socio-economic status and physical fitness. Boys were physically fitter than girls with the most significant difference being in agility. Subjects of normal weight have significantly better results than overweight or obese adolescents (+10·9% to 56·1%) (Pphysical fitness than those with low socio-economic status (+0·5% to 9·4%) (PPhysical fitness in French schoolchildren living in the region of Ile de France is relatively low and unfavourable, especially in girls, when compared with existing European test results. In contrast, the adolescent boys are generally fitter and also above the average of the European data. Introducing a health promotion curriculum in the schools of Ile de France is suggested to improve health and physical fitness. © 2015 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

  18. Modelling regional land change scenarios to assess land abandonment and reforestation dynamics in the Pyrenees (France)

    Science.gov (United States)

    Vacquie, Laure; Houet, Thomas; Sohl, Terry L.; Reker, Ryan; Sayler, Kristi L.

    2015-01-01

    Over the last decades and centuries, European mountain landscapes have experienced substantial transformations. Natural and anthropogenic LULC changes (land use and land cover changes), especially agro-pastoral activities, have directly influenced the spatial organization and composition of European mountain landscapes. For the past sixty years, natural reforestation has been occurring due to a decline in both agricultural production activities and rural population. Stakeholders, to better anticipate future changes, need spatially and temporally explicit models to identify areas at risk of land change and possible abandonment. This paper presents an integrated approach combining forecasting scenarios and a LULC changes simulation model to assess where LULC changes may occur in the Pyrenees Mountains, based on historical LULC trends and a range of future socio-economic drivers. The proposed methodology considers local specificities of the Pyrenean valleys, sub-regional climate and topographical properties, and regional economic policies. Results indicate that some regions are projected to face strong abandonment, regardless of the scenario conditions. Overall, high rates of change are associated with administrative regions where land productivity is highly dependent on socio-economic drivers and climatic and environmental conditions limit intensive (agricultural and/or pastoral) production and profitability. The combination of the results for the four scenarios allows assessments of where encroachment (e.g. colonization by shrublands) and reforestation are the most probable. This assessment intends to provide insight into the potential future development of the Pyrenees to help identify areas that are the most sensitive to change and to guide decision makers to help their management decisions.

  19. Setting up a Prospective Thyroid Biobank for Translational Research: Practical Approach of a Single Institution (2004-2009, Pasteur Hospital, Nice, France).

    Science.gov (United States)

    Lassalle, Sandra; Hofman, Véronique; Ilie, Marius; Butori, Catherine; Bonnetaud, Christelle; Gaziello, Marie Clotilde; Selva, Eric; Gavric-Tanga, Virginie; Guevara, Nicolas; Castillo, Laurent; Santini, José; Chabannon, Christian; Hofman, Paul

    2011-03-01

    In the last few years, conditions for setting up a human biobank in France have been upgraded by taking into account (1) the new laws and regulations that integrate the ethical and societal dimension of biobanking and delineate the risks for patients associated with the procurement of human cells and tissues, (2) the increasing request by scientists for human samples with proven biological quality and sophisticated sets of annotations, including information produced through the evergrowing use of molecular biology in pathology, and (3) establishment of procedures concerning the safety of the personnel working with biological products. For this purpose, health authorities and national research institutes in France have provided significant support for the set up of biobanks. The present work was conducted to describe how we set up a biobank targeting diseases of a specific organ (thyroid gland), with the aim of rapidly developing translational research projects. The prospective experience of a single institution (Pasteur Hospital, Nice, France) over a 6-year period (2004-2009) is presented from the practical point of view of a surgical pathology laboratory. We describe different procedures required to obtain high-quality thyroid biological resources and clinical annotations. The procedures were established for the management of biological products obtained from 1454 patients who underwent thyroid surgery. The preanalytical steps leading to the storage of frozen specimens were carried out in parallel with diagnostic procedures. As the number of international networks for research programs using biological products is steadily increasing, it is crucial to harmonize the procedures used by biobanks. In this regard, the described thyroid biobank has been set up using criteria established by the French National Cancer Institute (Institut National du Cancer) to guarantee the quality of different collections stored in biobanks.

  20. Trace metal concentrations in forest and lawn soils of Paris region (France) along a gradient of urban pressure

    Science.gov (United States)

    Ludovic, Foti

    2017-04-01

    Urban soils differ greatly from natural ones as they are located in areas of intense anthropogenic activity (e.g. pollution, physical disturbance, surface transformation). Urban soils are a crucial component of urban ecosystems, especially in public green spaces, and contribute to many ecosystem services from the mitigation of urban heat island to recreational services. In the last decade, the study of urban soils has emerged as an important frontier in environmental research, at least because of their impact on the quality of life of urban populations, because of the services they deliver and because they are more and more recognized as a valuable resource. One of the key issues is the pollution of urban soils because they receive a variety of deposits from local (vehicle emissions, industrial discharges, domestic heating, waste incineration and other anthropogenic activities) and from remote sources (through atmospheric transport). Typical contaminants include persistent toxic substances, such as trace metals (TMs) that have drawn wide attention due to their long persistence in the environment, their tendency to bioaccumulate in the food chain and their toxicity for humans and other organisms. Concentrations, spatial distributions, dynamics, impacts and sources of TMs (e.g. industry or fossil fuels combustion) have attracted a global interest in urban soils and are the subject of ongoing research (e.g. ecotoxicological urban ecology). Some studies have already documented soil pollution with TMs at both the town and regional scales. So far, several monitoring programs (e.g. National Network for the long term Monitoring of Forest Ecosystem, Regional Monitoring Quality of Soil in France) and studies have been carried out on a national scale to measure the ranges of TM concentrations and natural background values in French soils. These studies have focused on French agricultural and forest soils and have not tackled urban soils. No study has described TM

  1. Platelet functions in relation to dietary fats in farmers from two regions of France.

    Science.gov (United States)

    Renaud, S; Dumont, E; Godsey, F; Suplisson, A; Thevenon, C

    1979-02-15

    To determine whether the long-term feeding of dietary fats affect platelet functions in man, platelet aggregation (to thrombin ADP, collagen, epinephrine) and clotting activity of platelet-rich plasma (PRP), platelet-poor plasma and of washed platelets were studied in a mobile-laboratory in 44 healthy male farmers (40--45 years) from two French regions Var and Moselle, in relation to lipemia, glycemia, dietary nutriments, and platelet phospholipid composition. In the Moselle subjects, the platelet clotting activity of PRP and of washed platelets, the platelet aggregation to thrombin and ADP, were highly significantly (p less than 0.001) increased as compared to those of Var, but not the plasma cholesterol, which was identical in the two regions. In Moselle, the intake of total calories, total lipids and saturated fats was higher than in the Var. However, it was only with the saturated fat intake (mostly stearic acid) that the platelet clotting activity (p less than 0.01) and the platelet aggregation (p less than 0.001) were highly significantly correlated. The platelet clotting activity was also significantly (p less than 0.001) correlated with the fatty acid composition of the platelet phospholipid fractions phosphatidyl serine + phosphatidyl inositol.

  2. Trace element concentrations along a gradient of urban pressure in forest and lawn soils of the Paris region (France).

    Science.gov (United States)

    Foti, Ludovic; Dubs, Florence; Gignoux, Jacques; Lata, Jean-Christophe; Lerch, Thomas Z; Mathieu, Jérôme; Nold, François; Nunan, Naoise; Raynaud, Xavier; Abbadie, Luc; Barot, Sébastien

    2017-11-15

    The concentration, degree of contamination and pollution of 7 trace elements (TEs) along an urban pressure gradient were measured in 180 lawn and wood soils of the Paris region (France). Iron (Fe), a major element, was used as reference element. Copper (Cu), cadmium (Cd), lead (Pb) and zinc (Zn) were of anthropogenic origin, while arsenic (As), chromium (Cr) and nickel (Ni) were of natural origin. Road traffic was identified as the main source of anthropogenic TEs. In addition, the industrial activity of the Paris region, especially cement plants, was identified as secondary source of Cd. Soil characteristics (such as texture, organic carbon (OC) and total nitrogen (tot N) contents) tell the story of the soil origins and legacies along the urban pressure gradient and often can explain TE concentrations. The history of the land-use types was identified as a factor that allowed understanding the contamination and pollution by TEs. Urban wood soils were found to be more contaminated and polluted than urban lawns, probably because woods are much older than lawns and because of the legacy of the historical management of soils in the Paris region (Haussmann period). Lawn soils are similar to the fertile agricultural soils and relatively recently (mostly from the 1950s onwards) imported from the surrounding of Paris, so that they may be less influenced by urban conditions in terms of TE concentrations. Urban wood soils are heavily polluted by Cd, posing a high risk to the biological communities. The concentration of anthropogenic TEs increased from the rural to the urban areas, and the concentrations of most anthropogenic TEs in urban areas were equivalent to or above the regulatory reference values, raising the question of longer-term monitoring. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. A comparison of antibiotic point prevalence survey data from four Irish regional/general hospitals.

    LENUS (Irish Health Repository)

    Naughton, C

    2011-06-01

    Point prevalence surveys (PPS) are increasingly used to examining and compare hospital antibiotic consumption. The aim of this study was to identify the (1) point prevalence of antibiotic use in one regional hospital and (2) compare PPS data from similar regional\\/general hospitals.

  4. Comparison of two landslide susceptibility assessments in the Champagne-Ardenne region (France)

    Science.gov (United States)

    Den Eeckhaut, M. Van; Marre, A.; Poesen, J.

    2010-02-01

    The vineyards of the Montagne de Reims are mostly planted on steep south-oriented cuesta fronts receiving a maximum of sun radiation. Due to the location of the vineyards on steep hillslopes, the viticultural activity is threatened by slope failures. This study attempts to better understand the spatial patterns of landslide susceptibility in the Champagne-Ardenne region by comparing a heuristic (qualitative) and a statistical (quantitative) model in a 1120 km² study area. The heuristic landslide susceptibility model was adopted from the Bureau de Recherches Géologiques et Minières, the GEGEAA - Reims University and the Comité Interprofessionnel du Vin de Champagne. In this model, expert knowledge of the region was used to assign weights to all slope classes and lithologies present in the area, but the final susceptibility map was never evaluated with the location of mapped landslides. For the statistical landslide susceptibility assessment, logistic regression was applied to a dataset of 291 'old' (Holocene) landslides. The robustness of the logistic regression model was evaluated and ROC curves were used for model calibration and validation. With regard to the variables assumed to be important environmental factors controlling landslides, the two models are in agreement. They both indicate that present and future landslides are mainly controlled by slope gradient and lithology. However, the comparison of the two landslide susceptibility maps through (1) an evaluation with the location of mapped 'old' landslides and through (2) a temporal validation with spatial data of 'recent' (1960-1999; n = 48) and 'very recent' (2000-2008; n = 46) landslides showed a better prediction capacity for the statistical model produced in this study compared to the heuristic model. In total, the statistically-derived landslide susceptibility map succeeded in correctly classifying 81.0% of the 'old' and 91.6% of the 'recent' and 'very recent' landslides. On the susceptibility map

  5. [Toward a better knowledge of the pesticides used by municipality in rural society: example of Limousin Region (France)].

    Science.gov (United States)

    Guibaud, G; Gauthier-Moussard, C; Rigondaud, C; Moine, B

    2007-04-01

    A survey concerning pesticide uses by municipalities located in countryside areas, was carried out through inquiries submitted to 39 different municipalities representative of the Limousin area (France) except for Limoges city. The rate of answers was 72 % (28 municipalities). Extensive breeding of bovines and sheep represents the majority of agricultural practices in this area. The objective of this investigation to highlight the operational pesticides uses among different municipalities. The main results showed the use of a large number of different commercial products (61, representing 46 active molecules) as well as the intensive use of herbicides such as Glyphosate. Compared to the usual regional agricultural uses in Limousin, the part of Dichlobenil, Diuron, Isoxaben and Diflufénicanil used by the municipalities could be strong. The municipalities usually try to comply with the safety requirements regarding pesticide uses but the need for preventive actions such as the training of municipality workers as well as informations regarding alternative weeding techniques is required. Moreover, due to the relatively low permeability of the treated surfaces, the discharge of pesticides by water run-off can be significant and thus can contribute significantly to the pollution of the natural aquatic environments or the water resources for water supply.

  6. Mapping of the geogenic radon potential in France to improve radon risk management: methodology and first application to region Bourgogne

    Energy Technology Data Exchange (ETDEWEB)

    Ielsch, G., E-mail: geraldine.ielsch@irsn.f [Institut de Radioprotection et de Surete Nucleaire, DEI/SARG/BRN, BP 17, 92262 Fontenay-aux-Roses cedex (France); Cushing, M.E., E-mail: edward.cushing@irsn.f [Institut de Radioprotection et de Surete Nucleaire, DEI/SARG/BRN, BP 17, 92262 Fontenay-aux-Roses cedex (France); Combes, Ph., E-mail: philippe.combes@geoter.f [GEOTER SAS, Geologie Tectonique Environnement et Risques, 3, rue Jean Monnet, 34830 Clapiers (France); Cuney, M., E-mail: michel.cuney@g2r.uhp-nancy.f [CREGU et UMR G2R 7566, Universite Henri Poincare - NANCY I, Domaine Scientifique Victor Grignard, Entree 3B, BP 70 239 - F54 506 Vandoeuvre-les-Nancy Cedex (France)

    2010-10-15

    In order to improve regulatory tools for radon risk management in France, a harmonised methodology to derive a single map of the geogenic radon potential has been developed. This approach consists of determining the capacity of the geological units to produce radon and to facilitate its transfer to the atmosphere, based on the interpretation of existing geological data. This approach is firstly based on a classification of the geological units according to their uranium (U) content, to create a radon source potential map. This initial map is then improved by taking into account the main additional parameters, such as fault lines, which control the preferential pathways of radon through the ground and which can increase the radon levels in soils. The implementation of this methodology to the whole French territory is currently in progress. We present here the results obtained in one region (Bourgogne, Massif Central) which displays significant variations of the geogenic radon potential. The map obtained leads to a more precise zoning than the scale of the existing map of radon priority areas currently based solely on administrative boundaries.

  7. France and the Gulf of Tonkin Region: Shipping Markets and Political Interventions in South China in the 1890s

    Directory of Open Access Journals (Sweden)

    Bert Becker

    2015-09-01

    Full Text Available In the period of “new” imperialism in the late nineteenth and early twentieth centuries, France strived to create a sphere of influence in southwest China. To foster such imperialist policies, France’s policy makers regarded French companies operating in East Asia as instrumental. One such firm was Auguste Raphael Marty’s Tonkin Shipping Company, based in Haiphong, French Indochina, which operated steam coasters across the wider Gulf of Tonkin region. In the region’s highly competitive shipping market, Marty strived to achieve a monopoly when favorable conditions permitted during the final phase of the Sino-Japanese War. His profit-driven strategy caused huge losses for Chinese shippers and ultimately resulted in their boycotting his ships through the Tsap Yet syndicate. When French officials intervened on Marty’s behalf in negotiations with the Chinese government, the Syndicate was finally dissolved. It was followed by an agreement between the Chinese firm of Yuen Cheong Lee and Co. and the German firm of Jebsen and Co., based on long-established mutual trust between the owners. Although Marty received monetary compensation for his losses, he ruined his relationship with Chinese merchants. This case study presents little-known facts about the interactions among foreign firms in China and demonstrates the Chinese ability to react efficiently to unfair business practices.

  8. Results of percutaneous nephrolithotomy performed in a regional state hospital

    Directory of Open Access Journals (Sweden)

    Taner Çiftçi

    2011-12-01

    Full Text Available Aim: The aim of this study was to evaluate the results of percutaneous stone surgery that performe in a regional state hospital.Materials and methods: We retrospectively analyzed 183 percutaneous nephrolithotomy (PNL performed cases that treated at our clinic between June 2010 and July 2011. After necessary laboratory and radiological investigations, we performed PNL for the patients those diagnosed as having stones needed surgery. After surgery, we investigated radiologically whether residual stone fragments remained or not. When there were residual stone fragments (bigger than 4 mm, we performed ESWL, repeated percutaneous interventions and surveillance protocols. In six patients, open surgery was needed during PNL.Results: Of the totally 183 patients underwent PNL at our clinic, 102 were male and 81 were female. The mean age was 37.6 and mean stone burden was 35.5 mm2. Stone-free rate was 75.4% and the rate of the patients who have residual stones (bigger than 4mm was 25.7%. Stone free rates were 95% and 86% for stone burden lesser and more than 2 cm2, respectively. The mean blood loss was 186ml for per operational case. Totally four patients (8.5% underwent blood tranfusion.Conclusion: As a result, because of its high stone-free rates, the shorter hospital stay, minimal surgical scar and absence of wound infection, PNL is preserving its place for the treatment of stones bigger than 2 cm2. J Clin Exp Invest 2011; 2 (4: 371-374

  9. Utilization of noninvasive ventilation in acute care hospitals: a regional survey

    National Research Council Canada - National Science Library

    Maheshwari, Vinay; Paioli, Daniela; Rothaar, Robert; Hill, Nicholas S

    2006-01-01

    ...) in the United States. Accordingly, we performed a survey on the use of NPPV at acute care hospitals in a region of the United States to determine variations in utilization and between hospitals, the reasons for lower...

  10. A dense Black Carbon network in the region of Paris, France: Implementation, objectives, and first results

    Science.gov (United States)

    Sciare, Jean; Petit, Jean-Eudes; Sarda-Esteve, Roland; Bonnaire, Nicolas; Gros, Valérie; Pernot, Pierre; Ghersi, Véronique; Ampe, Christophe; Songeur, Charlotte; Brugge, Benjamin; Debert, Christophe; Favez, Olivier; Le Priol, Tiphaine; Mocnik, Grisa

    2013-04-01

    Motivations. Road traffic and domestic wood burning emissions are two major contributors of particulate pollution in our cities. These two sources emit ultra-fine, soot containing, particles in the atmosphere, affecting health adversely, increasing morbidity and mortality from cardiovascular and respiratory conditions and casing lung cancer. A better characterization of soot containing aerosol sources in our major cities provides useful information for policy makers for assessment, implementation and monitoring of strategies to tackle air pollution issues affecting human health with additional benefits for climate change. Objectives. This study on local sources of primary Particulate Matter (PM) in the megacity of Paris is a follow-up of several programs (incl. EU-FP7-MEGAPOLI) that have shown that fine PM - in the Paris background atmosphere - is mostly secondary and imported. A network of 14 stations of Black Carbon has been implemented in the larger region of Paris to provide highly spatially resolved long term survey of local combustion aerosols. To our best knowledge, this is the first time that such densely BC network is operating over a large urban area, providing novel information on the spatial/temporal distribution of combustion aerosols within a post-industrialized megacity. Experimental. As part of the PRIMEQUAL "PREQUALIF" project, a dense Black Carbon network (of 14 stations) has been installed over the city of Paris beginning of 2012 in order to produce spatially resolved Equivalent Black Carbon (EBC) concentration maps with high time resolution through modeling and data assimilation. This network is composed of various real-time instruments (Multi-Angle Absorption Photometer, MAAP by THERMO; Multi-wavelength Aethalometers by MAGEE Scientific) implemented in contrasted sites (rural background, urban background, traffic) complementing the regulated measurements (PM, NOx) in the local air quality network AIRPARIF (http

  11. Prevalence of psychoactive substances in truck drivers in the Nord-Pas-de-Calais region (France).

    Science.gov (United States)

    Labat, Laurence; Fontaine, Bernard; Delzenne, Chantal; Doublet, Anne; Marek, Marie Christine; Tellier, Dominique; Tonneau, Murielle; Lhermitte, Michel; Frimat, Paul

    2008-01-30

    A previous study conducted in 1995 showed that psychoactive drug use by workers was higher in safety/security workstations than in the rest of the labour force. In order to verify this finding, we conducted a new study in 2003-2004 in the Nord-Pas-de-Calais region, restricted to truck drivers. The aim of this study was to allow harmonizing the professional practice of the occupational physicians, proposing drug prevention and drug testing policies, validating the analytical methods and the guidelines in case of positive testing results. One thousand truck drivers were studied. Urines were tested for amphetamines, cannabinoids, cocaine, opiates, benzodiazepines, buprenorphine and methadone by immunoassay. Urine ethanol determinations were performed by an ADH method. Positive urines for drugs of abuse, methadone or buprenorphine were then tested by gas chromatography or liquid chromatography coupled to mass spectrometry. Out of the 1000 drivers, cannabinoids were detected in 85 cases, opiates in 41 cases, amphetamines in 3 cases and cocaine in only one case. Buprenorphine was detected in 18 cases, methadone in 5 cases and benzodiazepines in 4 cases. Urine ethanol was positive in 50 cases. We found only one case with 6-monoacetylmorphine. Other positive opiates were metabolites of antitussives. The relatively low number of benzodiazepine positive urines could be explained by the lack of sensitivity of the test we used. All these results confirm those of the previous study for cannabinoids and ethanol in safety/security workstations. Positive results for methadone and buprenorphine are eight times higher than in the general population. In conclusion, the authors think that it will be of a great interest to test urine of truck drivers for other classes of psychoactive drugs, using a liquid chromatography-mass spectrometry method.

  12. Predominant enteropathogens in acute diarrhea and associated variables in children at the Lambayeque Regional Hospital, Peru

    National Research Council Canada - National Science Library

    Heber Silva-Díaz; Olinda Bustamante-Canelo; Franklin-Rómulo Aguilar-Gamboa; Katya Mera-Villasis; Jhonatan Ipanaque-Chozo; Eberth Seclen-Bernabe; Martha Vergara-Espinoza

    2017-01-01

    Objective: To determine the type and frequency of predominant enteropathogens in acute diarrhea and their associated characteristics in children treated at Hospital Regional Lambayeque (HRL) - Peru...

  13. Improved blood culture identification by FilmArray in cultures from regional hospitals compared with teaching hospital cultures.

    Science.gov (United States)

    Inglis, Timothy J J; Bzdyl, Nicole; Chua, I-Ly Joanna; Urosevic, Nadezda M; Leung, Michael J; Geelhoed, Elizabeth

    2016-01-01

    Rapid identification of bacteria isolated from blood cultures by direct matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) is now in wide spread use in major centres but is not yet feasible in smaller hospital laboratories. A FilmArray multiplex PCR panel for blood culture isolate identification (BCID) provides an alternative approach to near point-of-care microbial identification in regional hospitals. We assessed the accuracy and time to identification of the BCID FilmArray in a consecutive series of 149 blood cultures from 143 patients in a teaching hospital and smaller regional hospitals, currently identified by direct MALDI-TOF and proprietary molecular methods. The BCID FilmArray contained 18 of 34 species and 20 of 23 species isolated from teaching and regional hospital, respectively. Overall, 85 % of the teaching hospital and 100 % of the regional hospital monomicrobial blood cultures were identified, compared with 60 and 68 %, respectively, for direct MALDI-TOF on the same cultures. There were no incorrect results from blood cultures containing Staphylococcus aureus, streptococci, Pseudomonas aeruginosa or Enterobacteriaceae. The three discrepant results were all in mixed cultures. The mean reduction in time to identification of blood culture isolates was 53 h, which did not include the time required to transport cultures from regional centres to a central laboratory. The overall performance of the BCID FilmArray is stronger in blood cultures from smaller regional hospitals that encounter a narrower range of bacterial species dominated by the commonest species. This approach is more suited to smaller clinical laboratories than the MALDI-TOF direct method.

  14. Diversity of 1,213 hepatitis C virus NS3 protease sequences from a clinical virology laboratory database in Marseille university hospitals, southeastern France.

    Science.gov (United States)

    Hajji, Hind; Aherfi, Sarah; Motte, Anne; Ravaux, Isabelle; Mokhtari, Saadia; Ruiz, Jean-Marie; Poizot-Martin, Isabelle; Tourres, Christian; Tivoli, Natacha; Gérolami, René; Tamalet, Catherine; Colson, Philippe

    2015-11-01

    Infection with hepatitis C virus (HCV) represents a major public health concern worldwide. Recent therapeutic advances have been considerable, HCV genotype continuing to guide therapeutic management. Since 2008, HCV genotyping in our clinical microbiology laboratory at university hospitals of Marseille, Southeastern France, has been based on NS3 protease gene population sequencing, to allow concurrent HCV genotype and protease inhibitor (PI) genotypic resistance determinations. We aimed, first, to analyze the genetic diversity of HCV NS3 protease obtained from blood samples collected between 2003 and 2013 from patients monitored at university hospitals of Marseille and detect possible atypical sequences; and, second, to identify NS3 protease amino acid patterns associated with decreased susceptibility to HCV PIs. A total of 1,213 HCV NS3 protease sequences were available in our laboratory sequence database. We implemented a strategy based on bioinformatic tools to determine whether HCV sequences are representative of our local HCV genetic diversity, or divergent. In our 2003-2012 HCV NS3 protease sequence database, we delineated 32 clusters representative of the majority HCV genetic diversity, and 61 divergent sequences. Five of these divergent sequences showed less than 85% nucleotide identity with their top GenBank hit. In addition, among the 294 sequences obtained in 2013, three were divergent relative to these 32 previously delineated clusters. Finally, we detected both natural and on-treatment genotypic resistance to HCV NS3 PIs, including a substantial prevalence of Q80K substitutions associated with decreased susceptibility to simeprevir, a second generation PI.

  15. [Computerization of hospital blood banks in France: what has been done and what remains to be done].

    Science.gov (United States)

    Py, J-Y; Schlanger, S; Gorodetzky, D; Lapègue, R; Besse-Moreau, M; Herr, A-L; Renaudier, P; Daurat, G; Breton, P

    2012-11-01

    French regulation requires hospital blood banks to have data processing of their blood transfusion activities. In order to help them to achieve this goal, guidelines were published by an official working party. For their diffusion, a study was launched to assess current gaps between guidelines and reality. Analysis of the first forty responses shows: 1) computerization is already set up for main blood banks and is going well for the others; 2) most of guideline functionalities are now working in main blood banks; but some points need specific developments; 3) taken as a whole, other blood banks are further from guideline requirements, even if some have already reached the goal; 4) guidelines are able to point out to all hospital blood banks what remains to be done.

  16. Designing a low-cost effective network for monitoring large scale regional seismicity in a soft-soil region (Alsace, France)

    Science.gov (United States)

    Bès de Berc, M.; Doubre, C.; Wodling, H.; Jund, H.; Hernandez, A.; Blumentritt, H.

    2015-12-01

    The Seismological Observatory of the North-East of France (ObSNEF) is developing its monitoring network within the framework of several projects. Among these project, RESIF (Réseau sismologique et géodésique français) allows the instrumentation of broad-band seismic stations, separated by 50-100 km. With the recent and future development of geothermal industrial projects in the Alsace region, the ObSNEF is responsible for designing, building and operating a dense regional seismic network in order to detect and localize earthquakes with both a completeness magnitude of 1.5 and no clipping for M6.0. The realization of the project has to be done prior to the summer 2016Several complex technical and financial constraints constitute such a projet. First, most of the Alsace Région (150x150 km2), particularly the whole Upper Rhine Graben, is a soft-soil plain where seismic signals are dominated by a high frequency noise level. Second, all the signals have to be transmitted in near real-time. And finally, the total cost of the project must not exceed $450,000.Regarding the noise level in Alsace, in order to make a reduction of 40 dB for frequencies above 1Hz, we program to instrument into 50m deep well with post-hole sensor for 5 stations out of 8 plane new stations. The 3 remaining would be located on bedrock along the Vosges piedmont. In order to be sensitive to low-magnitude regional events, we plan to install a low-noise short-period post-hole velocimeter. In order to avoid saturation for high potentiel local events (M6.0 at 10km), this velocimeter will be coupled with a surface strong-motion sensor. Regarding the connectivity, these stations will have no wired network, which reduces linking costs and delays. We will therefore use solar panels and a 3G/GPRS network. The infrastructure will be minimal and reduced to an outdoor box on a secured parcel of land. In addition to the data-logger, we will use a 12V ruggedized computer, hosting a seed-link server for near

  17. A new regional group of the lower paleolithic in Brittany (France), recently dated by electron spin resonance

    Energy Technology Data Exchange (ETDEWEB)

    Monnier, J.L.; Hinguant, S.; Gebhardt, A.; Marguerie, D.; Molines, N.; Morzadec, H. (Rennes-1 Univ., 35 (France)); Hallegouet, B. (Brest Univ., 29 (France)); Laurent, M.; Auguste, P.; Bahain, J.J.; Falgueres, C.; Yokoyama, Y. (Institut de Paleontologie, 75 - Paris (France))

    1994-07-07

    ESR dates obtained at Menez-Dregan 1 (Brittany, France) focus interest on this Lower Paleolithic site and demonstrate that the preserved anthropic combustion structures are among the oldest known in the world. It allows the dating not only of the little known 'Colombanian Group' (it is an 'archaic' original group characterized by many choppers and very few handaxes, different from the Acheulian), but also, for the first time, of the old beaches on the southern coast of Brittany. Preserved bone remains are also very infrequent in Palaeolithic sites of Western France. The dating of the paleolithic layer at the top of the third fossil beach can be connected with isotopic stage 11 or the beginning of isotopic stage 10; it shows that the age of the geological and archaeological layers of Menez-Dregan 1 is probably between 350.000 and 500.000 years.

  18. Point prevalence of hospital-acquired infections in two teaching hospitals of Amhara region in Ethiopia

    Directory of Open Access Journals (Sweden)

    Yallew WW

    2016-08-01

    Full Text Available Walelegn Worku Yallew,1 Abera Kumie,2 Feleke Moges Yehuala3 1Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, 2School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, 3Department of Medical Microbiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia Purpose: Hospital-acquired infection (HAI is a major safety issue affecting the quality of care of hundreds of millions of patients every year, in both developed and developing countries, including Ethiopia. In Ethiopia, there is no comprehensive research that presents the whole picture of HAIs in hospitals. The objective of this study was to examine the nature and extent of HAIs in Ethiopia. Methods: A repeated cross-sectional study was conducted in two teaching hospitals. All eligible inpatients admitted for at least 48 hours on the day of the survey were included. The survey was conducted in dry and wet seasons of Ethiopia, that is, in March to April and July 2015. Physicians and nurses collected the data according to the Centers for Disease Control and Prevention definition of HAIs. Coded and cleaned data were transferred to SPSS 21 and STATA 13 for analysis. Univariate and multivariable logistic regression analyses were used to examine the prevalence of HAIs and relationship between explanatory and outcome variables. Results: A total of 908 patients were included in this survey, the median age of the patients was 27 years (interquartile range: 16–40 years. A total of 650 (71.6% patients received antimicrobials during the survey. There were 135 patients with HAI, with a mean prevalence of 14.9% (95% confidence interval 12.7–17.1. Culture results showed that Klebsiella spp. (22.44% and Staphylococcus aureus (20.4% were the most commonly isolated HAI-causing pathogens in these hospitals. The association of patient age and hospital type with the occurrence of HAI was

  19. Management of Takotsubo cardiomyopathy in non-academic hospitals in France: The Observational French SyndromEs of TakoTsubo (OFSETT) study.

    Science.gov (United States)

    Yayehd, Komlavi; N'da, N'kenon W; Belle, Loïc; Bataille, Vincent; Hanssen, Michel; Leddet, Pierre; Aupetit, Jean-François; Commeau, Philippe; Filippi, Emmanuelle; Georges, Jean-Louis; Albert, Franck; Rangé, Grégoire; Meimoun, Patrick; Marcaggi, Xavier; Baleynaud, Serge; Nallet, Olivier; Dibie, Alain; Barnay, Claude; Jouve, Bernard; Legrand, Maud; Cattan, Simon; Mulak, Geneviève; Simon, Tabassome; Danchin, Nicolas; Dujardin, Jean-Jacques

    2016-01-01

    Takotsubo cardiomyopathy (TTC) is a rare condition characterized by a sudden temporary weakening of the heart. TTC can mimic acute myocardial infarction and is associated with a minimal release of myocardial biomarkers in the absence of obstructive coronary artery disease. To provide an extensive description of patients admitted to hospital for TTC throughout France and to study the management and outcomes of these patients. In 14 non-academic hospitals, we collected clinical, electrocardiographic, biological, psychological and therapeutic data in patients with a diagnosis of TTC according to the Mayo Clinic criteria. Of 117 patients, 91.5% were women, mean ± SD age was 71.4 ± 12.1 years and the prevalence of risk factors was high (hypertension: 57.9%, dyslipidaemia: 33.0%, diabetes: 11.5%, obesity: 11.5%). The most common initial symptoms were chest pain (80.5%) and dyspnoea (24.1%). A triggering psychological event was detected in 64.3% of patients. ST-segment elevation was found in 41.7% of patients and T-wave inversion in 71.6%. Anterior leads were most frequently associated with ST-segment elevation, whereas T-wave inversion was more commonly associated with lateral leads, and Q-waves with septal leads. The ratio of peak B-type natriuretic peptide (BNP) or N-terminal prohormone BNP (NT-proBNP) level to peak troponin level was 1.01. No deaths occurred during the hospital phase. After 1 year of follow-up, 3 of 109 (2.8%) patients with available data died, including one cardiovascular death. Rehospitalizations occurred in 17.4% of patients: 2.8% due to acute heart failure and 14.7% due to non-cardiovascular causes. There was no recurrence of TTC. This observational study of TTC included primarily women with atherosclerotic risk factors and mental stress. T-wave inversion was more common than ST-segment elevation. There were few adverse cardiovascular outcomes in these patients after 1-year follow-up. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  20. ANALYSIS OF ECONOMIC INDICATORS FOR ACTIVITY OF THE HOSPITALS IN SOFIA REGION

    OpenAIRE

    Tsvetelina M. Petrova-Gotova

    2015-01-01

    In the article are presented and analyzed the main economic indicators of hospitals’ activity in Sofia region for the period 2010 – 2012. The author formulates recommendations on optimizing the organization and management of activities and the financial resources of the reviewed hospitals. An important feature of effective hospital management is the style and resource thinking of the health manager. Achieving efficiency in the operation of the hospital requires an adequate approach by the hos...

  1. [Regional early mortality in relation to social and hospital structure].

    Science.gov (United States)

    Obladen, M

    1985-01-01

    Detailed analysis of governmental mortality statistics yields information on regional differences in the care for preterm infants in West Germany. 68% of newborn infants dying within the first 7 days of life are of low birth weight. In the 11 states, highest/lowest early neonatal mortality fell from 11.6/6.0 to 6.2/3.1 during the years 1978 to 1982. In the 31 administrative districts, a small negative correlation (r = -0.37) exists for neonatal mortality and tax revenue. Increased regional mortality indicates diminished regionalization of perinatal care for preterm infants.

  2. Multicultural healthcare providers in hospitals in the Gulf region

    Directory of Open Access Journals (Sweden)

    Aref Ibrahim Alabed

    2016-06-01

    Full Text Available In Gulf areas, most of the population more than 50% comprises of people form the other nationalities and hence the doctors in gulf area also belong from the different nationalities. The patient and ndash;physician relationship is inherently unequal given the status differences between clinicians and help-seekers. The multiculturalism / or due to different nationalities raises a lot of problems for doctors as well as the patients and this affect the satisfaction level of the patients. The absence of physician trust on behalf of this issue is considered to be a key mechanism underlying health care disparities. This study have been conducted to Gulf area are from different countries and this may lead to different ways of results in dealing with the patients at the same hospital which affects the patients' satisfaction level. The study have found out that patients' satisfaction level is highly dependent upon the nationality of doctors and similarity of the nationality. This issue can be overcome by training the healthcare professionals in leadership, communication, emotional intelligence and other skills in the hospital to have a higher patient satisfaction and to overcome the barriers that are aroused due to the different nationalities of the doctors. Descriptive research design is selected for this study because of its significance to the studies that will be directed in future and it is utilized to depict the specifications of the population under study. [Int J Res Med Sci 2016; 4(6.000: 2444-2448

  3. The learning curve for laparoscopic colectomy in colorectal cancer at a new regional hospital

    Directory of Open Access Journals (Sweden)

    Kuei-Yen Tsai

    2016-01-01

    Conclusion: Laparoscopic colectomy for colorectal cancer in a new regional hospital is feasible and safe. It does not need additional time for learning. Laparoscopic sigmoidectomy can be considered as the initial surgery for a trainee.

  4. [Care for elderly patients in Africa: Analysis of the financial implications of the SESAME plan on the budget of the regional hospital center in Thies, Senegal].

    Science.gov (United States)

    Faye, A; Diousse, P; Seck, I; Diongue, M; Ndiaye, P; Diagne-Camara, M; Tal-Dia, A; Dia, La

    2010-04-01

    The SESAME plan has been implemented at the Thies Regional Hospital Center (TRHC) for one year. The purpose of this study was to analyze the financial implications of the plan on the hospital budget for the sustainability of care for persons aged 60 and over. This descriptive study included analysis of budget data from October 2006 to September 2007 plus information obtained by interviewing the accountant and head of SESAME plan. The number of patients managed, sources of CHRT funding, grants from various SESAME plan partners, and expenditures for each partner were determined. The weight of the SESAME plan in the CHRT operating budget was determined by calculating the ratio of the overall cost of care for elderly persons in relation to the hospital's revenues and SESAME grants. During the study period, the CHRT received a total of 17375 elderly persons including 89% with no pension or social security. The institute pension scheme (IPRES) covered 21% of the plan as compared to 79% for the state. Utilization plan grants in relation to funding source was 41% for IPRES and 124% for the State. The total cost of services provided to beneficiaries of the SESAME plan exceeded the aggregate amount by 26 083 847 CFA francs. The weight of the SESAME plan in the operating cost of the CHRT was 17%. Prefinancing a plan to cover elderly care in hospitals should be sufficient to prevent deficits from impacting negatively on the operating budget of the hospital.

  5. Job stress and burnout in hospital employees: comparisons of different medical professions in a regional hospital in Taiwan.

    Science.gov (United States)

    Chou, Li-Ping; Li, Chung-Yi; Hu, Susan C

    2014-02-25

    To explore the prevalence and associated factors of burnout among five different medical professions in a regional teaching hospital. Cross-sectional study. Hospital-based survey. A total of 1329 medical professionals were recruited in a regional hospital with a response rate of 89%. These voluntary participants included 101 physicians, 68 physician assistants, 570 nurses, 216 medical technicians and 374 administrative staff. Demographic data included gender, age, level of education and marital status, and work situations, such as position, work hours and work shifts, were obtained from an electronic questionnaire. Job strain and burnout were measured by two validated questionnaires, the Chinese version of the Job Content Questionnaire and the Copenhagen Burnout Inventory. Among the five medical professions, the prevalence of high work-related burnout from highest to lowest was nurses (66%), physician assistants (61.8%), physicians (38.6%), administrative staff (36.1%) and medical technicians (31.9%), respectively. Hierarchical regression analysis indicated that job strain, overcommitment and low social support explained the most variance (32.6%) of burnout. Physician assistant is an emerging high burnout group; its severity is similar to that of nurses and far more than that of physicians, administrative staff and medical technicians. These findings may contribute to the development of feasible strategies to reduce the stress which results in the burnout currently plaguing most hospitals in Taiwan.

  6. Prevention and control of thalassemia at Saraburi Regional Hospital.

    Science.gov (United States)

    Chareonkul, Pichit; Kraisin, Janchay

    2004-01-01

    To evaluate the program in prevention and control of thalssemia among pregnant women and their spouses, prevention of new cases by screening tests, confirmatory test, genetic counselling, prenatal diagnosis, and selective abortion. The pregnant women, attending antenatal care unit, Saraburi center hospital, as well as their spouses. 1 January 2000-31 December 2001 As part of the antenatal care assessment, pregnant women before 16 weeks gestation were screened, with pre- and post-test counselling, by osmotic fragility (OF) and dichorophenol indophenol precipitate (DCIP) tests, and confirmed by complete blood count (CBC), mean corpuscular volume (MCV), hemoglobin typing and polymerase chain reaction for alphathal1 (PCR alphathal1) if any of two screening tests was positive. The husbands of those who were carriers of severe thalassemia were encouraged to have thalassemia screening and confirmation. When both the pregnant women and their husbands were carriers of severe thalassemia, the pregnant women would voluntarily perform the prenatal diagnosis. Termination of pregnancy would be offered when the fetus had severe thalassemia. There were 3,739 from 4,214 women (88.7% of all antenatal women), who participated in the program. OF and/or DCIP were positive in 1,742 of 3,739 subjects (46.5%). Of those, 960 from 1,742 (55.1%), had husbands who were willing to have the testing, and OF and/or DCIP were positive in 443 of 960 cases (46.1%). The confirmatory tests revealed carrier and disease of thalassemia, and hemoglobinopathies in 931 of 1,742 women (53.9%), and 135 of 960 husbands (14.0%). The 20 couples who had the possibility of having severe thalassemic newborns, were strongly advised to have prenatal diagnosis. The 12 risk pregnancies had been performed cordocentesis. Finally 3 of 12 (25.0%) fetuses were documented to have severe thalassemia and all of them decided to have selective abortion. The screening model for thalassemia carriers by using the combination of OF

  7. A survey of flood disaster preparedness among hospitals in the central region of Thailand.

    Science.gov (United States)

    Rattanakanlaya, Kanittha; Sukonthasarn, Achara; Wangsrikhun, Suparat; Chanprasit, Chawapornpan

    2016-11-01

    In 2011, Thailand was affected by the one of the worst flood disasters in recent times. Hospitals in Thailand were faced with the challenge of managing the health impacts from this natural disaster. The purpose of this study was to assess flood disaster preparedness among hospitals in the central region of Thailand. A survey questionnaire was given to twenty-seven key people responsible for hospital disaster preparedness that experienced disruptions to health services (severely, moderately and slightly) during the flood disaster in 2011 in the central region of Thailand. Of the twenty-four participating hospitals, not one had satisfied the standards in all the dimensions of flood disaster preparedness. All respondent hospitals were deficiently prepared with regard to surge capacity, the management of healthcare services and the management of the supporting systems. The availability of supplies and equipment were found to be in place but preparations were found to be inadequate in organizing staff at all participating hospitals. Trained staff members regarding disaster response were reported to be present in all respondent hospitals. Hospitals that experienced slightly disruptions to their health services did not elect to do any exercises to meet the set standards. None of the hospitals that experienced slightly disruptions to their health services performed any evaluation and improvement in terms of disaster preparedness. Many hospitals were not up to standard in terms of disaster preparedness. Hospitals should prioritize disaster preparedness to fulfill their responsibility during crisis situations and improve their flood disaster preparedness. Copyright © 2016 College of Emergency Nursing Australasia. Published by Elsevier Ltd. All rights reserved.

  8. [Primary care in France].

    Science.gov (United States)

    Sánchez-Sagrado, T

    2016-01-01

    The poor planning of health care professionals in Spain has led to an exodus of doctors leaving the country. France is one of the chosen countries for Spanish doctors to develop their professional career. The French health care system belongs to the Bismarck model. In this model, health care system is financed jointly by workers and employers through payroll deduction. The right to health care is linked to the job, and provision of services is done by sickness-funds controlled by the Government. Primary care in France is quite different from Spanish primary care. General practitioners are independent workers who have the right to set up a practice anywhere in France. This lack of regulation has generated a great problem of "medical desertification" with problems of health care access and inequalities in health. French doctors do not want to work in rural areas or outside cities because "they are not value for money". Medical salary is linked to professional activity. The role of doctors is to give punctual care. Team work team does not exist, and coordination between primary and secondary care is lacking. Access to diagnostic tests, hospitals and specialists is unlimited. Duplicity of services, adverse events and inefficiencies are the norm. Patients can freely choose their doctor, and they have a co-payment for visits and hospital care settings. Two years training is required to become a general practitioner. After that, continuing medical education is compulsory, but it is not regulated. Although the French medical Health System was named by the WHO in 2000 as the best health care system in the world, is it not that good. While primary care in Spain has room for improvement, there is a long way for France to be like Spain. Copyright © 2015 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  9. First assessment of triclosan, triclocarban and paraben mass loads at a very large regional scale: case of Paris conurbation (France).

    Science.gov (United States)

    Gasperi, Johnny; Geara, Darine; Lorgeoux, Catherine; Bressy, Adèle; Zedek, Sifax; Rocher, Vincent; El Samrani, Antoine; Chebbo, Ghassan; Moilleron, Régis

    2014-09-15

    The objective of this study was to examine the occurrence of parabens (5 congeners), triclosan (TCS) and triclocarban (TCC) at the scale of the Parisian sewer network and to provide representative knowledge on these compounds in France for a large area. For this purpose and in collaboration with the Parisian public sanitation service (SIAAP) in charge of the collect and treatment of the Parisian wastewater, this study focused on seven main sewer trunks of the Paris conurbation, accounting for 1900,000 m(3) d(-1), i.e., about 8 million inhabitants. Concentrations lying in the 2000-20000 ng l(-1) ranges were found in wastewater, confirming the ubiquity of parabens, TCS and TCC in our environment and household products. Parabens (>97%) and to a lesser extent TCS (68% in median) were mainly associated to the dissolved fraction, as demonstrated by low KD and KOC values. For the first time, this study also evaluated the pollutant mass loads per population equivalent (PE) of parabens, TCS and TCC at the large and representative scale of the Parisian conurbation. Hence, the median mass loads varied from 176 to 3040 μg PE(-1) d(-1) for parabens and from 26 to 762 μg PE(-1) d(-1) for TCS and TCC. Based on these results and according to the assumptions done, the extrapolation of the mass loads at the national scale pointed out an annual mass loads between 51.8 and 100.7 ty(-1) for methyl paraben (MeP) and between 11.2 and 23.5 ty(-1) for TCS. Mass loads per equivalent habitant and national mass loads are both extremely relevant and innovative data. Contrary to other countries, such data are nowadays rather difficult to gain in France and neither enquiry nor database provides access to information on the use and production of these chemicals. Since cosmetic industries are voluntarily and fully engaged in the substitution of parabens, triclosan and triclocarban in personal care product, this study could constitute a "time reference status" which could be used as a basis for

  10. Occurrence of CTX-M producing Escherichia coli in soils, cattle and farm environment in France (Burgundy region.

    Directory of Open Access Journals (Sweden)

    Alain eHartmann

    2012-03-01

    Full Text Available CTX-M (extended spectrum beta-lactamase- ESBL producing Escherichia coli are increasingly involved in human infections worldwide. The aim of this study was to investigate potential reservoirs for such strains: soils, cattle and farm environment. The prevalence of blaCTX-M genes was determined directly from soil DNA extracts obtained from 120 sites in Burgundy (France using real time PCR. blaCTX-M targets were found in 20% of the DNA extracts tested. Samples of cattle feces (n=271 were collected from 182 farms in Burgundy. Thirteen ESBL-producing isolates were obtained from 12 farms and further characterized for the presence of bla genes. Of the 13 strains, five and eight strains carried blaTEM-71 genes and blaCTX-M-1 genes respectively. Ten strains of CTX-M-1 producing E. coli were isolated from cultivated and pasture soils as well as from composted manure within 2 of these farms. The genotypic analysis revealed that environmental and animal strains were clonally related. Our study confirms the occurrence of CTX-M producing E. coli in cattle and reports for the first time the occurrence of such strains in cultivated soils. The environmental competence of such strains has to be determined and might explain their long term survival since CTX-M isolates were recovered from a soil that was last amended with manure one year before sampling.

  11. Hospital pharmacy practice in Saudi Arabia: Dispensing and administration in the Riyadh region

    Science.gov (United States)

    Alsultan, Mohammed S.; Khurshid, Fowad; Mayet, Ahmed Y.; Al-jedai, Ahmed H.

    2012-01-01

    Background There is very little published data assessing hospital pharmacy practice in Saudi Arabia. Hence, a comprehensive survey has been undertaken to evaluate hospital pharmacy services of the Kingdom of Saudi Arabia. Recently, we published the survey results on the prescribing and transcribing steps of the medication use process. This paper focuses on dispensing and administration. Methods A modified-American Society of Health-System Pharmacists (ASHP) survey questionnaire was personally delivered to the pharmacy directors of 48 hospitals in the Riyadh region. Three attempted follow-ups were made within 3 months to non-responders and the surveys were collected upon completion. The survey was conducted using similar methods to those of the ASHP surveys. Results Twenty-nine hospitals participated in the survey with a response rate of 60.4%. Centralized distribution (74%) is the most commonly used model for inpatient pharmacies. Overall, 21% of hospitals routinely use bar coding technology in medication dispensing. None of the hospitals are using a robotic distribution system to automate the dispensing of unit doses. Automated dispensing cabinets (ADCs) are used by 21% of hospitals as part of their decentralized distribution model. Sixty-one percent of hospital pharmacies have IV admixture preparation area in their facility. In the use of safety technology for medication administration, only one third of hospitals are using electronic medication administration records (eMARs), 7.4% had bar-code-assisted medication administration (BCMA) and 12% had smart infusion pumps. Conclusion Hospital pharmacies in the Riyadh region are fairly well developed in providing dispensing and administration services. Further improvement can be achieved by increasing the use of new technologies such as bar-code technology, unit dose drug distribution systems, pharmacy-based IV admixture services, smart infusion pumps, and automated medication distribution. PMID:23960805

  12. [Epidemiological data on human distomatosis (Fasciola hepatica L.) in the Limousin region of France. The species of plants eaten and snail hosts].

    Science.gov (United States)

    Rondelaud, D

    1980-01-01

    These epidemiological studies concern 187 cases of human fasciolasis which occurred in the region of Limousin, France on a period of 24 years. Four species of plants have been eaten: Nasturtium officinale, Roripa silvestris, Taraxacum gr. officinale, Valerianella olitoria. These plants have been eaten during all months of the year, but with higher numbers in July-August and from November to February. The cases of human fasciolasis almost take place on all years, but their numbers are high in years showing a very important infestation of cattle by Fasciola hepatica. In 2/3 of cases, the plants come from stations situated out of cattle pastures. The water-cress almost comes from natural stations or from familial plantations. Five species of snails have been observed in these stations: Lymnaea glabra, L. palustris, L. peregra, L. stagnalis, L. truncatula. The young snails of these species experimentally have been observed. The significance of these results is discussed.

  13. DISTRIBUTION AND HABITAT REQUIREMENTS OF THE WHITE-CLAWED CRAYFISH, AUSTROPOTAMOBIUS PALLIPES, IN A STREAM FROM THE PAYS DE LOIRE REGION, FRANCE: AN EXPERIMENTAL AND DESCRIPTIVE STUDY

    Directory of Open Access Journals (Sweden)

    BROQUET T.

    2002-07-01

    Full Text Available A population of white-clawed crayfish (Austropotamobius pallipes was studied from January to October 2000 in a stream from the Pays de Loire region (Western France. An experimental modification of habitat was performed in four stream sections by providing refuges for crayfish, followed by a regular survey of population dynamics in these areas. The crayfish distribution along the brook was studied in relation to several parameters, including water quality, current speed, brook depth and presence of refuges for crayfish. Presence of hiding places was the only habitat parameter correlated with crayfish distribution along the stream whereas colonization process in modified sections was determined by sun exposure and current speed conditions. Despite a presumably high growth rate and its ability to reach locally important densities, the population appeared to be fragmented.

  14. Incidence of hospital referred head injuries in Norway: a population based survey from the Stavanger region

    DEFF Research Database (Denmark)

    Rommer, Bertil Roland; Heskestad, Ben; Baardsen, Roald;

    2009-01-01

    BACKGROUND: In three previous Norwegian studies conducted between 1974 and 1993, the annual incidence rates of hospital admitted head injuries were 236, 200 and 169 per 100,000 population. The aim of this study was to describe the incidence of head injury in the Stavanger region and to compare......,317 inhabitants (2003). RESULTS: The annual incidence rate was 207/100,000 population for hospital referred head injury and 157/100,000 population for hospital admitted head injury. High age- and sex specific incidence rates were observed among the oldest, and the highest rate (882/100,000) among men above 90...

  15. Seasonal pattern of peptic ulcer hospitalizations: analysis of the hospital discharge data of the Emilia-Romagna region of Italy

    Directory of Open Access Journals (Sweden)

    Serra Mauro

    2010-04-01

    Full Text Available Abstract Background Previous studies have reported seasonal variation in peptic ulcer disease (PUD, but few large-scale, population-based studies have been conducted. Methods To verify whether a seasonal variation in cases of PUD (either compicated or not complicated requiring acute hospitalization exists, we assessed the database of hospital admissions of the region Emilia Romagna (RER, Italy, obtained from the Center for Health Statistics, between January 1998 and December 2005. Admissions were categorized by sex, age (per se in the region. For statistical analysis, the χ2 test for goodness of fit and inferential chronobiologic method (Cosinor and partial Fourier series were used. Results Of the total sample of PUD patients (26,848 [16,795 males, age 65 ± 16 yrs; 10,053 females, age 72 ± 15 yrs, p p p = 0.035, and several subgroups, with nadir in July. Finally, analysis of the monthly prevalence proportions yielded a significant (p = 0.025 biphasic pattern with a main peak in August-September-October, and a secondary one in January-February. Conclusions A seasonal variation in PUD hospitalization, characterized by three peaks of higher incidence (Autumn, Winter, and Spring is observed. When data corrected by monthly admission proportions are analyzed, late summer-autumn and winter are confirmed as higher risk periods. The underlying pathophysiologic mechanisms are unknown, and need further studies. In subjects at higher risk, certain periods of the year could deserve an appropriate pharmacological protection to reduce the risk of PUD hospitalization.

  16. Hospitalization for ambulatory care sensitive conditions and the role of primary care in Italian regions.

    Directory of Open Access Journals (Sweden)

    Aldo Rosano

    2011-03-01

    Full Text Available Abstract
    Background: Hospitalization may often be prevented by timely and effective outpatient care either by preventing the onset of an illness, controlling an acute illness or managing a chronic disease with an appropriate follow-up. The objective of the study is to examine the variability of hospital admissions within Italian regions for Ambulatory Care Sensitive Conditions (ACSCs, and their relationship with primary care supply.
    Methods: Hospital discharge data aggregated at a regional level collected in 2005 were analysed by type of ACS conditions. Main outcome measures were regional hospital admission rates for ACSCs. Negative binomial models were used to analyse the association with individual risk factors (age and gender and regional risk factors (propensity to hospitalisation and prevalence of specific conditions.
    Non-parametric correlation indexes between standardised hospital admission rates and quantitative measures of primary care services were calculated.
    Results: ACSC admissions accounted for 6.6% of total admissions, 35.7% were classified as acute conditions and 64.3% as chronic conditions. Admission rates for ACSCs varied widely across Italian regions with different patterns for chronic and acute conditions. Southern regions showed significantly higher rates for chronic conditions and North-eastern regions for acute conditions. We found a significant negative association between the provision of ambulatory specialist services and standardised hospitalization rates
    (SHR for ACS chronic conditions (r=-0.50; p=0.02 and an inverse correlation among SHR for ACS acute conditions and the rate of GPs per 1,000 residents, although the latter was not statistically significant.
    Conclusions: In Italy, about 480,000 inpatient hospital admissions in 2005 were attributable to ACSCs. Even
    adjusting for potential confounders

  17. Possible consequences of regionally based bundled payments for diabetic amputations for safety net hospitals in Texas.

    Science.gov (United States)

    Newhall, Karina; Stone, David; Svoboda, Ryan; Goodney, Philip

    2016-12-01

    Ongoing health reform in the United States encourages quality-based reimbursement methods such as bundled payments for surgery. The effect of such changes on high-risk procedures is unknown, especially at safety net hospitals. This study quantified the burden of diabetes-related amputation and the potential financial effect of bundled payments at safety net hospitals in Texas. We performed a cross-sectional analysis of diabetic amputation burden and charges using publically available data from Centers for Medicare and Medicaid and the Texas Department of Health from 2008 to 2012. Using hospital referral region (HRR)-level analysis, we categorized the proportion of safety net hospitals within each region as very low (0%-9%), low (10%-20%), average (20%-33%), and high (>33%) and compared amputation rates across regions using nonparametric tests of trend. We then used charge data to create reimbursement rates based on HRR to estimate financial losses. We identified 51 adult hospitals as safety nets in Texas. Regions varied in the proportion of safety net hospitals from 0% in Victoria to 65% in Harlingen. Among beneficiaries aged >65, amputation rates correlated to the proportion of safety net hospitals in each region; for example, patients in the lowest quartile of safety net had a yearly rate of 300 amputations per 100,000 beneficiaries, whereas those in the highest quartile had a yearly rate of 472 per 100,000 (P = .007). Charges for diabetic amputation-related admissions varied almost 200-fold, from $5000 to $1.4 million. Using reimbursement based on HRR to estimate a bundled payment, we noted net losses would be higher at safety net vs nonsafety net hospitals ($180 million vs $163 million), representing a per-hospital loss of $1.6 million at safety nets vs $700,000 at nonsafety nets (P Texas. Changes to traditional payment models should account for the disproportionate burden of high-risk procedures performed by these hospitals. Copyright © 2016. Published by

  18. [Nurse home visits in France].

    Science.gov (United States)

    Monguillon, Dominique; Gracia, Pierre-Benjamin

    2011-10-01

    Nurse home visits in France. More and more nurses carry out home visits, either as freelance nurses or employees of a nurse home visits service, a home hospital care structure or a nursing care centre. These home visits are both demanded by patients and encouraged by the health authorities. As a consequence, the service is expanding every year.

  19. Terrorism in France.

    Science.gov (United States)

    Carli, Pierre; Telion, Caroline; Baker, David

    2003-01-01

    France has experienced two waves of major terrorist bombings since 1980. In the first wave (1985-1986), eight bombings occurred in Paris, killing 13 and injuring 281. In the second wave (1995-1996), six bombings occurred in Paris and Lyon, killing 10 and injuring 262. Based on lessons learned during these events, France has developed and improved a sophisticated national system for prehospital emergency response to conventional terrorist attacks based on its national emergency medical services (EMS) system, Service d'Aide Medicale Urgente (SAMU). According to the national plan for the emergency medical response to mass-casualty events (White Plan), the major phases of EMS response are: (1) alert; (2) search and rescue; (3) triage of victims and provision of critical care to first priority victims; (4) regulated dispatch of victims to hospitals; and (5) psychological assistance. Following the 1995 Tokyo subway sarin attack, a national plan for the emergency response to chemical and biological events (PIRATOX) was implemented. In 2002, the Ministries of Health and the Interior collaborated to produce a comprehensive national plan (BIOTOX) for the emergency response to chemical, biological, radiological, and nuclear events. Key aspects of BIOTOX are the prehospital provision of specialized advance life support for toxic injuries and the protection of responders in contaminated environments. BIOTOX was successfully used during the 2003 Severe Acute Respiratory Syndrome (SARS) outbreak in France.

  20. Developmental Outcome of Very Low Boy Weight Babies Born in a Regional Public Hospital in Hong Kong%Regional Public Hospital in Hong Kong

    Institute of Scientific and Technical Information of China (English)

    KNR Yuen; CB Chow; D Allison

    2009-01-01

    Objectives To investigate the Short term development outcome of a cohort of Very low Birth Weight(VLRW)babies(i.e.Birth-weight less than 1500 g.)born in a Hong Kong regional public hospital in 2001.Design Non-randomized prospective cohort Study.Setting Regional public hospital in Hong Kong.Partieipants 29 babies with birth weight of less than 1500 g(i.e.very low birth weight babies)who were bom and survived to discharge in Kwong Wah Hospital in the period between lst January 2001 to 31st December 2001.Main outoome measures Deveiopmcntal outcome.Results A total of 27 very low birth weight babies(15 males and 12 females)were included in the study.The mean gestational age of the cohort was 28.6 weeks±3.08 weeks.The mean birth weight of the cohort of babies was 1120 g±270 g.Two patients defaulted follow up and assessment in the first two years of life.At the chronological age of 4 vears old,21 out of 25 babies (84%)had normal growth and development.Four out of 25 babies were found to have developmental delay,including one baby with severe handicap.Conehmion With advances in medical care,many low birth weight babies can now 8urvive,but a number of these high risk babies may have long term developmental problems.It is important to monitor these patients closely after discharge from hospital so that early identification and rehabilitation of developmental problems can be possible.

  1. [Research of regional medical consumables reagent logistics system in the modern hospital].

    Science.gov (United States)

    Wu, Jingjiong; Zhang, Yanwen; Luo, Xiaochen; Zhang, Qing; Zhu, Jianxin

    2013-09-01

    To explore the modern hospital and regional medical consumable reagents logistics system management. The characteristics of regional logistics, through cooperation between medical institutions within the region, and organize a wide range of special logistics activities, to make reasonable of the regional medical consumable reagents logistics. To set the regional management system, dynamic management systems, supply chain information management system, after-sales service system and assessment system. By the research of existing medical market and medical resources, to establish the regional medical supplies reagents directory and the initial data. The emphasis is centralized dispatch of medical supplies reagents, to introduce qualified logistics company for dispatching, to improve the modern hospital management efficiency, to costs down. Regional medical center and regional community health service centers constitute a regional logistics network, the introduction of medical consumable reagents logistics services, fully embodies integrity level, relevance, purpose, environmental adaptability of characteristics by the medical consumable reagents regional logistics distribution. Modern logistics distribution systems can increase the area of medical consumables reagent management efficiency and reduce costs.

  2. Predictors of regional variations in hospitalizations following emergency department visits for atrial fibrillation.

    Science.gov (United States)

    Barrett, Tyler W; Self, Wesley H; Jenkins, Cathy A; Storrow, Alan B; Heavrin, Benjamin S; McNaughton, Candace D; Collins, Sean P; Goldberger, Jeffrey J

    2013-11-01

    The emergency department (ED) is often where atrial fibrillation (AF) is first detected and acutely treated and affected patients dispositioned. We used the Nationwide Emergency Department Sample to estimate the percentage of visits resulting in hospitalization and investigate associations between patient and hospital characteristics with hospitalization at the national and regional levels. We conducted a cross-sectional study of adults with AF listed as the primary ED diagnosis in the 2007 to 2009 Nationwide Emergency Department Sample. We performed multivariate logistic regression analyses investigating the associations between prespecified patient and hospital characteristics with hospitalization. From 2007 to 2009, there were 1,320,123 weighted ED visits for AF, with 69% hospitalized nationally. Mean regional hospitalization proportions were: Northeast (74%), Midwest (68%), South (74%), and West (57%). The highest odds ratios for predicting hospitalization were heart failure (3.85, 95% confidence interval [CI] 3.66 to 4.02), chronic obstructive pulmonary disease (2.47, 95% CI 2.34 to 2.61), and coronary artery disease (1.65, 95% CI 1.58 to 1.73). After adjusting for age, privately insured (0.77, 95% CI 0.73 to 0.81) and self-pay (0.77 95% CI 0.66 to 0.90) patients had lower odds compared with Medicare recipients, whereas Medicaid (1.21, 95% CI 1.11 to 1.32) patients tended to have higher odds. Patients living in low-income zip codes (1.18, 95% CI 1.12 to 1.25) and patients treated at large metropolitan hospitals (1.75, 95% CI 1.59 to 1.93) had higher odds. In conclusion, our analysis showed considerable regional variation in the management of patients with AF in the ED and in associations between patient socioeconomic and hospital characteristics with ED disposition; adapting best practices from among these variations in management could reduce hospitalizations and health-care expenses. Copyright © 2013 Elsevier Inc. All rights reserved.

  3. Identifying geographical regions serviced by hospitals to assess laboratory-based outcomes

    Science.gov (United States)

    Gandhi, Sonja; Shariff, Salimah Z; Beyea, Michael M; Weir, Matthew A; Hands, Theresa; Kearns, Glen; Garg, Amit X

    2013-01-01

    Objective To define geographical regions (forward sortation areas; FSAs) in Southwestern Ontario, Canada from which patients would reliably present to a hospital with linked laboratory data if they developed adverse events related to medications dispensed in outpatient pharmacies. Design Descriptive research. Setting Forty-five hospitals in Southwestern Ontario, Canada, from 2003 to 2009. Participants Patients aged 66 years and older who received an outpatient prescription for any drug and presented to the emergency department in the subsequent 120 days. Main outcome measure The proportion of patients in a given FSA presenting to an emergency department at a hospital with linked laboratory data versus a hospital without linked laboratory data. To be included in the catchment area at least 90% of emergency department visits in an FSA must have occurred at laboratory-linked hospitals in a given year. Results Over the study period, there were 649 713 emergency department visits by patients with recent prescription claims from pharmacies in 1 of 118 FSAs. In total, 141 302 of these patients presented to an emergency department at a laboratory-linked hospital. For the year 2003, 12 FSAs met our criteria to be in the catchment area and this number grew to 25 FSAs by the year 2009. Conclusions The relevant geographical regions for hospitals with linked laboratory data have been successfully identified. Studies can now be conducted using these well-defined areas to obtain reliable information on the incidence and absolute risk of presenting to hospital with laboratory abnormalities in older adults dispensed commonly prescribed medications in outpatient pharmacies. PMID:23293246

  4. Medico-sociological analysis of consulting work at ophthalmologic regional hospital: communication approach

    Directory of Open Access Journals (Sweden)

    lorina I.G.

    2012-09-01

    Full Text Available The purpose of the article is to considerthe consulting work as a process of social communication. The way of such approach allowed to determine objective and function of communication system of ophthalmologic regional hospital, to consider the problems of communication management concerning the problem of computerization of Russian Health Service.

  5. Three cases of Capnocytophaga canimorsus meningitis seen at a regional hospital in one year

    DEFF Research Database (Denmark)

    Monrad, Rikke Nygaard; Hansen, Dennis Schrøder

    2012-01-01

    Three cases of meningitis caused by the fastidious Gram-negative rod Capnocytophaga canimorsus have been observed at a regional hospital in 1 y. The difficulties connected with the correct diagnosis by classical culturing methods in contrast to molecular methods, as well as possible reasons for t...

  6. Anticipating Change: How Many Acute Care Hospital Beds Will Manitoba Regions Need in 2020?

    Science.gov (United States)

    Finlayson, Greg; Stewart, David Kenney; Tate, Robert B.; MacWilliam, Leonard R.; Roos, Noralou P.

    2005-01-01

    Being able to anticipate future needs for health services presents a challenge for health planners. Using existing population projections, two models are presented to estimate the demand for hospital beds in regions of Manitoba in 2020. The first, a current-use projection model, simply projects the average use for a recent three-year period into…

  7. Assessing the disparity in spatial access to hospital care in ethnic minority region in Sichuan Province, China

    OpenAIRE

    Wang, Xiuli; Pan, Jay

    2016-01-01

    Background There is a great disparity in spatial accessibility to hospital care between ethnic minority and non-minority regions in China. Being one of the basic social demands, spatial access to hospital care in minority regions draws increasing attention in China in recent years. We performed this study to have a better understanding of spatial access to hospital care in ethnic minority region in China, and to guide the allocation of government investment in the future. Methods Sichuan Prov...

  8. Hospitals

    Data.gov (United States)

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

  9. The AIRPARIF-AEROSOL project: A comprehensive source apportionment study of fine aerosols (PM2.5) in the region of Paris (France)

    Science.gov (United States)

    Sciare, Jean; Ghersi, Veronique; Bressi, Michael; Lameloise, Philippe; Bonnaire, Nicolas; Rosso, Amandine; Nicolas, Jose; Moukhtar, Sophie; Ferron, Anais; Baumier, Dominique

    2010-05-01

    With a population of about 12 millions inhabitants (20% of the French population), Greater Paris (France) is one of the most populated megacity in Europe and among the few located in developed countries. Due to its favorable geographical situation (far from other big European cities and influenced very often by clean oceanic air masses), it may be considered as a good candidate for investigating the build-up of urban air pollution from temperate industrialized countries. Particulate mass of fine aerosols with aerodynamic diameter below 2.5μm (PM2.5) is continuously monitored at several stations from great Paris for almost 8 years by the local air quality network (AIRPARIF), using a conventional on-line automatic system (R&P TEOM; see Patashnik and Rupprecht, 1991). During the period 2000-2006, levels of PM2.5 in the region of Paris have shown rather stable yearly mean values ranging 13 to 16?g/m3 whereas most of the other pollutants monitored by AIRPARIF have shown a net decrease during this period (http:\\www.airparif.asso.fr). Since the year 2007, this situation has becoming worse for particulate pollution with a net increase of the yearly mean concentration of PM2.5 (up to 21?g/m3), which increase is partly due to the use of a new PM2.5 measurement technique (R&P TEOM-FDMS instrument) enabling a proper determination of the semi-volatile fraction of fine aerosols. Although this new method greatly improves the determination of PM2.5, it has also brought PM2.5 levels in the region of Paris closer to the 25?g/m3 yearly mean targeted value recommended by Europe for 2010 (limit value for 2015). Efficient abatement policies aiming at reducing levels of PM2.5 in the region of Paris will have to be fed by preliminary PM2.5 source apportionment studies and exhaustive aerosol chemistry studies (chemical mass balance) allowing a better separation between regional to continental aerosol sources. The objective of the AIRPARIF-AEROSOL project aims to perform a spatially- and

  10. Utilization of noninvasive ventilation in acute care hospitals: a regional survey.

    Science.gov (United States)

    Maheshwari, Vinay; Paioli, Daniela; Rothaar, Robert; Hill, Nicholas S

    2006-05-01

    Little information is available on the utilization of noninvasive positive-pressure ventilation (NPPV) in the United States. Accordingly, we performed a survey on the use of NPPV at acute care hospitals in a region of the United States to determine variations in utilization and between hospitals, the reasons for lower rates of utilization, and the techniques used for application. Using survey methodology, we developed a questionnaire consisting of 19 questions and distributed it by mail to directors of respiratory care at all 82 acute care hospitals in Massachusetts and Rhode Island. Nonresponders were contacted by phone to complete the survey. Responses were analyzed using standard statistics, including t tests and Mann-Whitney U tests where appropriate. We obtained responses from 71 of the 82 hospitals (88%). The overall utilization rate for NPPV was 20% of ventilator starts, but we found enormous variation in the estimated utilization rates among different hospitals, from none to > 50%. The top two reasons given for lower utilization rates were a lack of physician knowledge and inadequate equipment. In the 19 hospitals that provided detailed information, COPD and congestive heart failure constituted 82% of the diagnoses of patients receiving NPPV, but NPPV was still used in only 33% of patients with these diagnoses receiving any form of mechanical ventilation. The utilization rates for NPPV vary enormously among different acute care hospitals within the same region. The perceived reasons for lower utilization rates include lack of physician knowledge, insufficient respiratory therapist training, and inadequate equipment. Educational programs directed at individual institutions may be useful to enhance utilization rates.

  11. Factors associated with induced abortion at selected hospitals in the Volta Region, Ghana.

    Science.gov (United States)

    Klutsey, Ellen Eyi; Ankomah, Augustine

    2014-01-01

    Induced abortion rates remained persistently high in the Volta Region of Ghana in the 5 years from 2006 to 2011. Some hospitals, both rural and urban, report induced abortion-related complications as one of the top ten conditions in hospital admissions. This study explored demographic and other factors associated with induced abortion, and also assessed awareness of abortion-related complications among women of reproductive age in the Volta Region. A quantitative, hospital-based, unmatched case-control study was performed. The Volta Region was stratified into two health administration zones, ie, north and south. For each zone, hospitals were stratified into government and private hospitals. Employing simple random sampling, one private and three government hospitals were selected from each zone. This study is therefore based on eight hospitals, ie, six government hospitals and two private hospitals. Marital status, employment status, number of total pregnancies, and knowledge about contraception were found to be associated with induced abortion. Multiple logistic regression showed a 4% reduction in the odds of induced abortion in married women compared with women who were single (odds ratio [OR] 0.11, 95% confidence interval [CI] 0.07-0.22). Unemployed women of reproductive age were found to be 0.35 times less likely to seek induced abortion compared with their employed counterparts (OR 0.35, CI 0.19-0.65). It was also observed that women with their second pregnancies were 3.8 times more likely to seek induced abortion and women with more than two pregnancies were 6.6 times more likely to do so (OR 3.81, CI 1.94-7.49 and OR 6.58, CI 2.58-16.79, respectively). Women with no knowledge of contraceptive methods were 4.6 times likely to seek induced abortion (OR 4.64, CI 1.39-15.4). Compared with women who had not had induced abortion, women with a high number of pregnancies and no contraceptive knowledge were more likely to have induced abortion. It was found that lack

  12. A démarche estratégica: a metodologia de gestão do Centro Hospitalar Regional Universitário de Lille, França The strategic management: the methodology applied by the "Centre Hospitalier Regional Universitaire"(CHRU at Lille, France

    Directory of Open Access Journals (Sweden)

    Francisco Javier Uribe Rivera

    1997-01-01

    Full Text Available Este trabalho é uma apresentação geral do enfoque da "démarche" estratégica (o processo estratégico, aplicado pelo Centro Hospitalar Regional Universitário (CHRU de Lille, França. Este é um método de gestão hospitalar, baseado na análise estratégica das melhores alternativas de racionalização da missão hospitalar. Considera um ambiente de competição, onde é necessário estruturar redes de cuidados com base na negociação dos projetos de estabelecimento. O autor apresenta as fases e os principais instrumentos metodológicos do enfoque e faz uma avaliação preliminar de possibilidades.This work is a general presentation of the "Démarche Stratégique", a strategic process applied by the "Centre Hospitalier Régional Universitaire" (CHRU at Lille, France. The hospital management methodology relies on the strategic analysis of the best alternatives for rationalizing the hospital mission. It takes into account a competitive environment, in which it is necessary to structure health care networks based on the negotiation of inpatient care goals. The author presents the phases and main methodological tools of the approach, as well as a preliminary evaluation of its potentials.

  13. Patient satisfaction with nursing care in a regional university hospital in southern Spain.

    Science.gov (United States)

    González-Valentín, Araceli; Padín-López, Susana; de Ramón-Garrido, Enrique

    2005-01-01

    Patient satisfaction is a valid indicator for measurement of service quality. Patients' opinions are important because dissatisfaction suggests opportunities for improvement. We evaluated the satisfaction of patients with nursing care in a regional university hospital in southern Spain and determined the relevant sociodemographic and attendance characteristics. A cross-sectional descriptive study was undertaken using the SERVQUAL questionnaire. Reliability and validity of the SERVQUAL instrument were established. The only interaction considered was gender and education level. Analysis of covariance showed that the only factors significantly associated with lower patient satisfaction were female gender, higher educational level, lower overall satisfaction with the hospital, and not knowing the name of the nurse.

  14. Capability of a regional climate model to simulate climate variables requested for water balance computation: a case study over northeastern France

    Science.gov (United States)

    Boulard, Damien; Castel, Thierry; Camberlin, Pierre; Sergent, Anne-Sophie; Bréda, Nathalie; Badeau, Vincent; Rossi, Aurélien; Pohl, Benjamin

    2016-05-01

    This paper documents the capability of the ARW/WRF regional climate model to regionalize near-surface atmospheric variables at high resolution (8 km) over Burgundy (northeastern France) from daily to interannual timescales. To that purpose, a 20-year continuous simulation (1989-2008) was carried out. The WRF model driven by ERA-Interim reanalyses was compared to in situ observations and a mesoscale atmospheric analyses system (SAFRAN) for five near-surface variables: precipitation, air temperature, wind speed, relative humidity and solar radiation, the last four variables being used for the calculation of potential evapotranspiration (ET0). Results show a significant improvement upon ERA-Interim. This is due to a good skill of the model to reproduce the spatial distribution for all weather variables, in spite of a slight over-estimation of precipitation amounts mostly during the summer convective season, and wind speed during winter. As compared to the Météo-France observations, WRF also improves upon SAFRAN analyses, which partly fail at showing realistic spatial distributions for wind speed, relative humidity and solar radiation—the latter being strongly underestimated. The SAFRAN ET0 is thus highly under-estimated too. WRF ET0 is in better agreement with observations. In order to evaluate WRF's capability to simulate a reliable ET0, the water balance of thirty Douglas-fir stands was computed using a process-based model. Three soil water deficit indexes corresponding to the sum of the daily deviations between the relative extractible water and a critical value of 40 % below which the low soil water content affects tree growth, were calculated using the nearest weather station, SAFRAN analyses weather data, or by merging observation and WRF weather variables. Correlations between Douglas-fir growth and the three estimated soil water deficit indexes show similar results. These results showed through the ET0 estimation and the relation between mean annual SWDI

  15. Hospital care and capacity in the tri-state region of Indiana, Kentucky, and Ohio: analysis and insights.

    Science.gov (United States)

    Burns, David J; Chinta, Ravi; Kashyap, Vishal; Manolis, Chris; Sen, Amit

    2008-01-01

    Hospitals are a significant part of the burgeoning healthcare sector in the United States (U.S.) economy. Despite the availability of what some describe as the world's best healthcare, the U.S. suffers from wide discrepancies in healthcare provision across hospitals and regions of the country. Specifically, capacity, utilization, quality, and even financial performance of hospitals vary widely. Based on secondary data from 533 hospitals in the adjoining states of Indiana, Kentucky, and Ohio, this study develops several comparative metrics that enable benchmarking, which, in turn, leads to several inferences and implications for hospital administrators. The paper concludes with implications for hospital administrators and suggestions for future research.

  16. Fraud Prevention A Study In Regional Public Service Agency BLUD For Hospital In Malang Regency Indonesia

    Directory of Open Access Journals (Sweden)

    Koenta Adji Koerniawan

    2015-08-01

    Full Text Available This study aims to understand the effect of management perceptions in Regional Public Service Agency BLUD for Hospital in Malang regency Indonesia on the role of the Independent Auditor and their understanding towards Good Governance the General Audit Engagement and its implications for the prevention of corruption. This research is quantitative which placed latent variables General Audit Engagements as intervening variables. Partial Least Square PLS is used to confirm the model created in order to explain the relationship between variables. The results show that the perception of BLUD hospital management on the role of independent auditors and their understanding of good governance to give effect to the implementation of the audit engagement and the implications for the prevention of fraud in BLUDs hospital. This is consistent with the theory of auditing and fraud prevention concepts. JEL Classification M420 K420

  17. Parenteral Admixture Compatibility in Neurosurgery Ward in Prof. Dr. Margono Soekarjo Regional Public Hospital

    Directory of Open Access Journals (Sweden)

    Laksmi Maharani

    2014-03-01

    Full Text Available Parenteral admixtures (intravenous admixtures have been done commonly in hospitals. However, it has a possibility of failures, like incompatibilities and changes in drug stabilities. The aim of this study was to determine the rate of drug incompatibilities in mixing parenteral preparations in neurosurgery ward in Prof. Dr. Margono Soekarjo Regional Public Hospital which undergo physical incompatibility observed in organoleptic. This study was a prospective descriptive research for one month period. Data were collected and analyzed descriptively. The results showed that from 667 parenteral admixtures in neurosurgery ward in Prof Dr Margono Soekarjo Hospital in February 2010, there were 0.45% potential incompatibility and 2.55% actual incompatibility happened. Actual incompatibility shown as crystal 0.17%, sediment 0.17%, and 2.04% was non-permanent haze in phenytoin and sodium chloride or ringer lactate admixtures.

  18. Substandard emergency obstetric care - a confidential enquiry into maternal deaths at a regional hospital in Tanzania

    DEFF Research Database (Denmark)

    Sorensen, Bjarke Lund; Elsass, Peter; Nielsen, Brigitte Bruun

    2010-01-01

    OBJECTIVE: (i) To identify clinical causes of maternal deaths at a regional hospital in Tanzania and through confidential enquiry (CE) assess major substandard care and make a comparison to the findings of the internal maternal deaths audits (MDAs); (ii) to describe hospital staff reflections...... on causes of substandard care. METHODS: A CE into maternal deaths was conducted based on information available from written sources supplemented with participatory observations and interviews with staff. The compiled information was summarized and presented anonymously for external expert review to assess...... for major substandard care. Hospital based maternal deaths between 2006 and 2008 (35 months) were included. Of 68 registered maternal deaths sufficient information for reviewing was retrieved for 62 cases (91%). As a supplement, in-depth interviews with staff about the underlying causes of substandard care...

  19. Influence of the spatial variability of rainfall on hydrograph modelling at catchment outlet: a case study in the Cevennes region, France

    Directory of Open Access Journals (Sweden)

    Emmanuel Isabelle

    2016-01-01

    Full Text Available The influence of rainfall spatial variability on hydrographs modelling at catchment outlet remains an open scientific debate. [1] have proposed rainfall variability indexes aiming at summarising the influence of rainfall spatial organisation on hydrographs features. This preliminary work was based on a large simulated database. The present article shows how the proposed indexes may be used in a real case study to discriminate rainfall events for which information on spatial rainfall organization is crucial for hydrograph modelling, and therefore to better illustrate the added value of high resolution rainfall information as input of hydrological models. The presented case study is located in the Cevennes Region in south-eastern France. The tested flow events are split into two subsets according to the values of the rainfall variability indexes. The comparison between modelled and measured hydrographs is then performed separately for each subset. The results obtained suggest that, on average, modelling results taking into account high resolution rainfall data are significantly improved for the subset for which the influence of rainfall variability is expected to be significant according to the indexes values. Although limited to a relatively small number of hydrographs, this case study can be viewed as a first confirmation of the pertinence of the rainfall variability indexes proposed in [1] to investigate the influence of rainfall spatial variability on the shape of hydrographs at catchment outlet.

  20. Assessment of the susceptibility of roads to flooding based on geographical information - test in a flash flood prone area (the Gard region, France)

    Science.gov (United States)

    Versini, P.-A.; Gaume, E.; Andrieu, H.

    2010-04-01

    In flash flood prone areas, roads are often the first assets affected by inundations which make rescue operations difficult and represent a major threat to lives: almost half of the victims are car passengers trapped by floods. In the past years, the Gard region (France) road management services have realized an extensive inventory of the known road submersions that occurred during the last 40 years. This inventory provided an unique opportunity to analyse the causes of road flooding in an area frequently affected by severe flash floods. It will be used to develop a road submersion susceptibility rating method, representing the first element of a road warning system. This paper presents the results of the analysis of this data set. A companion paper will show how the proposed road susceptibility rating method can be combined with distributed rainfall-runoff simulations to provide accurate road submersion risk maps. The very low correlation between the various possible explanatory factors and the susceptibility to flooding measured by the number of past observed submersions implied the use of particular statistical analysis methods based on the general principals of the discriminant analysis. The analysis led to the definition of four susceptibility classes for river crossing road sections. Validation tests confirmed that this classification is robust, at least in the considered area. One major outcome of the analysis is that the susceptibility to flooding is rather linked to the location of the road sections than to the size of the river crossing structure (bridge or culvert).

  1. Analysis of maxillofacial prosthetics at university dental hospitals in the capital region of Korea

    Science.gov (United States)

    Lee, Jong-Ho

    2016-01-01

    PURPOSE The purpose of this study was to investigate the demographic patterns of maxillofacial prosthetic treatment to identify the characteristics and geographic distribution of patients with maxillofacial prosthetics in the capital region of Korea. MATERIALS AND METHODS This retrospective analytical multicenter study was performed by chart reviews. This study included patients who visited the department of prosthodontics at four university dental hospitals for maxillofacial prosthetic rehabilitation. Patients with facial and congenital defects or with insufficient medical data were excluded. The patients were classified into three categories based on the location of the defect. Patients' sex, age, and residential area were analyzed. Pearson's chi-square test with a significance level of 0.05 was used to analyze the variables. RESULTS Among 540 patients with maxillofacial prosthetics, there were 284 (52.59%) male patients and 256 (47.41%) female patients. The number of the patients varied greatly by hospital. Most patients were older than 70, and the most common defect was a hard palate defect. Chi-square analysis did not identify any significant differences in sex, age, and distance to hospital for any defect group (P>.05). CONCLUSION The results of this study indicated that there was imbalance in the distribution of patients with maxillofacial prosthetic among the hospitals in the capital region of Korea. Considerations on specialists and insurance policies for the improvement of maxillofacial prosthetics in Korea are required. PMID:27350859

  2. Factors associated with induced abortion at selected hospitals in the Volta Region, Ghana

    Directory of Open Access Journals (Sweden)

    Klutsey EE

    2014-08-01

    Full Text Available Ellen Eyi Klutsey,1 Augustine Ankomah2 1School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Volta Region, 2Department of Population, Family and Reproductive Health School of Public Health, University of Ghana, Legon, Accra, Ghana Background: Induced abortion rates remained persistently high in the Volta Region of Ghana in the 5 years from 2006 to 2011. Some hospitals, both rural and urban, report induced abortion-related complications as one of the top ten conditions in hospital admissions. This study explored demographic and other factors associated with induced abortion, and also assessed awareness of abortion-related complications among women of reproductive age in the Volta Region. Methods: A quantitative, hospital-based, unmatched case-control study was performed. The Volta Region was stratified into two health administration zones, ie, north and south. For each zone, hospitals were stratified into government and private hospitals. Employing simple random sampling, one private and three government hospitals were selected from each zone. This study is therefore based on eight hospitals, ie, six government hospitals and two private hospitals. Results: Marital status, employment status, number of total pregnancies, and knowledge about contraception were found to be associated with induced abortion. Multiple logistic regression showed a 4% reduction in the odds of induced abortion in married women compared with women who were single (odds ratio [OR] 0.11, 95% confidence interval [CI] 0.07–0.22. Unemployed women of reproductive age were found to be 0.35 times less likely to seek induced abortion compared with their employed counterparts (OR 0.35, CI 0.19–0.65. It was also observed that women with their second pregnancies were 3.8 times more likely to seek induced abortion and women with more than two pregnancies were 6.6 times more likely to do so (OR 3.81, CI 1.94–7.49 and OR 6.58, CI 2.58–16.79, respectively

  3. The Role of the Nobles-Philanthropists in the Activities of Hospitals in the Danube Region

    Directory of Open Access Journals (Sweden)

    Nataliya Goncharova

    2015-08-01

    Full Text Available Reviews the legal and regulatory basis in the sphere of the guardianship treatment centres in the Russian Empire in the middle of the XIXth century, alleging the establishment of the public supervision over the activities of city, County and provincial hospitals. Contents of the powers of the Trustees, their objectives and main activities. Specific examples in the Danube region proved the thesis that among the Trustees were dominated by representatives of the nobility.

  4. Benefits of an ISO 9001 certification--the case of a Swiss regional hospital.

    Science.gov (United States)

    Staines, A

    2000-01-01

    This paper reports the experience of a quality management project leading to an ISO 9001 certification in a Swiss regional hospital. It describes the motivations for the project, the process that was followed and the benefits of the approach. It also shows its limitations, problems encountered as well as costs and resources involved. The emphasis is on practical issues. Choices that were made are discussed and lessons are drawn.

  5. Analysis of maxillofacial prosthetics at university dental hospitals in the capital region of Korea

    OpenAIRE

    2016-01-01

    PURPOSE The purpose of this study was to investigate the demographic patterns of maxillofacial prosthetic treatment to identify the characteristics and geographic distribution of patients with maxillofacial prosthetics in the capital region of Korea. MATERIALS AND METHODS This retrospective analytical multicenter study was performed by chart reviews. This study included patients who visited the department of prosthodontics at four university dental hospitals for maxillofacial prosthetic rehab...

  6. Reducing Ambulance Diversion at Hospital and Regional Levels: Systemic Review of Insights from Simulation Models

    Directory of Open Access Journals (Sweden)

    M Kit Delgado

    2013-09-01

    Full Text Available Introduction: Optimal solutions for reducing diversion without worsening emergency department (ED crowding are unclear. We performed a systematic review of published simulation studies to identify: 1 the tradeoff between ambulance diversion and ED wait times; 2 the predicted impact of patient flow interventions on reducing diversion; and 3 the optimal regional strategy for reducing diversion.Methods: Data Sources: Systematic review of articles using MEDLINE, Inspec, Scopus. Additional studies identified through bibliography review, Google Scholar, and scientific conference proceedings. Study Selection: Only simulations modeling ambulance diversion as a result of ED crowding or inpatient capacity problems were included. Data extraction: Independent extraction by two authors using predefined data fields.Results: We identified 5,116 potentially relevant records; 10 studies met inclusion criteria. In models that quantified the relationship between ED throughput times and diversion, diversion was found to only minimally improve ED waiting room times. Adding holding units for inpatient boarders and ED-based fast tracks, improving lab turnaround times, and smoothing elective surgery caseloads were found to reduce diversion considerably. While two models found a cooperative agreement between hospitals is necessary to prevent defensive diversion behavior by a hospital when a nearby hospital goes on diversion, one model found there may be more optimal solutions for reducing region wide wait times than a regional ban on diversion.Conclusion: Smoothing elective surgery caseloads, adding ED fast tracks as well as holding units for inpatient boarders, improving ED lab turnaround times, and implementing regional cooperative agreements among hospitals. [West J Emerg Med. 2013;14(5:489-498.

  7. France, tourism

    OpenAIRE

    Jean-Pierre, Philippe; Perrain, David

    2016-01-01

    International audience; This encyclopedia is the most comprehensive and updated source of reference in tourism research and practice. It covers both traditional and emerging concepts and terms and is fully international in its scope. More than 700 contributions of 766 internationally renowned experts from 113 countries provide a definitive access to the knowledge in the field of tourism, hospitality, recreation and related fields. All actors in this field will find reliable and up to date def...

  8. Real-time measurements of levoglucosan in fine aerosols (PM2.5) in the region of Paris (France)

    Science.gov (United States)

    Sciare, J.; Bonnaire, N.; Mocnik, G.; Nicolas, J.; Petit, J. E.; Bressi, M.; Sarda-Estève, R.; Drinovic, L.

    2012-04-01

    Levoglucosan - one the major monosaccharide anhydride compounds produced by the combustion of cellulose and hemicellulose - is emitted in large amounts by wildfires or residential wood burning (during winter months). Over the past few years, this specific tracer has received more and more attention at it can be used in a quantitative way to derive atmospheric concentrations of biomass burning aerosols [Favez et al., 2010] which aerosol source has strong implications for climate and air quality studies. A new technique has been developed and is presented here to investigate real-time concentrations of levoglucosan in fine aerosols (PM2.5). This technique is based on a Particle-into-liquid-sampler (PILS, Brechtel Manufacturing inc., model 4002) used "on-line" and coupled with an electrospray ionisation source - tandem mass spectrometry (ESI-MS/MS, AB SCIEX model 3200 QTRAP). Air was drawn in the PILS at 15LPM and removed from particles larger than 2.5μm aerodynamic diameter (AD) using a very sharp cyclone. Water-soluble aerosols were collected in the PILS and sent in the 10μl loop of the ESI-MS/MS at a flowrate of 50μl/min. Flow injection analysis (FIA) was then performed every 2.5min for the quantification of levoglucosan using a specific transition 161-113 m/z (negative mode), by Multiple Reaction Monitoring (MRM) mode. An internal levoglucosan standard was injected every 10 samples (i.e. every 25min) in order to check the stability of the mass spectrometry calibration. Field blanks were performed using a total filter upstream of the PILS instrument and did not show any detectable amount of levoglucosan. A limit of quantification (LOQ) better than 1 ng/m3 was calculated here for levoglucosan in FIA mode. Based on these settings, unattended measurements of levoglucosan by PILS-ESI-MS/MS have been performed every 2.5 min in the region of Paris for a couple of weeks during the winter 2011 showing concentrations ranging from below 1ng/m3 to more than 500ng/m3. These

  9. Regard sur la participation de populations marginalisées à la recherche-action. Le cas des squatteurs en Ile-de-France The participation of Marginalised populations in research-action: a case study of squatters in the Ile-de-France region (Paris and surrounding region

    Directory of Open Access Journals (Sweden)

    Lionel Pourtau

    2011-05-01

    Full Text Available La recherche-action comporte deux caractéristiques principales : elle met en œuvre la collaboration entre plusieurs types d’acteurs et vise une transformation de la réalité sociale. Elle possède des forces et des faiblesses différentes de la recherche à objectif strictement cognitif. L’article rend compte d’une recherche-action menée par des sociologues, des intervenants sociaux et des populations vivant en squats en Ile-de-France. Les auteurs analysent les enjeux méthodologiques qui se sont posés sur ce terrain particulier relevant de la sociologie de la déviance. Ceux-ci sont liés, notamment, à la participation de chaque groupe d’acteurs aux différentes étapes de la recherche, à la présence d’intérêts différents portés par chacun d’entre eux, et à la conciliation entre les principes habituellement de rigueur dans l’enquête sociologique et les principes de la recherche-action.Research-Action has two main objectives: to allow different players to cooperate, and to transform social reality. This methodology has both the strengths and the weaknesses of strictly cognitive research. In this article, the authors discuss a research-action project which brought together sociologists, social workers and squatters from the Ile-de-France region (Paris and surrounding region. Methodological issues that arise specifically in the context of deviance are addressed, notably the participation of the different players at different stages of the research project, their different areas of interest, as well as the reconciliation between more conventional sociological research and the principles of research-action.

  10. Human bite injuries in the oro-facial region at the Muhimbili National Hospital, Tanzania

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    Simon Elison NM

    2008-04-01

    Full Text Available Abstract Background Human bites in the maxillofacial region compromise function and aesthetics, resulting in social and psychological effects. There is paucity of information regarding human bite injuries in Tanzania. The aim of the study was to assess the occurrence, treatment modalities and prognosis of human bite injuries in the oro-facial region at the Muhimbili National Hospital Dar es Salaam, Tanzania. Methods In a prospective study the details of patients with human bite injuries in the oro-facial region who attended at the Department of Oral and Maxillofacial Surgery of the Muhimbili National Hospital between January 2001 and December 2005 were recorded. Data included information on age, sex, site, duration of the injury at the time of reporting to hospital, reasons, details of treatment offered and outcome after treatment. Results A total of 33 patients, 13 males and 20 females aged between 12 and 49 years with human bite injuries in the oro-facial region were treated. Thirty patients presented with clean uninfected wounds while 3 had infected wounds. The most (45.5% frequently affected site was the lower lip. Treatment offered included thorough surgical cleansing with adequate surgical debridement and primary suturing. Tetanus prophylaxis and a course of broad-spectrum antibiotics were given to all the patients. In 90% of the 30 patients who were treated by suturing, the healing was uneventful with only 10% experiencing wound infection or necrosis. Three patients who presented with wounds that had signs of infection were treated by surgical cleansing with debridement, antibiotics and daily dressing followed by delayed primary suturing. Conclusion Most of the human bite injuries in the oro-facial region were due to social conflicts. Although generally considered to be dirty or contaminated they could be successfully treated by surgical cleansing and primary suture with a favourable outcome. Management of such injuries often need

  11. hospital

    African Journals Online (AJOL)

    Pattern of congenital orthopaedic malformations in an African teaching hospital ... malformation in this environment while congenital hip dislocation (CDH) is rare when .... malformations of radial dysplasia and other congenital malformations.

  12. Trends and Regional Variation in Hospital Mortality, Length of Stay and Cost in Hospital of Ischemic Stroke Patients in Alberta Accompanying the Provincial Reorganization of Stroke Care.

    Science.gov (United States)

    Ohinmaa, Arto; Zheng, Yufei; Jeerakathil, Thomas; Klarenbach, Scott; Häkkinen, Unto; Nguyen, Thanh; Friesen, Dan; Ruseski, Jane; Kaul, Padma; Ariste, Ruolz; Jacobs, Philip

    2016-12-01

    This study aimed to evaluate the trends and regional variation of stroke hospital care in 30-day in-hospital mortality, hospital length of stay (LOS), and 1-year total hospitalization cost after implementation of the Alberta Provincial Stroke Strategy. New ischemic stroke patients (N = 7632) admitted to Alberta acute care hospitals between 2006 and 2011 were followed for 1 year. We analyzed in-hospital mortality with logistic regression, LOS with negative binomial regression, and the hospital costs with generalized gamma model (log link). The risk-adjusted results were compared over years and between zones using observed/expected results. The risk-adjusted mortality rates decreased from 12.6% in 2006/2007 to 9.9% in 2010/2011. The regional variations in mortality decreased from 8.3% units in 2008/2009 to 5.6 in 2010/2011. The LOS of the first episode dropped significantly in 2010/2011 after a 4-year slight increase. The regional variation in LOS was 15.5 days in 2006/2007 and decreased to 10.9 days in 2010/2011. The 1-year hospitalization cost increased initially, and then kept on declining during the last 3 years. The South and Calgary zones had the lowest costs over the study period. However, this gap was diminishing. After implementation of the Alberta Provincial Stroke Strategy, both mortality and hospital costs demonstrated a decreasing trend during the later years of study. The LOS increased slightly during the first 4 years but had a significant drop at the last year. In general, the regional variations in all 3 indicators had a diminishing trend. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  13. [AIDS mortality in France].

    Science.gov (United States)

    Hatton, F; Maguin, P; Nicaud, V; Renaud, G

    1986-01-01

    A study about mortality by AIDS had been undertaken since July 1st 1983, in the Service of Information on Medical causes of Death (INSERM SC8), which is in charge of developing mortality statistics in France. From July 1st 1983 to September 30th 1985, 243 deaths due to AIDS were recorded. Only the cases where this diagnosis was clearly mentioned were selected; more than 90% were notified by hospitals and mainly by highly specialized services. The number of deaths, which was low and varied rather irregularly at the beginning, then increased by successive stages. The first year, during which a tenth of deaths was recorded every three months, was followed by a great increase, doubling, then tripling the initial numbers. Lastly, a second and sudden rise occurred during the third trimester of 1985, the trimestrial number of deaths due to AIDS reaching 80.

  14. Health-related quality of life of people living with HIV followed up in hospitals in France: comparing trends and correlates between 2003 and 2011 (ANRS-VESPA and VESPA2 national surveys).

    Science.gov (United States)

    Douab, Taoufiq; Marcellin, Fabienne; Vilotitch, Antoine; Protopopescu, Camelia; Préau, Marie; Suzan-Monti, Marie; Sagaon-Teyssier, Luis; Lert, France; Carrieri, Maria Patrizia; Dray-Spira, Rosemary; Spire, Bruno

    2014-01-01

    In recent years, France has witnessed both structural changes in the population of people living with HIV and a relative improvement in the social representation of HIV infection. However, potential changes in people's day-to-day experience with HIV have not been documented. We used data from the national surveys ANRS-VESPA (2003) and VESPA2 (2011) to compare the levels and patterns of correlates of health-related quality of life (HRQL) in adult HIV-infected patients followed up in French hospitals over a period of eight years. Mean physical and mental SF-12 scores were compared (VESPA, n = 2072; and VESPA2, n = 2267) using analysis of variance (ANOVA) F tests. Heckman regression models were then used to identify independent correlates of physical and mental quality of life in the two surveys, while accounting for possible bias due to missing score values. A common set of potential socio-demographic, clinical, behavioral, and psychosocial correlates was tested. Individuals reported a decrease in physical quality of life in VESPA2 compared with VESPA (mean score (standard error): 47.5 (0.2) versus 49.6 (0.2), p mental HRQL (44.3 (0.3) versus 42.3 (0.3), p mental quality of life. Older age and unemployment were independently associated with impaired physical quality of life. Immigrants from Sub-Saharan Africa reported better mental quality of life. Findings show that quality of life levels in adult HIV-infected patients followed up at hospital in France has significantly, yet modestly, changed in recent years. However, the pattern of quality of life correlates has remained relatively stable. The impact of patient-provider relationships on self-reported outcomes is confirmed. Further research is needed to identify potential differences in quality of life correlates in specific subgroups of patients, such as men who have sex with men, women, immigrants, and injecting drug users.

  15. Evaluation of hospital-learning environment for pediatric residency in eastern region of Saudi Arabia

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    Waleed H. BuAli

    2015-04-01

    Full Text Available Purpose: No study had been conducted to assess the hospitals’ environment for learning purposes in multicenter sites in Saudi Arabia. It aims to evaluate the environment of hospitals for learning purposes of pediatric residents. Methods: We applied Postgraduate Hospital Educational Environment Measure (PHEEM to measure the learning environment at six teaching hospitals in the Eastern Region of Saudi Arabia from September to December 2013. Results: The number of respondents was 104 (86.7% out of 120 residents and 37 females and 67 male residents have responded. The residents’ response scored 100 out of 160 maximum score in rating of PHEEM that showed overall learning environment is favorable for training. There were some items in the social support domain suggesting improvements. There was no significant difference between male and female residents. There was a difference among the participant teaching hospitals (p<0.05. Conclusion: The result pointed an overall positive rating. Individual item scores suggested that their social life during residency could be uninspiring. They have the low satisfactory level and they feel racism, and sexual discrimination. Therefore, there is still a room for improvement.

  16. A gestão estratégica dos hospitais na França: balanço e perspectivas Strategic management of hospitals in France: balance and perspectives

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    Michel Crémadez

    2010-08-01

    Full Text Available A gestão estratégica é introduzida nos hospitais franceses no final da década de oitenta, num contexto de ineficácia e necessidade de controle das despesas de saúde. Este conceito tem inspirado uma série de reformas do governo, da organização e da dinâmica dos hospitais e do modo de regulação do sistema de saúde francês, pressupondo uma verdadeira mudança da cultura profissional. As mudanças no contexto econômico e no modo de financiamento dos hospitais, no comportamento dos usuários, o envelhecimento da população, o desenvolvimento das patologias crônicas e a intensificação da concorrência, constituem novos desafios a serem enfrentados. O envolvimento dos atores é fundamental e a gestão estratégica, baseada na mobilização dos atores, torna-se, hoje, um modo de administração particularmente adaptado à área da saúde. Este artigo tem por objetivo apresentar o impacto do conceito de gestão estratégica na evolução do meio hospitalar francês e as consequências desta evolução sobre as perspectivas de difusão da gestão estratégica no setor da saúde. Para isso, examina-se a evolução do contexto francês até 2010, os novos desafios que os hospitais franceses devem enfrentar e, por fim, as consequências destes desafios sobre a maneira de conceber os serviços, de administrar as relações entre os atores do sistema de saúde e de organizar o funcionamento operacional dos hospitais.The strategic management was introduced in French hospitals in the late 80s, in a context of inefficiency and the need to control healthcare expenditure. This concept has inspired a series of government reforms, the organization and dynamics of hospitals and the mode of regulating the French health system, assuming a real change of professional culture. The changes in the economic context and in the finance of hospitals, the behavior of users, the population aging, the development of chronic diseases and increased competition

  17. Hospital admissions due to ambulatory care sensitive conditions among children by age group and health region

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    Kelly Holanda Prezotto

    2015-02-01

    Full Text Available OBJECTIVE to describe hospital admissions for ambulatory care sensitive conditions in children under five years of age in the State of Paraná, Brazil by condition type, age group and health region. METHOD a temporal ecological study was conducted using data from the Unified Health System Hospital Information System for the period 2000 to 2011. Conditions were grouped in accordance with the list of ambulatory care sensitive conditions in Brazil. RESULTS there was an increase in the rate of admissions for ambulatory care sensitive conditions in all age groups in 50% of the health regions, with a marked increase in children under the age of one. Pneumonia, gastroenteritis and asthma were the main causes of admissions. There was an increase in the proportion of overall admissions accounted for by pneumonia and gastroenteritis. CONCLUSION the increase in admissions reveals the need for actions to improve access to primary healthcare and provide effective treatment of the main ambulatory care sensitive conditions in order to prevent hospital admissions among children.

  18. [Supporting system for regional medical liaison and role of a central hospital].

    Science.gov (United States)

    Kitano, Seigo

    2003-04-01

    The current status and future development of the supporting system for regional medical liaison and a role of the central hospital in the network were outlined. One of such supportive systems for regional medical network would be tele-medicine or tele-mentoring that include radiological and pathological diagnoses in distance, tele-surgery, and tele-education. Most of these systems are facilitated in the universities and affiliated hospitals and generally need high-cost communication equipment. Another approach is the information sharing system through the modern telecommunication network. Electronic patient record (EPR) systems are the key to achieving this and currently active in several areas. Since the recent progress in information technology (IT) is astonishing, community-based EPR systems are practical with the capability of clinical information exchange between different institutions and even with patients. The role of a central hospital in these systems must be capacious. Management and continuous operation of the system would be the most important affairs. For extending these supporting systems to the ones working in a broader area, the establishment of a "one ID for one patient" system is crucial. Strict security management of the data base and legal institution for distant medical practice still remain as the future tasks.

  19. Institutional traps in the hospitality industry financing (by the example of Krasnodar region

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    Alla Yu. Baranova

    2016-09-01

    Full Text Available Objective to determine and classify the institutional traps in financing the hospitality industry in Russia. Methods abstractlogical generalization and observation. Results basing on the analysis of statistics and regional program of tourism development in Krasnodar region the challenges and obstacles were identified to the development and improvement of tourist services quality. The research result is the identification and systematization of institutional traps in the financing of tourism expressed in the increased public support of the sector. In particular a significant proportion of touristrecreational sector funding is still taken from the budget though the specific weight of profitable health resort organizations amounted to 60 over the past three years. In the process of research the author formulated a general concept of the institutional structure of the hospitality industry in Russia and the model of the sector financing through a system of incentives and benefits for vacationers forming the tourist clusters and forming a mechanism of dialogue between the authorities and representatives of tourist business. Scientific novelty the institutional traps are defined and systematized which are formed in the system of tourism financing measures to overcome them are proposed. Practical significance the proposed recommendations can be used by the entities of the hospitality industry to enhance business activities and by authorities to implement tasks outlined in the state programs.

  20. Assessing the role of spatial rainfall variability on watersheds response using weather radar A case study in the Gard region, France

    Science.gov (United States)

    Anggraheni, Evi; Payrastre, Olivier; Emmanuel, Isabelle; Andrieu, Herve

    2014-05-01

    The consideration of spatial rainfall variability in hydrological modeling is not only an important scientific issue but also, with the current development of high resolution rainfall data from weather radars, an increasing request from managers of sewerage networks and from flood forecasting services. Although the literature on this topic is already significant, at this time the conclusions remain contrasted. The impact of spatial rainfall variability on the hydrological responses appears to highly depend both on the organization of rainfall fields and on the watershed characteristics. The objective of the study presented here is to confirm and analyze the high impact of spatial rainfall variability in the specific context of flash floods. The case study presented is located in the Gard region in south east of France and focuses on four events which occurred on 13 different watersheds in 2008. The hydrological behaviors of these watersheds have been represented by the distributed rainfall - runoff model CINECAR, which already proved to well represent the hydrological responses in this region (Naulin et al., 2013). The influence of spatial rainfall variability has been studied here by considering two different rainfall inputs: radar data with a resolution of 1 km x 1 km and the spatial average rainfall over the catchment. First, the comparison between simulated and measured hydrographs confirms the good performances of the model for intense rainfall events, independently of the level of spatial rainfall variability of these events. Secondly, the simulated hydrographs obtained from radar data are taken as reference and compared to those obtained from the average rainfall inputs by computing two values: the time difference and the difference of magnitude between the simulated peaks discharge. The results highly depend on the rainfall event considered, and on the level of organization of the spatial rainfall variability. According to the model, the behavior of the

  1. Differential impact of parental region of birth on negative parenting behavior and its effects on child mental health: Results from a large sample of 6 to 11 year old school children in France

    OpenAIRE

    Kovess-Masfety, Viviane; Husky, Mathilde; Pitrou, Isabelle; Fermanian, Christophe; Shojaei, Taraneh; Chee, Christine Chan; Siddiqi, Arjumand; Beiser, Morton

    2016-01-01

    Background In France, one in 10 residents has immigrated mainly from North Africa, West Africa or the Caribbean including the French West Indies. However little is known about how parents from these regions behave when they migrate to countries that have different cultural norms. It is therefore important to determine how ethno-cultural background affects parental behavior and subsequent child mental health in the context of immigration. The objectives are: 1) to compare negative parenting be...

  2. Assessment of the susceptibility of roads to flooding based on geographical information – test in a flash flood prone area (the Gard region, France

    Directory of Open Access Journals (Sweden)

    P.-A. Versini

    2010-04-01

    Full Text Available In flash flood prone areas, roads are often the first assets affected by inundations which make rescue operations difficult and represent a major threat to lives: almost half of the victims are car passengers trapped by floods. In the past years, the Gard region (France road management services have realized an extensive inventory of the known road submersions that occurred during the last 40 years. This inventory provided an unique opportunity to analyse the causes of road flooding in an area frequently affected by severe flash floods. It will be used to develop a road submersion susceptibility rating method, representing the first element of a road warning system.

    This paper presents the results of the analysis of this data set. A companion paper will show how the proposed road susceptibility rating method can be combined with distributed rainfall-runoff simulations to provide accurate road submersion risk maps.

    The very low correlation between the various possible explanatory factors and the susceptibility to flooding measured by the number of past observed submersions implied the use of particular statistical analysis methods based on the general principals of the discriminant analysis.

    The analysis led to the definition of four susceptibility classes for river crossing road sections. Validation tests confirmed that this classification is robust, at least in the considered area. One major outcome of the analysis is that the susceptibility to flooding is rather linked to the location of the road sections than to the size of the river crossing structure (bridge or culvert.

  3. Regional variation in obstetrical intervention for hospital birth in the Republic of Ireland, 2005–2009

    Directory of Open Access Journals (Sweden)

    Lutomski Jennifer E

    2012-11-01

    Full Text Available Abstract Background Obstetrical interventions during childbirth vary widely across European and North American countries. Regional differences in intrapartum care may reflect an inpatient-based, clinician-oriented, interventional practice style. Methods Using nationally representative hospital discharge data, a retrospective cohort study was conducted to explore regional variation in obstetric intervention across four major regions (Dublin Mid Leinster; Dublin Northeast; South; West within the Republic of Ireland. Specific focus was given to rates of induction of labour, caesarean delivery, epidural anaesthesia, blood transfusion, hysterectomy and episiotomy. Logistic regression analyses were performed to assess the association between geographical region and interventions while adjusting for patient case-mix. Results 323,588 deliveries were examined. The incidence of interventions varied significantly across regions; the greatest disparities were observed for rates of induction of labour and caesarean delivery. Women in the South had nearly two-fold odds of having prostaglandins (adjusted OR: 1.75, 95% CI 1.68-1.82, whereas women in the West had 1.85 odds (95% CI 1.77-1.93 of artificial rupture of membrane. Women delivering in the Dublin Northeast, South and West regions had more than two-fold increased odds of elective caesarean delivery relative to women delivering in the Dublin Mid Leinster region. The Dublin Northeast region had the highest odds of emergency caesarean delivery (adjusted OR: 1.36; 95% CI: 1.31-1.40. Conclusions Substantial regional variation in intrapartum care was observed within this small, relatively homogeneous population. The association of intervention use with region illustrates the need to encourage uptake of scientific based practice guidelines to better inform clinical judgment.

  4. Prevalence and Correlates of Drug-drug Interactions in the Regional Hospital of Gjilan, Kosovo.

    Science.gov (United States)

    Shabani, Driton; Tahiri, Zejdush; Bara, Petrit; Hudhra, Klejda; Malaj, Ledian; Jucja, Besnik; Bozalia, Adnan; Burazeri, Genc

    2014-08-01

    Our aim was to assess the prevalence and socioeconomic and clinical correlates of drug-drug interactions among the adult population of transitional Kosovo. A cross-sectional study was conducted including a representative sample of 1921 patients aged ≥18 years (mean age: 57.8±11.2 years; 50.3% women; overall response: 96%) from the regional hospital of Gjilan, Kosovo, during 2011-2013. Potential drug-drug-interactions were assessed and clinical data as well as demographic and socioeconomic information were collected. Binary logistic regression was used to assess the correlates of drug-drug interactions. Upon multivariable adjustment for all the demographic and socioeconomic factors as well as the clinical characteristics, drug-drug interactions were positively and significantly related to older age (OR=2.1, 95%CI=1.3-2.8), a lower educational attainment (OR=1.4, 95%CI=1.1-1.9), a longer hospitalization period (OR=2.7, 95%CI=2.1-3.6), presence of three groups of diseases [infectious diseases (OR=1.7, 95%CI=1.3-2.4), cardiovascular diseases (OR=1.8, 95%CI=1.4-2.6), respiratory diseases (OR=1.6, 95%CI=1.2-2.5)], presence of comorbid conditions (OR=3.2, 95%CI=2.3-4.4) and an intake of at least four drugs (OR=5.9, 95%CI=4.6-7.1). Our study provides important evidence on the prevalence and socioeconomic and clinical correlates of drug-drug interactions among the hospitalized patients in the regional hospital of Gjilan, Kosovo. Findings from our study should raise the awareness of decision-makers and policy makers about the prevalence and determinants of drug-drug interactions in the adult population of post-war Kosovo.

  5. Occupational stressors, burnout and coping strategies between hospital and community psychiatric nurses in a Dublin region.

    Science.gov (United States)

    McTiernan, K; McDonald, N

    2015-04-01

    Burnout negatively impacts the delivery of mental health services. Psychiatric nurses face stressors that are distinct from other nursing specialities. The research was conducted in Ireland and captured a relatively large sample of respondents. The results compared the stressors, coping strategies and burnout levels between hospital and community-based psychiatric nurses. Occupational stress can negatively impact on the well-being of psychiatric nurses, which in turn can lead to poor client care. There is a dearth of published research conducted in Ireland that examines stress within the discipline. A between-groups study, undertaken in February 2011, investigated stressors, burnout and coping strategies between hospital and community-based psychiatric nurses in a Dublin region. Sixty-nine participants (8 males and 61 females), aged between 18 to 60 years voluntarily completed the Mental Health Professional Stress Scale, the Maslach Burnout Inventory and the PsychNurse Methods of Coping Scale. The findings revealed that nurses were operating in a moderately stressful environment. Stressors focused on organizational issues as opposed to client issues. The main stressors identified were lack of resources, workload and organizational structures/processes. Both groups reported average levels of emotional exhaustion, low levels of depersonalization and average levels of personal accomplishment. A Mann-Whitney U-test and Independent Samples t-test found significant differences between hospital and community-based nurses regarding depersonalization and personal accomplishment, respectively. Hospital nurses reported higher depersonalization scores, and community nurses had a greater sense of personal accomplishment. The personal accomplishment scores of hospital nurses were below mental health professional norms. No significant differences emerged regarding coping strategies. Avoidant coping strategies were favoured by both groups. It is recommended that interventions

  6. [Maternal mortality in France, 2007-2009].

    Science.gov (United States)

    Saucedo, M; Deneux-Tharaux, C; Bouvier-Colle, M-H

    2013-11-01

    To monitor the maternal mortality which is an indicator of the quality of obstetric and intensive care, France has a specific approach since 1996. Recently linkages have been introduced to improve the inclusion of cases. Here are the results for the 2007 to 2009 period. The identification of the pregnancy associated deaths is lying on different data bases that are medical causes of death, birth register and hospital discharges. To document the cases, confidential enquiries are conducted by two assessors on the field; a committee of medical experts analyses the documents, select the underlying cause and assess the quality of health care. Two hundred and fifty-four obstetric deaths were identified from 2007 to 2009 giving the maternal mortality ratio (MMR) of 10.3 per 100,000 births. The maternal age and nationality, the region of deaths are associated to the MMR. The haemorrhages are the leading cause but their ratio is 1.9 versus 2.5 previously; this decrease results from the postpartum haemorrhage by uterine atony going down. The suboptimal care are still frequent (60%) but slightly less than before. The linkage method should be pursued. Maternal mortality is rather stable in France. We may reach more reduction as deaths due to atony decreased as suboptimal care did.

  7. 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.

  8. Making regional facility location decisions: the example of Hospital do Oeste Norte, Portugal

    Directory of Open Access Journals (Sweden)

    Jorge Gonçalves

    2014-11-01

    Full Text Available This paper seeks to contribute to the debate on the decision-making process for the location of large public facilities, responding to the growing demand for greater rationality in public investment whilst still offering services of quality and addressing the problem of spatial friction. The specific problem analysed in this paper is the need to define the best location for a public hospital in a particular region of Portugal. The singularity of the approach adopted lies above all in the seg- mentation into macro-location and micro-location.

  9. Making regional facility location decisions: the example of Hospital do Oeste Norte, Portugal.

    Science.gov (United States)

    Gonçalves, Jorge; Antunes Ferreira, J; Condessa, Beatriz

    2014-11-01

    This paper seeks to contribute to the debate on the decision-making process for the location of large public facilities, responding to the growing demand for greater rationality in public investment whilst still offering services of quality and addressing the problem of spatial friction. The specific problem analysed in this paper is the need to define the best location for a public hospital in a particular region of Portugal. The singularity of the approach adopted lies above all in the segmentation into macro-location and micro-location.

  10. Fiebre por mordedura de rata: reporte de un caso probable en el Hospital Regional del Cuzco

    Directory of Open Access Journals (Sweden)

    Miguel Cabada Samame

    2003-01-01

    Full Text Available A 4 year old patient was admitted to the Emergency Department of Hospital Regional de Cusco with 17 days history of a rat bite. One week later, the patient developed fever and rash, which lasted for 3 days. Fever, an abscess on the forehead with lymphangitis, and cervical lymphadenopathy were observed on admission. The VDRL test was positive but FTA-Abs was negative. He was diagnosed of rat bite fever and treated with IV penicillin G with a favorable response. The case is discussed and pertinent literature is reviewed. (Rev Med Hered 2003; 14:44-47.

  11. France in Black Africa,

    Science.gov (United States)

    1989-01-01

    mediation role between African governments and their private creditors. 123 France in Black Africa To further complicate matters, France herself is...34La coop6ration Franco-Ivoirienne, annde 1986," Mission de Cooperation et d’Action Culturelle , Ambassade de France en C6te D’Ivoire, Abidjan, 1987, p. 8...Ministry in "La France et l’Afrique: Etude des relations Franco-Africaines politiques, finan- cires, economiques, commerciales et culturelles ," Paris, 1984

  12. Assessment by regional modelling of the impact of monopile foundations on the hydrodynamics and sediment transport: case of Courseulles-sur-Mer (France) wind farm

    Science.gov (United States)

    Rivier, Aurélie; Bennis, Anne-Claire; Pinon, Grégory; Magar, Vanesa; Gross, Markus

    2015-04-01

    Offshore monopile foundations of wind turbines modify hydrodynamics and sediment transport at local scale and also at regional scale. The aim of this work is to assess these changes and to parametrize them in a regional model. These modifications were previously evaluated using the regional circulation model MARS3D (Lazure and Dumas, 2008) in tests-cases (Rivier et al., 2014) using two approaches: in the first approach, monopiles are explicitly modelled in the mesh as dry cells and in the second approach a sub-grid parametrization which considers the drag force exerted by a monopile on the flow is used. The sub-grid parametrization is improved close to the bed in this paper by adding a drag force term in the momentum equations, source terms in the turbulence model and by increasing the bed shear stress at monopile location. Changes in hydrodynamics regime, especially near-bed, affect sediment transport regime and modifications due to monopiles on sediment dynamics is also investigated using the MARS3D sediment transport module (Le Hir et al., 2011) which solves the advection-diffusion equations. Test-cases are run using hydrodynamical conditions and sediment grain sizes typical from the area located off Courseulles-sur-Mer (Normandy, France) where an offshore wind farm is planned to be built. Velocity, turbulent kinetic energy and bed thickness changes due to the monopile simulated by both approaches are compared to each other and to experimental measurements made in a flume at the University of Caen or to published data (e.g. Roulund et al., 2005; Dargahi,1989). Then the model is applied in a real configuration on an area including the future offshore wind farm of Courseulles-sur-Mer. Four monopiles are represented in the model using both approaches and modifications of the hydrodynamics and sediment transport are assessed along a tidal cycle. Currents increase at the side edge of the monopile and decrease in front of and downstream the monopile. Turbulent kinetic

  13. KPC-2-producing Klebsiella pneumoniae in a hospital in the Midwest region of Brazil.

    Science.gov (United States)

    Biberg, Camila Arguelo; Rodrigues, Ana Claudia Souza; do Carmo, Sidiane Ferreira; Chaves, Claudia Elizabeth Volpe; Gales, Ana Cristina; Chang, Marilene Rodrigues

    2015-06-01

    The emergence of β-lactamase-producing Enterobacteriaceae in the last few decades has become major challenge faced by hospitals. In this study, isolates of Klebsiella pneumoniae carbapenemase-2 (KPC-2)-producing K. pneumoniae from a tertiary hospital in Mato Grosso do Sul, Brazil, were characterized. Bacterial identification was performed by matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF; Bruker Daltonics, Germany) mass spectrometry. The minimum inhibitory concentrations of carbapenems were determined using the agar dilution method as recommended by the Clinical Laboratory Standards Institute guidelines. Carbapenemase production was detected using the modified Hodge test (MHT) and polymerase chain reaction (PCR), followed by DNA sequencing. Of 360 (12.2%) K. pneumoniae isolates obtained between May 2009 and May 2010, 44 (12.2%) were carbapenem nonsusceptible. Of these 44 isolates, thirty-six K. pneumoniae isolates that were positive by MHT and PCR carried the bla KPC-2 gene. Thus, KPC-2producing Klebsiella pneumoniae has been present in a Brazilian hospital located in the Midwest region since at least 2009.

  14. KPC-2-producing Klebsiella pneumoniae in a hospital in the Midwest region of Brazil

    Directory of Open Access Journals (Sweden)

    Camila Arguelo Biberg

    2015-06-01

    Full Text Available The emergence of β-lactamase-producing Enterobacteriaceae in the last few decades has become major challenge faced by hospitals. In this study, isolates of Klebsiella pneumoniae carbapenemase-2 (KPC-2-producing K. pneumoniae from a tertiary hospital in Mato Grosso do Sul, Brazil, were characterized. Bacterial identification was performed by matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF; Bruker Daltonics, Germany mass spectrometry. The minimum inhibitory concentrations of carbapenems were determined using the agar dilution method as recommended by the Clinical Laboratory Standards Institute guidelines. Carbapenemase production was detected using the modified Hodge test (MHT and polymerase chain reaction (PCR, followed by DNA sequencing. Of 360 (12.2% K. pneumoniae isolates obtained between May 2009 and May 2010, 44 (12.2% were carbapenem nonsusceptible. Of these 44 isolates, thirty-six K. pneumoniae isolates that were positive by MHT and PCR carried the blaKPC-2 gene. Thus, KPC-2producing Klebsiella pneumoniae has been present in a Brazilian hospital located in the Midwest region since at least 2009.

  15. KPC-2-producing Klebsiella pneumoniae in a hospital in the Midwest region of Brazil

    Science.gov (United States)

    Biberg, Camila Arguelo; Rodrigues, Ana Claudia Souza; do Carmo, Sidiane Ferreira; Chaves, Claudia Elizabeth Volpe; Gales, Ana Cristina; Chang, Marilene Rodrigues

    2015-01-01

    The emergence of β-lactamase-producing Enterobacteriaceae in the last few decades has become major challenge faced by hospitals. In this study, isolates of Klebsiella pneumoniae carbapenemase-2 (KPC-2)-producing K. pneumoniae from a tertiary hospital in Mato Grosso do Sul, Brazil, were characterized. Bacterial identification was performed by matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF; Bruker Daltonics, Germany) mass spectrometry. The minimum inhibitory concentrations of carbapenems were determined using the agar dilution method as recommended by the Clinical Laboratory Standards Institute guidelines. Carbapenemase production was detected using the modified Hodge test (MHT) and polymerase chain reaction (PCR), followed by DNA sequencing. Of 360 (12.2%) K. pneumoniae isolates obtained between May 2009 and May 2010, 44 (12.2%) were carbapenem nonsusceptible. Of these 44 isolates, thirty-six K. pneumoniae isolates that were positive by MHT and PCR carried the bla KPC-2 gene. Thus, KPC-2producing Klebsiella pneumoniae has been present in a Brazilian hospital located in the Midwest region since at least 2009. PMID:26273265

  16. Baltic Factor in Russia-France Relations

    Directory of Open Access Journals (Sweden)

    Maltsev Leonid A.

    2016-12-01

    Full Text Available The article aims to identify the role of the Baltic factor in Russia-France relations. Despite the fact that the Baltic Sea region (BSR no longer plays an important role in Russia-France bilateral relations, the authors attach significance to analysing the dynamics and changes of the BSR role in European politics in the post- Napoleonic period. The authors compare the Russian and the July Monarchies (1830—1848 in the context of the current Vienna system of international relations. The article describes the role of the 1830—1831 uprising in Poland, which was an event of particular importance. The monarchies of the two countries had to take into account new social phenomena, which were more pronounced in France. After the suppression of the uprising in the Polish part of the Russian Empire, Polish emigrants residing in France became the stumbling block for the development of Russia- France relations. The article explores the role of P. de Barante, Ambassador of France to Russia and describes France and Russia’s trade and economic interests in the Baltic Sea region. The authors conclude that the specificity of Russia-France bilateral relations became more apparent during the First and Second World Wars. However, the Baltic factor has lost its relevance over time.

  17. Determinants of regional labour productivity growth: A study for the hospitality sector in Spain

    Directory of Open Access Journals (Sweden)

    Bienvenido Ortega Aguaza

    2013-01-01

    Full Text Available The aim of this paper is to analyze the determinants of labour productivity growth in the hospitality industry in Spain using regional data over the period 1996-2004. The results obtained suggest that the increase in the number of 3-star hotels and the reduction process in the stock of physical capital per worker are factors which may have contributed to the fall in productivity growth. However, increased regional tourism intensity has a positive impact on the growth of labour productivity. Nonetheless, changes in demand-related factors, such as average length of stay and the seasonality of demand, have not had a significant aggregate impact on labour productivity growth during this period.

  18. Induced second trimester abortion and associated factors in Amhara region referral hospitals.

    Science.gov (United States)

    Mulat, Amlaku; Bayu, Hinsermu; Mellie, Habtamu; Alemu, Amare

    2015-01-01

    Although the vast majority of abortions are performed in the first trimester, still 10-15% of terminations of pregnancies have taken place in the second trimester period globally. As compared to first trimester, second trimester abortions are disproportionately contribute for maternal morbidity and mortality especially in low-resource countries where access to safe second trimester abortion is limited. The main aim of this study was to assess the prevalence and associated factors of induced second trimester abortion in Amhara region referral hospitals, northwest Ethiopia. Institution based cross-sectional study was conducted in Amhara region referral hospitals among 416 women who sought abortion services. Participants were selected using systematic sampling technique. Data were collected using pretested structured questionnaire through interviewing. After the data were entered and analyzed; variables which have P value abortion was 19.2%. Being rural (AOR = 1.86 [95% CI = 1.11-3.14]), having irregular menstrual cycle (AOR = 1.76 [95% CI = 1.03-2.98]), not recognizing their pregnancy at early time (AOR = 2.05 [95% CI = 1.21-3.48]), and having logistics related problems (AOR = 2.37 [95% CI = 1.02-5.53]) were found to have statistically significant association with induced second trimester abortion. Induced second trimester abortion is high despite the availability of first trimester abortion services. Therefore, increase accessibility and availability of safe second trimester abortion services below referral level, counseling and logistical support are helpful to minimize late abortions.

  19. Hospital Workers' Awareness of Health and Environmental Impacts of Poor Clinical Waste Disposal in the Northwest Region of Cameroon

    DEFF Research Database (Denmark)

    Mochungong, Peter I. K.; Gulis, Gabriel; Sodemann, Morten

    2010-01-01

    a survey to evaluate hospital workers' awareness of health and environmental impacts of poor clinical waste disposal in Cameroon. We randomly distributed 500 questionnaires to hospital workers in three hospitals in the Northwest Region of Cameroon in April 2008. In addition, we observed collection......, segregation, transportation, and disposal of clinical waste at the three hospitals. Of 475 total respondents, most lacked sufficient awareness of any environmental or public health impacts of poor clinical waste disposal and had never heard of any policy-national or international- on safe clinical waste...

  20. Estimating biogenic contributions to secondary pollutants: formation at regional scale (Fosse Rhenan, France); Impact des emissions naturelles sur les episodes de pollution photochimique: application a la region du Fosse Rhenan

    Energy Technology Data Exchange (ETDEWEB)

    Moukhtar, S.

    2005-02-15

    Biotic volatile organic compounds (VOCs) play a significant role in the formation and development of photochemical pollution events. In this context, the integration of biotic VOCs in the CHIMERE chemical transport model has been improved by the use of a double numerical and experimental approach. Field measurements have permitted to determine the flux of emissions of biotic VOCs from three tree species particularly abundant in France: Abies alba, Fagus sylvatica and Pseudotsuga menziesii. A database has been updated and used to estimate the annual VOC emissions by the French forestry system. A critical synthesis of the bibliography about the reactivity of biotic VOCs has led to the elaboration of a new chemical mechanism which has been implemented in the CHIMERE model. The results of this model have been compared to the observations available for the region of the Rhine through (Fosse Rhenan) characterized by strong biotic VOC emissions. These modifications does not change much the ozone concentrations but they have strong impacts on the modeling of peroxy-acetyl-nitrate (PAN) and formaldehyde concentrations. (J.S.)

  1. [End of life in France].

    Science.gov (United States)

    Vacheron, André

    2013-01-01

    Two major changes in end-of-life management have occured in recent decades: first, because of the increase in life expectancy and the resulting aging of the population, most deaths now involve old or very old people; second, more than two-thirds of deaths occur in a hospital or an institution. Our fellow citizens are afraid of suffering and death. They wish for a peaceful death, as rapid as possible and, in recent surveys, say they favour euthanasia. Yet euthanasia is illegal in France and in most other Western countries (with the exception of the Benelux nations). Palliative care ensures dignity in death, without anxiety of suffering, and is expanding rapidly in France. Léonetti's law of 22 April 2005 ensures the protection of the weakest, who should never be considered unworthy of life, yet is poorly known to the public and even to physicians. It now needs to be applied in practice.

  2. Impact of a pneumatic tube system transport on hemostasis parameters measurement: the experiment of Cochin universitary hospital (AP-HP, Paris, France).

    Science.gov (United States)

    Calmette, Leyla; Ibrahim, Firas; Gouin, Isabelle; Horellou, Marie-Hélène; Mazoyer, Élisabeth; Fontenay, Michaela; Flaujac, Claire

    2017-02-01

    Samples transported by pneumatic tube system are submitted to forces of acceleration and deceleration which can affect laboratory parameters. At Cochin hospital, majority of samples of hemostasis, except for platelets tests, are transported by pneumatic tube system. The objective of this study was to evaluate the impact of a pneumatic tube system (PTS) transport compared to hand-delivered transport on samples and to qualify Cochin hospital PTS according to requirements of standard ISO 15189. A bibliographical study was made and showed that pneumatic tube system particularly influences platelets tests. Four citrate tubes were collected in 5 healthy volunteers in the maternity: 2 tubes were transported by PTS and 2 others were hand-delivered to the laboratory. Five coagulation tests were analyzed: prothrombine time (PT), activated partial thromboplastin time (aPTT), factor (F) V, FVIII and platelet closure time with PFA-100TM collagen/epinephrine. For each volunteer, the results obtained by PTS and by hand-delivered transport were compared with formula usually used for biological analysis retake: 2.8 x standard deviation of reproductibility variation coefficient (SH GTA 01, COFRAC). This study did not show an impact of PTS on PT, aPTT, FV and FVIII. For PFA-100TM collagen/epinephrine, we noted an impact on 2/5 volunteers. These results, in agreement with the literature, led to the conclusion that Cochin hospital PTS is in compliance to transport samples for usual coagulation tests except platelet tests. This study allowed to issue French recommendations for PTS transport of hemostasis tubes qualification available on "Groupe français d'hémostase et thrombose" Web site.

  3. Patrones de las enfermedades raras congénitas en pacientes ingresados en un hospital regional

    Directory of Open Access Journals (Sweden)

    M.C. Martínez Cirre

    2013-08-01

    Full Text Available Fundamento. Describir el patrón de pacientes ingresados por enfermedades raras correspondientes a anomalías congénitas en un hospital regional. Métodos. Estudio transversal retrospectivo. Se consideraron las altas de hospitalización de los años 2009-2012 con diagnóstico principal entre los códigos CIE 9R MC 740-759. La fuente de información fue el Conjunto Mínimo Básico de Datos. Se analizaron variables sociodemográficas y clínicas. Resultados. Ingresan en el hospital por enfermedades raras congénitas un 1,6% de la población Un 58,5% fueron varones, con edad media de 21,4 ± 21,5 años. Las Categorías Diagnósticas Mayores más frecuentes fueron Enfermedades del sistema nervioso (86,9%, Enfermedades del aparato circulatorio (51,7% y Sistema músculo-esquelético (50,3%. El 18% de las hospitalizaciones correspondieron a reingresos de pacientes. El servicio con mayor número de episodios fue Cirugía Pediátrica, 29%, seguido de Neurocirugía, 20%. Conclusiones. El patrón de enfermedad rara congénita en el hospital Universitario Virgen de las Nieves corresponde a un paciente joven, con una enfermedad perteneciente al grupo de la Categoría Diagnóstica Mayor Enfermedad del sistema nervioso tratada quirúrgicamente y un porcentaje de reingresos no elevado.

  4. Differences between hospital- and community-acquired blood exposure incidents revealed by a regional expert counseling center.

    NARCIS (Netherlands)

    Wijk, P.T. van; Pelk-Jongen, M.; Boer, E. de; Voss, A.; Wijkmans, C.; Schneeberger, P.M.

    2006-01-01

    OBJECTIVE: One year (2003) regional analysis of all blood exposure incidents from hospitals as well as from the community. DESIGN: Establishment of an easily accessible regional expert counseling center, operating 24 h a day, for all accidental blood exposures. Tasks of the center were to register i

  5. Differences between hospital- and community-acquired blood exposure incidents revealed by a regional expert counseling center.

    NARCIS (Netherlands)

    Wijk, P.T. van; Pelk-Jongen, M.; Boer, E. de; Voss, A.; Wijkmans, C.; Schneeberger, P.M.

    2006-01-01

    OBJECTIVE: One year (2003) regional analysis of all blood exposure incidents from hospitals as well as from the community. DESIGN: Establishment of an easily accessible regional expert counseling center, operating 24 h a day, for all accidental blood exposures. Tasks of the center were to register i

  6. Internal medicine and emergency admissions: from a national hospital discharge records (SDO study to a regional analysis

    Directory of Open Access Journals (Sweden)

    Filomena Pietrantonio

    2016-02-01

    Full Text Available In Italy, the number of internists has grown by 10% since 1990 reaching 11,435 units, they manage 39,000 beds in 1060 Internal Medicine (IM wards. The Internists are expected to ensure a cost-effective management of poly-pathological and complex patients. A collaborative study between the Federation of Associations of Hospital Doctors on Internal Medicine (FADOI and the Consortium for Applied Health Economics Research (C.R.E.A. Sanità based on data from hospital discharge records has been conducted starting from November 2014. In this article the preliminary results are shown with focus on emergency admissions characteristics to contribute to define the role of hospital IM. Evaluation is performed comparing emergency and planned admissions, IM impact on hospital admissions, availability of community-based healthcare services, diagnosis-related groups (DRGs weight in IM and regional differences in managing hospital admissions with focus on IM department. In 2013 IM wards discharged 1,073,526 patients (16.18% of the total discharged by hospitals with a total economic value of 3,426,279.88 € (average DRG 3882.80 €, from 3682.19 to 4083.42. The average length of stay (LOS in IM was 9.3 days. IM covers 27% of admissions from Emergency Room. Determinants significantly affecting the emergency admissions are old age and comorbidities of the patients that also have a role in increasing LOS. 55% of Italian hospital admissions are emergency admissions. Hospitalization rates in emergency are systematically higher than those in election and the greatest differences are in the regions with inefficiently organized regional network. The role of the hospital IM appears central in the offer of beds to the emergency room by accepting 27% of urgent admissions. The increasing impact of IM on hospital management will put the internists as authoritative stakeholders in health policy.

  7. [Speech by the chairperson: roles and practices of university hospitals in regional cooperation].

    Science.gov (United States)

    Kanemitsu, Keiji

    2013-12-01

    A medical department has been established for each of the six prefectures constituting the Tohoku Region. In addition to their traditional roles in education, medical examination and treatment, and research, university hospitals play significant roles in community health care. In the aftermath of the Great East Japan Earthquake on March 11, 2011, in particular, many medical institutions were paralyzed, damaging the health of the general population, including evacuees, and putting many through emotional turmoil. The situation, including damage directly caused by the disaster, varied across localities, and medical institutions engaged in vastly different activities depended on the manpower available in their laboratory medicine (test) departments, specializations of doctors and technicians, and available resources. The disaster caused serious problems such as infectious diseases, regional infection control, economy class syndrome experienced by residents in temporary housing, and radiation exposure in Fukushima Prefecture. Here, each speaker will present how the laboratory medicine department of his/her university has established regional cooperation, and we will discuss their achievements and issues.

  8. [Epidemiological, clinical, and prognostic study of the measles in the Aioun regional hospital in Mauritania].

    Science.gov (United States)

    Boushab, B M; Savadogo, M; Sow, M S; Dao, S

    2015-01-01

    Our cross-sectional study was conducted at the Aioun Regional Hospital from February 1 to April 30, 2011, and included all cases of active measles. Its objectives were to determine the epidemiological, clinical, prognostic features of this disease. The case definition was that of World Health Organization (WHO). In three months, we collected 36 cases, which accounted for 8.84% (36/407) of admissions. The M/F sex ratio was 1.25, and the patients' mean age 16.5 years (range: 1-33 years). The majority of the patients came from rural areas (72%) and 89% had not been vaccinated against measles. The maculopapular rash had irregular contours and intervals of healthy skin. The main clinical manifestations that accompanied the fever and rash were respiratory (83%) and digestive (42%) manifestations. Other associated signs included dehydration (22%), malnutrition (14%), and convulsions (8%). The average duration of hospitalization was 7.5 days ± 3 days (range: 2-12). The overall case fatality rate was 8%. The factors of poor prognosis were non-vaccination (P = 0.018), malnutrition (P = 0.0059), and convulsions (P = 0.0553). Measles remains a public health problem in Mauritania. Strong efforts should be made to improve epidemiological surveillance and vaccination for better control of this disease.

  9. [Clinical and epidemiological characteristics of humeral supracondylar fractures in pediatric patients in a Regional General Hospital].

    Science.gov (United States)

    Barrón-Torres, Erika Alejandrina; Sánchez-Cruz, Juan Francisco; Cruz-Meléndez, José Ramses

    2015-01-01

    Supracondylar humerus fractures are common in children between 5-7 years of age and more frequent in the males, 90-95% of these fractures are in extension mechanism, the urgency of immediate attention is to prevent complications and sequelae. To establish the clinical and epidemiological profile of supracondylar humerus fractures, in a General Regional Hospital from the Instituto Mexicano del Seguro Social in Yucatan Mexico, during 2011-2013. A cross-sectional study. Strength association was measured by odds ratios and statistical significance with chi(2) test, p value was considered in < 0.05 RESULTS: 56 cases were analyzed, the mean age was 2.6 ± 5.33 years, the mechanism of injury was falling over at home, male gender is associated with extent injure mechanism (OR 5.6, 95% CI 1.0-30.1, p = 0.03), we observed that at most time elapsed between injury and medical means more hospital days (r = 0.40; p = 0.002), surgical treatment was established in 44 cases (78.6%), 18 (40.9%) with closed technique and placement of cloves and 26 (59.1%) with open reduction, in 100% cross configuration was used, ten complications were reported. Supracondylar humerus fractures are a common injury in children, males are more likely to be injured by extension, and the speed in medical treatment is an important issue. Copyright © 2015. Published by Masson Doyma México S.A.

  10. Human albumin use at hospitals in the Metropolitan Region of Rio de Janeiro, Brazil.

    Science.gov (United States)

    Matos, Guacira Corrêa de; Rozenfeld, Suely; Martins, Monica

    2010-05-01

    The study analyzes the use of human albumin in hospitals in Rio de Janeiro, Brazil, using inpatient data from the information system of Brazil's health system between 1999 and 2001. Death was the main outcome as patients died in 32% of admissions in which human albumin was used as compared with 4% of all admissions in the same period and region. The Charlson Comorbidity Index was included for risk adjustment. Human albumin was used in 10,111 in-patients more than 1 year old. 87,774 50-ml bottles of 20% human albumin were consumed at a cost of US$ 1,755. The main diagnoses were neoplasms (29.1%), diseases of the digestive system (17.5%) and circulatory system (16%). Death rate increased with age, public ownership of the hospital, clinical services (as opposed to surgical services), length of stay and use of intensive care. Death was associated with use of more than four bottles of human albumin (PR: 1.30; 99%CI: 1.23-1.37), adjusted for severity and speciality. The results are cause for concern as they may be related to poor compliance with guidelines, excess of risk to patients and unnecessary expenses for the public health system.

  11. Evaluation of the therapeutic use of antibiotics in Aegean Region hospitals of Turkey: A multicentric study

    Directory of Open Access Journals (Sweden)

    O Ozgenç

    2011-01-01

    Full Text Available Purpose: The antibiotic restriction policy has been validated nationwide since February 2003 by the Ministry of Health because the excessive consumption of antimicrobials causes a high cost. The aim of this study was to evaluate the therapeutic use of antibiotics in Aegean Region hospitals and to assess the impact of this nationwide antibiotic restriction policy. This new policy is based on justification that the infectious disease (ID physicians should be primarily responsible for the prescription of antimicrobials. Materials and Methods: Eight university and government hospitals were included in the study. The criteria of the Council for Appropriate and Rational Antibiotic Therapy (CARAT were considered. Both patient-based and antibiotic-based analyses were performed. For the analysis of inappropriate use, logistic regression was modeled. Results: Therapeutic use was determined in 540 patients by a total of 29 ID physicians.In the study, 30.2% of the patients were given antimicrobials and empirically started antibiotics accounted for 79% cases of therapeutic antibiotic use, and 60% of those were inappropriate (P = 0.001. The appropriate use of ID level antibiotics (P = 0.000 were very compatible with other antimicrobial groups. Conclusion: The study shows that the Turkish government′s new intervention policy on antimicrobial prescribing has been effective.

  12. Candidemia in a major regional tertiary referral hospital - epidemiology, practice patterns and outcomes.

    Science.gov (United States)

    Teo, Jocelyn Qi-Min; Candra, Samuel Rocky; Lee, Shannon Jing-Yi; Chia, Shannon Yu-Hng; Leck, Hui; Tan, Ai-Ling; Neo, Hui-Peng; Leow, Kenneth Wei-Liang; Cai, Yiying; Ee, Rachel Pui-Lai; Lim, Tze-Peng; Lee, Winnie; Kwa, Andrea Lay-Hoon

    2017-01-01

    Candidemia is a common cause of nosocomial bloodstream infections, resulting in high morbidity and mortality. This study was conducted to describe the epidemiology, species distribution, antifungal susceptibility patterns and outcomes of candidemia in a large regional tertiary referral hospital. A retrospective surveillance study of patients with candidemia was conducted at Singapore General Hospital between July 2012 and December 2015. In addition, incidence densities and species distribution of candidemia episodes were analysed from 2008 to 2015. In the period of 2012 to 2015, 261 candidemia episodes were identified. The overall incidence was 0.14/1000 inpatient-days. C. glabrata (31.4%), C. tropicalis (29.9%), and C. albicans (23.8%) were most commonly isolated. The incidence of C. glabrata significantly increased from 2008 to 2015 (Coefficient 0.004, confidence interval 0-0.007, p = 0.04). Fluconazole resistance was detected primarily in C. tropicalis (16.7%) and C. glabrata (7.2%). fks mutations were identified in one C. albicans and one C. tropicalis. Candidemia episodes caused by C. tropicalis were more commonly encountered in patients with haematological malignancies (p = 0.01), neutropenia (p Candidemia is associated with poor outcomes. Strategies optimising antifungal therapy, especially in the critically-ill population, should be explored.

  13. Absence of Pneumocystis dihydropteroate synthase mutants in Brittany, France.

    Science.gov (United States)

    Le Gal, Solène; Robert-Gangneux, Florence; Perrot, Maëla; Rouillé, Amélie; Virmaux, Michèle; Damiani, Céline; Totet, Anne; Gangneux, Jean-Pierre; Nevez, Gilles

    2013-05-01

    Archival Pneumocystis jirovecii specimens from 84 patients monitored at Rennes University Hospital (Rennes, France) were assayed at the dihydropteroate synthase (DHPS) locus. No patient was infected with mutants. The results provide additional data showing that P. jirovecii infections involving DHPS mutants do not represent a public health issue in Brittany, western France.

  14. [The computer assisted pacemaker clinic at the regional hospital of Udine (author's transl)].

    Science.gov (United States)

    Feruglio, G A; Lestuzzi, L; Carminati, D

    1978-01-01

    For a close follow-up of large groups of pacemaker patients and for evaluation of long term pacing on a reliable statistical basis, many pacemaker centers in the world are now using computer systems. A patient data system with structured display records, designed to give complete, comprehensive and surveyable information and which are immediately retrievable 24 hours a day, on display or printed sets, seems to offer an ideal solution. The pacemaker clinic at the Regional Hospital of Udine has adopted this type of system. The clinic in linked to a live, on-line patient data system (G/3, Informatica Friuli-Venezia Giulia). The input and retrieval of information are made through a conventional keyboard. The input formats have fixed headings with coded alternatives and a limited space for comments in free text. The computer edits the coded information to surveyable reviews. Searches can be made on coded information and data of interest.

  15. Quality of stroke care at an Irish Regional General Hospital and Stroke Rehabilitation Unit.

    LENUS (Irish Health Repository)

    Walsh, T

    2012-01-31

    BACKGROUND: Robust international data support the effectiveness of stroke unit (SU) care. Despite this, most stroke care in Ireland are provided outside of this setting. Limited data currently exist on the quality of care provided. AIM: The aim of this study is to examine the quality of care for patients with stroke in two care settings-Regional General Hospital (RGH) and Stroke Rehabilitation Unit (SRU). METHODS: A retrospective analysis of the stroke records of consecutive patients admitted to the SRU between May-November 2002 and April-November 2004 was performed applying the UK National Sentinel Audit of Stroke (NSAS) tool. RESULTS: The results of the study reveal that while SRU processes of care was 74% compliant with standards; compliance with stroke service organisational standards was only 15 and 43% in the RGH and SRU, respectively. CONCLUSION: The quality of stroke care in our area is deficient. Comprehensive reorganisation of stroke services is imperative.

  16. [Consultation per video-conferencing with regional hospitals: the MEDKOM project of the Hannover Medical University].

    Science.gov (United States)

    Link, H; Poliwoda, H

    1999-01-01

    Consultations between doctors are necessary tools for decisions in diagnosis and treatment of patients. The mainstay is a sound communication between the participants, using verbal and audio-visual means. Usually clinical findings and imaging results are included. Using video technology with ISDN (integrated services digital network), such consulting can be performed across any distance. The department of hematology and oncology of the Medical School Hanover has introduced such a system in 1989 for conferencing with 12 regional hospitals and two private practices. It is now a well recognized and established system being applied for 270 sessions and for 1100 Patients per year. It is an integrated part of the co-operation, also allows medical education and quality improvement.

  17. [Results of the treatment of open heart injuries at a central regional hospital].

    Science.gov (United States)

    Segida, V F; Efremov, N I; Chernov, A I

    1994-09-01

    In a period of 10 years seven patients with open injury to the heart were treated. Their ages ranged from 17 to 39 years. One patient had a gunshot injury, in six the injury was inflicted with a knife. In three patients the injuries were combined (concurrent injury to the lung in 2 and to the diaphragm in one) and in four isolated. Perforating injury of both ventricles and damage of the interventricular septum were found in one case. All patients underwent emergency closure of the heart wounds with an atraumatic synthetic thread and drainage of the pleural cavity. Complications developed in the postoperative period in six patients: suppuration of the operative wound in one and pericarditis in five. One patient died. Analysis of the obtained data testifies to the expediency of two-stage treatment with rehabilitation in cardiological departments. This shortens the period of rehabilitation of patients with open injuries to the heart treated in a central regional hospital.

  18. Specialized consultant in radiological safety to the Salamanca regional hospital, PEMEX. VI. - December of 2001; Asesoria especializada en seguridad radiologica al hospital regional Salamanca, 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

    2002-01-15

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

  19. Specialized consultant in radiological safety to the Salamanca regional hospital, PEMEX. IV. - October of 2001; Asesoria especializada en seguridad radiologica al hospital regional Salamanca, 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 Salamanca regional hospital, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  20. Specialized consultant in radiological safety to the Villahermosa regional hospital, PEMEX. IV. - November and December of 2002; Asesoria especializada en seguridad radiologica al Villahermosa hospital regional, PEMEX, IV.- Noviembre y Diciembre de 2002

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Hernandez C, J.E.; Rodriguez A, F.; Garcia A, J

    2003-02-15

    The Villahermosa regional hospital, 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)

  1. Specialized consultant in radiological safety to the Salamanca regional hospital, PEMEX. III. - September of 2001; Asesoria especializada en seguridad radiologica al hospital regional Salamanca, PEMEX. III.- Septiembre 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 Salamanca regional hospital, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  2. Specialized consultant in radiological safety to the Salamanca regional hospital, PEMEX. I. - July of 2001; Asesoria especializada en seguridad radiologica al hospital regional Salamanca, PEMEX. I.- Julio de 2001

    Energy Technology Data Exchange (ETDEWEB)

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

    2001-09-15

    The Salamanca regional hospital, 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)

  3. Specialized consultant in radiological safety to the Villahermosa regional hospital, PEMEX. III. - September and October of 2002; Asesoria especializada en seguridad radiologica al hospital regional Villahermosa, PEMEX, III.- Septiembre y Octubre de 2002

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Rodriguez A, F.; Garcia A, J

    2003-02-15

    The Villahermosa regional hospital, 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 radiolpogic 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)

  4. Specialized consultant in radiological safety to the Salamanca regional hospital, PEMEX. II. - August of 2001; Asesoria especializada en seguridad radiologica al hospital regional Salamanca, PEMEX. II.- Agosto 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 Salamanca regional hospital, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  5. Specialized consultant in radiological safety to the Salamanca regional hospital, PEMEX. V. - November of 2001; Asesoria especializada en seguridad radiologica al hospital regional Salamanca, 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 Salamanca regional hospital, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  6. Informe: Los hospitales de día intramuros para enfermos mentales en Francia Day-care hospitals for mental patients in France.

    Directory of Open Access Journals (Sweden)

    R Martínez

    1991-01-01

    Full Text Available Los hospitales de día intramuros ocupan un lugar predominante en el abanico de la asistencia psiquiátrica en Francia.
    Fueron concebidos como estructuras intermedias encaminadas a favorecer la desactivación de ese proceso inexorable, que es la cronificación de los pacientes en psiquiatría.
    Su misión primordial es la de preparar y favorecer la reinserción de los pacientes psiquiátricos procedentes del hospital, sin olvidar la dependencia adquirida por el enfermo respecto a la institución durante sus, a menudo, largas estancias en el medio psiquiátrico.

  7. Neglected roots of regionalism? The Commissioners for the special areas and grants to hospital services in the 1930s.

    Science.gov (United States)

    Mohan, J

    1997-08-01

    The inter-war years in the UK were notable for debates about the extent to which an extension of state intervention in hospital provision was desirable and necessary, and about the limits to and future of the voluntary hospital system which relied largely on various forms of private charity. These themes were intertwined in the UK's 'Special Areas', locations recognized as having suffered adversely from the inter-war depression, with consequent effects on their ability to finance desirable investments in social infrastructures. Grant aid was offered to hospitals in these locations under the terms of the Special Areas legislation of 1934, but there were extensive debates about the principle and practice of such subsidies to hospital development. This paper reviews these debates and considers whether the measures taken by the Commissioners can be seen as neglected antecedents of the regionalism detected in British hospital policy by several commentators.

  8. Melanoma in the Italian Population and Regional Environmental Influences: A National Retrospective Survey on 2001–2008 Hospitalization Records

    OpenAIRE

    Prisco Piscitelli; Cosimo Neglia; Andrea Falco; Matteo Rivezzi; Nadia Agnello; Alberto Argentiero; Giovanna Chitano; Chiara Distante; Giulia Della Rosa; Giorgia Vinci; Antonella De Donno; Alessandro Distante; Antonella Romanini

    2015-01-01

    Objective: To assess the burden of regional environmental factors influencing the incidence of Melanoma in the Italian population and overcome the problem of partial population coverage by local cancer registries and thematic archives. Methods: We analyzed the Italian national hospitalization records from 2001 to 2008 provided by the Ministry of Health, excluding hospital re-admissions of the same patients, in order to assess the occurrence of Melanoma over a 8-year period. Data were presente...

  9. Clarification of the antecedents of hospital nurse organizational citizenship behavior -- an example from a Taiwan regional hospital.

    Science.gov (United States)

    Chu, Cheng-I; Lee, Ming-Shinn; Hsu, Hsiang-Ming; Chen, I-Chi

    2005-12-01

    Organizational citizenship behaviors (OCB) are deemed indispensable due to their importance in promoting positive relationships among employees and involving employees in the organization's activities. OCB is believed to facilitate attainment of a hospital's goals and enhance a hospital's performance. The aim of this study is to extend the work of previous studies by providing an integrated model of OCB and demonstrate its applicability in a non-Western culture. Questionnaires were completed by 314 non-supervisory hospital nurses, each of whom was given a supervisor rating for their OCB. Exploratory factor analysis was used to assess the convergent and discriminant validity of the variables in the model. Multiple regression analysis was used because it provided estimates of net effects and explanatory power. The results showed that job satisfaction, supervisor support, job involvement, and procedural justices had significant effects on the nurses' citizenship behaviors. Since the study used a non-Western site in one of Taiwan's health care institutions, its overall findings should contribute to further understanding of the cross-cultural aspects of OCB.

  10. Prevalencia de quistes odontogénicos: Hospital Regional Valdivia entre los años 1990 y 2010 Prevalence of odontogenic cysts: Hospital Regional Valdivia, between years 1990-2010

    OpenAIRE

    F.I. Peters; G.P. López; E.G. Preisler; C.C. Sotomayor; Z.M. Donoso; V.S. Hernández

    2012-01-01

    Objetivo: Determinar la prevalencia de quistes odontogénicos en población atendida en el Hospital Regional Valdivia, en el periodo entre 1990-2010, según la última clasificación de lesiones quísticas de la Organización Mundial de la Salud (OMS), 2005. Esta investigación corresponde a un estudio descriptivo de corte transversal censal. Metodología: Se revisaron informes de biopsias del Hospital Regional Valdivia (HRV), durante un periodo de 20 años (1990-2010),seleccionando los informes con di...

  11. [Decreased hospital spending as a result of antibiotic prescriptions dispensed in community pharmacies. Results from the Midi-Pyrenees region.].

    Science.gov (United States)

    Gallini, Adeline; Taboulet, Florence

    2010-01-01

    A contract between French hospitals and national health authorities was signed in early 2006 to improve the rational use of antibiotics in hospitals. The contract offers a financial reward in the event of decreased spending as a result of hospital prescriptions dispensed in community pharmacies compared to the previous year. The article describes the limitations relating to the financial rewards defined by the contract, particularly those concerning the measurement and relevance of the chosen indicator. Since no national data are currently available, quantitative results drawn from the Midi-Pyrénées region are used to illustrate the analysis.

  12. Morbidade Materna Grave e Near Misses em Hospital de Referência Regional

    Directory of Open Access Journals (Sweden)

    Márcia Lait Morse

    Full Text Available OBJETIVO: Analisar perfil epidemiológico da morbidade materna grave/near miss em uma maternidade pública de referência regional, utilizando diferentes critérios identificadores. MÉTODOS: Trata-se de um estudo descritivo de corte transversal dos casos de morbidade materna grave/near miss realizado em Hospital de referência regional entre junho e outubro de 2009, identificados a partir dos livros de registro de internação da maternidade e análise dos prontuários clínicos. Foram estudadas mulheres que, durante a gestação, parto ou puerpério, apresentaram qualquer quadro clínico compatível com os critérios definidores de morbidade materna grave/near miss de Waterstone et al., Mantel et al. e Organização Mundial de Saúde. RESULTADOS: Entre as 1.544 internações foram identificadas 89 mulheres com morbidade materna grave, considerando os critérios adotados. As razões de morbidade materna grave/near miss variaram entre 81,4 a 9,4 por 1.000 NV, dependendo do critério utilizado. O índice de Mortalidade foi de 3,2%, chegando a 23% no critério da OMS. Das 89 mulheres, apenas 40% fizeram mais de seis consultas de pré-natal e 10% não realizaram qualquer consulta. Os marcadores mais encontrados foram a pré-eclâmpsia grave seguida de hemorragia grave, internação em UTI, Síndrome HELLP e eclâmpsia. Ocorreram três mortes maternas por causas obstétricas com RMM de 280/100.000 NV e uma morte tardia. O critério da OMS se mostrou mais específico, identificando os casos mais graves, enquanto o de Waterstone foi mais sensível. CONCLUSÃO: O estudo da morbidade materna grave/near miss em um hospital de referência regional pode contribuir para o conhecimento da magnitude deste evento, como também identificar suas características e condições clínicas mais frequentes, sendo extremamente importante para o enfrentamento da morbi-mortalidade materna.

  13. Prevalence study of nosocomial infections in a north-Bari region hospital in the years 2007-2010

    Directory of Open Access Journals (Sweden)

    Tito Del Gaudio

    2012-09-01

    Full Text Available Nosocomial infections, arising from complications during hospital treatment, represent one of the most important cause of disease. The Andria hospital has initiated a prevalence study, as a part of a general program promoted by the “Agenzia Regionale per la Sanità” (Regional Health Board of Regione Puglia. Samples were collected from patients hospitalized in the period 2007 - 2010. Risk factors, ongoing infections, selected antibiotic therapy, site of infection, microorganism types, as well as patient’s clinic and personal data, were all elements taken into account. The study shows that nosocomial infections, due to different health care related risk factors, are most frequently encountered in Intensive Care Units. A poor adhesion to the Regione Puglia antibiotic prophylaxis guidelines was observed in surgery. An insufficient use of cultural methods to confirm/diagnose the presence of bacterial infections was also observed; this fact could lead to underestimate the incidence of nosocomial infections.

  14. Morbidade Materna Grave e Near Misses em Hospital de Referência Regional

    Directory of Open Access Journals (Sweden)

    Márcia Lait Morse

    2011-06-01

    Full Text Available OBJETIVO: Analisar perfil epidemiológico da morbidade materna grave/near miss em uma maternidade pública de referência regional, utilizando diferentes critérios identificadores. MÉTODOS: Trata-se de um estudo descritivo de corte transversal dos casos de morbidade materna grave/near miss realizado em Hospital de referência regional entre junho e outubro de 2009, identificados a partir dos livros de registro de internação da maternidade e análise dos prontuários clínicos. Foram estudadas mulheres que, durante a gestação, parto ou puerpério, apresentaram qualquer quadro clínico compatível com os critérios definidores de morbidade materna grave/near miss de Waterstone et al., Mantel et al. e Organização Mundial de Saúde. RESULTADOS: Entre as 1.544 internações foram identificadas 89 mulheres com morbidade materna grave, considerando os critérios adotados. As razões de morbidade materna grave/near miss variaram entre 81,4 a 9,4 por 1.000 NV, dependendo do critério utilizado. O índice de Mortalidade foi de 3,2%, chegando a 23% no critério da OMS. Das 89 mulheres, apenas 40% fizeram mais de seis consultas de pré-natal e 10% não realizaram qualquer consulta. Os marcadores mais encontrados foram a pré-eclâmpsia grave seguida de hemorragia grave, internação em UTI, Síndrome HELLP e eclâmpsia. Ocorreram três mortes maternas por causas obstétricas com RMM de 280/100.000 NV e uma morte tardia. O critério da OMS se mostrou mais específico, identificando os casos mais graves, enquanto o de Waterstone foi mais sensível. CONCLUSÃO: O estudo da morbidade materna grave/near miss em um hospital de referência regional pode contribuir para o conhecimento da magnitude deste evento, como também identificar suas características e condições clínicas mais frequentes, sendo extremamente importante para o enfrentamento da morbi-mortalidade materna.OBJECTIVE: To investigate severe maternal morbidity/near misses in a tertiary

  15. Obstetric anaesthesia at district and regional hospitals in KwaZulu ...

    African Journals Online (AJOL)

    ... in KwaZulu-Natal: human resources, caseloads and the experience of doctors. ... Only 3% of responding doctors working in rural hospitals had a Diploma in ... in obstetric anaesthesia and documents workload patterns at district hospitals.

  16. A démarche stratégique (gestão estratégica hospitalar: um instrumento de coordenação da prática hospitalar baseado nos custos de oportunidade e na solidariedade The hospital strategic management: one regional coordination mean of hospital practice based on opportunity costs and solidarity

    Directory of Open Access Journals (Sweden)

    Elizabeth Artmann

    2003-01-01

    Full Text Available Este texto é uma apresentação geral da metodologia de gestão estratégica hospitalar de M. Crémadez e F. Grateau (França, incluindo os objetivos, as fases e as principais ferramentas do enfoque. O trabalho destaca os aspectos microeconômicos do mesmo e suas possibilidades para estruturar redes de serviços através da pactuação de metas e objetivos entre hospitais. Inclui a apresentação de um caso de aplicação do enfoque como instrumento de coordenação regional da especialidade de cirurgia geral dos hospitais de uma área programática (AP-4 da cidade do Rio de Janeiro.This text is a general presentation of the hospital strategic management methodology elaborated by M. Crémadez and F. Grateau (France, including the goals, phases and main tools of the approach. The work takes into account the microeconomic aspects of the methodology and its potentials to stucture health care networks based on negotiation of hospitals goals. The text includes the presentation of one experience of implementation of the approach as a regional coordination mean applied by general surgery discipline of programatic area (AP-4 hospitals of Rio de Janeiro city.

  17. Quality of bowel cleansing in hospitalized patients undergoing colonoscopy: A multicentre prospective regional study.

    Science.gov (United States)

    Rotondano, Gianluca; Rispo, Antonio; Bottiglieri, Maria E; De Luca, Leonardo; Lamanda, Roberto; Orsini, Luigi; Bruzzese, Dario; Galloro, Giuseppe; Romano, Marco; Miranda, Agnese; Loguercio, Carmelina; Esposito, Pasquale; Nardone, Gerardo; Compare, Debora; Magno, Luca; Ruggiero, Simona; Imperatore, Nicola; De Palma, Giovanni D; Gennarelli, Nicola; Cuomo, Rosario; Passananti, Valentina; Cirillo, Michele; Cattaneo, Domenico; Bozzi, Rosa Maria; D'Angelo, Valentina; Marone, Piero; Riccio, Elisabetta; De Nucci, Claudio; Monastra, Santo; Caravelli, Giancarlo; Verde, Clelia; Di Giorgio, Pietro; Giannattasio, Francesco; Capece, Giuseppe; Taranto, Domenico; De Seta, Massimiliano; Spinosa, Giuseppe; De Stefano, Salvatore; Familiari, Valeria; Cipolletta, Livio; Bianco, Maria Antonia; Sansone, Stefano; Galasso, Giovanni; De Colibus, Patrizia; Romano, Maurizio; Borgheresi, Patrizia; Ricco, Giovanni; Martorano, Marco; Gravina, Antonietta Gerarda; Marmo, Riccardo; Rea, Matilde; Maurano, Attilio; Labianca, Orazio; Colantuoni, Enrico; Iuliano, Donato; Trovato, Claudio; Fontana, Aldo; Pasquale, Luigi; Morante, Aristide; Perugini, Bruno; Scaglione, Giuseppe; Mauro, Biagio

    2015-08-01

    Quality of bowel cleansing in hospitalized patients undergoing colonoscopy is often unsatisfactory. No study has investigated the inpatient or outpatient setting as cause of inadequate cleansing. To assess degree of bowel cleansing in inpatients and outpatients and to identify possible predictors of poor bowel preparation in the two populations. Prospective multicentre study on consecutive colonoscopies in 25 regional endoscopy units. Univariate and multivariate analysis with odds ratio estimation were performed. Data from 3276 colonoscopies were analyzed (2178 outpatients, 1098 inpatients). Incomplete colonoscopy due to inadequate cleansing was recorded in 369 patients (11.2%). There was no significant difference in bowel cleansing rates between in- and outpatients in both colonic segments. In the overall population, independent predictors of inadequate cleansing both at the level of right and left colon were: male gender (odds ratio, 1.20 [1.02-1.43] and 1.27 [1.05-1.53]), diabetes mellitus (odds ratio, 2.35 [1.68-3.29] and 2.12 [1.47-3.05]), chronic constipation (odds ratio, 1.60 [1.30-1.97] and 1.55 [1.23-1.94]), incomplete purge intake (odds ratio, 2.36 [1.90-2.94] and 2.11 [1.68-2.65]) and a runway time >12h (odds ratio, 3.36 [2.40-4.72] and 2.53 [1.74-3.67]). We found no difference in the rate of inadequate bowel preparation between hospitalized patients and outpatients. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  18. From grass to grace: How SLMTA revolutionised the Bamenda Regional Hospital Laboratory in Cameroon

    Directory of Open Access Journals (Sweden)

    Siyem C. Nkwawir

    2014-09-01

    Full Text Available Background: Public health laboratories form the foundation on which today’s clinical laboratory practice in Cameroon is built. The advent of the Strengthening Laboratory Management Toward Accreditation (SLMTA programme in 2009 empowered the Bamenda Regional Hospital Laboratory (BRHL to improve its working culture, practices and management.Objectives: To evaluate the results of SLMTA implementation at BRHL and discuss lessons learned.Method: In 2010, the SLMTA programme was rolled out in Cameroon to improve laboratory quality management systems in five laboratories, including BRHL. Three workshops were conducted (the first centralised, the remaining two on-site at each laboratory and improvement projects were implemented after each workshop with the assistance of mentors. Audits were used in order to evaluate performance and to identify areas for further improvement.Results: BRHL had the lowest score (18% amongst the cohort at the baseline audit and the highest (81% at the official Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA audit conducted in August 2013 by the African Society for Laboratory Medicine. Improvements were observed in each of the 12 Quality System Essentials; improvement was especially noteworthy in the areas of facilities and safety, and purchasing and inventory. Staff investment and pride in the quality of laboratory services increased.Conclusion: BRHL’s remarkable improvement was achieved with a combination of SLMTA training activities, intensive on-site mentorship and the collective focus of all laboratory staff. The experience at Bamenda Hospital illustrates what can be achieved when a laboratory successfully harnesses the energy of its staff and implements changes to improve the quality of services in a transformation taking them from grass to grace.

  19. Regional and supraregional biochemistry services in Scotland: a survey of hospital laboratory users.

    Science.gov (United States)

    Murphy, M J; Dryburgh, F J; Shepherd, J

    1994-05-01

    To ascertain the views of Scottish hospital laboratory users on aspects of regional and supraregional biochemical services offered by the Institute of Biochemistry at Glasgow Royal Infirmary. A questionnaire was circulated asking questions or inviting opinions under various headings, including current patterns of usage of the services provided, availability of information on specimen collection requirements and reference ranges, current arrangements for transport of specimens, turnaround times for delivery of reports, layout and content of request and report forms, quantity and quality of interpretive advice, potential changes in laboratory services, and overall impression of the services provided. Opportunities were provided for free text comment. The questionnaire was circulated in 1992 to heads of department in 23 Scottish hospital biochemistry laboratories. Twenty one replies were received. Services used widely included trace metals/vitamins (n = 20) and specialised endocrine tests (n = 19). Other services also used included specialised lipid tests (n = 13), toxicology (n = 12), thyroid function tests (n = nine), and tumour markers (n = eight). Fifteen laboratories used one or more of the services at least weekly. Most (n = 20) welcomed the idea of a handbook providing information on specimen collection and reference ranges. Nine identified loss of specimens as a problem. Other perceived problems included the absence of reference ranges from report forms, quantity and quality of interpretive advice, and turnaround times of some tests. Overall impressions of the service(s) offered were very good (n = 12); adequate (n = seven); poor (n = one). Useful information was obtained about patterns of use and transport arrangements. Areas identified as requiring follow up included provision of information, alternative ways of communicating reports, and improvement in quantity and quality of interpretive advice.

  20. Sharps injuries among nurses in a Thai regional hospital: prevalence and risk factors.

    Science.gov (United States)

    Honda, M; Chompikul, J; Rattanapan, C; Wood, G; Klungboonkrong, S

    2011-10-01

    Sharps injuries (SIs) are one of the most serious occupational accidents among nurses due to the possible severe consequences, such as the transmission of infectious diseases and inducing of mental impairment. To discover the prevalence of SIs among nurses in a regional hospital in Thailand and to identify factors associated with SIs. A cross-sectional study was conducted in 2011. Stratified random sampling was used to select the respondents, with wards as the strata and the number of nurses selected proportional to the size of the ward nurse population. 261 self-administered questionnaires were distributed to nurses who used needles, syringes or other sharp medical equipment in their work. Data were analyzed using chi-square tests, correlation analysis and multiple logistic regression analysis. The prevalence of SIs for the previous 12 months was 55.5% among the 250 nurses who returned a completed questionnaire. Of these, 91.1% were with blood. Needles (52.8%) were the main cause of SIs. The reporting rate of SIs to the hospital was 23.8%. SIs had a significant association with each of marital status, work duration, work department, attitude regarding SI prevention, and preventive management. Using multiple logistic regression analysis, attitude was found to be the strongest predictor of SIs when adjusted for other factors. Nurses who had negative attitudes towards prevention of SIs were nearly two times more likely to have SIs than those with positive attitudes (adjusted odds ratio = 1.86; 95% CI: 1.03-3.38). The study showed a high prevalence of SIs, but a low reporting rate. This suggests the reporting system requires simplification and also should include a quick response management component. Promoting positive attitudes to SI prevention, and improving the reporting system would reduce SIs.

  1. Sharps Injuries among Nurses in a Thai Regional Hospital: Prevalence and Risk Factors

    Directory of Open Access Journals (Sweden)

    S Klungboonkrong

    2011-09-01

    Full Text Available Background: Sharps injuries (SIs are one of the most serious occupational accidents among nurses due to the possible severe consequences, such as the transmission of infectious diseases and inducing of mental impairment.Objective: To discover the prevalence of SIs among nurses in a regional hospital in Thailand and to identify factors associated with SIs.Methods: A cross-sectional study was conducted in 2011. Stratified random sampling was used to select the respondents, with wards as the strata and the number of nurses selected proportional to the size of the ward nurse population. 261 self-administered questionnaires were distributed to nurses who used needles, syringes or other sharp medical equipment in their work. Data were analyzed using chi-square tests, correlation analysis and multiple logistic regression analysis.Results: The prevalence of SIs for the previous 12 months was 55.5% among the 250 nurses who returned a completed questionnaire. Of these, 91.1% were with blood. Needles (52.8% were the main cause of SIs. The reporting rate of SIs to the hospital was 23.8%. SIs had a significant association with each of marital status, work duration, work department, attitude regarding SI prevention, and preventive management. Using multiple logistic regression analysis, attitude was found to be the strongest predictor of SIs when adjusted for other factors. Nurses who had negative attitudes towards prevention of SIs were nearly two times more likely to have SIs than those with positive attitudes (adjusted odds ratio=1.86; 95% CI: 1.03–3.38.Conclusion: The study showed a high prevalence of SIs, but a low reporting rate. This suggests the reporting system requires simplification and also should include a quick response management component. Promoting positive attitudes to SI prevention, and improving the reporting system would reduce SIs.

  2. [Incidence of Modic degenerative changes in patients with chronic lumbar pain at Monterrey Regional ISSSTE Hospital].

    Science.gov (United States)

    Villarreal-Arroyo, M; Mejia-Herrera, J C; Larios-Forte, M C

    2012-01-01

    Several papers have studied the degenerative changes of endplates, but there are no publications referring to the Mexican population. The purpose of the study is to report the incidence of Modic degenerative changes in the patients seen at the Spine Service, Monterrey Regional ISSSTE Hospital. Specific objectives are: to describe the type of Modic change and the most frequent location, to describe the degeneration patterns and to report the incidence of the various diagnoses made during 2009. Incidence study using the MRI records at the Radiology Department, Monterrey Regional ISSSTE Hospital, interpreted blindly and independently by two observers. A total of 240 lumbar spine MRIs were reviewed, for a total of 1,200 intervertebral spaces. They were divided by age groups. Group I included 16 patients, Group II 32, Group III 80, and Group IV 112. No patients in Group I had Modic changes. Four patients (12.5%) in Group II had type II Modic changes with 25% involvement of L4-L5 (10%); 32% of Group IV patients had changes, with L5-S1 as the most affected level. Most Modic changes (85%) were located in L4-L5 and L5-S1, with the latter as the most frequently affected level. Type I represented 5%, Type II 30%, and Type III 65%. The percentage of patients with Modic changes increased with age, which confirms that degenerative changes are age related. Morphologic disc changes are expressed as the percentage of affected patients in each group. Besides the severity of degeneration, the number of affected levels also increases with age. Thirty percent of patients ages 30-39 years have one or two degenerated levels, while 50% of those over age 50 have 3 or more degenerated levels. The most frequently degenerated level was L5-S1, followed by L4-L5 and L3-L4. The most frequent degeneration pattern was lower segment degeneration (L4-L5, L5-S1). A small proportion of patients over age 50 (4%) did not have disc degeneration, suggesting that age is not the only factor that determines

  3. Differential impact of parental region of birth on negative parenting behavior and its effects on child mental health: Results from a large sample of 6 to 11 year old school children in France.

    Science.gov (United States)

    Kovess-Masfety, Viviane; Husky, Mathilde; Pitrou, Isabelle; Fermanian, Christophe; Shojaei, Taraneh; Chee, Christine Chan; Siddiqi, Arjumand; Beiser, Morton

    2016-05-04

    In France, one in 10 residents has immigrated mainly from North Africa, West Africa or the Caribbean including the French West Indies. However little is known about how parents from these regions behave when they migrate to countries that have different cultural norms. It is therefore important to determine how ethno-cultural background affects parental behavior and subsequent child mental health in the context of immigration. The objectives are: 1) to compare negative parenting behaviors of French residents from diverse ethno-cultural backgrounds 2) to examine the relationship between parental region of origin and child mental health, and 3) to investigate the extent to which ethno-cultural context moderates the effect of parenting styles on child mental health. A cross-sectional study was conducted in 2005 in 100 schools in South-East France. The Dominic Interactive and the parent-reported Strengths and Difficulties Questionnaire were used to assess child psychopathology. The Parent Behavior and Attitude Questionnaire was used to assess parenting styles. The final sample included data on 1,106 mother and child dyads. Caring and punitive attitudes were significantly different across mothers as a function of region of origin. This association was stronger for punitive attitudes with the highest prevalence in the Caribbean/African group, while mothers from Maghreb were more similar to French natives. Differences in caring behaviors were similar though less pronounced. Among children of Maghrebian descent, punitive parenting was associated with an increased risk of internalizing disorders while this association was weaker among children of African and Afro-Caribbean descent. Parental region of origin is an important component of both parenting styles and their effect on child mental health. Interventions on parenting should consider both the region of origin and the differential impact of origin on the effect of parenting styles, thus allowing for a finer

  4. France at CERN

    CERN Document Server

    2001-01-01

    From 19 to 22 June, for the 8th edition of France at CERN, 31 French companies presented their latest technology to the Laboratory. Demonstrating the latest in French technology during France at CERN. The France at CERN exhibition was inaugurated by Mr. Bernard Frois, Director of the Department Energy, Transport, Environment and Natural Resources at the Technology Directorate of the Ministry of Research. 'France is happy to be a Member of CERN, which is a successful example of the construction of scientific Europe,' he declared during the inauguration, 'this exhibition is an excellent opportunity to put fundamental research and advanced technology in contact.' Mr. Philippe Petit, French Ambassador to Switzerland, and Mr. Alexandre Defay, technical adviser of the Minister of Research, were also present to represent France and its industry. Representing CERN at the 19 June opening of the exhibition was Claude Detraz, who said, 'I hope that this exhibition will make it possible to weave stronger links between ...

  5. Under-reporting of notifiable infectious disease hospitalizations in a health board region in Ireland: room for improvement?

    LENUS (Irish Health Repository)

    Brabazon, E D

    2008-02-01

    Rapid notification of infectious diseases is essential for prompt public health action and for monitoring of these diseases in the Irish population at both a local and national level. Anecdotal evidence suggests, however, that the occurrence of notifiable infectious diseases is seriously underestimated. This study aims to assess the level of hospitalization for notifiable infectious diseases for a 6-year period in one health board region in Ireland and to assess whether or not there was any under-reporting during this period. All hospital in-patient admissions from 1997 to 2002 inclusive with a principal diagnosis relating to \\'infectious and parasitic diseases\\' (ICD codes 001-139) of residents from a health board region in Ireland were extracted from the Hospital In-Patient Enquiry System (HIPE). All notifiable infectious diseases were identified based on the 1981 Irish Infectious Disease Regulations and the data were analysed in the statistical package, JMP. These data were compared with the corresponding notification data. Analysis of the hospital in-patient admission data revealed a substantial burden associated with notifiable infectious diseases in this health board region: there were 2758 hospitalizations by 2454 residents, 17,034 bed days and 33 deaths. The statutory notification data comprises both general practitioner and hospital clinician reports of infectious disease. Therefore, only in cases where there are more hospitalizations than notifications can under-reporting be demonstrated. This occurred in nine out of 22 notifiable diseases and amounted to an additional 18% of notifications (or 572 cases) which were \\'missed\\' due to hospital clinician under-reporting. The majority of these under-reported cases were for viral meningitis (45%), infectious mononucleosis (27%), viral hepatitis C unspecified (15%) and acute encephalitis (5.8%). This study has highlighted the extent of under-reporting of hospitalized notifiable infectious diseases, in a

  6. Morbimortalidad neonatal durante seis meses en un hospital regional en Ghana

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    María Caridad Corría Santos

    2014-08-01

    Full Text Available Se realizó un trabajo descriptivo de corte transversal sobre la morbimortalidad en la unidad de cuidados intensivos neonatales del Hospital Regional Sunyani de Ghana, en un periodo de seis meses, desde agosto de 2009 hasta enero de 2010, con el objetivo de determinar el comportamiento de la morbimortalidad de 170 neonatos, que necesitaron de estos servicios en el periodo estudiado. Se revisaron las entidades o eventos clínicos definidos y diagnosticados al egreso, así como la cantidad de pacientes que sobrevivieron y los fallecidos. Los datos fueron obtenidos de historias clínicas y el libro de registro del referido servicio. Los resultados se presentaron en tablas y mediante el empleo de la estadística porcentual. La prematuridad estuvo presente en 89 pacientes (52%, seguido de la asfixia, en 51 (30% y de la sepsis neonatal, en 46 (27%. Fallecieron 33 neonatos (19,4% y sobrevivieron 137 (80,6%. Las entidades clínicas más frecuentes en los fallecidos fueron: prematuridad en 21 pacientes (63%, asfixia perinatal en 19 neonatos (57,6% y la sepsis en 9 (27,3%. Un paciente falleció (0,6% con diagnóstico de tétanos neonatal. La letalidad y la sobrevida se comportaron como en la generalidad de los países en vías de desarrollo

  7. Misoprostol for treatment of incomplete abortion at the regional hospital level: results from Tanzania.

    Science.gov (United States)

    Shwekerela, B; Kalumuna, R; Kipingili, R; Mashaka, N; Westheimer, E; Clark, W; Winikoff, B

    2007-11-01

    To investigate the safety, efficacy, and acceptability of misoprostol versus manual vacuum aspiration (MVA) for treatment of incomplete abortion. A prospective open-label randomised trial. Kagera Regional Hospital, Bukoba, Tanzania. Three hundred women with a clinical diagnosis of incomplete abortion and a uterine size misoprostol or MVA. If abortion was clinically complete at 7-day follow up, the woman was released from the study. If it was still incomplete, the woman was offered the choice of an additional 1-week follow up or immediate MVA. Cases still incomplete after a further week were offered MVA. Incidence of successful abortion (success defined as no secondary surgical intervention provided), incidence of adverse effects, patient satisfaction. Success was very high in both arms (misoprostol: 99%; MVA: 100%; difference not significant). Most adverse effects were higher in the misoprostol arm, although the mean pain score was higher in the MVA arm (3.0 versus 3.5; P misoprostol (75%) than with MVA (55%, P = 0.001), and a higher proportion of women in the misoprostol arm said that they would recommend the treatment to a friend (95% versus 75%, P Misoprostol is as effective as MVA at treating incomplete abortion at uterine size of misoprostol appears higher. Given the many practical advantages of misoprostol over MVA in low-resource settings, misoprostol should be more widely available for treatment of incomplete abortion in the developing world.

  8. Capnocytophaga canimorsus sepsis: two clinical cases at the Bolzano Regional Hospital

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    Patrizia Innocenti

    2010-12-01

    Full Text Available Capnocytophaga canimorsus is a commensal bacterium in the oral cavity of dogs and cats and has been isolated from humans with a history of dog or cat bites or scratches. C. canimorsus are capnophilic facultative anaerobic, fastidious gram negative fusiform rods, included in the CDC group DF-2 or dysgonic fermenter 2. The bacterium can cause severe illness in patients at elevated risk i.e. after splenectomy, with alcohol addiction, chronic lung or liver diseases or immunosuppression. In 2010 at the Bolzano Regional Hospital (Northern-Italy C. canimorsus was isolated from blood cultures in two splenectomised patients suffering from septicaemia.The bacterium is difficult to cultivate because of its specific requirements for nutrients as well as to identify with routine automated instruments; therefore we used molecular typing by 16S rDNA sequencing.The true number of C. canimorsus infections is probably underestimated due to the fastidious growth of the organism. However, given the severity of the disease and the poor outcome one should consider this bacterium to apply appropriate diagnostic methods for this etiologic agent.

  9. Knowledge, Skills and Competencies of Hospitality Companies in the South Moravian Region

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    Klapalova Alena

    2013-06-01

    Full Text Available In 2009, a survey focused on barriers to entrepreneurship among managers and/or owners of companies in the hospitality industry in the South Moravian Region was carried out (Klapalová,2011 at the College of Business and Hotel Management in Brno. Results of this survey revealed that knowledge together with skills and competencies was considered to be the biggest barrier to sustainable successful entrepreneurship of these companies and this perception wasalso confirmed by Spearman’s correlations analysis with statistically significant coefficient at the 0.05 level (Spearman’s rho=0.214, p=0.18, when analyzing the relation to financial performanceof companies. The issue of knowledge was not investigated deeper in the survey but it raised several questions for further research. This paper offers preliminary and partial results of an inquiry done during the autumn and winter 2011 and spring and summer 2012 which takes up the previous survey from 2009 with the aim to explore the types of knowledge, skills and competencies perceived as the most important for company success and as the most missing in nowadays entrepreneurship of inquired companies. Three relationships of knowledge categories were analysed: relation to the age and size of companies and relation to the indicators of financial performance. The findings have several managerial implications, both for business practice and educational organisations.

  10. The Benefits of Streamlined Hip Fracture Management in a Regional Hospital.

    Science.gov (United States)

    Mow, T C; Lukeis, Jen; Sutherland, A G

    2017-06-01

    Hip fracture is an increasingly common injury in the growing elderly population. The morbidity and mortality associated with this injury can be reduced by minimizing delays to surgical treatment. We describe the impact of a regional hospital service redesign project that utilized the principles of smart simplicity, a management strategy that lays emphasis on collaboration to achieve desired goals. Prior to the redesign, patients with hip fractures were taking an average of 72 hours for surgical treatment. A hip fracture working group was created to examine closely the process of hip fracture care, and a single key performance indicator (KPI) of "surgery within 48 hours" was adopted. This allowed identification of processes that could be clarified and streamlined, with the agreement of relevant stakeholders, in the creation of a new hip fracture pathway. In the first 3 months of the pathway's implementation, 16 of 18 patients had surgery within 48 hours of presentation. In a 6-month follow-up audit after 2 years of implementation, 36 of 39 patients were treated within 48 hours. This was significantly different to the time to surgery seen in the 12 months prior to the redesign (P KPI has allowed a significant culture shift in the treatment of hip fractures in our institution in the months following its institution. Collaborative, multidisciplinary collaboration has facilitated a higher standard of care and demonstrated significant cost benefit.

  11. Barriers to adherence to antiretroviral treatment in a regional hospital in Vredenburg, Western Cape, South Africa

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    Ivo N. Azia

    2016-02-01

    Full Text Available Background: South Africa currently runs the largest public antiretroviral treatment (ART programme in the world, with over 80% of people living with HIV and/or AIDS on ART. However, in order to appreciate the benefits of using ART, patients are subject to uncompromising and long-term commitments of taking at least 95% of their treatment as prescribed. Evidence shows that this level of adherence is seldom achieved because of a multilevel and sometimes interwoven myriad of factors.Objective: We described the challenges faced by patients on ART in Vredenburg with regard to ART adherence.Methods: A descriptive qualitative research design was used. Eighteen non-adhering patients on ART in the Vredenburg regional hospital were purposefully selected. Using a semistructured interview guide, we conducted in-depth interviews with the study participants in their mother tongue (Afrikaans. The interviews were audio-taped, transcribed verbatim and translated into English. The data were analysed manually using the thematic content analysis method.Results: Stigma, disclosure, unemployment, lack of transport, insufficient feeding, disability grants and alternative forms of therapy were identified as major barriers to adherence, whereas inadequate follow-ups and lack of patient confidentiality came under major criticisms from the patients.Conclusion: Interventions to address poverty, stigma, discrimination and disclosure should be integrated with group-based ART adherence models in Vredenburg while further quantitative investigations should be carried out to quantify the extent to which these factors impede adherence in the community.

  12. THE IMPLEMENTATION OF THE SYSTEMATIZATION OF NURSING ICU - NEONATAL HOSPITAL REGIONAL DE CÁCERES-MT

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    Eliene de Souza Porto

    2013-01-01

    Full Text Available The study aimed to analyze the implementation of the Nursing Care System (NCS in the ICU - Neonatal Hospital Regional de Cáceres Dr. Anthony Fontes - HRCAF. This is an exploratory qualitative approach with descriptive profile of the case study. Data were collected through interviews with five nurses from ICU - Neonatal, using as research instrument, a questionnaire containing open and closed questions and analyzing a chart. The results showed that nurses know and realize the importance of NCS as a methodological tool that guides the practice of care and as professional recognition, although not held by all. The analysis of the records showed that there Systematization of Nursing Care at this clinic. Of the 707 days analyzed records there were only 30 (4.25% Nursing Research, none (0.0% record Diagnosis and Planning, 57 (8.26% days with record Deployment, Assessment and 23 record (3.24% in which its registered nursing care, assistance totaling 15.55% recorded in medical records. With the completion of this study, it was noted that the SAE often becomes impossible in practice of nursing because of various difficulties such as lack of time, lack of human resources, work overload, and the generic form organizational structure.

  13. Success Factors Associated with Health Information Systems Implementation: A study of an Australian Regional Hospital

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    Carmine Sellitto

    2014-09-01

    Full Text Available This paper identifies five factors from the literature that are important for the successful implementation of health information systems (HIS. The HIS factors identified include stakeholder engagement, the support of management and local champions, understanding HIS imposed change, user training and the impact of government incentives. The paper further explored the introduction of a commonly used HIS (Medical Director® in a regional Australian hospital and used the implementation factors as a guide for reporting stakeholder perceptions of the system. The implementation of the HIS in view of the systems users was a failure with all factors except the training issues poorly addressed. The study also reports the practicalities encountered with the system’s introduction and documents several new operational factors that were found to be associated with HIS implementation. Overall, the factors provided a sound criterion on which to judge the implementation performance (success or otherwise of the HIS. The factors identified have the potential to be used as a guide by others who are engaged with information systems in the health area.

  14. Prevalence, risk factors and molecular epidemiology of highly resistant gram negative rods in hospitalized patients in the Dutch region Kennemerland

    NARCIS (Netherlands)

    Souverein, Dennis; Euser, Sjoerd M; Herpers, Bjorn L; Diederen, Bram; Houtman, Patricia; van Seventer, Marina; van Ess, Ingeborg; Kluytmans, Jan; Rossen, John W A; Den Boer, Jeroen W

    2016-01-01

    BACKGROUND: This paper describes (1) the Highly Resistant Gram Negative Rod (HR-GNR) prevalence rate, (2) their genotypes, acquired resistance genes and (3) associated risk factors of HR-GNR colonization among the hospitalized population in the Dutch region Kennemerland. METHODS: Between 1 October 2

  15. Prevalence, risk factors and molecular epidemiology of highly resistant gram negative rods in hospitalized patients in the Dutch region Kennemerland

    NARCIS (Netherlands)

    Souverein, Dennis; Euser, Sjoerd M.; Herpers, Bjorn L.; Diederen, Bram; Houtman, Patricia; van Seventer, Marina; van Ess, Ingeborg; Kluytmans, Jan; Rossen, John W. A.; Den Boer, Jeroen W.

    2016-01-01

    Background: This paper describes (1) the Highly Resistant Gram Negative Rod (HR-GNR) prevalence rate, (2) their genotypes, acquired resistance genes and (3) associated risk factors of HR-GNR colonization among the hospitalized population in the Dutch region Kennemerland. Methods: Between 1 October 2

  16. RED-BLOOD-CELL TRANSFUSIONS FOR TOTAL HIP-REPLACEMENT IN A REGIONAL-HOSPITAL - A 6-YEAR ANALYSIS

    NARCIS (Netherlands)

    Biesma, Douwe H.; van Iperen, Charlotte E.; Kraaijenhagen, Rob J.; Marx, Joannes J. M.; van de Wiel, Harry B. M.; van De Wiel, Albert

    1994-01-01

    To evaluate changes in the need for homologous blood and to assess the imp act of autologous blood transfusion, red cell transfusions in unilateral total hip replacement surgery, performed electively in the period 1986-1991, were studied in a regional hospital. Transfusion data, perioperative blood

  17. Tissue banking in a regional hospital: a promising future concept? First report on fresh frozen tissue banking in a hospital without an integrated institute of pathology.

    Science.gov (United States)

    von Strauss und Torney, Marco; Güller, Ulrich; Rezaeian, Farid; Brosi, Philippe; Terracciano, Luigi; Zuber, Markus

    2012-10-01

    Vital tissue provided by fresh frozen tissue banking is often required for genetic tumor profiling and tailored therapies. However, the potential patient benefits of fresh frozen tissue banking are currently limited to university hospitals. The objective of the present pilot study--the first one in the literature--was to evaluate whether fresh frozen tissue banking is feasible in a regional hospital without an integrated institute of pathology. Patients with resectable breast and colon cancer were included in this prospective study. Both malignant and healthy tissue were sampled using isopentan-based snap-freezing 1 h after tumor resection and stored at -80 °C before transfer to the main tissue bank of a University institute of pathology. The initial costs to set up tissue banking were 35,662 US$. Furthermore, the running costs are 1,250 US$ yearly. During the first 13 months, 43 samples (nine samples of breast cancer and 34 samples of colon cancer) were collected from 41 patients. Based on the pathology reports, there was no interference with standard histopathologic analyses due to the sample collection. This is the first report in the literature providing evidence that tissue banking in a regional hospital without an integrated institute of pathology is feasible. The interesting findings of the present pilot study must be confirmed by larger investigations.

  18. The Factors Influencing Economic Efficiency of the Hospital Bed Care in Terms of the Regional Allowance Organizations

    Directory of Open Access Journals (Sweden)

    Vaňková Ivana

    2014-09-01

    Full Text Available This paper aims to provide an efficiency evaluation of selected hospital bed care providers during years 2010 -2012 with respect to selected factors: The size of the hospital establishment according to number of beds, number of hospitalized patients, the average length of stay per a patient in care, total staff cost calculated per bed, total revenues calculated per bed, and total costs calculated per bed. For this purpose, hospitals providing primarily acute bed care were chosen. From the legal point of view, they are allowance organizations of a particular region. The evaluation concerns both allocative efficiency and technical efficiency. The allocative efficiency is treated from the proper algorithm point of view and it compares total costs calculated per bed with total revenues calculated per bed. A method denominated Data Envelopment Analysis was applied for the calculation of the technical efficiency of units. To be more specific, it was input-oriented model with constant returns to scale (CCR. The input parameters involve the number of beds, the average length of stay and costs per day of stay. Output parameters were as follows: Bed occupancy in days and the number of hospitalized patients. The data published by the Institute of Health Information and Statistic of the Czech Republic and by ÚFIS system (the Data Base of Ministry of Finance of the Czech Republic were used as the source of data. The evaluation implies that only three hospitals were economically-effective: Silesian Hospital in Opava, Hospital Jihlava, and TGM Hospital Hodonín. The most significant factor influencing the efficiency was determined - the average length of stay.

  19. A Study on Strategic Planning and Procurement of Medicals in Uganda's Regional Referral Hospitals.

    Science.gov (United States)

    Masembe, Ishak Kamaradi

    2016-12-31

    This study was an analysis of the effect of strategic planning on procurement of medicals in Uganda's regional referral hospitals (RRH's). Medicals were defined as essential medicines, medical devices and medical equipment. The Ministry of Health (MOH) has been carrying out strategic planning for the last 15 years via the Health Sector Strategic Plans. Their assumption was that strategic planning would translate to strategic procurement and consequently, availability of medicals in the RRH's. However, despite the existence of these plans, there have been many complaints about expired drugs and shortages in RRH's. For this purpose, a third variable was important because it served the role of mediation. A questionnaire was used to obtain information on perceptions of 206 respondents who were selected using simple random sampling. 8 key informant interviews were held, 2 in each RRH. 4 Focus Group Discussions were held, 1 for each RRH, and between 5 and 8 staff took part as discussants for approximately three hours. The findings suggested that strategic planning was affected by funding to approximately 34% while the relationship between funding and procurement was 35%. The direct relationship between strategic planning and procurement was 18%. However when the total causal effect was computed it turned out that strategic planning and the related variable of funding contributed 77% to procurement of medicals under the current hierarchical model where MOH is charged with development of strategic plans for the entire health sector. Since even with this contribution there were complaints, the study proposed a new model called CALF which according to a simulation, if adopted by MOH, strategic planning would contribute 87% to effectiveness in procurement of medicals.

  20. Quality of diabetes care at Armed Forces Hospital, Southern Region, Kingdom of Saudi Arabia, 2006

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    Ibrahim S Al-Arfaj

    2010-01-01

    Full Text Available Objective: The aim of this study was to assess the current status of care provided by the Diabetes Center at Armed Forces Hospital, Southern Region. Materials and Methods : A total of 260 patients were randomly selected from the diabetic patients attending the Diabetes Center. Study tools comprised patients′ data sheets and patients′ interview questionnaire. Results : Two-thirds of the patients were aged 50 years or more. Half of patients had had the disease for less than 10 years. Diet therapy alone was followed by 2.3% of diabetic patients. More than half of patients (56.5% were on insulin. Most of the diabetic patients were tested for HbA1c at least once per year (88.1%, and 71.5% had their lipid profile done at least once within two years. Low indicators included having a dilated eye examination (35.4%, assessment for nephropathy (28.8%, and having a well-documented foot examination (12.7%. Highest risk HbA1c level (>9.5% was reached by 38.8% of patients, 48.8% had a low-density lipoprotein level of <130 mg/dl, and 36.5% of patients had controlled blood pressure (≤130/80 mmHg. Most patients were satisfied with their interaction with the treating doctor, 41.5% were satisfied with access to treatment. Hypertension was found to be the most frequent comorbidity (38.5%. Conclusion : The quality of services as regard to process and outcome are low at the Diabetes Center. The overall diabetic patients′ satisfaction was high, whereas their satisfaction was low as regards to access to treatment or health professionals.

  1. Predominant enteropathogens in acute diarrhea and associated variables in children at the Lambayeque Regional Hospital, Peru

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    Heber Silva-Díaz

    2017-01-01

    Full Text Available Objective: To determine the type and frequency of predominant enteropathogens in acute diarrhea and their associated characteristics in children treated at Hospital Regional Lambayeque (HRL - Peru. Materials and methods: A cross-sectional analytical study was carried out in 70 fecal samples between March and May 2015. These samples were studied by coproculture and immunochromatography for the detection of enteropathogenic bacteria and viruses, respectively, while enteroparasites were sought by direct microscopic examination, Kinyoun staining method and ELISA for the detection of coproantigens (Entamoeba histolytica, Giardia lamblia and Cryptosporidium spp. Leukocyte count and chemical tests (Benedict, Thevenon and Sudan III were also performed for the functional study of the diarrheal disease. Results: In 48.6% of the samples, the infectious etiology of diarrhea was detected, prevailing the parasitic cause (25.8%, followed by the bacterial (17.1% and viral (5.8% ones. The most common enteropathogens were G. lamblia (18.6% and Salmonella enteritidis (10.0%. An association between greater than 100 fecal leukocytes per field and the bacterial etiology (p=0.027 was observed, while less than 10 fecal leukocytes per field (p=0.002 and a positive Sudam III test (p=0.003 were associated with the parasitic etiology. Conclusions: In more than half of the samples (51.4% the infectious etiology of diarrhea could not be proven, whereas Giardia lamblia was the most frequent cause of diarrhea in the studied population. However, it is necessary to implement more sensitive and specific techniques for the detection of a greater range of enteropathogens with which to improve the diagnosis and treatment of the disease

  2. Statin Associated Hepatic Adverse Effects: A Retrospective Review from a Regional Hospital in Sultanate of Oman

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    Jimmy Jose

    2014-09-01

    Full Text Available Objective: This study aimed at evaluating the prevalence, pattern and predisposing factors for hepatic adverse effects with statins in a regional hospital in Sultanate of Oman. Methods: A retrospective review of the patient files in Department of Medicine during the year 2011 was done to evaluate any hepatic dysfunction possibly related to statins among the patients. For each case of suspected statin induced hepatic effect, additional details on temporal relationship, pattern of presentation, management, final outcome and any contributing factors were obtained. Difference in the occurrence of hepatic effects based on the patient demographics and drug characteristics was additionally evaluated. Results: A total of 927 patients meeting the inclusion criteria were included for the study. Mean age of the evaluated patients was 63.1 ± 11.37 and median duration of use of statin in months was 22 (IQR, 43.25. In 40 (4% of the 927 patients, there was presence of a hepatic effect considered to be statin related and only in 12 (1% patients a significant transaminase rise (>3 times was observed. Median duration of use of statin among those patients who developed suspected statin induced hepatic effects and those who did not was 45 (IQR,52 and 21 (IQR, 43 months, respectively and the difference observed was statistically significant. A significant difference in the prevalence of hepatic effects was observed only based on the duration of statin use. Conclusion: There was an infrequent occurrence of significant hepatic effects associated with statins in the study population. Our results support the latest recommendations including from United States Federal Drug Administration (US FDA that statins appear to be associated with a very low risk of serious liver injury and that routine periodic monitoring of transaminases does not appear to detect or prevent serious liver injury in association with statins.

  3. The hospital cost of road traffic accidents at a South African regional trauma centre: a micro-costing study.

    Science.gov (United States)

    Parkinson, F; Kent, S J W; Aldous, C; Oosthuizen, G; Clarke, D

    2014-01-01

    Road traffic crashes are responsible for a vast amount of death and disability in developing countries. This study uses a bottom up, micro-costing approach to determine the cost of road traffic related crashes in South Africa. Using the data from one hundred consecutive RTC related admissions to a regional hospital in South Africa we performed a bottom up costing study. To calculate costs patients were reviewed every 48 h and all interventions were recorded for each individual patient. Prices of interventions were obtained from hospital pricelists. A total cost was calculated on an individual basis. The total cost of in-patient care for these patients was US $6,98,850. Upper limb injuries were the most expensive, and the total cost increased with the number of body regions injured. The biggest expenditure was on ward overheads ($2,81,681). Ninety operations were performed - the total cost of theatre time was $1,48,230 and the cost of orthopaedic implants was $1,26,487. The cost of care of a RTC victim is significant. In light of the high numbers of RTC victims admitted over the course of the year this is a significant cost burden for a regional hospital to bear. This cost must be taken into account when allocating hospital budgets. Copyright © 2013 Elsevier Ltd. All rights reserved.

  4. [Prevalence of anemia in pregnancy, Pucallpa Regional Hospital, Perú].

    Science.gov (United States)

    Becerra, C; Gonzales, G F; Villena, A; de la Cruz, D; Florián, A

    1998-05-01

    Population based health surveys in Peru show that the general fertility rates, proportion of pregnant adolescents, and maternal and child morbidity are higher in the jungle regions than in other parts of the country. Endemic intestinal parasitic diseases increase the risk of anemia in pregnant women already suffering from iron, folic acid, and other nutritional deficiencies. This is the most common complication of pregnancy in many Latin American countries and is often associated with premature labor, low birthweight, and perinatal mortality. There are very few studies on this subject based on jungle populations and no reliable estimates of the prevalence of anemia in local pregnant women. The present study was designed to determine the prevalence of anemia in pregnant women attending the Regional Hospital in Pucallpa, located in the Peruvian jungle, from January 1993 to June 1995. This cross-sectional study, which was based on the registries of prenatal and childbirth services encompassing 1,015 pregnant women, looked into the potential association between anemia and such variables as the mother's chronological age, schooling, previous pregnancies, and weight at the beginning of pregnancy. Maternal hemoglobin levels were compared with the newborns' weight at birth. The prevalence of anemia in this population sample was 70.1%. This value was not modified when adjusted for maternal age, schooling, or interval between births. Anemia prevalence was directly related to the number of previous pregnancies and inversely related to weight gain during pregnancy. The perinatal mortality rate was 37.7 per 1,000 births. Neither this rate nor the birthweights were associated with the mother's degree of anemia. A multivariate regression analysis showed that maternal body weight at the start of pregnancy (P = 0.0001), weight gain during pregnancy (P = 0.0001), and the number of pregnancies (P = 0.008) are predictors of birthweight. Results showed that the high prevalence of

  5. Frecuencia de micosis en pacientes inmunosuprimidos de un hospital regional de la Ciudad de México

    OpenAIRE

    Hernández-Hernández Francisca; Córdova-Martínez Erika; Manzano-Gayosso Patricia; López-Alvarez Rocío; Bazán-Mora Elva; López-Martínez Rubén

    2003-01-01

    Objetivo. Aislar e identificar hongos en diferentes especímenes de pacientes inmunocomprometidos, atendidos en un hospital de la Ciudad de México, y determinar su asociación con micosis. Material y métodos. Se realizó un estudio de tipo observacional transversal en pacientes del Hospital Regional General Ignacio Zaragoza, de junio de 1999 a mayo de 2000. De 108 pacientes se procesaron 268 especímenes para estudio micológico que incluyó examen directo, frotis, cultivos y microcultivos en medio...

  6. Age and regional differences in clinical presentation and risk of hospitalization for dengue in Brazil, 2000-2014

    Directory of Open Access Journals (Sweden)

    Marcelo N. Burattini

    Full Text Available OBJECTIVES: Dengue cases range from asymptomatic to severe, eventually leading to hospitalization and death. Timely and appropriate management is critical to reduce morbidity. Since 1980, dengue has spread throughout Brazil, affecting an increasing number of individuals. This paper describes age and regional differences in dengue’s clinical presentation and associated risk of hospitalization based on more than 5 million cases reported to the Brazilian Ministry of Health from 2000-2014. METHODS: We performed a retrospective analysis of ∼5,450,000 dengue cases, relating clinical manifestations and the risk of hospitalization to age, gender, previous infection by dengue, dengue virus serotype, years of formal education, delay to first attendance and the occurrence of dengue during outbreaks and in different Brazilian regions. RESULTS: Complicated forms of dengue occurred more frequently among those younger than 10 years (3.12% vs 1.92% and those with dengue virus 2 infection (7.65% vs 2.42%, with a delay to first attendance >2 days (3.18% vs 0.82% and with ≤4 years of formal education (2.02% vs 1.46%. The risk of hospitalization was higher among those aged 6-10 years old (OR 4.57; 95% CI 1.43-29.96 and those who were infected by dengue virus 2 (OR 6.36; 95% CI 2.52-16.06, who lived in the Northeast region (OR 1.38; 95% CI 1.11-2.10 and who delayed first attendance by >5 days (composite OR 3.15; 95% CI 1.33-8.9. CONCLUSIONS: In Brazil, the occurrence of severe dengue and related hospitalization is associated with being younger than 10 years old, being infected by dengue virus 2 or 3, living in the Northeast region (the poorest and the second most populated and delaying first attendance for more than 2 days.

  7. France at CERN

    CERN Multimedia

    CERN Bulletin

    2010-01-01

    Rolf Heuer, CERN Director General, visits the exhibition "La France au CERN". The exhibition France at CERN, organized by UBIFRANCE in collaboration with CERN's GS/SEM (Site Engineering and Management) service, took place from Monday 7 to Wednesday 9 June in the Main Building. The 36 French firms taking part came to present their products and technologies related to the Organization's activities. The next exhibition will be "Netherlands at CERN" in November.

  8. Pediatric disaster preparedness of a hospital network in a large metropolitan region.

    Science.gov (United States)

    Ferrer, Rizaldy R; Balasuriya, Darshi; Iverson, Ellen; Upperman, Jeffrey S

    2010-01-01

    We describe pediatric-related emergency experiences and responses, disaster preparation and planning, emergency plan execution and evaluation, and hospital pediatric capabilities and vulnerabilities among a disaster response network in a large urban county in the West Coast of the United States. Using semistructured key informant interviews, the authors conducted qualitative research between March and April 2008. Eleven hospitals and a representative from the community clinic association agreed to participate (86 percent response rate) and a total of 22 key informant interviews were completed. Data were analyzed using ATLAS.ti.v.5.0, a qualitative analytical software program. Although hospitals have infrastructure to respond in the event of a large-scale disaster, well-established disaster preparedness plans have not fully accounted for the needs of children. The general hospitals do not anticipate a surge of pediatric victims in the event of a disaster, and they expect that children will be transported to a children's hospital as their conditions become stable. Even hospitals with well-established disaster preparedness plans have not fully accounted for the needs of children during a disaster. Improved communication between disaster network hospitals is necessary as incorrect information still persists.

  9. Critical acidity loads in France; Charges critiques d`acidite en France

    Energy Technology Data Exchange (ETDEWEB)

    Probst, A.; Party, J.P.; Fevrier, C. [Centre de Geochimie de la Surface (UPR 06251 du CNRS), 67 - Strasbourg (France); Dambrine, E. [Centre de Recherches Forestieres, INRA, 45 - Orleans (France); Thomas, A.L.; King, D. [Institut National de Recherches Agronomique (INRA), 45 - ORDON (France); Stussi, J.M. [Centre National de la Recherche Scientifique (CNRS), 54 - Vandoeuvre-les-Nancy (France)

    1997-12-31

    Based on results from several systematic forest and surface water monitoring programs, carried out in various parts of France as well as in Europe, acidity critical loads have been calculated for soils and surface waters; critical loads are presented for water and soils in crystalline mountainous regions such as Ardennes, Vosges and Massif Central; links with geochemistry, ecosystems and types of trees are discussed and perspectives are given for the calculation of acid and nitrogen critical loads on the whole France

  10. Melanoma in the Italian Population and Regional Environmental Influences: A National Retrospective Survey on 2001–2008 Hospitalization Records

    Directory of Open Access Journals (Sweden)

    Prisco Piscitelli

    2015-08-01

    Full Text Available Objective: To assess the burden of regional environmental factors influencing the incidence of Melanoma in the Italian population and overcome the problem of partial population coverage by local cancer registries and thematic archives. Methods: We analyzed the Italian national hospitalization records from 2001 to 2008 provided by the Ministry of Health, excluding hospital re-admissions of the same patients, in order to assess the occurrence of Melanoma over a 8-year period. Data were presented by age groups (absolute number of cases from 20 to ≥80 years old and per Region (rates per 100,000 inhabitants for each year. Results: The overall number of new hospitalizations due to malignant Melanoma increased by 16.8% from 2001 (n = 4846 to 2008 (n = 5823, with the rate per 100,000 inhabitants passing from 10.5 to almost 12.0 at a national level. The majority of new diagnoses of malignant Melanoma was observed in two age groups: 61–70 years old (from 979 in 2001 up to 2109 in 2008, corresponding to 15.1 and 18.1 new cases per 100,000 inhabitants, respectively and 71–80 years old (from 954 in 2001 up to 1141 in 2008, corresponding to 19.5 and 21.8 new cases per 100,000 inhabitants, respectively. The number of hospitalizations due to Melanoma increased in all age groups with the only exception of the youngest patients aged 20–30 years old. The highest increases over the 8-year period were observed in people aged ≥81 years old (+34%, 61–70 years old (+20% and surprisingly in the age group 31–40 years old (+17%. Southern Regions showed lower hospitalization rates compared to Northern Italy and Region Lazio. The highest increases between 2001 and 2008 were observed in Trentino/Alto Adige, Friuli Venezia Giulia, Valla d’Aosta and Veneto Region. Conclusions: Hospitalizations due to malignant Melanoma in Italy seem to be influenced by environmental or population-related factors showing a decreasing incidence rate from the Northern to Southern

  11. Operation and Organization of Ambulatory Surgery in France. Results of a Nationwide Survey; The OPERA study.

    Science.gov (United States)

    Beaussier, Marc; Albaladejo, Pierre; Sciard, Didier; Jouffroy, Laurent; Benhamou, Dan; Ecoffey, Claude; Aubrun, Frederic

    2017-08-04

    Operation and organization of ambulatory surgical activity in France remains largely undocumented. Because organizational processes are a major determinant of the quality of care and patient safety, this could appear in contrast with the strong encouragement by French authorities to physicians and hospitals to further develop surgery in an ambulatory setting. This nationwide observational prospective survey, carried out between December 2013 and December 2014, was undertaken to characterize the organizational processes of ambulatory surgery in France. Three hundred centers were randomly chosen from a list of 891 hospitals practicing ambulatory surgery, with stratification according to the type of facility (public general hospital, university hospital, private hospital) and region. An email was sent to the board of the randomly chosen facilities with an attached information letter explaining how the survey worked. Hospitals who did not reply to this email were contacted by phone. Among the 206 hospitals that answered the survey, 92 were private, 78 were public and 36 were university hospitals. Median accommodation capacities of ambulatory units were 8 beds, mostly distinct from conventional surgical ward. Patient pathways dedicated to ambulatory surgery appear as the current predominant practice. 77% of the French ambulatory units have a head nurse in charge of logistics and coordination. Several items have still to be improved, such as the adherence to modern fasting rules and the unnecessary use of stretcher to move the patient. Objective discharge score is used in 77% of ambulatory units. Information was provided on operations (number of beds, dedicated pathways, dedicated staff, governance) and on organizational processes (information, preoperative fasting rules, pre-and postoperative contacts, postoperative care, discharge criteria, follow-up and outcomes). This survey highlights the implementation of some positive organizational parameters corresponding to

  12. Obstetric regional analgesia in the Jesenice General hospital in year 2006

    Directory of Open Access Journals (Sweden)

    Aleksandra Kern

    2007-11-01

    Full Text Available Background: The aim of this retrospective analysis of the obstetric regional analgesia (ORA in Jesenice General Hospital in year 2006 was to evaluate our work and present results. We analysed workload, quality of the analgesia and patients’ satisfaction. We also estimated the OR for vacuum extraction (VE in nulliparous labouring women having ORA. We compared quality of analgesia and total local analgesic consumption in nulliparous women having VE or spontaneous delivery.Methods: We performed retrospective analysis of labours with ORA in year 2006. All women received epiduraly mixture of 0.1 % bupivacaine with 2 µg of fentanyl per ml in intermittent boluses.The labour pain was assessed using visual analogue scale (VAS. We used median and interquartile range to describe distribution of these values and mean with standard deviation to describe distribution of other data (local anaesthetic consumption. We considered patient with pain VAS 3 or less adequately treated, VAS 4 and 5 sufficiently and VAS 6 and more insufficiently treated. We used odds ratio as measurement of risk for VE, t-test for differences in local anaesthetic consumption and Mann-Whitney test to evaluate differences in pain between tested groups.Results: 225 labouring women opted for ORA or 38 % of all labouring women in year 2006. We performed 224 ORA, 59 % during regular work, 41 % during turn of duty. 18 % of ORA were performed between 10 p.m. and 7.00 a.m. In 98 % of cases epidural analgesia was used. Anaesthesiologic work took 16 minutes in average (SD 6.06. Analgesia was started at VAS median 5 (IQR 4–6.5 and at average cervical dilatation 4.1 cm (SD 1.4. Average consumption of bupivacaine was 55 mg (SD 23.7 and fentanyl 91.7 µg (SD 46.5. Most common complications were inadequate analgesia, and misplacement of epidural catheter (10/222, dural tap (6/222, and unilateral analgesia (2/222. 70 labours were ended with VE (13 %; n = 532. There were 27 (8.7 %; n = 309 VE in

  13. Hospital-based stroke care in Ireland: results from one regional register.

    LENUS (Irish Health Repository)

    Fan, C W

    2000-01-01

    Most patients with acute stroke are admitted to hospital. If stroke services in this country are to be improved, we need accurate and reliable information about the types of stroke patients being admitted, their present management and outcome.

  14. Studies about Management and Management of Medicines at the Regional Public Hospital of Kwaingga Keerom Regency Province of Papua

    Directory of Open Access Journals (Sweden)

    Herlina Pabuntang

    2017-02-01

    Full Text Available Hospital has a strategic role in providing quality services in accordance with the standards established and can reach all layers of society. Medicines management in hospitals need to have a good management. Purpose of this research to describe the planning of medicines, medicines acceptance, storage, procurement and distribution of medicines and know and understand the factors supporting and restricting and countermeasure strategy stock out of the medicines conducted by the management of the Kwaingga Hospital Regency of Keerom in 2016. Research methodology was qualitative descriptive study with the kind of approach to the case studies. Population and sample examined was the officer on duty in hospital health Kwaingga as many as 9 people. Data collection is done by observation, in-depth interviews and documentation. Data analysis technique used is descriptive qualitative. Research results obtained that the medicines planning in Kwaingga Hospital is done based on the amount of the budget is provided by the regional Government of the Regency of Keerom and funds dropping from Papua Province, and the selection of the remedy is done based on national formularium (FORNAS. Procurement of medicines in Kwaingga Hospital done by a third party so that it takes a relatively long time. Acceptance of medication in Kwaingga Hospital running slow. this is because the process of procurement of medicines carried out by third parties. Storage of medicines stored in the warehouse of medicines with the State of the storage areas are qualified by BPOM. Medicines distribution is done by installation of pharmaceuticals for room each performed four times each month with the format LPLPO by request of each room.

  15. Hospital workers' awareness of health and environmental impacts of poor clinical waste disposal in the Northwest Region of Cameroon.

    Science.gov (United States)

    Mochungong, Peter I K; Gulis, Gabriel; Sodemann, Morten

    2010-01-01

    Due to the infectious nature of some clinical waste, poor disposal practices have sparked concern regarding the impact on public health and the environment. Lack of sufficient knowledge of the associated risks may be a strong factor contributing to inadequate disposal practices. We conducted a survey to evaluate hospital workers' awareness of health and environmental impacts of poor clinical waste disposal in Cameroon. We randomly distributed 500 questionnaires to hospital workers in three hospitals in the Northwest Region of Cameroon in April 2008. In addition, we observed collection, segregation, transportation, and disposal of clinical waste at the three hospitals. Of 475 total respondents, most lacked sufficient awareness of any environmental or public health impacts of poor clinical waste disposal and had never heard of any policy--national or international--on safe clinical waste management. Methods of collecting, segregating, transporting and disposing clinical waste at the three hospitals was poor. The development of a comprehensive policy on efficient clinical waste management in Cameroon is imperative.

  16. Study of Patients Absconding Behavior in a General Hospital at Southern Region of Iran

    Directory of Open Access Journals (Sweden)

    Mohammad Khammarnia

    2015-03-01

    Full Text Available Background Patients’ escape from hospital imposes a significant cost to patients as well as the health system. Besides, for these patients, exposure to adverse events (such as suicide, self-harm, violence and harm to hospital reputation are more likely to occur compared to others. The present study aimed to determine the characteristics of the absconding patients in a general hospital through a case-control design in Shiraz, Iran. Methods This case-control study was conducted on 413 absconded patients as case and 413 patients as control in a large general hospital in Shiraz, southern Iran. In this study, data on the case and control patients was collected from the medical records using a standard checklist in the period of 2011–3. Then, the data were analyzed using descriptive and analytical statistics, through SPSS 16. Results The finding showed that 413 patients absconded (0.50% and mean of age in case group was 40.98 ± 16.31 years. In univariate analysis, variables of gender [Odds Ratio (OR= 2], ward (OR= 1.22, insurance status (OR= 0.41, job status (OR= 0.34 and residence expenditure were significant. However, in multivariate analysis significant variables were age (ORadj= 0.13, gender (ORadj= 2.15, self-employment/unemployed (ORadj= 0.47, emergency/admission (ORadj= 2.14, internal/admission (ORadj= 3.16, insurance status (ORadj= 4.49 and residence expenditure (ORadj= 1.15. Conclusion Characteristics such as middle age, male gender, no insurance coverage, inability to afford hospital expenditures and admission in emergency department make patients more likely abscond from the hospital. Therefore, it may be necessary to focus efforts on high-risk groups and increase insurance coverage in the country to prevent absconding from hospital.

  17. How chemical pollution becomes a social problem. Risk communication and assessment through regional newspapers during the management of PCB pollutions of the Rhône River (France).

    Science.gov (United States)

    Comby, Emeline; Le Lay, Yves-François; Piégay, Hervé

    2014-06-01

    The case study of the polychlorinated biphenyl (PCB) pollutions of the Rhône River (France) offers the possibility of studying criteria for the construction of social problems that result from chemical pollution (2005-2010). We investigated the dynamics of competition that create and define pollution as a social problem and entail its decline. News outlets are crucial for determining how an environmental issue emerges locally or nationally; this study used newspapers to highlight the potential of new outlets as a data source to analyze discourse variability, science-policy-media connections and the hydrosphere. Media coverage was based on a content analysis and textual data analysis of 75 articles. Analytical frameworks such as the Downs Model and the Public Arena Model (Hilgartner and Bosk, 1988) that consider time and stakeholders were tested to determine how human alteration of the hydrosphere can become a social problem and to analyze different communication strategies held by stakeholders. In terms of management, we described the temporal dynamics of the social problem based on the case study and considered an explanation of the selections. We considered the organization of particular stakeholders who define the social problem from its beginning to end by focusing on their discourses, relationships, decision-making and political choices, and scientific studies. Despite some biases, newspapers are useful for retrospectively evaluating the emergence of a social problem in the public arena by describing it through discourse and then understanding the temporal patterns of information. Despite uncertainties and information flow, decisions are made and science is translated to the public. Copyright © 2014 Elsevier B.V. All rights reserved.

  18. Strategic supporting role of a regional state-level hospital during medical rescue after Wenchuan earthquake.

    Science.gov (United States)

    Shi, Ying Kang; Zheng, Shang Wei

    2008-11-01

    Shortly after the Wenchuan earthquake, the administrative leaders of West China Hospital accurately defined the role of the hospital during the medical rescue work as the treatment center for seriously wounded people, the support center for local hospitals and clinics in the disaster areas in Sichuan Province, and the logistics support center for medical teams from other provinces. Integrated leadership of management and efficient multidepartment co-ordination and co-operation were emphasized. The hospital was immediately transformed from regular mode into a double-track emergency mode. Scientific allocation and dispatch of resources were ensured to meet the changing demand from all levels of rescue work. Three stages were defined based on the conditions of wounded people delivered to the hospital, with different main focuses for each stage. Because of the multidisciplinary co-operation and concerted efforts of a large number of experts from other provinces and countries, an effective and efficient medical rescue service was offered to all wounded people. Until 2 June 2008, 2618 injured people from the disaster area have been treated, of whom 1751 were admitted to the inpatient department, 1135 were seriously wounded, 127 were admitted into the intensive care unit, 1239 underwent surgery, and 77 were treated with haemodialysis. There was an inpatient mortality less than 0.7%. Moreover, even during such a period, routine medical service was offered to patients other than people wounded in the disaster.

  19. FacilitiesHospitals_HOSPITAL

    Data.gov (United States)

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

  20. [Health and politics in France].

    Science.gov (United States)

    Tabuteau, Didier

    2012-06-01

    Health is a dual notion. It is individual, singular and intimate. It is also collective, statistical and political. The modern problematic of health relies upon a balance of complex relations between individual and collective acceptances of the notion. You can try to outline the evolutions and the main concepts through a quadruple approach: health and politics, health and its professionals, health and society and in the end, health and the State. The relationships between health and politics in France are affected by the historical delay of France in public health, namely because of a structural weakness of the administrative organization of public health. Nevertheless France developed a dense and well organized care system and a universal social protection against the disease. The creation of the health professions in France was marked by a historical opposition between the doctors and the state which led to a failure of hygienist medicine and a fundamental misunderstanding on health insurance. Medical domination led to the organization of a system based on professional dichotomy and the delegation of the regulation skills to the health care professionals. The role of health issues in the French society was deeply renewed by the development of the medical and epidemiological knowledge. This resulted in a new political responsibility in the management of health risks but also in the confirmation of the patients' rights and the role of their associations in the health systems operations and the piloting of public policies. In this environment, the state has recently and progressively confirmed its dominating role in the health sector. A public hospital service was created In the 60's and 70's, then in the 80's there were recurrent interventions in order to control health spendings and eventually in the 90's health safety devices were set up. More recently, a process of health policies institutionalization confirmed this evolution. In the future, health issues should

  1. Energy statistics. France; Statistiques energetiques. France

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2003-04-01

    This document summarizes in a series of tables the main energy statistics of France for 2002: supplies, uses and sectoral consumption for all energies (coal, petroleum, gas, electricity, renewable energies); domestic production of primary energy (1973-2002); primary energy consumption (1973-2002); end-use energy consumption (1973-2002); general indicators (energy bill, US$ rate, prices, energy independence, GDP - 1973-2002); projections (primary energy consumption, 1973-2002); detailed data for petroleum, natural gas, electric power, and solid mineral fuels (resources, uses, prices, imports, production, domestic consumption, 1973-2002). (J.S.)

  2. Accounting for the uncertainties in radar-raingauge rainfall estimation and the parametric uncertainties of the hydrological model in the prediction of flash floods in the Cévennes-Vivarais region, France

    Science.gov (United States)

    Navas, Rafael; Delrieu, Guy

    2017-04-01

    The Cévennes-Vivarais is a Mediterranean medium-elevation mountainous region of about 32000 km2 located in the south-east of France, prone to heavy precipitation events and subsequent flash floods and floods occurring mainly during the autumn season. Due to this vulnerability, it is a well instrumented region in terms of rainfall (4 weather radars of the French ARAMIS radar network, 250 hourly raingauges) and river discharge (45 stations) observations. A high-resolution (1 km2, 1 hour) radar-raingauge rainfall re-analysis has been established for the period 2007-2014 by using the kriging with external drift (KED) technique (Delrieu et al. 2014; Boudevillain et al. 2016). In the present communication, we present first a geostatistical method aimed at generating radar-raingauge rainfall ensembles based on the KED error standard deviations and the space-time structure of the residuals to the drift. The method is implemented over the four main watersheds of the Cévennes-Vivarais region by considering a spatial segmentation in hydrological meshes of variable sizes from 10 to 300 km2. A distributed hydrological model based on the SCS curve number and unit hydrograph concepts is then implemented in continuous mode for these watersheds. A sensitivity analysis allows us to identify the most sensitive parameters and to generate ensembles of "acceptable" hydrological simulations by using 16 discharge time series. Several results of this simulation framework will be highlighted: (1) the overall quality of the hydrological simulations as a function of the gauged watershed characteristics, (2) the transferability of the acceptable parameter sets from one year to another, (3) the effect of the space and time resolution of rainfall estimations on the hydrological simulations for gauged watersheds, (4) the respective impact of rainfall and model parametric uncertainties over a range of spatial and temporal scales for ungauged watersheds. References: Delrieu, G., A. Wijbrans, B

  3. Knowledge and attitude of healthcare workers and patients on healthcare associated infections in a regional hospital in Ghana

    Directory of Open Access Journals (Sweden)

    Irene Ocran

    2014-04-01

    Full Text Available Objective: To assess knowledge and attitude of healthcare workers (HCWs and patients on healthcare associated infections (HAIs in the central regional hospital in Ghana. Methods: The purposive random sampling method was used to administer questionnaires over a period of 6 months to HCWs and patients visiting the hospital. Results: A total of 210 patients and 71 HCWs were sampled. One hundred and three (53.8% patients had some knowledge of HAIs with 52 (28.4% being informed by a HCW compared with 63 (88.7% of HCWs who were well informed about HAIs. Ninety-seven (46.2% responding patient always washed their hands while 65 (31% and 48 (22.9% respectively sometimes or never washed their hands within or after leaving the hospital. Out of those who washed their hands, 64 (39.5% always washed with soap while 46 (28.4% did sometimes. This positively and significantly correlated (r=0.440, P<0.001 with knowledge on HAIs which was however insignificant in HCWs (r=0.025, P=0.835. As many as 48 (67.6% of HCWs believed that authorities in the hospital had done little to prevent HAIs with the main reason being that the hospital was unclean. Whereas, 112 (53.3% of patients considered the hospital clean. Twenty-seven (38% of HCWs had had confirmed HAIs of which cholera made up 12 (16.9% while 94 (44.8% of patients believed they had had unconfirmed HAIs. Conclusions: Although knowledge on HAIs is adequate, low compliance on preventive techniques resulting in high HAIs indicates attitudinal change is the best means of prevention.

  4. The reception of Cambodian refugees in France

    NARCIS (Netherlands)

    Wijers, G.D.M.

    2011-01-01

    Cambodian refugees’ arrival in France has helped initiate an atypical political mobilization in the process of their reception. The French political power balance, the sociocultural “mood” (zeitgeist) and the “mediatization” of the Indochinese region have impacted on their resettlement and given the

  5. The impact of ice-skating injuries on orthopaedic admissions in a regional hospital.

    LENUS (Irish Health Repository)

    Dillon, J P

    2012-02-03

    Since the opening of a temporary ice-rink in our hospital\\'s catchment area, we have observed an increase in patients requiring in-patient treatment for orthopaedic intervention. The authors performed a prospective analysis of all patients admitted to our unit over a one-month period. Epidemiological data, wearing of protective gear and skater experience were collected. Fracture type, treatment required, average length of hospital stay and number of days missed from work was also recorded. Ice-skating injuries accounted for 7.7% of our total admissions over the study period. There was a significant variation noted in the types of fracture sustained ranging from comminuted fractures of the radial head to spiral fractures of the tibia. The average length of hospital stay was 2.6 days and average time missed from work was 6.1 weeks. This paper highlights the potential serious injuries that can occur in ice-skating and their impact on admissions to our orthopaedic unit.

  6. Study on the Upgrading and Recognition of Qualifications in the Field of the Restoration and Rehabilitation of the Architectural Heritage. Summary Report. National Reports: Federal Republic of Germany, Belgium Dutch-Speaking Region, France, Italy, United Kingdom. CEDEFOP Panorama. First Edition.

    Science.gov (United States)

    Paulet, Jean-Louis; And Others

    Five studies assessed the impact on systems and jobs of the recognition of qualifications in the field of the restoration and rehabilitation of the architectural heritage in five countries: Germany, Belgium Dutch-speaking region, France, Italy, and the United Kingdom. A striking feature in all five countries was the insignificant share of initial…

  7. [The home palliative care transition manual for the regional cooperation from the general ward at Shizuoka Red Cross Hospital].

    Science.gov (United States)

    Shiraishi, Ko

    2007-12-01

    Recently, a home palliative care has been recommended for terminal stage cancer patients. However, a few clinics are available providing a home palliative care. As a result of that, there have been many cases of the terminal stage cancer patients who could not receive a peace of mind care and die peacefully at home. Home palliative care has been promoted in Shizuoka City by starting Shizuoka city regional cooperation conference of cancer management with a help from Shizuoka city medical association and the general hospital. It is important to have the knowledge and technique put into practice by clinics and home visiting nurses for a further improvement of the palliative care. In order to transfer patient smoothly, the palliative care team conference is held in the general ward and the homecare transition manual is used at the hospital. An application of homecare insurance, the visiting doctor and nurse are arranged in parallel to management of physical and psychological symptoms of the patient, the visiting doctor and nurse are arranged. Before a patient is discharged from the hospital, the meeting will be held among the ward staff, visiting nurse and the patient's family. We intervened 8 cases from April to July 2007. Six out of 8 cases were transferred to home, and 2 patients were died at home. The home care transition manual will be shared with other hospitals from now on.

  8. ENTEROBACTERIACAE, PRODUCING ESBLS AND METALLO-β-LACTAMASE NDM-1, ISOLATED IN HOSPITALS OF BALTIC REGION COUNTRIES

    Directory of Open Access Journals (Sweden)

    S. A. Egorova

    2013-01-01

    Full Text Available Abstract. We studied the prevalence of K. pneumoniae and E. coli resistance to extended spectrum cephalosporins and carbapenems, isolated from patients of eight hospitals in St-Petersburg from January to May, 2012. Prevalence of cephalosporin resistant isolates varied in different hospitals: E. coli – from 7,8 to 50%, K. pneumoniae – from 25,4 to 88,4%. Isolates produced extended spectrum beta-lactamases СТХ-М, mainly СТХ-М-1, also СТХ-М-2 and СТХ-М-9. Twenty two carbapenem-resistant K. pneumoniae strains (also resistant to other antimicrobials were isolated in three hospitals. MALDI-TOF MS showed that carbapenem resistance was caused by carbapenemase. Carbapenemases of all isolates belonged to metallo-β-lactamases according to results of the ROSCO Diagnostica tests. The gene coding production of New Delhi metallo-β-lactamase (blaNDM-1 were detected in all strains. Our data confirmed that the main cephalosporin resistance mechanism of E. coli и K. pneumoniae in Baltic region (including Russia, St-Petersburg is CTX-M-1 production. For the first time in Russia K. pneumoniae strains  producing metallo-β-lactamases NDM-1 were isolated in several hospitals of St-Petersburg.

  9. [Isolated yeast species in urine samples in a Spanish regional hospital].

    Science.gov (United States)

    Heras-Cañas, Victor; Ros, Luis; Sorlózano, Antonio; Gutiérrez-Soto, Blanca; Navarro-Marí, José María; Gutiérrez-Fernández, José

    2015-01-01

    Candiduria detection in hospitalized or immunocompromised patients is of great clinical significance. The aim of our study was to describe the isolation frequency of significant species of yeasts in urine samples processed in our hospital during the period 2010- 2013, and to analyze their susceptibility to commonly used antifungal agents. Species identification was performed by seeding on a chromogenic medium, the filamentation test and automated systems (ASM Vitek and MALDI Biotyper), while susceptibility was determined using the ASM Vitek system. Of the 632 yeast isolates in urine, 371 were Candida albicans species and 261 non-C. albicans Candida spp. The species with the highest number of resistant isolates were Candida glabrata and Candida krusei. Based on the results obtained, we believe that species identification and the susceptibility study should be current practice in the laboratories when species other than C. albicans are isolated.

  10. [Incidence of oral cancer in AIDS patients at the "20 de Noviembre" Regional Hospital, ISSSTE].

    Science.gov (United States)

    Solís Morán, C E; Molina Moguel, J L

    1990-09-01

    Ever since its initial outbursts in high-risk groups, AIDS has had an appalling impact within the oncological sphere, since it combines opportunistic pathologies with the occurrence of malignancies caused by loss of defensive cells, thus allowing abnormal or cancerous cells to multiply. This paper conveys some recent concepts on AIDS, as well as a study undertaken at the "20 de Noviembre" Hospital, aimed at identifying the most common opportunistic diseases which often occur in the oral cavity upon contracting AIDS.

  11. The lived experience of patients regarding patients' rights practice at hospitals in Amhara Region, northern Ethiopia

    Directory of Open Access Journals (Sweden)

    Berhane A

    2016-05-01

    Full Text Available Adugnaw Berhane,1 Fikre Enquselassie2 1College of Health Sciences, Debre Berhan University, Debre Berhan, 2School of Public Health, Addis Ababa University, Addis Ababa, EthiopiaBackground: There are a number of different international guidelines promoting the practice of observing patients’ rights in the health care service. Patients experience greater satisfaction in the health care service when their rights are protected. The purpose of this study was to examine patients’ experiences regarding their rights in hospital settings in northern Ethiopia.Patients and methods: Data were collected using semistructured interviews of 22 patients, who have had experience of health care service in the hospital setting. The patients were selected from the outpatient and inpatient departments of referral and district hospitals in northern Ethiopia. The interview data were tape-recorded, transcribed, translated, reviewed, and analyzed using a phenomenographic approach. Categories of descriptions were constructed based on the patients’ conceptions and ways of understanding the phenomenon of patients’ rights practice.Results: The findings revealed four main qualitatively different ways of understanding patients’ rights practice from the patients’ perspective. These main categories of description were patient-centered practice, being secured, respecting patients’ dignity, and getting referral.Conclusion: The different conceptions of patient rights give us a deeper understanding of how patients may experience patients’ rights practice. The result provides a foundation for developing health care practice that equips the patient with a positive experience, thus contributing in drafting patients’ bill of rights in the local context.Keywords: patient rights, phenomenography, hospital health care, patient experience

  12. Consultation-liaison service in a regional hospital in Hong Kong.

    Science.gov (United States)

    Wong, M M C; Yiu, M G C

    2014-06-01

    To examine consultation-liaison psychiatric services in a general hospital in Hong Kong. All records of Tseung Kwan O Hospital psychiatric consultations from 1 July 2012 to 30 June 2013 were extracted from the database. Patients' demographic data, sources and reasons of referral, psychiatric and suicidal histories, current suicidal attempt, psychiatric diagnoses, psychiatric outcomes, as well as waiting times were analysed accordingly. A total of 1392 psychiatric consultations were received, of which 82% were attended to within the same working day when the referral was received, and 99% were attended to by the end of the next working day. The commonest reasons of consultation were unstable emotion followed by suicidal / deliberate self-harm and aggression. There were 246 consultations with actual suicidal attempt. Overall, 270 (19%) patients who received consultation-liaison psychiatric services were admitted to the psychiatric wards. Follow-up in the psychiatric outpatient department was arranged for 691 (50%) patients while 57 (4%) required referral to the community psychiatric nursing service in addition to outpatient department arrangement. Management of suicidal attempters and provision of risk assessment continue to be the major tasks of consultation-liaison psychiatrists and nurses. A readily available on-site consultation-liaison psychiatric service is an essential component of services provided in acute general hospitals.

  13. [Regional geriatric team--a model for cooperation between nursing homes and hospitals].

    Science.gov (United States)

    Sellaeg, Wenche Frogn

    2005-04-21

    Few studies describe and evaluate the use of ambulatory geriatric teams in nursing homes. This article gives an account of a model in which a multidisciplinary group from the local hospital has been visiting 17 communities in Norway twice a year for 11 years. The ambulatory geriatric team includes a geriatrician, a geriatric nurse, a physiotherapist and an occupational therapist. Their aim is to raise the quality of geriatric assessment and care and to enhance the cooperation between the hospital and the nursing homes in the communities. The team members are doing a comprehensive geriatric assessment of some of the patients; they assess cases for further referral, and examine patients with declining functioning with a view to rehabilitation. The team provides instruction in various aspects of geriatrics to community care professionals. Much time is devoted to discussions on problems raised by the staff, such as management of patients with dementia-related behavioural problems, and to provide feedback to staff-members. The team liaise between hospitals, nursing homes and community care services in the communities in order to enhance communication between the professionals involved. An evaluation of the team was done on behalf of the National Institute of Health through a postal questionnaire which was returned by 223 doctors, nurses and allied health care professionals. The results indicate that visits by the ambulatory team improve the knowledge of doctors and allied professionals about diseases in the elderly; 92% reported that they now felt they were doing a better job.

  14. Candida species distribution and fluconazole susceptibility of blood isolates at a regional hospital in Passo Fundo, RS, Brazil

    Directory of Open Access Journals (Sweden)

    Maira Giseli C. Silva

    2015-06-01

    Full Text Available ABSTRACT Introduction: Candidemia is a bloodstream infection produced by Candida genus yeasts. Objective: The purpose of this study was to characterize the epidemiology and the fluconazole susceptibility in Candida species isolated from patients at a regional hospital in Passo Fundo, RS. Methods: Records from the laboratory were used to identify patients with positive blood cultures for Candida between 2010 and 2011. The in vitro activity of fluconazole was determined using the disk diffusion method. Results: Were analyzed 24 positive blood cultures for Candida and found a 54.16% mortality rate. C. albicans was the most prevalent species, followed by C. parapsilosis and C. krusei. For susceptibility to fluconazole, C. albicans, C. parapsilosis and C. tropicalis showed 100% sensitivity. However, C. krusei was 100% resistant; and C. glabrata, 50% resistant. Conclusion: The high mortality and fluconazole resistance rates emphasize the importance of the diagnosis of candidemia in a hospital environment.

  15. Perceptions on hospitality when visiting secluded communities of guaranis, caiçaras e quilombolas in Paraty region

    Directory of Open Access Journals (Sweden)

    Luis Alberto Beares

    2008-10-01

    Full Text Available Tourism in secluded communities puts different cultures in contact with each other and must be handled carefully not to cause environmental damage as well as cultural loss which might jeopardize the local development and create hostile relationships. The proposal of in sito tourism, considering the local memory and patrimony as a hospitality potential, was observed during technical visitations to three communities located in the Paraty region and surroundings: Guarani, Caiçara (fishermen and Quilombola(African slaves descendants. Through field work involving visitations to communities and interviews with locals, information regarding cultural differences and the importance of the land occupation in the history of each of the communities was assessed. The common link in the history of these peoples is the struggle for the right of land possession. During visits when people shared their territory various forms of hospitality in each community were verified, issued from different cultures and cultural values.

  16. Urban Sociology in France.

    Science.gov (United States)

    Amiot, Michel

    1986-01-01

    Divides the history of urban sociology in France into three periods: (1) functionalism, which lasted from 1910 until the 1960s, (2) neo-Marxist socioeconomics lasting from 1968 until 1979, and (3) anthropological approach which is still dominant. Reviews theoretical perspectives and research characteristic of each period. (JDH)

  17. VISAS FOR FRANCE

    CERN Multimedia

    Relations with the Host States Service

    2002-01-01

    1. Definition of a visa A visa is an administrative document required by the nationals of certain countries to cross a border. The visas referred to in this article ('consular visas') are issued to people who do not live in France (not to be confused with 'exit and/or re-entry visas' issued to people living in France; cf. communiqué of 26 May 1998, ref. CERN/DSU-DO/RH/8283). 2. Types of visa The numerous types of visa include, in particular: short-stay visas, which allow their holders to enter France for a continuous or non-continuous period not exceeding three months in any six; long-stay visas, which are required by those applying for a residence document (Carte spéciale issued by the French Ministry of Foreign Affairs or Carte de séjour issued by a Préfecture). 3. Visa requirement 3.1 General rule In France, the requirement to obtain a visa varies, in particular, according to nationality and the length of stay. To put it simply, three different situations can...

  18. International Relations in France

    DEFF Research Database (Denmark)

    Breitenbauch, Henrik Ø.

    Why is the French International Relations (IR) discipline different from the transnational-American discipline? By analysing argument structures in research articles across time, this book shows how the discipline in France is caught between the American character of the discipline and the French...

  19. Traveling in France.

    Science.gov (United States)

    Philyaw, Henry; And Others

    This minicourse guide for teachers of French is intended to help motivate and prepare students for travel in France. Activities are outlined in eleven related areas, including (1) planning for the trip, (2) currency, (3) going through customs, (4) tipping, (5) shopping, (6) guided tours, (7) touring on your own, (8) social life and entertainment,…

  20. [Development of internal medicine since the establishment of the Regional Hospital in Sarajevo from 1894 until today].

    Science.gov (United States)

    Grujić, M

    1994-01-01

    The first bigger regular hospital in Sarajevo was built by the Bosnian vali Osman-pasha in the year 1866 and had only 32 beds. The construction expenses and keeping, according the Porta's approval was supported by Gazi-Husrevbeg's Vakuf, the name was The Vakuf's Hospital. In the year 1894, initiated by the Regional Government (Landesregierung) the Regional Hospital (Landesspital) came to existence, 1894, when opened had 238 beds, with modern outfits and technical facilities. There were 4 departments: Internal, Surgery, Dermatovenerology and Gynecology-Obstetrics. The Department for Internal Diseases had 50 beds. The first chief was Primarius Dr Geza Kobler, came from the Viennese Medical Faculty and had been assistant to Prof. Schretter. Simultaneously, he was director of the Hospital. His assistants were: Dr Berthold Haas to 1898 and Dr Heinrich Propper to 1900 and the interns were: Dr Bodo Koloman, Dr Alexander Dorner, Dr Erwin Horn, Dr Dragan Plentaj and Dr Risto Jeremić. Later, as chief was appointed Dr Ludomil Sas-Korcinski, professor of the Cracau University, his associates were to the year 1910: Dr Hamdija Karamehmedović, later to became chief of the Department for Infectious Diseases and the Intern, Dr Mustafa Kadić. At the eve of the World War 1, in 1914, the pavilion "K" was built, where the Department housed. At that time chief was Primarius Dr Ljubo Bilić, while his associates were Dr Gavro Bozić, Dr Vjekoslav Kusan and Dr Duro Ostojić. Later, some other doctors same, having a permanent job, Dr Bogdan Zimonjić, Dr Miron Simić, Dr David Pinto, Dr Sreten Kaluräercić and Dr David Baruh.(ABSTRACT TRUNCATED AT 250 WORDS)

  1. Epidemiology of measles in the Central Region of Ghana: a five-year case review in three district hospitals.

    Science.gov (United States)

    Bosu, W K; Odoom, S; Deiter, P; Essel-Ahun, M

    2003-06-01

    As part of a national accelerated campaign to eliminate measles, we conducted a study, to define the epidemiology of measles in the Central Region. A descriptive survey was carried out on retrospective cases of measles. Patients were drawn from the three district hospitals (Assin, Asikuma and Winneba Hospitals) with the highest number of reported cases in the region. Records of outpatient and inpatient measles patients attending the selected health facilities between 1996 and 2000. Data on reported measles cases in all health facilities in the three study, districts were also analysed. The distribution of measles cases in person (age and sex), time (weekly, or monthly, trends) and place (residence), the relative frequency, of cases, and the outcome of treatment. There was an overall decline in reported cases of measles between 1996 and 2000 both in absolute terms and relative to other diseases. Females constituted 48%-52% of the reported 1508 cases in the hospitals. The median age of patients was 36 months. Eleven percent of cases were aged under nine months; 66% under five years and 96% under 15 years. With some minor variations between districts, the highest and lowest transmission occurred in March and September respectively. Within hospitals, there were sporadic outbreaks with up to 34 weekly cases. In Ghana, children aged nine months to 14 years could be appropriately targeted for supplementary, measles immunization campaigns. The best period for the campaigns is during the low transmission months of August to October. Retrospective surveillance can expediently inform decisions about the timing and target age groups for such campaigns.

  2. Hospital-based register of stroke in the Molise Region: focus on main subtypes of stroke. Years 2009-2013.

    Science.gov (United States)

    Iacoviello, Licia; Costanzo, Simona; Persichillo, Mariarosaria; Sparano, Antonio; Bartolo, Michelangelo; Polizzi, Bianca Maria; Donati, Maria Benedetta; de Gaetano, Giovanni

    2016-02-01

    We determined incidence and intra-hospital mortality rate of stroke in Molise, Italy, to provide information for planning regional healthcare facilities and to ameliorate stroke management in this region. This study is part of the "Rete Molisana dell'Ictus Cerebrale (REMOLIC)" study, a population-based Cerebrovascular Registry in Molise, from 2009 to 2013, with a cold pursuit approach. The crude annual incidence rates for total stroke per 100,000 inhabitants, notified by hospital discharge records, were 198 for 2009, 185 for 2010, 169 for 2011, and 176 for both 2012 and 2013. There was a significant decrease in risk in the years 2011-2013 [RR2011 vs. 2009: 0.85 (0.76-0.98), RR2012 vs. 2009: 0.89 (0.79-0.99), RR2013 vs. 2009: 0.89 (0.79-0.99)] as compared with 2009. For the year 2010, after adjustment to the Italian, European, and world populations, the overall incidence rates were 165, 134, and 67 per 100,000/year, respectively. Similar trends were found when men and women were analyzed separately. In the average, 20.8 % of subjects admitted for a cerebrovascular accident died during the hospitalization, among these 93.5 % in the first 28 days. The duration of hospital stay was constant in the years (2009-2012), except during 2013, where there was a significant decrease in the average (p years. This study underlines the need to plan better stroke management in Italy, in order to obtain outcomes more similar to those of the best performing countries.

  3. Caesarean delivery in the Limbé and the Buea regional hospitals, Cameroon: frequency, indications and outcomes

    Science.gov (United States)

    Tanyi, Tanyi John; Atashili, Julius; Fon, Peter Nde; Robert, Tchounzou; Paul, Koki Ndombo

    2016-01-01

    Introduction Neonatal outcomes can be directly and indirectly affected by caesarean delivery (CD). Data on CD rates in semi-urban and rural hospitals in resource-limited settings are scarce and yet are needed to better guide the care of women and neonates in these settings. we carried out this study to determine the frequency of CD, its indications and the frequency of the various adverse neonatal outcomes (ANO) in the Limbe Regional Hospital (LRH) and the Buea Regional Hospital (BRH), Cameroon. We also assessed the relationship between the indication for CD and ANO in the said hospitals. Methods This was a hospital-based retrospective and prospective cross-sectional study using descriptive and analytic methods conducted in the LRH and the BRH maternity units within a nine months period in 2015. Informed consent was obtainedfrom mothers of the neonates. Data analyses were performed using Epi-Info 3.5.4 software. Results We recruited 199 neonates born through CD. The prevalence of CD was 13.3% with cephalopelvic disproportion (CPD) being the most frequent (32.2%) indication for CD. There were 52 (26.1%) ANO following CD and respiratory distress was the most common 24 (46.2%) of all ANO. Emergency indications for CD were associated with more ANO 49 (34.5%) as compared to elective indications for CD 3 (5.3%) [p-value<0.001]. We noted a significant association between indications for CD and the various type of ANO, with CPD having the worse prognostic neonatal outcomes 30.8% [p-value=0.02]. Conclusion The prevalence of ANO associated with CD in our hospitals was high with a worrying prognosis. While the exact reasons are unknown, the creation of well-equipped neonatal units with trained staff, may contribute to reduce neonatal morbidity and fatalities. Furthermore, the association of CPD to worse prognostic neonatal outcomes calls for clinicians, to consider additional management options, such as antibiotic prophylaxis and oxygen therapy to the neonates, prior to CD.

  4. Bartonella henselae en niños con adenitis regional atendidos en un hospital nacional del Perú, 2012

    Directory of Open Access Journals (Sweden)

    Edwin Miranda-Choque

    Full Text Available Con el objetivo de determinar la frecuencia de casos seropositivos a Bartonella henselae en niños con adenitis regional atendidos en un hospital nacional del Perú, se realizó un estudio trasversal en 106 niños con adenitis regional mayor de 1 cm de diámetro, de aparición aguda, con tiempo de enfermedad mayor de cinco días, atendidos en el Instituto Nacional de Salud del Niño durante el año 2012. Se definió seropositividad para B. henselae mediante el examen de inmunofluorescencia indirecta, siendo positivos 86 niños (81,1% con una mediana de edad de 7 años, rango de 5 a 11; en el análisis bivariado se encontraron como factores asociados, edad mayor de 5 años, antecedentes de fiebre, adenopatía mayor de 4 cm y reporte de contacto con gato. En conclusión, los niños con adenitis regional atendidos en este hospital de referencia nacional presentaron una frecuencia alta de serología positiva para B. henselae

  5. Bartonella henselae en niños con adenitis regional atendidos en un hospital nacional del Perú, 2012

    Directory of Open Access Journals (Sweden)

    Edwin Miranda-Choque

    2014-04-01

    Full Text Available Con el objetivo de determinar la frecuencia de casos seropositivos a Bartonella henselae en niños con adenitis regional atendidos en un hospital nacional del Perú, se realizó un estudio trasversal en 106 niños con adenitis regional mayor de 1 cm de diámetro, de aparición aguda, con tiempo de enfermedad mayor de cinco días, atendidos en el Instituto Nacional de Salud del Niño durante el año 2012. Se definió seropositividad para B. henselae mediante el examen de inmunofluorescencia indirecta, siendo positivos 86 niños (81,1% con una mediana de edad de 7 años, rango de 5 a 11; en el análisis bivariado se encontraron como factores asociados, edad mayor de 5 años, antecedentes de fiebre, adenopatía mayor de 4 cm y reporte de contacto con gato. En conclusión, los niños con adenitis regional atendidos en este hospital de referencia nacional presentaron una frecuencia alta de serología positiva para B. henselae

  6. Current preventive policies and practices against Vaccine-Preventable Diseases and tuberculosis targeted for workers from hospitals of the Sardinia Region, Italy

    OpenAIRE

    Campagna, M.; Argiolas, F.; Soggiu, B.; Mereu, N.M.; Lai, A.; Galletta, M.; R.C. Coppola

    2016-01-01

    Summary Introduction. Health care Workers are exposed to infectious diseases more than the general population. Many of these infections are preventable by vaccination. The objective in this study is to investigate whether, how, and which vaccination underwent Sardinia Health Care Workers (HCWs) and the variability of policies in different Hospital Health Managements of the whole region. Methods. In March 2013, we enrolled the Hospital Health Management of all the 32 Sardinia hospitals. We inv...

  7. Epidemiology of patients hospitalized for ocular trauma in the Chaoshan region of China, 2001-2010.

    Directory of Open Access Journals (Sweden)

    He Cao

    Full Text Available BACKGROUND: The burden and pattern of ocular trauma in China are poorly known and not well studied. We aimed at studying the epidemiological characteristics of patients hospitalized for ocular trauma at major ophthalmology departments in the largest industrial base of plastic toys in China. METHODS: A retrospective study of ocular trauma cases admitted to 3 tertiary hospitals in China from 1st January 2001 to 31st December 2010 was performed. RESULTS: The study included a total of 3,644 injured eyes from 3,559 patients over the 10-year period: 2,008 (55.1% open-globe injuries, 1,580 (43.4% closed-globe injuries, 41 (1.1% chemical injuries, 15 (0.4% thermal injuries and 678 (18.6% ocular adnexal injuries. The mean age of the patients was 29.0±16.8 years with a male-to-female ratio of 5.2∶1 (P = 0.007. The most frequent types of injury were work-related injuries (1,656, 46.5% and home-related injuries (715, 20.1%. The majority of injuries in males (56.2% and females (36.0% occurred in the 15-44 age group and 0-14 age group, respectively. The final visual acuity correlated with the initial visual acuity (Spearman's correlation coefficient = 0.659; P<0.001. The Ocular Trauma Score also correlated with the final visual acuity (Spearman's correlation coefficient = 0.655; P<0.001. CONCLUSIONS: This analysis provides an epidemiological study of patients who were hospitalized for ocular trauma. Preventive efforts are important for both work-related and home-related eye injuries.

  8. A Study of Post-Caesarean Section Wound Infections in a Regional Referral Hospital, Oman

    Directory of Open Access Journals (Sweden)

    Hansa Dhar

    2014-05-01

    Full Text Available Objectives: The aim of this study was to determine the incidence of surgical site infections (SSI in patients undergoing a Caesarean section (CS and to identify risk factors, common bacterial pathogens and antibiotic sensitivity. SSI significantly affect the patient’s quality of life by increasing morbidity and extending hospital stays. Methods: A retrospective cross-sectional study was conducted in Nizwa Hospital, Oman, to determine the incidence of post-Caesarean (PCS SSI from 2001 to 2012. This was followed by a case-control study of 211 PCS cases with SSI. Controls (220 were randomly selected cases, at the same hospital in the same time period, who had undergone CS without any SSI. Data was collected on CS type, risk factors, demographic profile, type of organism, drug sensitivity and date of infection. Results: The total number of PCS wound infections was 211 (2.66%. There was a four-fold higher incidence of premature rupture of the membranes (37, 17.53% and a three-fold higher incidence of diabetes (32, 15.16% in the PCS cases compared with controls. The most common organisms responsible for SSI were Staphylococcus aureus (66, 31.27% and the Gram-negative Escherichia coli group (40, 18.95%. The most sensitive antibiotics were aminoglycoside and cephalosporin. Polymicrobial infections were noted in 42 (19.90%, while 47 (22.27% yielded no growth. A high incidence of associated risk factors like obesity, hypertension, anaemia and wound haematoma was noted. Conclusion: Measures are recommended to reduce the incidence of SSI, including the implementation of infection prevention practices and the administration of antibiotic prophylaxis with rigorous surgical techniques.

  9. Recording and Management of CCT in a Public Hospital in the Region of Laconia in Greece

    Directory of Open Access Journals (Sweden)

    Georgia Gkiouzeli

    2013-01-01

    Full Text Available Background: Cranium-cerebral traumas in today’s era are a serious public health problem with bothsocial and economic dimensions. They are characterized as an ‘epidemic’, due to the increase in car accidents and they particularly affect the productive population.The objective of this study was to investigate the occurrence and allocation of Cranium-cerebral traumas among the population in the Prefecture of Laconia, in order to determine the explanatory factors or risk factors, the record of how they are managed (diagnosis, therapy, and outcome and their correlation with demographics and other factors.Methodology: This study was conducted with the collection of data from hospital archives and Emergency Department logbooks from the General Hospital of Sparta. Specifically designed record forms were used which included patient demographics, means of arrival to the hospital, the clinical pictures, the gravity of the injury, possible accompanying injuries, diagnostic tests, treatment and outcome, as well as evidence related to the causes of the injury.Results: 2352 cases of children and adults with Cranium-cerebral traumas were included in this study who came to the Emergency Department from 1st of January 2005 to 31st of December 2010. The cause of Cranium-cerebral traumas in adults is affected by gender, nationality and place of residence, while in children it is affected by place of residence and the means of arrival to the Emergency Department. Respectively, the outcome of Cranium–cerebral traumas in adults is affected by place of residence and their means of arrival to the hospital while in children it is affected by nationality and place of residence.Conclusions: This study has revealed the magnitude of the problem and the epidemiological characteristics of Cranium-cerebral traumas in the Prefecture of Laconia, with the ultimate need for intervention at a level of prevention. Proposals regard the improvement in road networks, informative

  10. Bloqueo regional axilar en trauma de miembro superior en el Hospital General Luis Vernaza.

    OpenAIRE

    Mendoza Ligua, Rosa Mariluz

    2015-01-01

    El objetivo del trabajo fue determinar tiempo de analgesia en el posoperatorio, medir analgesia mediante escala visual análoga (EVA), protocolizar el bloqueo axilar del plexo braquial como anestesia de elección en el trauma de miembro superior antebrazo muñeca y mano para disminuir losrequerimientos analgésico posquirúrgicos, valoración demográfica por edad sexo y ASA en el Hospital General Luis Vernaza. Materiales y métodos: El estudio fue prospectivo analítico experi...

  11. Treatment outcome for a sample of patients with Class II division 1 malocclusion treated at a regional hospital orthodontic department.

    LENUS (Irish Health Repository)

    Burden, D J

    1998-01-01

    This retrospective study assessed the outcome of orthodontic treatment of 264 patients with Class II division 1 malocclusion (overjet greater than 6 mm). The sample comprised patients who had completed their fixed appliance orthodontic treatment at a regional hospital orthodontic unit in the Republic of Ireland. The PAR Index (Peer Assessment Rating) was used to evaluate treatment outcome using before and after treatment study casts. The results revealed that treatment for this particular type of malocclusion was highly effective with a very few patients failing to benefit from their orthodontic treatment.

  12. A training network for introducing telemedicine, telecare and hospital informatics in the Adriatic-Danube-Black Sea region.

    Science.gov (United States)

    Anogeianaki, Antonia; Ilonidis, George; Anogianakis, George; Lianguris, John; Katsaros, Kyriakos; Pseftogianni, Dimitra; Klisarova, Anelia; Negrev, Negrin

    2004-01-01

    DIMNET is a training mechanism for a region of central Europe. The aim is to upgrade the information technology skills of local hospital personnel and preserve their employability following the introduction of medical informatics. DIMNET uses Internet-based virtual classrooms to provide a 200-hour training course in medical informatics. Training takes place in the cities of Drama, Kavala, Xanthi and Varna. So far, more than 600 people have benefited from the programme. Initial results are encouraging. DIMNET promotes a new vocational training culture in the Balkans and is supported by local governments that perceive health-care as a fulcrum for economic development.

  13. Hospitals, Hospital Locations in 9 county South Georgia area, Published in 1999, 1:4800 (1in=400ft) scale, Southern Georgia Regional Commission.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Hospitals dataset, published at 1:4800 (1in=400ft) scale, was produced all or in part from Field Survey/GPS information as of 1999. It is described as 'Hospital...

  14. General and specific factors in the explanation of regional variation of hospital admission rates: policy consequences for Belgium and the Netherlands.

    NARCIS (Netherlands)

    Groenewegen, P.P.; Zee, J. van der

    1987-01-01

    The analysis of regional variations in hospital admission rates for Belgium and the Netherlands shows that the available number of hospital beds together with the health status of the population (roughly indicated by age-adjusted mortality rates) are common factors to influence these admissions in

  15. General and specific factors in the explanation of regional variation of hospital admission rates: policy consequences for Belgium and the Netherlands

    NARCIS (Netherlands)

    Zee, J. van der; Groenewegen, P.P.

    The analysis of regional variations in hospital admission rates for Belgium and the Netherlands shows that the available number of hospital beds together with the health status of the population (roughly indicated by age-adjusted mortality rates) are common factors to influence these admissions in

  16. Risk of Lung Cancer and Indoor Radon Exposure in France

    Energy Technology Data Exchange (ETDEWEB)

    Baysson, H.; Tirmarche, M.; Tymen, G.; Ducloy, F.; Laurier, D.

    2004-07-01

    It is well established that radon exposure increases risks of lung cancer among underground miners. to estimate the lung cancer risk linked to indoor radon exposure, a hospital based case-control study was carried out in France, With a focus on precise reconstruction of past indoor radon exposure over the 30 years preceding the lung cancer diagnosis. The investigation rook place from 1992 to 1998 in four regions of France: Auvergne, Brittany, Languedoc and Limousin. During face-to-face interviews a standardized questionnaire was used to ascertain demographic characteristics, information on active and passive smoking, occupational exposure, medical history as well as extensive details on residential history. Radon concentrations were measured in the dwellings where subjects had lived at least one year during the 5-30 year period before interview. Measurements of radon concentrations were performed during a 6-month period, using two Kodalpha LR 115 detectors, one in the living room and one in the bedroom. The time-weighted average (TWA) radon concentration for a subject during the 5-30 year period before interview was based on radon concentrations over all addresses occupied by the subject weighted by the number of years spent at each address. For the time intervals without available measurements, we imputed the region-specific arithmetic average of radon concentrations for measured addresses of control subjects. Lung cancer risk was examined in relation to indoor radon exposure after adjustment for age, sex, region, cigarette smoking and occupational exposure. The estimated relative a risk per 100 Bq/m''3 was 1.04, at the borderline of statistical significance (95 percent Confidence Interval: 0.99, 1..1). These results are in agreement with results from other indoor radon case-control studies and with extrapolations from underground miners studies. (Author) 31 refs.

  17. Pediatric blood transfusion practices at a regional referral hospital in Kenya.

    Science.gov (United States)

    Nabwera, Helen M; Fegan, Greg; Shavadia, Jay; Denje, Douglas; Mandaliya, Kishor; Bates, Imelda; Maitland, Kathryn; Hassall, Oliver W

    2016-11-01

    Severe anemia in children is a major public health problem in sub-Saharan Africa. In this study we describe clinical and operational aspects of blood transfusion in children admitted to Coast Provincial General Hospital, Kenya. This was an observational study where over a 2-year period, demographic and laboratory data were collected on all children for whom the hospital blood bank received a transfusion request. Clinical data were obtained by retrospective review of case notes over the first year. There were 2789 requests for blood for children (median age, 1.8 years; interquartile range [IQR], 0.6-6.6 years); 70% (1950) of the samples were crossmatched with 85% (1663/1950) issued. Ninety percent (1505/1663) were presumed transfused. Median time from laboratory receipt of request to collection of blood was 3.6 hours (IQR, 1.4-12.8 hr). Case notes of 590 children were reviewed and median pretransfusion hemoglobin level was 6.0 g/dL (IQR, 4.2-9.1 g/dL). Ninety-four percent (186) were transfused "appropriately" while 52% (120) were transfused "inappropriately." There was significant disagreement between the clinical and laboratory diagnosis of severe anemia (exact McNemar's test; p practice. © 2016 The Authors. Transfusion published by Wiley Periodicals, Inc. on behalf of AABB.

  18. Cuidado intensivo en un hospital regional: Características demográficas y mortalidad

    Directory of Open Access Journals (Sweden)

    Donato A Salas-Segura

    2005-07-01

    Full Text Available Objetivo: Describir las principales características de la población ingresada a la Unidad de Cuidado Intensivo, Hospital Tony Facio Castro de Limón. Materiales y métodos: Se recabó la información de todos los pacientes ingresados a la Unidad de Cuidado Intensivo del Hospital Tony Facio, durante un período de 6 meses. Los datos fueron almacenados y procesados en una base creada en SPSS 11.0. Resultados: Se estudiaron un total de 155 pacientes, 82 (53% eran hombres, 113 ingresaron del área de medicina, 34 al área quirúrgica y 8 a la ginecobstétrica. La estancia promedio fue de 5,22 días. La mayoría de los pacientes (30% ingresaron por síndrome coronario agudo. La mortalidad general fue del 15,5% (24 pacientes, y la causa principal fue shock séptico. Conclusión: Se presentan los primeros datos publicados en el país sobre las características demográficas de la población que ingresa a una unidad de cuidado intensivo

  19. PREVALENCE OF HEPATITIS B INFECTION IN A TERTIARY CARE HOSPITAL, NORTH EAST REGION OF INDIA

    Directory of Open Access Journals (Sweden)

    Arun

    2014-09-01

    Full Text Available : BACKGROUND: HBV Virus is one of the major health problems in India. Hepato cellular carcinoma due to HBV infection is 5th most frequent cancer in world wide. About 30% population has serological evidence of current or past infection with HBV. In the natural history of HBV infection, the most important event is HBeAg, Seroconversion is characterized by loss of HBeAg and development of antibody against HBeAg. AIMS: The aim of the study was to determine sero prevalence of hepatitis B infection among different age, sex groups and to understand the risk factors that define the development of HBsAg. DESIGN - The study design was based on clinical evaluation and serological testing. METHODS: The study was conducted in the Department of Microbiology of a tertiary care hospital, G.B. Panth Hospital. Agartala, West Tripura during the period over 5 years, 2001 – 2005.In this retrospective study, total 21, 121 numbers of patients serum were examined by ELISA method to detect the Hepatitis B surface antigen in different categories of patient as a marker of infection. out of 21, 121 patients, 1044 number of cases were seropositive showing the prevalence rate 4.94% in compared with hepatitis B virus infection in India is 4%. Details clinical history, age, sex, risk factors were recorded carefully. -

  20. Inter-annual variability in flowering of orchids: lessons learned from 8 years of monitoring in a Mediterranean region of France

    Directory of Open Access Journals (Sweden)

    Hélène Vogt-Schilb

    2013-12-01

    Full Text Available It is important to evaluate the loss of biodiversity caused by global changes. In the case of orchids, it is still unclear how long the monitoring duration should be chosen in order to achieve a good compromise between the reliability of the orchid dynamics recorded and sampling duration (e.g. years of monitoring. This study aims to propose a method of monitoring orchids. Using a large database, we investigated the inter-annual variability in flowering of orchids in a French Mediterranean region. The database includes an 8-year-long study (2006–2013 of 47 species at 26 locations in three different types of habitats. The number of individual plants that flowered per species varied significantly between years, but not the number of species. Depending on habitat, two to four years were needed to observe the total number of species per location. Therefore, in Mediterranean regions a one-year-study seems to be insufficient to produce reliable results.

  1. Impact of a Baby-Friendly hospital on breastfeeding indicators in Shaqlawa district in Erbil governorate, Kurdistan region of Iraq.

    Science.gov (United States)

    Shaker, N Z; Hasan, S S; Ismail, Z A

    2016-03-15

    This study aimed to assess the impact of the Baby-Friendly Hospital Initiative on WHO-defined breastfeeding indicators in Shaqlawa district in Kurdistan region of Iraq. A household survey was carried out on a purposive non-probability sample of 200 mothers with a child aged < 30 months. Mothers were interviewed using a structured form to determine demographic data and feeding practices of the most recent child. The rate of early initiation of breastfeeding was 38.1%, exclusive breastfeeding was 15.4% and continued breastfeeding was 61.0% and 39.5% at 1 and 2 years of age respectively. A significant relationship was found between delivery at the Baby- Friendly accredited hospital and early initiation of breastfeeding but not with exclusive or continued breastfeeding. While continued breastfeeding at 1 year and 2 year was good, early initiation and exclusive breastfeeding indicators were not at an acceptable level, which indicates an ineffective role for the Baby-Friendly Hospital Initiative.

  2. [Development of a microbiology data warehouse (Akita-ReNICS) for networking hospitals in a medical region].

    Science.gov (United States)

    Ueki, Shigeharu; Kayaba, Hiroyuki; Tomita, Noriko; Kobayashi, Noriko; Takahashi, Tomoe; Obara, Toshikage; Takeda, Masahide; Moritoki, Yuki; Itoga, Masamichi; Ito, Wataru; Ohsaga, Atsushi; Kondoh, Katsuyuki; Chihara, Junichi

    2011-04-01

    The active involvement of hospital laboratory in surveillance is crucial to the success of nosocomial infection control. The recent dramatic increase of antimicrobial-resistant organisms and their spread into the community suggest that the infection control strategy of independent medical institutions is insufficient. To share the clinical data and surveillance in our local medical region, we developed a microbiology data warehouse for networking hospital laboratories in Akita prefecture. This system, named Akita-ReNICS, is an easy-to-use information management system designed to compare, track, and report the occurrence of antimicrobial-resistant organisms. Participating laboratories routinely transfer their coded and formatted microbiology data to ReNICS server located at Akita University Hospital from their health care system's clinical computer applications over the internet. We established the system to automate the statistical processes, so that the participants can access the server to monitor graphical data in the manner they prefer, using their own computer's browser. Furthermore, our system also provides the documents server, microbiology and antimicrobiotic database, and space for long-term storage of microbiological samples. Akita-ReNICS could be a next generation network for quality improvement of infection control.

  3. Incidence and Etiology of Surgical Site Infections among Emergency Postoperative Patients in Mbarara Regional Referral Hospital, South Western Uganda

    Directory of Open Access Journals (Sweden)

    Abubaker Lubega

    2017-01-01

    Full Text Available Background. This prospective hospital based study was conducted to determine the incidence, risk factors, and causative agents of surgical site infection their susceptibility to among 114 emergency postoperative patients at the Mbarara Regional Referral Hospital between September 2014 and January 2015. Methods. Consented patients were consecutively enrolled and their preoperative, intraoperative, and postoperative data were collected. Follow-ups were done in the surgical outpatient clinics. Wound specimens were collected and processed as per Sops; susceptibility testing was done using the Kirby-Bauer disc diffusion technique. Data was analyzed using STATA 11.0. Results. Overall SSI incidence was 16.4%: 5.9% superficial and 47.1% deep and organ space SSIs each. Klebsiella pneumoniae was the most predominant organism (50% followed by Staphylococcus aureus (27.8%. E. coli and P. aeruginosa both accounted for 11.1%. Wound class (p=0.009, anaemia (p=0.024, low serum albumin (p=0.046, and property of suture material used (p=0.006 were significantly associated with SSIs. All organisms had 100% resistance to ampicillin, tetracycline, septrin, and erythromycin. Ciprofloxacin and ceftriaxone are highly sensitive to all organisms. Conclusion. The incidence of SSI in this hospital is very high. Klebsiella pneumoniae is the predominant cause. Ciprofloxacin are very potent antibiotics against organisms that cause SSI.

  4. Incidence and Etiology of Surgical Site Infections among Emergency Postoperative Patients in Mbarara Regional Referral Hospital, South Western Uganda

    Science.gov (United States)

    Joel, Bazira; Justina Lucy, Najjuka

    2017-01-01

    Background. This prospective hospital based study was conducted to determine the incidence, risk factors, and causative agents of surgical site infection their susceptibility to among 114 emergency postoperative patients at the Mbarara Regional Referral Hospital between September 2014 and January 2015. Methods. Consented patients were consecutively enrolled and their preoperative, intraoperative, and postoperative data were collected. Follow-ups were done in the surgical outpatient clinics. Wound specimens were collected and processed as per Sops; susceptibility testing was done using the Kirby-Bauer disc diffusion technique. Data was analyzed using STATA 11.0. Results. Overall SSI incidence was 16.4%: 5.9% superficial and 47.1% deep and organ space SSIs each. Klebsiella pneumoniae was the most predominant organism (50%) followed by Staphylococcus aureus (27.8%). E. coli and P. aeruginosa both accounted for 11.1%. Wound class (p = 0.009), anaemia (p = 0.024), low serum albumin (p = 0.046), and property of suture material used (p = 0.006) were significantly associated with SSIs. All organisms had 100% resistance to ampicillin, tetracycline, septrin, and erythromycin. Ciprofloxacin and ceftriaxone are highly sensitive to all organisms. Conclusion. The incidence of SSI in this hospital is very high. Klebsiella pneumoniae is the predominant cause. Ciprofloxacin are very potent antibiotics against organisms that cause SSI. PMID:28168215

  5. Problems and solutions on issues of medical care quality in community-acquired pneumonia in hospitals of Saratov region

    Directory of Open Access Journals (Sweden)

    Lotsmanov Yu.F.

    2011-06-01

    Full Text Available Qualitative assessment of diagnostics and treatment of patients with community-acquired pneumonia (CAP was carried out in ten therapeutic departments of urban and district hospitals of Saratov region, using quality indicators (Qls. Each case of CAP was assessed in expert health care quality (HCQ card according to the diagnostic and treatment quality federal standards and the basic Ql. The application of Ql in CAP patients allowed revealing the following: low CAP agent isolation rate; late hospitalization of CAP patients; low frequency of sputum bacteriological and bacterioscopic investigations prior to antibiotic therapy; insufficient frequency of step-by-step introduction of antibiotics. Recommendations on CAP patients dispenserization were not properly prescribed; recommendations on vaccination were absent. The basic measures of HCQ improvement are as follows: organizing for each CAP patient therapeutic and diagnostic quality control according to Ql; quick administrative decisions; using of HCQ expertise during the first 2-3 days of treatment to correct diagnosis and treatment; optimizing hospital diagnostic resources (laboratory and instrumental and rational pharmacotherapy

  6. [Current situation of pediatric emergency in tertiary and teaching hospitals in 15 provinces, municipalities and autonomous regions in China Mainland].

    Science.gov (United States)

    2014-12-01

    Pre-hospital care, emergency department and critical care medicine are the key components of emergency medical service system. Two investigations about the pediatric critical care medicine in China mainland showed great progress. In recent years, most hospitals in China mainland have established emergency department, hardware configuration and staff status were gradually standardized. But most of the emergency departments mainly provide service to adult patients and pediatric emergency medicine lags behind. The purpose of this investigation was to understand the current situation and main problems of pediatric emergency in China mainland. A questionnaire developed by the Subspecialty Group of Pediatrics, Chinese Society of Emergency Medicine and the Subspecialty Group of Emergency Medicine, Chinese Society of Pediatrics was e-mailed to the members of the above-mentioned two subspecialty groups. The contents of the questionnaire included 46 items which were divided into 5 categories: the general situation of the hospital, the pediatric emergency setting and composition, key equipments and techniques, staff status, training program and running data from 2011 to 2012. Sixty-three questionnaires were delivered and 27 (42.9%) hospitals responded which located in 15 different provinces, municipalities and autonomous regions. Among the 27 hospitals, 10 (37.0%) had no pediatric resuscitation room; 25 (92.6%) had no equipments for cardiac output monitor and gastric lavage; 13 (48.1%) had no bedside fibrolaryngoscope or fiberbronchoscope; 5 (18.5%) had no blood gas analyzer; 4 (14.8%) without respirator, defibrillator, bedside radiography or ultrasonic equipment; 2 (7.4%) had no neonatal incubator; 9 (33.3%) could not do intraossous infusion. The average ratio of professional emergency pediatricians to all physicians was 43.5%. Twenty hospitals incompletely filled in the pediatric emergency running data. The main problems existing in pediatric emergency include: imperfect

  7. Decline in hospitalization for genital warts in the Veneto region after an HPV vaccination program: an observational study.

    Science.gov (United States)

    Cocchio, Silvia; Baldovin, Tatjana; Bertoncello, Chiara; Buja, Alessandra; Furlan, Patrizia; Saia, Mario; Baldo, Vincenzo

    2017-04-05

    Human papillomavirus (HPV) is one of the most common sexually transmitted pathogens. This observational study was conducted to estimate the trend of hospitalization for genital warts (GWs) in the Veneto region (Italy) from 2004 to 2015. All patients with GWs were identified in the hospital discharge records of all public and accredited private hospitals that related to Veneto residents and contained the ICD9-CM code 078.11 associated with a genital surgical procedure (vulval/vaginal warts, penile warts and anal warts). Annual total and sex- and age-specific hospitalization rates and trends were calculated and correlated with the different HPV vaccine coverage over the study period. An annual rate of 11.8 per 100,000 population (8.6 per 100,000 males, and 14.8 per 100,000 females) was found, corresponding to 6076 hospitalizations for condyloma (53.3% vulval/vaginal, 35.8% anal, 8.3% penile, and 2.6% both penile or vulval/vaginal and anal). Among females, the rate of overall GWs remained stable to 2007 (19.1 per 100,000), then dropped significantly, reaching a rate of 11.3 per 100,000 in 2015 (average annual percent changes [AAPC]: -6.1%; 95% CI: -8.4; -3.7). For males, the overall rate increased over the study period (from 6.4 per 100,000 in 2004 to 10.8 per 100,000 in 2015; AAPC: 3.8%; 95% CI: 1.2; 6.4). Among the potentially vaccinated females (12- to 20-year-olds) there was a 62.1% decrease in the number of vulval/vaginal warts from the years 2010-2012 to the years 2013-2015 due to an increase in the HPV coverage rate. A similar reduction among males was observed in the same period and the same age group for penile warts (-68.2%). GWs have an important impact on the health services and data suggest that GW-related hospitalization rates rapidly decline in a population with a high HPV vaccination coverage (about 75%). Further efforts should be made to better clarify the epidemiological picture regarding HPV-related diseases, with particular regard to sexual

  8. A retrospective study on the outcomes of cataract surgery in an Eastern Regional Health Authority hospital of Trinidad and Tobago

    Directory of Open Access Journals (Sweden)

    Ebiakpo-aboere Sonron

    2015-09-01

    Full Text Available Background. Worldwide, cataract is a major cause of blindness. The paper aims to evaluate factors associated with borderline and poor outcomes of cataract surgery at an Eastern Regional Health Authority (ERHA hospital in Trinidad and Tobago.Materials and Methods. A hospital-based, retrospective study was done on 401 patients who had undergone cataract surgery (unilateral and bilateral at an ERHA Hospital between March 2009 and September 2014. Data was collected on variables concerning demographic, medical history, surgical history, ocular findings and visual acuity (VA. The outcome variable of interest was Snellen’s post-operative (presenting VA which was transformed into a dichotomous variable with borderline and poor outcomes as one and good outcomes as the other. Data were analysed using univariate and multivariate logistic regression analyses.Results. Good outcome (presenting VA 6/18 or better was seen in 350 (67% eyes. The fitted model consisted of ocular co-morbidity (OR =2.133; 95% CI [1.346–3.380], hypertension (OR = 0.520; 95% CI [0.381–0.928], surgical procedure (OR = 1.56; 95% CI [1.004–2.425], good preoperative VA (OR = 0.388, 95% CI [0.211–0.714], borderline preoperative VA (OR = 0.485; 95% CI = [0.278–0.843] and year of first visit to clinic (OR = 2.243; 95% CI [1.215–4.141].Conclusion. There is a need for community-based outreach to increase awareness of eye health and diseases. It is recommended that the general population is encouraged to take responsibility for personal management. The facilities at the Hospital should also be enhanced.

  9. SÍNDROME HELLP: EXPERIENCIA DEL HOSPITAL REGIONAL DE PUERTO MONTT, 2000-2006

    OpenAIRE

    Caro M.,José; Anwandter Sch.,Carlos; Schaffeld P,Soledad; Vega G,Fernando; López S,Carolina; Jara P,Jacqueline

    2008-01-01

    Objetivos: Caracterizar el síndrome HELLP en una población obstétrica de la décima Región de Chile. Método: Análisis de 33 pacientes con síndrome HELLP asistidas en el hospital de Puerto Montt, en el período 2000-2006. Resultados: La incidencia fue 1,3 casos por mil partos. La edad gestacional promedio de presentación fue de 33 semanas. En 84,8% de las pacientes el diagnóstico fue anteparto. El 27% de las pacientes recibió dexametasona. La principal complicación materna fue la insuficiencia r...

  10. Plasmodium vivax hospitalizations in a monoendemic malaria region: severe vivax malaria?

    Science.gov (United States)

    Quispe, Antonio M; Pozo, Edwar; Guerrero, Edith; Durand, Salomón; Baldeviano, G Christian; Edgel, Kimberly A; Graf, Paul C F; Lescano, Andres G

    2014-07-01

    Severe malaria caused by Plasmodium vivax is no longer considered rare. To describe its clinical features, we performed a retrospective case control study in the subregion of Luciano Castillo Colonna, Piura, Peru, an area with nearly exclusive vivax malaria transmission. Severe cases and the subset of critically ill cases were compared with a random set of uncomplicated malaria cases (1:4). Between 2008 and 2009, 6,502 malaria cases were reported, including 106 hospitalized cases, 81 of which fit the World Health Organization definition for severe malaria. Of these 81 individuals, 28 individuals were critically ill (0.4%, 95% confidence interval = 0.2-0.6%) with severe anemia (57%), shock (25%), lung injury (21%), acute renal failure (14%), or cerebral malaria (11%). Two potentially malaria-related deaths occurred. Compared with uncomplicated cases, individuals critically ill were older (38 versus 26 years old, P malaria monoinfection with critical illness is more common than previously thought.

  11. An exploratory study of the pattern of consent for autopsy in a regional hospital setting.

    LENUS (Irish Health Repository)

    Kaar, T K

    2012-02-03

    A prospective study of the pattern of responses to requests for autopsy in a general surgical unit was performed. Information on the characteristics of the deceased, of the requestee and of the requester was documented in the case of 66 patients who died while in hospital. Permission to perform autopsy was not requested in 39 out of 66 cases and this was the most frequent contributory factor to the low rate of autopsy. Once a decision to grant or refuse autopsy is made by relatives of the deceased, the decision is unlikely to be reversed. Permission to perform autopsy was more likely to be sought when the deceased was male than when deceased was female. The relatives of patients who had recently undergone surgery were more likely to refuse permission for autopsy than were those of patients who had not had recent surgery.

  12. A realist evaluation of the management of a well- performing regional hospital in Ghana

    Directory of Open Access Journals (Sweden)

    Kegels Guy

    2010-01-01

    Full Text Available Abstract Background Realist evaluation offers an interesting approach to evaluation of interventions in complex settings, but has been little applied in health care. We report on a realist case study of a well performing hospital in Ghana and show how such a realist evaluation design can help to overcome the limited external validity of a traditional case study. Methods We developed a realist evaluation framework for hypothesis formulation, data collection, data analysis and synthesis of the findings. Focusing on the role of human resource management in hospital performance, we formulated our hypothesis around the high commitment management concept. Mixed methods were used in data collection, including individual and group interviews, observations and document reviews. Results We found that the human resource management approach (the actual intervention included induction of new staff, training and personal development, good communication and information sharing, and decentralised decision-making. We identified 3 additional practices: ensuring optimal physical working conditions, access to top managers and managers' involvement on the work floor. Teamwork, recognition and trust emerged as key elements of the organisational climate. Interviewees reported high levels of organisational commitment. The analysis unearthed perceived organisational support and reciprocity as underlying mechanisms that link the management practices with commitment. Methodologically, we found that realist evaluation can be fruitfully used to develop detailed case studies that analyse how management interventions work and in which conditions. Analysing the links between intervention, mechanism and outcome increases the explaining power, while identification of essential context elements improves the usefulness of the findings for decision-makers in other settings (external validity. We also identified a number of practical difficulties and priorities for further

  13. Feasibility study for epidemic prevention and control in a regional hospital.

    Science.gov (United States)

    Chen, Yung-Liang; Yeh, Ming-Yang; Huang, Shau-Yen; Liu, Chi-Ming; Sun, Chi-Chen; Lu, Hsu-Feng; Chiu, Tsan-Hung; Hsia, Te-Chun; Chung, Jing-Gung

    2012-03-01

    Epidemic prevention policies in hospitals address issues such as, indoor air quality control, cleanliness of medical staff clothing and employee hand-washing procedures. Our hospital employed Bio-Kil to treat air-conditioning filters and nursing staff uniforms. We also assessed the efficacy of different detergents. Using Bio-Kil technology, the mean bacterial count in the air was reduced from 108.8 CFU/h/plate (n=420) to 68.6 CFU/h/plate (n=630). On the lower hems of the Bio-Kil-treated gowns, the mean bacterial count was 1,201 CFU/100 cm(2), markedly lower than the bacterial count of 7,753 CFU/100 cm(2), found on the parts of the gowns not treated with Bio-Kil (p=0.0401). On the cuffs of sleeves treated with Bio-Kil, the mean count was 1,165 CFU/100 cm(2), markedly lower than that of 2,131 CFU/100 cm(2), found on the cuffs not treated with Bio-Kil (p=0.0073). With regard to the mean bacterial eradication rates of antimicrobial solutions, Steridal Solution, 75% alcohol and Bio-Kil (3rd generation) were shown to be the most effective, with rates exceeding 80%. Hibiscrub with paper towels and Fresh Protect Skin were the second most effective. Bio-Kil (1st generation), tap water with paper towels, liquid hand soap with paper towels and ozone water were the least effective. One important observation was that hand-washing without the use of paper towels increased the bacterial count by as much as 84% . Bio-Kil is effective in reducing bacterial counts in the air, on nursing staff uniforms and is an effective detergent.

  14. A realist evaluation of the management of a well-performing regional hospital in Ghana.

    Science.gov (United States)

    Marchal, Bruno; Dedzo, McDamien; Kegels, Guy

    2010-01-25

    Realist evaluation offers an interesting approach to evaluation of interventions in complex settings, but has been little applied in health care. We report on a realist case study of a well performing hospital in Ghana and show how such a realist evaluation design can help to overcome the limited external validity of a traditional case study. We developed a realist evaluation framework for hypothesis formulation, data collection, data analysis and synthesis of the findings. Focusing on the role of human resource management in hospital performance, we formulated our hypothesis around the high commitment management concept. Mixed methods were used in data collection, including individual and group interviews, observations and document reviews. We found that the human resource management approach (the actual intervention) included induction of new staff, training and personal development, good communication and information sharing, and decentralised decision-making. We identified 3 additional practices: ensuring optimal physical working conditions, access to top managers and managers' involvement on the work floor. Teamwork, recognition and trust emerged as key elements of the organisational climate. Interviewees reported high levels of organisational commitment. The analysis unearthed perceived organisational support and reciprocity as underlying mechanisms that link the management practices with commitment. Methodologically, we found that realist evaluation can be fruitfully used to develop detailed case studies that analyse how management interventions work and in which conditions. Analysing the links between intervention, mechanism and outcome increases the explaining power, while identification of essential context elements improves the usefulness of the findings for decision-makers in other settings (external validity). We also identified a number of practical difficulties and priorities for further methodological development. This case suggests that a well

  15. Enterococcal urinary tract infections: eight years experience at a regional hospital in Trinidad, West Indies

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective To investigate the prevalence of significant enterococcal isolates from urine and determine what factors are associated with the increased prevalence, with particular reference to antibiotic susceptibilities. Methods Retrospective analysis over an 8-year period of hospital laboratory records of urinary isolates of enterococci was done. Species were identified via colony morphology, growth in 6.5% sodium chloride and their ability to hydrolyze esculin in the presence of 40% bile salts. Susceptibility testing via the disc diffusion technique with 9 commonly used antibiotics was also done as defined by the National Committee for Clinical Laboratory Standards. Results From 39?881 urine specimens, 9116 (22.9%) were culture positive. Of this 9116, 1001 (11.0%) were enterococci, the 4th most common urinary isolate. E. coli was the most common (36.2%). Most enterococci were from pediatric patients (28.4%) and the urology unit (24.5%). All enterococci were fully sensitive to ampicillin and augmentin (amoxicillin-clavulanic acid). Sensitivity to gentamicin decreased significantly from 79% in 1990 to 58% in 1997 (P<0.005). Sensitivity to the cephalosporins and nitrofuratoin were relatively stable, but sensitivity to nalidixic acid varied. No resistance to vancomycin was detected during the study, and no cases of bacteremia complicated bacteriuria were seen. Conclusion Isolation of enterococci was relatively stable during the 8-year period, and all isolates were fully sensitive to the older β-lactams, ampicillin, cefaclor and augmentin, but displayed varying degrees of multi-resistance to other commonly used urinary agents such as nalidixic acid and co-trimoxazole (trimethoprim-sulfamethoxazole). Because of the emergence of multi-resistant enterococci in many countries, and the high cost of drugs in our society, it is imperative that vigilance be maintained in monitoring enterococcal infections in hospitals.

  16. France: Health system review.

    Science.gov (United States)

    Chevreul, Karine; Durand-Zaleski, Isabelle; Bahrami, Stéphane Bahrami; Hernández-Quevedo, Cristina; Mladovsky, Philipa

    2010-01-01

    The Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis. The French health care system is a mix of public and private providers and insurers. Public insurance, financed by both employees and employer contributions and earmarked taxes, is compulsory and covers almost the whole population, while private insurance is of a complementary type and voluntary. Providers of outpatient care are largely private. Hospital beds are predominantly public or private non-profit-making. The French population enjoys good health and a high level of choice of providers. It is relatively satisfied with the health care system. However, as in many other countries, the rising cost of health care is of concern with regards to the objectives of the health care system. Many measures were or are being implemented in order to contain costs and increase efficiency. These include, for example, developing pay-for-performance for both hospitals and self-employed providers and increasing quality of professional practice; refining patient pathways; raising additional revenue for statutory health insurance (SHI); and increasing the role of voluntary health insurance (VHI). Meanwhile, socioeconomic disparities and geographic inequality in the density of health care professionals remain considerable challenges to providing a good level of equity in access to health care. Organizational changes at the regional level are important in attempting to tackle both equity and efficiency-related challenges. While the organizational structure of the system

  17. Taxation in France

    CERN Multimedia

    HR Department

    2016-01-01

    Information regarding income tax in France. Request for additional information: social security number and personal details.   Some members of the personnel living in France have received a letter from the French tax authorities accompanied by a form, to be returned by 31 March 2016 at the latest, asking them to indicate their social security number and to confirm their personal details. As employed members of the CERN personnel are members of the Organization’s own health insurance scheme and do not participate in the French social security system, we recommend that you tick the box indicating that you do not have a social security number. We also advise you to specify in writing that, as an employed member of the CERN personnel, you do not participate in the French social security system especially by virtue of the 1970 agreement on social security between France and CERN: “Je ne suis pas soumis(e), en tant que fonctionnaire du CERN, à la sécurit&...

  18. THE ADMINISTRATIVE SYSTEM IN FRANCE

    Directory of Open Access Journals (Sweden)

    DOINA POPESCU

    2012-05-01

    Full Text Available According to the Constitution promulgated on the 6th of October 1958, with the latest amendments made in 1999, France is a presidential republic. The three authority branches are broadly represented in the French administration: the judicial branch – French courts of law are divided into: judicial courts and administrative courts. Judicial courts are under the supreme authority of the Court of Cassation with jurisdiction to cancel judgments passed courts on inferior hierarchy levels and plays a central role in the appropriate performance of the activity. The legislative body - normally, the legislation is voted by Parliament. French Parliament is comprised of two chambers: the National Assembly and the Senate. The National Assembly is elected for five years by way of direct universal voting. The Senate is elected by way of indirect universal voting by the electoral group. The election system is based on rules contained in the Election Code. The executive authority is divided between the President of the Republic and the Prime Minister. The President of the Republic makes the appointments for civil and military positions located at the highest state level. The Council of Ministers is responsible for appointing the positions of state councillors, prefect and public administration director. The central government is headed by the Prime Minister. Regional authorities – the regions are free territories administered by elected Councils. As far as the metropolitan part of France is concerned, there are 22 such territories, to which are added other four districts / counties which are located out of borders. The region’s Prefect represents the state and is empowered to deploy legal actions in order to protect the state’s best interest. County authorities – there are currently 96 de districts, to which four other territories located out of borders are added, as well as the territorial communities of Mayoutte and St-Pierre et Miquelon. There are

  19. Association between treatment or usual care region and hospitalization for fall-related traumatic brain injury in the Connecticut Collaboration for Fall Prevention.

    Science.gov (United States)

    Murphy, Terrence E; Baker, Dorothy I; Leo-Summers, Linda S; Allore, Heather G; Tinetti, Mary E

    2013-10-01

    To evaluate the association between the treatment region (TR) or usual care region (UCR) of the Connecticut Collaboration for Fall Prevention (CCFP), a clinical intervention for prevention of falls, and the rate of hospitalization for fall-related traumatic brain injury (FR-TBI) in persons aged 70 and older and to describe the Medicare charges for FR-TBI hospitalizations. Using a quasi-experimental design, rates of hospitalization for FR-TBI were recorded over an 8-year period (2000-2007) in two distinct geographic regions (TR and UCR) chosen for their similarity in characteristics associated with occurrence of falls. Two geographical regions in Connecticut. More than 200,000 persons aged 70 and older. Clinicians in the TR translated research protocols from the Yale Frailty and Injuries: Cooperative Studies of Intervention Techniques, a successful fall-prevention randomized clinical trial, into discipline- and site-specific fall-prevention procedures for integration into their clinical practices. Rate of hospitalization for FR-TBI in persons aged 70 and older. Connecticut Collaboration for Fall Prevention's TR exhibited lower rates of hospitalization for FR-TBI than the UCR (risk ratio = 0.84, 95% credible interval = 0.72-0.99). The significantly lower rate of hospitalization for FR-TBI in CCFP's TR suggests that the engagement of practicing clinicians in the implementation of evidence-based fall-prevention practices may reduce hospitalizations for FR-TBI. © 2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society.

  20. Multi-time-scale hydroclimate dynamics of a regional watershed and links to large-scale atmospheric circulation: Application to the Seine river catchment, France

    Science.gov (United States)

    Massei, N.; Dieppois, B.; Hannah, D. M.; Lavers, D. A.; Fossa, M.; Laignel, B.; Debret, M.

    2017-03-01

    In the present context of global changes, considerable efforts have been deployed by the hydrological scientific community to improve our understanding of the impacts of climate fluctuations on water resources. Both observational and modeling studies have been extensively employed to characterize hydrological changes and trends, assess the impact of climate variability or provide future scenarios of water resources. In the aim of a better understanding of hydrological changes, it is of crucial importance to determine how and to what extent trends and long-term oscillations detectable in hydrological variables are linked to global climate oscillations. In this work, we develop an approach associating correlation between large and local scales, empirical statistical downscaling and wavelet multiresolution decomposition of monthly precipitation and streamflow over the Seine river watershed, and the North Atlantic sea level pressure (SLP) in order to gain additional insights on the atmospheric patterns associated with the regional hydrology. We hypothesized that: (i) atmospheric patterns may change according to the different temporal wavelengths defining the variability of the signals; and (ii) definition of those hydrological/circulation relationships for each temporal wavelength may improve the determination of large-scale predictors of local variations. The results showed that the links between large and local scales were not necessarily constant according to time-scale (i.e. for the different frequencies characterizing the signals), resulting in changing spatial patterns across scales. This was then taken into account by developing an empirical statistical downscaling (ESD) modeling approach, which integrated discrete wavelet multiresolution analysis for reconstructing monthly regional hydrometeorological processes (predictand: precipitation and streamflow on the Seine river catchment) based on a large-scale predictor (SLP over the Euro-Atlantic sector). This

  1. Touristic specialization and returns on human capital in the hospitality sector of the Spanish regions

    Directory of Open Access Journals (Sweden)

    Alejandro García Pozo

    2012-01-01

    Full Text Available El objetivo de este trabajo es evaluar la existencia y el grado de especialización en la industria turística de las principales regiones españolas desde la perspectiva del stock de capital humano y de los rendimientos de la educación, centrándose en el subsector de la hostelería. Para ello, se ha utilizado una versión extendida de la ecuación de salarios de Mincer (1974 y datos procedentes de la Encuesta de Estructura Salarial para el año 2006. Todas las regiones analizadas muestran rendimientos de la educa-ción más bajos en el sector de la hostelería que los que se presentan en otros servicios privados. Existen también diferencias signifi cativas en los rendimientos de la educación entre regiones, especialmente en Cataluña y en las Islas Canarias.

  2. Changing trends in nervous system diseases among hospitalized children in the Chongqing region

    Institute of Scientific and Technical Information of China (English)

    Xin Zou; Nong Xiao; Bei Xu

    2008-01-01

    OBJECTIVE: To investigate the changing trends of nervous system diseases among hospitalized children and the risk factors of death. METHOD: The disease was statistically classified according to the International Statistical Classification of Disease and Health Problem (ICD10). The retrospective investigation includes demographic characteristics, as well as categories and fatality rates for nervous system diseases. All data was statistically analyzed. RESULTS: The percentage of nervous system diseases among inpatients in all wards was 2.4% (2 537/ 107 250) between January 1993 and December 1999, and 3.6% (6 082/170 619) between January 2000 and December 2006. The first ten patterns of various etiologic forms of nervous system diseases were identical-epilepsies and seizures, infections of the central nervous system, autoimmune and demyelination disorders, cerebral palsy, motor unit disorders, hypoxic-ischemic encephalopathy, hydrocephalus, extra-pyramidal disorders, congenital abnormalities of nervous system, and headache. Epilepsies and seizures took first place in both year groups, with 29.4% and 35%, respectively. Bacterial infections were responsible for the majority of cranial infections in both year groups, with 78.9% and 63.6% respectively. The death rate in the year group January 2000 to December 2006 was significantly less than in the year group January 1993 to December 1999 (X2= 27.832, P<0.01). CONCLUSION: Among all nervous system diseases, epilepsies and seizures were among the most common, with the lowest fatality rate.

  3. Pattern of gastrointestinal diseases in adult patients admitted to Samtah General Hospital, Gizan region, Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Aderoju Emmanuel

    1999-01-01

    Full Text Available To determine the relative frequencies of gastrointestinal diseases (GI in patients admitted to Samtah General Hospital, Gizan, the records of 2,442 adults admitted to the medical and surgical services for gastrointestinal diseases during the period 1413 to 1416 were analyzed retrospectively. 1,028 patients had acute appendicitis. The remaining 1,414 patients were admitted for various other GI diseases. In these 1,414 patients the commonest diseases were gastrointestinal infections (36.4%, peptic ulcer disease (19%, gall bladder disease (18.5%, viral hepatitis and its sequelae (20.7%. Despite the high prevalence of cholelithiasis, acute pancreatitis was uncommon (0.1 %. Inflammatory bowel disease was rare. There was no gender - related difference in the prevalence of gastrointestinal infections, peptic ulcer disease and carcinoma of the stomach. Males were significantly more afflicted than females with viral hepatitis (p< 0.0001, cirrhosis of the liver (p< 0.0001, hepatocellular carcinoma (p< 0.0005, variceal bleeding (p< 0.0005, and peptic ulcer bleeding (p< 0.005. As a large proportion of our patients had preventable diseases, it is expected that immunization and other public health measures will reduce the frequency of these diseases in the future.

  4. [Indications of primary cesarean deliveries in a regional teaching hospital and reasonable strategies for reducing them].

    Science.gov (United States)

    Zelli, P; Boussat, B; Wetzel, A; Ronin, C; Pons, J-C; Sergent, F

    2016-10-01

    To characterize the indications of primary cesarean sections and discuss the various possibilities to reduce them. Retrospective study, carried out over a period of 1 year in a university hospital having a level 3 perinatal activity, including the 499 primary cesarean sections of 2013. Two groups were defined by parity: nulliparous patients (group 1) and multiparous patients who had never previously been delivered by cesarean section (group 2). We have assessed the indication of every primary cesarean section and health status of newborns in each group. Groups 1 and 2 respectively included 369 and 130 patients. The cesarean section rate in 2013 was 24.7% with a primary cesarean section rate of 17%. Seventy-four percent of the primary caesarean deliveries were performed on nulliparous women and 26% on multiparous (Pcesarean delivery were non-reassuring fetal heart rate tracing (47.1%), failure to progress (24.8%) for which nulliparous women were more involved (29% vs. 13%, Pcesarean section rate. Copyright © 2016. Published by Elsevier Masson SAS.

  5. Implant associated surgical site infection in orthopaedics: a regional hospital experience.

    Science.gov (United States)

    Madu, K A; Enweani, U N; Katchy, A U; Madu, A J; Aguwa, E N

    2011-01-01

    Post operative surgical site infection following implant surgery is a major problem in orthopedic surgical practice. Infection occurring after internal fixation of a fracture is a devastating complication and may be difficult to treat. The frequency of occurrence of surgical site infection has decreased with improvements in aseptic technique. The objectives of the study are to determine the incidence of surgical site infection following orthopaedic related implant surgeries and to indentify the predisposing factors. The study was a prospective study conducted at the National orthopedic hospital, Enugu. Wound surveillance was carried out for the 97 patients included in this study for a period of 6 months postoperatively. The diagnosis of surgical site infection was in accordance with the CDC's guideline for prevention of surgical site infection published in 1999. The study included 61 males and 36 females giving a ratio of 1.7:1. The study population was aged 7 to 83 years with a mean age of 38.7 +/- 18.3 years. The infection rate was found to be 9.3% with staphylococcus aureus as the most common causative organism in 55.6% of cases. Two of the nine infected cases required implant removal. Significant factor was a theatre population of more than 6 persons. Surgical site infection following implant surgery is relatively common in our environment with staphylococcus aureus as the major causative organism. Increased theatre populations increase the risk of implant associated surgical site infection.

  6. Regions compete for French synchrotron

    CERN Multimedia

    2000-01-01

    Ten regions in France have placed bids to host the planned national synchrotron Soleil. Leading contenders include a joint bid from Ile-de-France and Essonne for Orsay, offering FF 1 billion towards the construction costs (2 paragraphs).

  7. Where are the radioactive wastes in France? Brochure no 1; Ou sont les dechets radioactifs en France? Brochure no 1

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2004-07-01

    This document is one of the 6 regional brochures which make the geographical inventory of radioactive wastes in France. For each region, a table lists the recorded sites and a regional map localizes those having a detailed descriptive file. These files mention the most important waste owners (medical, research, nuclear and military industries), the type of waste and the type of management. The polluted sites are also mentioned, even if they are already decontaminated. The volume no 1 concerns the Ile-de-France region (Paris region). (J.S.)

  8. Regional and temporal variations in coding of hospital diagnoses referring to upper gastrointestinal and oesophageal bleeding in Germany

    Directory of Open Access Journals (Sweden)

    Garbe Edeltraut

    2011-08-01

    Full Text Available Abstract Background Health insurance claims data are increasingly used for health services research in Germany. Hospital diagnoses in these data are coded according to the International Classification of Diseases, German modification (ICD-10-GM. Due to the historical division into West and East Germany, different coding practices might persist in both former parts. Additionally, the introduction of Diagnosis Related Groups (DRGs in Germany in 2003/2004 might have changed the coding. The aim of this study was to investigate regional and temporal variations in coding of hospitalisation diagnoses in Germany. Methods We analysed hospitalisation diagnoses for oesophageal bleeding (OB and upper gastrointestinal bleeding (UGIB from the official German Hospital Statistics provided by the Federal Statistical Office. Bleeding diagnoses were classified as "specific" (origin of bleeding provided or "unspecific" (origin of bleeding not provided coding. We studied regional (former East versus West Germany differences in incidence of hospitalisations with specific or unspecific coding for OB and UGIB and temporal variations between 2000 and 2005. For each year, incidence ratios of hospitalisations for former East versus West Germany were estimated with log-linear regression models adjusting for age, gender and population density. Results Significant differences in specific and unspecific coding between East and West Germany and over time were found for both, OB and UGIB hospitalisation diagnoses, respectively. For example in 2002, incidence ratios of hospitalisations for East versus West Germany were 1.24 (95% CI 1.16-1.32 for specific and 0.67 (95% CI 0.60-0.74 for unspecific OB diagnoses and 1.43 (95% CI 1.36-1.51 for specific and 0.83 (95% CI 0.80-0.87 for unspecific UGIB. Regional differences nearly disappeared and time trends were less marked when using combined specific and unspecific diagnoses of OB or UGIB, respectively. Conclusions During the study

  9. Maternal 'near miss' at Royal Darwin Hospital: An analysis of severe maternal morbidity at an Australian regional tertiary maternity unit.

    Science.gov (United States)

    Jayaratnam, Skandarupan; Burton, Alice; Connan, Kirsten Fiona; de Costa, Caroline

    2016-08-01

    Assessment of severe maternal morbidity using World Health Organization (WHO) 'near-miss' criteria is gaining in importance as a valuable tool in the assessment of maternity care of women. Identification of cases allows an understanding of aetiology of severe morbidity and factors contributing to poor maternal outcomes. The aim of this study is to determine the rate of maternal 'near miss' at Royal Darwin Hospital (RDH) and the utility of the WHO near-miss criteria as a tool for data collection in a regional Australian context. Cases of maternal 'near miss' and deaths were prospectively identified over a period of 12 months using the WHO criteria. During the audit period, there were 2080 live births at Royal Darwin Hospital (RDH): 10 women presented with a 'near miss' and there was one maternal death. The maternal mortality ratio for the hospital was 48/100 000 live births, the maternal 'near-miss' index ratio was 4.8/1000 live births, and the combination of maternal deaths and near misses gave a severe maternal outcome (SMO) ratio of 5.3/1000 live births. The main cause of obstetric 'near miss' was obstetric haemorrhage. Indigenous women and women from remote areas comprised a significant portion of 'near-miss' cases. The rates of maternal 'near miss' at RDH are consistent with other studies in the developed world. The WHO maternal 'near-miss' audit tool helps health professionals understand and anticipate severe maternal morbidities, with the aim of improving maternal and perinatal outcomes. © 2016 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  10. Why does it take so long? ‘Lean processing’ in the aseptic compounding unit at the Midland Regional Hospital Tullamore

    LENUS (Irish Health Repository)

    Greene, C

    2011-06-01

    Increasing numbers of oncology\\/haematology patients attending Midland Regional Hospital Tullamore (MRHT) has increased the workload of the Regional Oncology Haematology Pharmacy (ROHP) compounding unit. Staff restrictions require optimisation of current workflow practices. This audit (November 2010 and June 2011) focused on workflow in the aseptic compounding unit.\\r\

  11. Local-regional anesthesia in the management of stingray stings: Experience of the Bouffard medical-surgical hospital in Djibouti.

    Science.gov (United States)

    Vanoye, C; Lacroix, G; Le Gonidec, E; Couret, A; Benois, A; Peigne, V

    2017-01-27

    Stingray injuries are very painful. Systemic analgesics are ineffective, and the use of local-regional anesthesia has been reported. This retrospective descriptive study reviewed all cases of stingray injuries seen at the emergency department of the Bouffard Hospital (Djbouti, Africa) between 2011 and 2014. The study included 35 patients. Most of the injuries (n= 31, 89%) concerned the lower limbs. Median pain intensity was 6 [5-8] on a visual analog scale of 0 (no pain) to 10. The following systemic medications were administered: acetaminophen to 13 (27%) patients, morphine to 8 (23%), and tramadol to 6 (17%). In all, 25 (71%) patients received local-regional anesthesia, 15 (60%) by injections at the ankle. All procedures were successful, and no adverse event was reported. This study reports clinical data about stingray injuries in the Red Sea area and highlights the interest of local-regional anesthesia in their management. Most of the procedures were distal and could be performed by trained emergency physicians.

  12. First case of human gongylonemosis in France

    Directory of Open Access Journals (Sweden)

    Pesson Bernard

    2013-01-01

    Full Text Available Gongylonema spp. are cosmopolitan spirurid nematodes that are common parasites of wild and domesticated mammals and birds. Gongylonema pulchrum Molin, 1857 is most common in ruminants, where it invades mucosa and submucosa of the mouth, tongue, oesophagus and forestomachs. It extremely rarely occurs in man, and fewer than 60 cases have been reported worldwide. We report a case from the Alsace region, which appears to be the first case of human gongylonemosis described in France.

  13. Prevalencia de quistes odontogénicos: Hospital Regional Valdivia entre los años 1990 y 2010 Prevalence of odontogenic cysts: Hospital Regional Valdivia, between years 1990-2010

    Directory of Open Access Journals (Sweden)

    F.I. Peters

    2012-12-01

    Full Text Available Objetivo: Determinar la prevalencia de quistes odontogénicos en población atendida en el Hospital Regional Valdivia, en el periodo entre 1990-2010, según la última clasificación de lesiones quísticas de la Organización Mundial de la Salud (OMS, 2005. Esta investigación corresponde a un estudio descriptivo de corte transversal censal. Metodología: Se revisaron informes de biopsias del Hospital Regional Valdivia (HRV, durante un periodo de 20 años (1990-2010,seleccionando los informes con diagnósticos histopatológicos de quistes odontogénicos. Las variables a analizar fueron: año de emisión del informe, género y edad del paciente, localización anatómica de la lesión, diagnóstico histopatológico. Los datos se almacenaron en planilla de base de datos para su análisis estadístico. Resultados: De las 1.850 biopsias del territorio maxilofacial evaluadas, la prevalencia de Quistes Odontogénicos alcanzó un 11,9%. Según tipo de quiste, los más prevalente fueron el quiste radicular (84,5%, quiste dentígero (14,1% y quiste residual (0,9%. El de menor prevalencia fue el quiste de erupción (0,5%. Un 52,7% del total de quistes odontogénicos correspondieron al género femenino. El rango de edad de presentación va entre los 4 y los 81 años (promedio 31,7±3,7 años. El área anatómica más afectada es el maxilar superior con 65,5%. Conclusión: Los Quistes odontogénicos son entidades diagnosticadas histopatológicamente en forma variable durante el periodo de tiempo comprendido entre los años 1990 y 2010, en el HRV. Se presentan en mayor frecuencia en mujeres, sin predilección por género, afectando principalmente a la 3ª década de vida. La entidad quística mas prevalente fue el quiste radicular.Objective: Determine the prevalence of Odontological Cysts in the attended patients of Hospital Regional Valdivia, between 1990 and 2010, according to the World Health Organization (WHO classification of tumour like lesions, 2005

  14. Frecuencia de micosis en pacientes inmunosuprimidos de un hospital regional de la Ciudad de México

    Directory of Open Access Journals (Sweden)

    Hernández-Hernández Francisca

    2003-01-01

    Full Text Available OBJETIVO: Aislar e identificar hongos en diferentes especímenes de pacientes inmunocomprometidos, atendidos en un hospital de la Ciudad de México, y determinar su asociación con micosis. MATERIAL Y MÉTODOS: Se realizó un estudio de tipo observacional transversal en pacientes del Hospital Regional General Ignacio Zaragoza, de junio de 1999 a mayo de 2000. De 108 pacientes se procesaron 268 especímenes para estudio micológico que incluyó examen directo, frotis, cultivos y microcultivos en medios específicos además de pruebas bioquímicas. La mayoría de pacientes tenía diagnóstico clínico de tuberculosis pulmonar y de síndrome de inmunodeficiencia adquirida. RESULTADOS: Se obtuvieron 183 aislamientos de levaduras y 66 de hongos filamentosos. Se diagnosticaron 45 micosis que en su mayoría correspondieron a candidosis pulmonar (32 casos. Las especies de Candida más frecuentes asociadas a patología fueron Candida albicans y C parapsilosis. Se obtuvieron cinco aislamientos de Cryptococcus neoformans variedad neoformans, uno de C albidus, tres de Histoplasma capsulatum y uno de Geotrichum candidum, asociados a infección micótica. CONCLUSIONES: El 41.6% de los pacientes estudiados presentaron una micosis asociada principalmente a síndrome de inmunodeficiencia adquirida y a tuberculosis pulmonar.

  15. The effects of resource improvement on decision-to-delivery times for cesarean deliveries in a Ghanaian regional hospital.

    Science.gov (United States)

    Onuoha, Onyi; Ramaswamy, Rohit; Srofenyoh, Emmanuel K; Kim, Sung M; Owen, Medge D

    2015-09-01

    To evaluate the effects of having a dedicated obstetric operating room (OR) on the decision-to-delivery interval (DDI) in a large referral hospital in Ghana. An observational study was undertaken of all patients undergoing cesarean delivery at Ridge Regional Hospital, Accra, before (pre-OR; August-September 2011) and after (post-OR; August-September 2012) introduction of an obstetric OR. The primary outcome was the DDI. In total, 581 cesareans were performed in the pre-OR period and 574 in the post-OR period. Overall, the median DDI decreased from 259 min (interquartile range [IQR] 161-432) in the pre-OR period to 195 min (IQR 138-319) in the post-OR period (Pdeliveries. Only one emergency cesarean-in the post-OR period-was conducted within the recommended 30-minute timeframe. An obstetric OR lowered the DDI for cesarean delivery; however, a realistic timeframe for emergency cesareans in low-income countries remains to be determined. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  16. Citrobacter amalonaticus human urinary tract infections, Marseille, France

    Science.gov (United States)

    Garcia, V.; Abat, C.; Moal, V.; Rolain, J.-M.

    2016-01-01

    Citrobacter amalonaticus is a bacterium that has rarely been reported as a human pathogen. Here we report four cases of C. amalonaticus infections occurring in patients hospitalized in Marseille, France, and review all cases described in the published literature. PMID:26958347

  17. Citrobacter amalonaticus human urinary tract infections, Marseille, France.

    Science.gov (United States)

    Garcia, V; Abat, C; Moal, V; Rolain, J-M

    2016-05-01

    Citrobacter amalonaticus is a bacterium that has rarely been reported as a human pathogen. Here we report four cases of C. amalonaticus infections occurring in patients hospitalized in Marseille, France, and review all cases described in the published literature.

  18. Citrobacter amalonaticus human urinary tract infections, Marseille, France

    OpenAIRE

    Garcia,V.; C. Abat; V. Moal; J.-M. Rolain

    2016-01-01

    Citrobacter amalonaticus is a bacterium that has rarely been reported as a human pathogen. Here we report four cases of C. amalonaticus infections occurring in patients hospitalized in Marseille, France, and review all cases described in the published literature.

  19. Providing for Disabled Students: University of Grenoble, France.

    Science.gov (United States)

    PEB Exchange, 2000

    2000-01-01

    Examines how France's University of Grenoble provides for its disabled students in its residence halls, including a description of the university's service for disabled service. A hospital/education center where disabled students can receive care and physiotherapy while attending school is highlighted. (GR)

  20. The quality of nursing care regarding personal hygiene of patients admitted to a selected hospital in the Kavango region

    Directory of Open Access Journals (Sweden)

    A. van Dyk

    2004-09-01

    Full Text Available The aim of the study was to determine the quality of nursing care regarding personal hygiene of patients admitted to a hospital in the Kavango region of Namibia. The study was prompted by repeated media reports over the radio. Commentators and listeners expressed concern over the seeming lack of adequate hygienic measures, specifically with regard to patient care. To objectively quantify and describe the extent ot this problem, a single objective was stated, namely to measure the quality of nursing care with regard to patient hygiene. A descriptive survey design was chosen to explore and describe the problem. A check-list was developed to observe thirty patients (the total population over a period of one week.

  1. Impact of ALSO training on the management of prolonged labor and neonatal care at Kagera Regional Hospital, Tanzania

    DEFF Research Database (Denmark)

    Sorensen, Bjarke Lund; Rasch, Vibeke; Massawe, Siriel

    2010-01-01

    5.6% to 71.5% (RR 12.71; 95% CI, 9.04-17.88). There was a significant decrease from 6 to 0 neonatal deaths before discharge among those born with an Apgar score after 1minute of 4 or more (P=0.03). CONCLUSION: ALSO training had no effect on the management of prolonged labor. Early contact between......OBJECTIVE: To evaluate the management of prolonged labor and neonatal care before and after Advanced Life Support in Obstetrics (ALSO) training. METHODS: Staff involved in childbirth at Kagera Regional Hospital, Tanzania, attended a 2-day ALSO provider course. In this prospective intervention study....... During prolonged labor, action was delayed for more than 3hours in half of the cases. The stillbirth rate, Apgar scores, and frequency of neonatal resuscitation did not change significantly. After the intervention, there was a significant increase in newborns given to their mothers within 10minutes, from...

  2. Seroprevalence of HDV among non-hospitalized HBs Ag positive patients from KPK-region of Pakistan

    Institute of Scientific and Technical Information of China (English)

    Ismail Jalil; Muhammad Arshad; Zara Rafaque; Fazle Raziq; Robina Wazir; Sajid Malik; Javid Iqbal Dasti

    2016-01-01

    Objective: To study the seroprevalence of hepatitis B virus(HBV) and hepatitis delta virus(HDV) infections in patients visiting outpatient department of a major tertiary care hospital in Khyber Pakhtunkhwa region of Pakistan.Methods: Blood samples were collected from non-hospitalized patients. Serological analysis was done by ELISA and viral DNA was amplified by PCR. The amplified DNA was analyzed by agarose gel electrophoresis.Results: Altogether, 946 blood samples were screened, overall percentage of HBs Agpositive patients remained 22.41%(prevalence: 224.10/1 000; CI: 0.197 5 ± 0.250 7) with the highest incidence rates among relatively younger age groups(20–29 years). The prevalence of HBV–HDV co-infection was found to be 46.75/1 000; CI: 0.031 8 ± 0.061 7.In HBs Ag-positive patients, anti-HBc-total was detected in 86.79% while 25.00% were positive for anti-HBc-immunoglobulin M. Similarly, among these patients, HBV DNA was detected in 64.13% and 10.85% were co-infected with HDV. Different symptoms were associated with the prevailing infection, including malaise(62%), anorexia(66%) and fatigue(73%). The most commonly associated symptom was abdominal discomfort. Among these patients, certain risk factors, including surgery, visit to dentist and intravenus infusions were frequently associated with the infection(x~2= 95.23; df = 11; P < 0.000 1).Conclusions: Overall, this study confirmed higher prevalence of active HBV/HDV infection, among young patients from Khyber Pakhtunkhwa region having no prior history of viral hepatitis.

  3. [Complexity of care and organizational effectiveness: a survey among medical care units in nine Lombardy region hospitals].

    Science.gov (United States)

    Pasquali, Sara; Capitoni, Enrica; Tiraboschi, Giuseppina; Alborghetti, Adriana; De Luca, Giuseppe; Di Mauro, Stefania

    2017-01-01

    Eleven medical care units of nine Lombardy Region hospitals organized by levels of care model or by the traditional departmental model have been analyzed, in order to evaluate if methods for complexity of patient-care evaluation represent an index factor of nursing organizational effectiveness. Survey with nine Nurses in managerial position was conducted between Nov. 2013-Jan. 2014. The following factors have been described: context and nursing care model, staffing, complexity evaluation, patient satisfaction, staff well-being. Data were processed through Microsoft Excel. Among Units analysed ,all Units in levels of care and one organized by the departmental model systematically evaluate nursing complexity. Registered Nurses (RN) and Health Care Assistants (HCA) are on average numerically higher in Units that measure complexity (0.55/ 0.49 RN, 0.38/0.23 HCA - ratio per bed). Adopted measures in relation to changes in complexity are:rewarding systems, supporting interventions, such as moving personnel within different Units or additional required working hours; reduction in number of beds is adopted when no other solution is available. Patient satisfaction is evaluated through Customer Satisfaction questionnaires. Turnover, stress and rate of absenteeism data are not available in all Units. Complexity evaluation through appropriate methods is carried out in all hospitals organized in levels of care with personalized nursing care models, though complexity is detected with different methods. No significant differences in applied managerial strategies are present. Patient's satisfaction is evaluated everywhere. Data on staffing wellbeing is scarcely available. Coordinated regional actions are recommended in order to gather comparable data for research, improve decision making and effectiveness of Nursing care.

  4. The development and evaluation of a health education programme for pregnant women in a regional hospital, southern Thailand.

    Science.gov (United States)

    Thassri, J; Kala, N; Chusintong, L; Phongthanasarn, J; Boonsrirat, S; Jirojwong, S

    2000-12-01

    The maternal mortality rate (MMR) in Thailand is higher than neighbouring developing countries including Malaysia and Singapore. The 1993 MMR of Thailand was 249 per 100 000 livebirths which was four times higher than the rates in Malaysia and Singapore (World Health Organization 1995). The major causes of these deaths were haemorrhage, toxaemia of pregnancy and sepsis which were likely to be prevented by adequate prenatal care (Thailand Ministry of Public Health 1996). A large proportion of Thai pregnant women have poor health. Between 1994 and 1995, a national study conducted by Thailand Ministry of Health showed that 39% of pregnant women were anaemic, defined as haemoglobin concentration lower than 33% (Supamethaporn 1997). Another study conducted in the southern region also indicated that 13.8% of pregnant women were anaemic caused by iron deficiency (Phatthanapreechakul et al. 1997). Other behaviours which increased risks associated with child birth included non-antenatal care (ANC) attendance, undertaking physically demanding tasks and failure to increase nutritional intake during their pregnancy period (N. Phiriyanuphong et al. 1992, unpublished report). These factors emphasize the importance of a health education programme which could facilitate women to, for example, increase protein and iron intake during pregnancy which would reduce complications from their poor health status. This study was conducted in a regional hospital in Thailand where there was no systematic and well-planned health education programme for pregnant women. The initial aim was to design a health education programme using input from the hospital health care professionals including obstetricians, nurses, nutritionists, health educators and health promoters. An active involvement of these personnel assisted to sustain the provision of the programme provided for pregnant women after the cessation of the study project. Another aim of the study was to evaluate the outcomes of the

  5. Earthquake foci in metropolitan France and the lesser Antilles

    Energy Technology Data Exchange (ETDEWEB)

    Dorel, J.; Gagnepain-Beyneix, J. (Institut de Physique du Globe, Univ. Paris-6 (France)); Frechet, J. (Universite Scientifique et Medical de Grenoble, Saint Martin d' Heres (France))

    A selection of local mechanism for metropolitan France and the lesser Antilles is presented. The data has been chosen on the basis of its quality and only mechanisms for which the faults planes would be determined with a precision of less than 20/sup 0/ are presented. The data concerns four principal regions: The Jura-Rhein graben, the Alps, the Pyrenees and the lesser Antilles. Finally a brief review of the neotectonic environment of the earthquakes in metropolitan France is presented.

  6. Assessment of picture archiving and communication system (PACS) at three of ministry of health hospitals in Riyadh region - Content analysis.

    Science.gov (United States)

    Alalawi, Zainab M; Eid, Monief M; Albarrak, Ahmed I

    Picture archiving and communication system (PACS) are management information systems used for distributing, viewing and archiving digital images by integrating different types of modalities through communication networks. PACS have many advantages that can lead to improving health care quality. PACS has been widely used in hospitals in Saudi Arabia for the past 10 years. However, an extensive review of literature in the field of PACS, among physicians and radiologists in Saudi Arabia, showed lack of local studies of this costly and newly implemented technology. Therefore, this assessment is very important to provide an insightful study of PACS in Saudi Arabia to provide proper recommendations for the PACS projects implementation nationwide. The objectives of this study are to, firstly, assess the perceived benefits of PACS among physicians and radiologists specifically in quality of care, secondly, assess the perceived challenges of PACS implementation and adoption inside and outside the radiology department, and thirdly, to compare between physicians' and radiologists' perceptions toward PACS. A cross-sectional descriptive study at three of Ministry of Health (MOH) Hospitals in the Riyadh region, Saudi Arabia. The researchers used two separate surveys questionnaires, for administration to the physicians and radiologists at the three hospitals. Apart from the questionnaire, included is feedback as responses to open-ended questions. Content analysis was used to analyze the feedback under two themes: benefits or challenges. The response rate was 46% (84/183) physicians and 88% (15/17) radiologists have participated in this study. The result showed that 70% physicians' views affirms that PACS improved physicians' efficiency. On the other hand, all radiologists who responded affirmed that PACS improved efficiency. For questions on the ability to make decisions, 69% of views have affirmed that PACS improved physician's abilities to make decisions regarding patient care

  7. [Survival in patients with liver cirrhosis at the Durango, IMSS Regional General Hospital].

    Science.gov (United States)

    Rodríguez-Hernández, Heriberto; Jacobo-Karam, Janett S; Castañón-Santillán, María del Carmen; Arámbula-Chávez, Mayela; Martínez-Aguilar, Gerardo

    2002-01-01

    In Mexico, hepatic cirrhosis mortality exhibits important regional differences. To analyze global survival of cirrhotic patients, according to etiology and functional status. Between March 1990 to August 1998, newly diagnosed patients with hepatic cirrhosis were included in a follow-up study. Subjects were analyzed monthly. Information on clinical evolution, complications, and dates of events (death) and complications were registered. Survival was estimated using Kaplan-Meier method. Ninety nine subjects were included in the survival analysis, 66 with alcoholic and 33 with viral cirrhosis (HCV and HBV in 24 and nine patients, respectively). Ninety seven percent of patients were decompensated at diagnosis, and 81% had ascites. Probabilities for survival in the entire series were 69.7, 37.6 and 23.6% at 24, 48, and 60 months, respectively. There were no significant differences in the survival of patients grouped according to etiology. When survival was analyzed by Child-Pugh score, it was slightly higher in the alcoholic cirrhosis group. In this study survival probability of patients with viral cirrhosis was lower than in patients with alcohol cirrhosis.

  8. The France energy situation; La situation energetique de la France

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2006-07-01

    This analysis of the french energy situation provides information and key data on some key facts about the energy in France, the France energy supply and demand, the major principles of energy policy, the challenges of french energy policy and the DGEMP (general directorate for energy and raw materials). (A.L.B.)

  9. Battle of France WWII

    Science.gov (United States)

    Gadhath, Arpitha Rao

    The purpose of this thesis is to build an interactive Geographical Information System (GIS) tool, relating to the series of events that occurred during the Battle of France World War II. The tool gives us an insight about the countries involved in the battle, their allies and their strategies. This tool was created to use it as a one stop source of information regarding all the important battles that took place, which lead to the fall of France. The tool brings together the maps of all the countries involved. Integrated with each map is the data relevant to that map. The data for each country includes the place of attack, the strategies used during the attack, and the kind of warfare. The tool also makes use of HTML files to give all the information, along with the images from the time of the war and a footage which explains everything about the particular battle. The tool was build using JAVA, along with the use of MOJO (Map Objects Java Objects) to develop Maps of each of the countries. MOJO is developed by ESRI (Environmental Science Research Institute) which makes it easier to add data to the maps. It also makes highlighting important information easier making use of pop-up windows, charts and infographics. HTML files were designed making use of the open-source template developed by Bootstrap. The tool is built in such a way that the interface is simple and easy for the user to use and understand.

  10. France at CERN

    CERN Multimedia

    GS Department

    2010-01-01

    Industrial Exhibition Administration Building Bldg 61 Tuesday 8 June: 9 a.m. – 5.30 p.m. Wednesday 9 June: 9 a.m. – 4 p.m. “FRANCE AT CERN” – INDUSTRIAL EXHIBITION Thirty-six French companies are presenting their latest technological advances during the industrial exhibition "France at CERN", featuring products and technologies specifically related to the activities of the CERN facility. Presenting their know-how in electric vehicles, PSA - PEUGEOT/CITROEN are sponsoring the event. Seminars will be hold in the Main Building’s conference rooms: R&D innovation strategy in Pôle Nucléaire Bourgogne (08/06/2010 – 13h) MU by Peugeot (08/06/2010 – 14h) Citroën (08/06/2010 – 15h) « Elément 14 » : a unique design engineer community for sharing Electronic Engineering Solutions (09/06/2010 – 11h) Individual B2B meetin...

  11. The Future of the CEMAC CFA Franc

    Directory of Open Access Journals (Sweden)

    Julius Agbor Agbor

    2013-08-01

    Full Text Available A total of 80 currency boards have come into existence at some point since the mid-19th century, but to date only about 15 of them still exist, among which is the CFA franc monetary zone. The future sustainability of the CFA franc zone, to which the CEMAC CFA franc belongs, is increasingly questioned in the light of increasing asymmetries in exposure to external shocks, differential speeds of adjustment of the real exchange rate following shocks, differential impacts in economic fundamentals, and low levels of intra-regional trade and financial flows between CEMAC and WAEMU. For the CEMAC bloc of countries in particular, the future sustainability of the fixed exchange regime depends crucially on continued oil exports, which currently represent about 90percent of export revenues and 40 percent of GDP. Should oil reserves deplete in the near future or oil prices decline significantly, a substantial source of foreign reserves would be lost, thereby exposing the regime to collapse. Even without resource depletion, continued volatility in global financial markets is increasing the risks of collapse of the fixed exchange regime as oil and commodity price swings ignite currency speculation as well as render reserves much more volatile. Against this backdrop, the present study examines the stakes facing the CEMAC CFA franc, discusses the exit options from the currency board and makes recommendations towards a sustainable monetary policy framework for CEMAC countries going forward. The analysis points to the imperative of pursuing a full monetary union with a single CEMAC franc pegged to the U.S. dollar and further suggest that, like the experience of the eurozone, the CEMAC monetary arrangement can be best implemented only by complying with the principle of political union.

  12. Frecuencia de micosis en pacientes inmunosuprimidos de un hospital regional de la Ciudad de México Frequency of mycoses in immunosuppressed patients in a regional hospital in Mexico City

    Directory of Open Access Journals (Sweden)

    Francisca Hernández-Hernández

    2003-12-01

    Full Text Available OBJETIVO: Aislar e identificar hongos en diferentes especímenes de pacientes inmunocomprometidos, atendidos en un hospital de la Ciudad de México, y determinar su asociación con micosis. MATERIAL Y MÉTODOS: Se realizó un estudio de tipo observacional transversal en pacientes del Hospital Regional General Ignacio Zaragoza, de junio de 1999 a mayo de 2000. De 108 pacientes se procesaron 268 especímenes para estudio micológico que incluyó examen directo, frotis, cultivos y microcultivos en medios específicos además de pruebas bioquímicas. La mayoría de pacientes tenía diagnóstico clínico de tuberculosis pulmonar y de síndrome de inmunodeficiencia adquirida. RESULTADOS: Se obtuvieron 183 aislamientos de levaduras y 66 de hongos filamentosos. Se diagnosticaron 45 micosis que en su mayoría correspondieron a candidosis pulmonar (32 casos. Las especies de Candida más frecuentes asociadas a patología fueron Candida albicans y C parapsilosis. Se obtuvieron cinco aislamientos de Cryptococcus neoformans variedad neoformans, uno de C albidus, tres de Histoplasma capsulatum y uno de Geotrichum candidum, asociados a infección micótica. CONCLUSIONES: El 41.6% de los pacientes estudiados presentaron una micosis asociada principalmente a síndrome de inmunodeficiencia adquirida y a tuberculosis pulmonar.OBJECTIVE: To isolate and identify the fungi in specimens collected from immunocompromised patients seen in Mexico City hospital, and to assess their association with mycosis. MATERIAL AND METHODS: A total of 268 specimens from 108 patients were processed for mycological study, including direct examination, smears, cultures, and microcultures in specific media, in addition to biochemical tests. Most of the patients had been diagnosed with pulmonary tuberculosis and Acquired Immunodeficiency Syndrome (AIDS. RESULTS: One hundred and eighty-three yeasts and 66 mycelial fungi were isolated. Forty-five mycoses were diagnosed; the most frequent

  13. Prevalence, risk factors and molecular epidemiology of highly resistant gram negative rods in hospitalized patients in the Dutch region Kennemerland

    Directory of Open Access Journals (Sweden)

    Dennis Souverein

    2016-03-01

    Full Text Available Abstract Background This paper describes (1 the Highly Resistant Gram Negative Rod (HR-GNR prevalence rate, (2 their genotypes, acquired resistance genes and (3 associated risk factors of HR-GNR colonization among the hospitalized population in the Dutch region Kennemerland. Methods Between 1 October 2013 and 31 March 2014, cross-sectional prevalence measurements were performed in three regional hospitals as part of each hospitals infection control program. Rectal swabs were analyzed at the Regional Public Health Laboratory Kennemerland by direct culturing. Genotypes and acquired resistance genes of positive isolates were determined using Whole Genome Sequencing with the MiSeq instrument (Illumina. Association between several independent variables and HR-GNR positivity was examined using logistic regression models. Results Out of 427 patients, 24 HR-GNR positive isolates were recovered from 22 patients, resulting in a regional HR-GNR colonization prevalence (95 % CI of 5.2 % (3.6–7.9. Of these 22 positive patients, 15 were Extended Spectrum Beta-Lactamase (ESBL positive (3.5 % (2.1–5.7, 7 patients were positive for a Fluoroquinolones and Aminoglycosides (Q&A resistant Enterobacteriaceae (1.6 % (0.8–3.3 and from one patient (0.2 % (0–1.3 a Stenotrophomonas maltophilia resistant towards co-trimoxazole was isolated. No carbapenemase producing Enterobacteriaceae (CPE, multi-resistant Acinetobacter species or multi-resistant Pseudomonas aeruginosa were isolated. The ESBL genes found were bla CTX-M-1 (n = 4, 25.0 %, bla CTX-M-15 (n = 3, 18.8 %, bla CTX-M-27 (n = 2, 12.5 %, bla CTX-M-14b (n = 2, 12.5 %, bla CTX-M-9 (n = 2, 12.5 %, bla CTX-M-14 (n = 1, 6.3 %, bla CTX-M-3 (n = 1, 6.3 %, bla SHV-11 (n = 1, 6.3 % and bla SHV-12 (n = 1, 6.3 %. Being known HR-GNR positive in the past was the only significant associated risk factor for HR-GNR positivity, odds ratio (95 % CI: 7.32 (1.82–29.35, p

  14. Experiência de farmacovigilância no Hospital Universitário Regional de Maringá, Estado do Paraná Pharmacovigilance at Regional University Hospital in Maringá, PR

    Directory of Open Access Journals (Sweden)

    Ana Carolina Feitoza Bohm

    2002-04-01

    Full Text Available Este trabalho relata a experiência da investigação dos casos suspeitos de reações adversas registrados no Hospital Universitário Regional de Maringá, Estado do Paraná. Descreve-se o procedimento para a coleta dos dados e a estratégia das visitas domiciliares utilizadas tanto para o esclarecimento do diagnóstico, como para que as medidas de orientação do uso e armazenamento correto de medicamentos sejam fornecidas a estas pessoas e aos seus familiares. No período de 1996 a 2000, foram registrados 316 casos suspeitos de reações adversas, dos quais foi possível realizar visita domiciliar em 105. A aplicação do algoritmo de Naranjo permitiu classificar os casos suspeitos em casos provados (4,8%, prováveis (56,7%, possíveis (34,6% e duvidosos (3,9%. Verificou-se também que a maioria das notificações são provenientes de busca ativa nos prontuários e que as notificações voluntárias ainda são mínimas. Portanto, estratégias visando ao aumento das notificações voluntárias por parte dos profissionais de saúde, independentemente da gravidade dos casos suspeitos ou das reações serem conhecidas ou não, deverão ser elaboradasThis work describes the investigative experience of suspected cases of adverse drug reactions reported at Regional University Hospital of Maringá. Data collection and home visit procedures are described as both - a way to clarify the diagnosis; a way to provide these people and their family information about using and storage of medication. From 1996 to 2000, 316 cases of suspicious adverse drug reactions were registered. From the total, in only 105 cases the home visit was carried out. The application of the Algorithm of Naranjo allowed classifying the suspicious cases in evident cases (4,8%, probable (56,7%, possible (34,6% and doubtful (3,9%. It was also verified that most of the notifications originate from active search in medical files and that the spontaneous reporting are still few. Therefore

  15. David Ziziemsky y el ingreso del psicoanálisis francés en el hospital de niños Sor María Ludovica de la ciudad de La Plata

    OpenAIRE

    2011-01-01

    El presente trabajo forma parte de un proyecto de investigación más amplio cuyo fin es delimitar el contexto de recepción del psicoanálisis francés en la ciudad de La Plata en el período que se extiende desde 1966 hasta 1976. El concepto de recepción, supone que la lectura de una obra no consiste en una mera asimilación pasiva sino en un proceso que, concebido desde una perspectiva dialéctica, pone en juego una selección que realiza el lector en tanto se ve implicado su propio punto de vista....

  16. Public-private partnership models in France and in Europe.

    Science.gov (United States)

    Demotes-Mainard, Jacques; Canet, Emmanuel; Segard, Lionel

    2006-01-01

    The workshop entitled "Public-Private partnerships models in Europe-- comparison between France and European countries" brought together representatives of academia and industry, of national or European health research programs, of regional or national public-private partnership (PPP) initiatives, and of biotechnology with the following objectives: sharing a common vision on the needs, expectations and challenges of public-private partnership, based on the analysis of actual and original cases, and of new initiatives on public-private partnership, drawing conclusions and identifying key success factors, identifying trails for progress and drawing recommendations. The major event in this field is a European public-private partnership initiative between pharmaceutical industry (European Federation of Pharmaceultical Industry and Associations, EFPIA) and the European Commission (DG Research--health priority) resulting in the European Technology Platform project "Innovative Medicines Initiative" (IMI). Its architecture is based on the identification of the main bottlenecks to the development of innovative treatments (predictive pharmacology and toxicology, identification and validation of biomarkers, patients' recruitment, risk evaluation, and cooperation with the regulatory authorities). Simultaneously, initiatives both at the national and regional levels also foster PPP in the therapeutic field. Regional competitivity clusters acting in the biomedical sector, and national PPP calls such as the ANR (National Research Agency) RIB (Research and Innovation in Biotechnology) call are incentives for PPP projects. These regional and national PPP levels help public and private partners to further build consortia able to compete for EU-level calls, thus acting as incubators for EU PPP projects. In spite of incentives and of the regional and national structuring of PPP, weaknesses in the French system are linked to its fragmentation--multiple transfer agencies, multiple

  17. Regions of High Out-Of-Hospital Cardiac Arrest Incidence and Low Bystander CPR Rates in Victoria, Australia

    Science.gov (United States)

    Straney, Lahn D.; Bray, Janet E.; Beck, Ben; Finn, Judith; Bernard, Stephen; Dyson, Kylie; Lijovic, Marijana; Smith, Karen

    2015-01-01

    Background Out-of-hospital cardiac arrest (OHCA) remains a major public health issue and research has shown that large regional variation in outcomes exists. Of the interventions associated with survival, the provision of bystander CPR is one of the most important modifiable factors. The aim of this study is to identify census areas with high incidence of OHCA and low rates of bystander CPR in Victoria, Australia Methods We conducted an observational study using prospectively collected population-based OHCA data from the state of Victoria in Australia. Using ArcGIS (ArcMap 10.0), we linked the location of the arrest using the dispatch coordinates (longitude and latitude) to Victorian Local Government Areas (LGAs). We used Bayesian hierarchical models with random effects on each LGA to provide shrunken estimates of the rates of bystander CPR and the incidence rates. Results Over the study period there were 31,019 adult OHCA attended, of which 21,436 (69.1%) cases were of presumed cardiac etiology. Significant variation in the incidence of OHCA among LGAs was observed. There was a 3 fold difference in the incidence rate between the lowest and highest LGAs, ranging from 38.5 to 115.1 cases per 100,000 person-years. The overall rate of bystander CPR for bystander witnessed OHCAs was 62.4%, with the rate increasing from 56.4% in 2008–2010 to 68.6% in 2010–2013. There was a 25.1% absolute difference in bystander CPR rates between the highest and lowest LGAs. Conclusion Significant regional variation in OHCA incidence and bystander CPR rates exists throughout Victoria. Regions with high incidence and low bystander CPR participation can be identified and would make suitable targets for interventions to improve CPR participation rates. PMID:26447844

  18. Regions of High Out-Of-Hospital Cardiac Arrest Incidence and Low Bystander CPR Rates in Victoria, Australia.

    Directory of Open Access Journals (Sweden)

    Lahn D Straney

    Full Text Available Out-of-hospital cardiac arrest (OHCA remains a major public health issue and research has shown that large regional variation in outcomes exists. Of the interventions associated with survival, the provision of bystander CPR is one of the most important modifiable factors. The aim of this study is to identify census areas with high incidence of OHCA and low rates of bystander CPR in Victoria, Australia.We conducted an observational study using prospectively collected population-based OHCA data from the state of Victoria in Australia. Using ArcGIS (ArcMap 10.0, we linked the location of the arrest using the dispatch coordinates (longitude and latitude to Victorian Local Government Areas (LGAs. We used Bayesian hierarchical models with random effects on each LGA to provide shrunken estimates of the rates of bystander CPR and the incidence rates.Over the study period there were 31,019 adult OHCA attended, of which 21,436 (69.1% cases were of presumed cardiac etiology. Significant variation in the incidence of OHCA among LGAs was observed. There was a 3 fold difference in the incidence rate between the lowest and highest LGAs, ranging from 38.5 to 115.1 cases per 100,000 person-years. The overall rate of bystander CPR for bystander witnessed OHCAs was 62.4%, with the rate increasing from 56.4% in 2008-2010 to 68.6% in 2010-2013. There was a 25.1% absolute difference in bystander CPR rates between the highest and lowest LGAs.Significant regional variation in OHCA incidence and bystander CPR rates exists throughout Victoria. Regions with high incidence and low bystander CPR participation can be identified and would make suitable targets for interventions to improve CPR participation rates.

  19. Regions of High Out-Of-Hospital Cardiac Arrest Incidence and Low Bystander CPR Rates in Victoria, Australia.

    Science.gov (United States)

    Straney, Lahn D; Bray, Janet E; Beck, Ben; Finn, Judith; Bernard, Stephen; Dyson, Kylie; Lijovic, Marijana; Smith, Karen

    2015-01-01

    Out-of-hospital cardiac arrest (OHCA) remains a major public health issue and research has shown that large regional variation in outcomes exists. Of the interventions associated with survival, the provision of bystander CPR is one of the most important modifiable factors. The aim of this study is to identify census areas with high incidence of OHCA and low rates of bystander CPR in Victoria, Australia. We conducted an observational study using prospectively collected population-based OHCA data from the state of Victoria in Australia. Using ArcGIS (ArcMap 10.0), we linked the location of the arrest using the dispatch coordinates (longitude and latitude) to Victorian Local Government Areas (LGAs). We used Bayesian hierarchical models with random effects on each LGA to provide shrunken estimates of the rates of bystander CPR and the incidence rates. Over the study period there were 31,019 adult OHCA attended, of which 21,436 (69.1%) cases were of presumed cardiac etiology. Significant variation in the incidence of OHCA among LGAs was observed. There was a 3 fold difference in the incidence rate between the lowest and highest LGAs, ranging from 38.5 to 115.1 cases per 100,000 person-years. The overall rate of bystander CPR for bystander witnessed OHCAs was 62.4%, with the rate increasing from 56.4% in 2008-2010 to 68.6% in 2010-2013. There was a 25.1% absolute difference in bystander CPR rates between the highest and lowest LGAs. Significant regional variation in OHCA incidence and bystander CPR rates exists throughout Victoria. Regions with high incidence and low bystander CPR participation can be identified and would make suitable targets for interventions to improve CPR participation rates.

  20. Chapter 40: history of neurology in France.

    Science.gov (United States)

    Clarac, François; Boller, François

    2010-01-01

    The history of neurology in France is characterized by the very high degree of centralization in that country where "everything seems to happen in Paris," and yet the considerable degree of autonomous diversity in the evolution of some other medical schools such as Montpellier and Strasbourg. It could be argued that France saw the birth of clinical neurology as a separate discipline since Jean Martin Charcot at the Salpêtrière Hospital obtained a chair of diseases of the nervous system in 1892, a first in the history of the academic world. The chapter shows, however, that the work of Charcot was preceded by a long evolution in medical thinking, which culminated with the introduction of experimental medicine developed by Claude Bernard and François Magendie, and by the study of aphasia by Paul Broca and its localization of language in a specific area of the brain. Many of the great neurologists of France like Duchenne de Boulogne, Gilles de la Tourette, Joseph Babinski and Pierre Marie gravitated around Charcot while others like Charles-Edward Brown-Sequard and Jules Dejerine developed their talents independently. The history of Sainte-Anne Hospital further illustrates this independence. It also shows the relation between neurology and psychiatry with Henri Ey, Jean Delay and Pierre Deniker, who collaborated with Henri Laborit in the clinical development of chlorpromazine. Sainte Anne also saw the birth of modern neuropsychology with Henry Hécaen. Jean Talairach and his group developed human stereotaxic neurosurgery and a 3-dimensional brain atlas that is used around the world. The chapter also mentions institutions (the CNRS and INSERM) that have contributed to developments partially independently from medical schools. It concludes with a presentation of schools located outside of Paris that have played a significant role in the development of neurology. Six of the most important ones are described: Montpellier, Toulouse, Bordeaux, Strasbourg, Lyon, and

  1. FRANCE AT CERN

    CERN Multimedia

    2001-01-01

    From 19 to 22 June 2001 Administration Building Bldg 60/61 - ground and 1st floor 09.00 hrs - 17.30 hrs Thirty-one companies will present their latest technology at the 'France at CERN' exhibition. The French industry will exhibit products and technologies which are related to the field of particle physics. The main subjects are: cryogenics and vacuum technology, superconductivity, measurement, detection, regulation, control and testing, electrical and electronic equipment, mechanics. The exhibition is organised by the French Committee for Trade Events Abroad. There follows : the list of exhibitors, the list of lectures which will be given at the exhibition. A detailed programme will be available in due course at : your Divisional secretariat, the reception information desk, Building 33, the exhibition. LIST OF EXHIBITORS Air Liquide Air Liquide Alcatel Vacuum Technology Alstom Industrie S.A. Alstom Magnets & Superconductors/Jeumont Industrie ATI Electronique Atos S.A. Axon' Cable S.A...

  2. FRANCE AT CERN

    CERN Multimedia

    C.-L. Jullien-Woringer/SPL-DI

    2001-01-01

    From 19 to 22 June 2001 Administration Building Bldg 60/61 - ground and 1st floor 09.00 hrs - 17.30 hrs Thirty companies will present their latest technology at the 'France at CERN' exhibition. The French industry will exhibit products and technologies which are related to the field of particle physics. The main subjects are: cryogenics and vacuum technology, superconductivity, measurement, detection, regulation, control and testing, electrical and electronic equipment, mechanics. The exhibition is organised by the French Committee for Trade Events Abroad. There follows : the list of exhibitors, the list of lectures which will be given at the exhibition. A detailed programme will be available in due course at : your Divisional secretariat, the reception information desk, Building 33, the exhibition. LIST OF EXHIBITORS Air Liquide Alcatel Vacuum Technology Alstom Industrie S.A. Alstom Magnets & Superconductors/Jeumont Industrie ATI Electronique Atos S.A. Axon' Cable S.A. Cedrat Recher...

  3. [Measles in France].

    Science.gov (United States)

    Antona, Denise; Baudon, Claire; Freymuth, François; Lamy, Mathieu; Maine, Catherine; Parent du Chatelet, Isabelle; Lévy-Bruhl, Daniel

    2012-11-01

    From January 2008 to May 2012, over 22,000 cases of measles were reported in France. The highest incidence rate was observed in children below one year of age. Over 50% of cases were reported in young adults. Almost 5,000 patients were hospitalised including 1,023 with severe pneumonia, 27 with encephalitis and/or myelitis : 10 died. This situation is linked to insufficient and heterogeneous vaccination coverage with pockets of susceptible people allowing virus circulation. Although the vaccine coverage in children has now improved for both doses, the issue of convincing young susceptible adults to catch up for measles vaccination remains critical, if the elimination target is to be met, and in order to protect the most vulnerable population unable to benefit from this vaccination (children below 1 year, immunodeficient people, pregnant women).

  4. FRANCE AT CERN

    CERN Multimedia

    2001-01-01

    From 19 to 22 June 2001 Administration Building Bldg 60/61 - ground and 1st floor 09.00 hrs - 17.30 hrs Thirty-one companies will present their latest technology at the 'France at CERN' exhibition. The French industry will exhibit products and technologies which are related to the field of particle physics. The main subjects are: cryogenics and vacuum technology, superconductivity, measurement, detection, regulation, control and testing, electrical and electronic equipment, mechanics. The exhibition is organised by the French Committee for Trade Events Abroad. There follows : the list of exhibitors, the list of lectures which will be given at the exhibition. A detailed programme will be available in due course at : your Divisional secretariat, the reception information desk, Building 33, the exhibition. LIST OF EXHIBITORS Air Liquide Air Liquide Alcatel Vacuum Technology Alstom Industrie S.A. Alstom Magnets & Superconductors/Jeumont Industrie ATI Electronique Atos S.A. Axon' Cable S.A...

  5. France at CERN

    CERN Multimedia

    2003-01-01

    From 23 to 25 September 2003 Administration Building Bldg 60/61 - ground and 1st floor 09.30 hrs - 17.30 hrs Twenty five companies will present their latest technology at the "France at CERN" exhibition. The French industry will exhibit products and technologies which are related to the field of particle physics. The main subjects are: electrical engineering, electronics, computer data processing, mechanical engineering, vacuum & low temperatures technologies, particles detectors and civil engineering. The exhibition is organised by UBIFRANCE, the French Committee for Trade Events Abroad. There follows : - the list of exhibitors. A detailed programme will be available in due course at : - your Divisional secretariat, - the reception information desk, Building 33, - the exhibition. A web page is available under the following link: http://www.lafranceaucern.com LIST OF EXHIBITORS 1 Air Liquide 14 Nicomatic 2 ATI Electronique 15 Photonis 3 ATIM 16 Positronic industries SAS 4 ATOS 17 Quantel 5 AXON 18 Ra...

  6. France at CERN

    CERN Multimedia

    2003-01-01

    From 23 to 25 September 2003 Administration Building Bldg 60/61 - ground and 1st floor 09.30 hrs - 17.30 hrs Twenty five companies will present their latest technology at the "France at CERN" exhibition. The French industry will exhibit products and technologies which are related to the field of particle physics. The main subjects are: electrical engineering, electronics, computer data processing, mechanical engineering, vacuum & low temperatures technologies, particles detectors and civil engineering. The exhibition is organised by UBIFRANCE, the French Committee for Trade Events Abroad. There follows : - the list of exhibitors. A detailed programme will be available in due course at : - your Divisional secretariat, - the reception information desk, Building 33, - the exhibition. A web page is available under the following link: http://www.lafranceaucern.com LIST OF EXHIBITORS 1 Air Liquide14 Nicomatic 2 ATI Electronique15 Photonis 3 ATIM16 Positronic industries SAS 4 ATOS17 Qu...

  7. France at CERN

    CERN Multimedia

    2003-01-01

    From 22 to 25 September 2003 Administration Building Bldg 60/61 - ground and 1st floor 09.30 hrs - 17.30 hrs Twenty five companies will present their latest technology at the "France at CERN" exhibition. The French industry will exhibit products and technologies which are related to the field of particle physics. The main subjects are: electrical engineering, electronics, computer data processing, mechanical engineering, vacuum & low temperatures technologies, particles detectors and civil engineering. The exhibition is organised by UBIFRANCE, the French Committee for Trade Events Abroad. Please find below: - the list of exhibitors. A detailed programme will be available in due course at : - your Divisional secretariat, - the reception information desk, Building 33, - the exhibition. LIST OF EXHIBITORS 1 Air Liquide14 Nicomatic 2 ATI Electronique15 Photonis 3 ATIM16 Positronic industries SAS 4 ATOS17 Quantel 5 AXON18 Radiospares 6 Cedrat Technologies19 Rexor 7 CIAT20 SDS Service &...

  8. France at CERN

    CERN Multimedia

    2005-01-01

    From 04 to 06 october 2005 Administration Building Bldg 60/61 - ground and 1st floor 09:00 - 17:30   Thirty-two companies will present their latest technology at the "France at CERN" exhibition. French industry will exhibit products and technologies which are related to the field of particle physics. The main subjects are: mechanical engineering, electrical engineering, electronics, data processing, various supplies, civil engineering and buildings, and vacuum and low temperature technology. The exhibition is organised by UBIFRANCE, the French Committee for Trade Events Abroad.  You will find below : the list of exhibitors.   A detailed programme will be available in due course at : your Departmental secretariat, the reception information desk, Building 33, the exhibition itself.   A detailed list of the firms involved is already available under the following FI link: http://fi-dep.web.cern.ch/fi-dep/structure/memberstates/exhibitions_visits.htm     LIST OF EXHIBITORS AIR LIQUIDE DTA ALSTO...

  9. France at CERN

    CERN Multimedia

    2005-01-01

    From 04 to 06 october 2005 Administration Building Bldg 60/61 - ground and 1st floor 09:00 - 17:30   Thirty-two companies will present their latest technology at the "France at CERN" exhibition. French industry will exhibit products and technologies which are related to the field of particle physics. The main subjects are: mechanical engineering, electrical engineering, electronics, data processing, various supplies, civil engineering and buildings, and vacuum and low temperature technology. The exhibition is organised by UBIFRANCE, the French Committee for Trade Events Abroad.  You will find below : the list of exhibitors.   A detailed programme will be available in due course at : your Departmental secretariat, the reception information desk, Building 33, the exhibition itself.   A detailed list of the firms involved is already available under the following FI link: http://fi-dep.web.cern.ch/fi-dep/structure/memberstates/exhibitions_visits.htm     LIST OF EXHIBITORS AIR LIQUIDE DTA ALSTOM...

  10. The CQI/TQM journey in France.

    Science.gov (United States)

    Maguerez, G

    1997-01-01

    In France interest in continuous quality improvement (CQI) and other quality improvement (QI) approaches is recent and experience modest, but the pace of change should quicken now that the government has required that all hospitals be accredited within the next five years. In addition, in the face of increasing competition, hospitals, public and private, may find a quality strategy to be critical in helping them survive. In fall 1994 the National Agency for the Promotion of Medical Evaluation (ANDEM) was mandated by the Ministry of Health to set up a national demonstration project based on quality assurance and CQI methodologies. The program was designed to identify the key success factors for implementing such programs within hospitals. The program involves 28 18-month CQI projects, which deal with prevention of nosocomial infection, patient safety in anesthesia, medical records, blood transfusion safety, drug dispensing safety, and control of violence in psychiatric settings. Participating hospitals are required to analyze the variation in the involved processes and attempt to reduce variation through cross-departmental quality management programs. The general method for each team's management of the project closely follows the PDCA (Plan-Do-Check-Act) cycle. Preliminary experience suggests that the participating hospitals have benefited from following the same model and sharing of accounts of their progress. Representatives of the 28 teams met in fall 1995 and June 1996, and future meetings are planned. Most of the teams have collected quantitative data about the current processes and have started to pilot test process changes.

  11. Reduction of the nosocomial meticillin-resistant Staphylococcus aureus incidence density by a region-wide search and follow-strategy in forty German hospitals of the EUREGIO, 2009 to 2011

    NARCIS (Netherlands)

    Jurke, A; Kock, R; Becker, K; Thole, S; Hendrix, R; Rossen, J; Daniels-Haardt, I; Friedrich, AW

    2013-01-01

    Meticillin-resistant Staphylococcus aureus (MRSA) disseminates between hospitals serving one patient catchment area. Successful prevention and control requires concerted efforts and regional surveillance. Forty hospitals located in the German EUREGIO have established a network for combating MRSA. In

  12. Reduction of the nosocomial meticillin-resistant Staphylococcus aureus incidence density by a region-wide search and follow-strategy in forty German hospitals of the EUREGIO, 2009 to 2011

    NARCIS (Netherlands)

    Jurke, A; Kock, R; Becker, K; Thole, S; Hendrix, R; Rossen, J; Daniels-Haardt, I; Friedrich, AW

    2013-01-01

    Meticillin-resistant Staphylococcus aureus (MRSA) disseminates between hospitals serving one patient catchment area. Successful prevention and control requires concerted efforts and regional surveillance. Forty hospitals located in the German EUREGIO have established a network for combating MRSA. In

  13. [Motivations of parents taking their children to the hospital in emergencies. Results of a psychosocial survey at the Regional University Hospital Center of Grenoble].

    Science.gov (United States)

    Marguet, M C; Lejosne, G; Berthier, N; Bost, M

    1988-01-01

    A psycho-social survey by questionnaire was conducted among parents accompanying their children to the Pediatric Emergency Ward of the Medical Center of Grenoble, in order to identify the motivations of those who do not seek a medical advice prior to their coming to the hospital. From this survey, several motivating factors were identified: an economical factor, the difficulty to rapidly call a physician, the place of residence, an insufficient knowledge of the medical services, the familiarity of parents with the hospital, the advice of relatives, the anxiety caused by the child's illness and the comforting image of the hospital. In a synthetic analysis, several types of parents are distinguished according to their behavior.

  14. Open letter to Mr Christian Bataille, Deputy of Nord region, France. Open letter on nuclear energy; Lettre ouverte a Monsieur Christian Bataille, depute du Nord. Lettre ouverte sur le nucleaire

    Energy Technology Data Exchange (ETDEWEB)

    Delacroix P

    2007-02-15

    The author, by means of a letter to the deputy Christian Bataille, presents arguments to the shutdown of old nuclear power plants. He points out the environmental and economical arguments in favor of a decrease of the nuclear power use in France. (A.L.B.)

  15. Hospital, Tigray Region, Ethiopia

    African Journals Online (AJOL)

    Background: Ruptured uterus is a common cause of maternal and perinatal mortality and ... cause, treatment, complications, and maternal and fetal mortality associated with raptured uterus. A ... trauma, anemia and in the iong term because of.

  16. The Challenges and Opportunities of Social Media in the Hospitality Industry. A Study of the North East Region of Romania

    Directory of Open Access Journals (Sweden)

    Andreea Maha

    2015-05-01

    and YouTube are apparently not that popular. Social Media accounts are not used at their full capacity and from the total number identified on each segment, not all have a direct reference from their own site, for in case of Facebook 31 out of 48, Twitter 7 out of 10 and YouTube 7 out of 10. The most important limitation is considered to be the consistency of the sample we used. We only investigated the hotels (rated 3 to 5 stars from the North-East region of Romania. A sample including all the hotels from Romania would have given a more realistic view of the use of Social Media in the hospitality industry. Another possible study limitation can be that the Social Media accounts may have been missed as it did not feature in the first three pages search results. The worst part is that the same mistake would be made by the potential customers searching for that hotel that is why we considered this error an acceptable one. As we made only a qualitative research, the results must be validated in a future research. The results of this research can be used by hotel managers and also by those who manage Internet websites. Business people who intend to enter on hospitality market might also be interested in this information. For the North-East region of Romania, during our documentation stage for this article, there was no study identified, similar to the one we realized. Also Romania, as a country where tourism industry it is in early stages of development, needs to benefit from this kind of research, for creating new strategies and implement best practices in the field.

  17. Market access pathways for cell therapies in France.

    Science.gov (United States)

    Rémuzat, Cécile; Toumi, Mondher; Jørgensen, Jesper; Kefalas, Panos

    2015-01-01

    Cell therapies can be classified into three main categories of products: advanced therapy medicinal products (ATMPs), ATMPs prepared on a non-routine basis (hospital exemptions), and minimally manipulated cells. Despite the benefits that cell therapies can bring to patients, they are subject to complex pathways to reach the market in France. The objective of this study was to identify and describe routes to market access for cell therapies in France and how these vary by regulatory status. The research was structured following five main steps: (1) identification of the French regulatory framework for cell therapies; (2) identification of the health products categorised as cell therapies in France; (3) mapping of the market access pathways per category of cell therapy; (4) validation of findings by interviewing experts; and (5) development of a roadmap summarising market access pathways for cell therapies in France. The secondary research methodology included a comprehensive literature review conducted on websites of French public health institutions, complemented by a research for peer-reviewed articles, abstracts, and grey literature. Different market access pathways are possible depending on the cell therapy category. For ATMPs, market access pathways depend on the licensing status of the therapy. Licensed ATMPs followed the same market access pathways as 'conventional' pharmaceuticals, whereas not-yet-licensed ATMPs can be funded via a specific financial allowance under the framework of a Temporary Authorisation for Use procedure or various research programmes. For new ATMPs that are associated with a separate medical device (not considered as 'combined ATMPs') or associated with a new medical procedure, additional pathways will apply for the medical device and/or medical procedure to be reimbursed in the ambulatory settings or at hospital. The most likely funding option for ATMPs prepared on a non-routine basis is outside the diagnosis-related group (DRG

  18. Lower extremity reconstruction: epidemiology, management and outcomes of patients of the Federal District North Wing Regional Hospital

    Directory of Open Access Journals (Sweden)

    JEFFERSON LESSA SOARES MACEDO

    Full Text Available ABSTRACT Objective: to evaluate the management of lower limbs complex traumatic injuries by analyzing their characteristics, types, conduct and evolution, with emphasis on surgical treatment. Methods: we conducted a prospective study of patients treated by Plastic Surgery at a regional hospital of the Federal District during a one-year period. We collected data through serial evaluations and telephone contact records. Results: we studied 40 patients, with a mean age of 25.6 years, predominantly male (62.5%. The most frequent wounds were of the distal third of the lower limb (37.5%. Bone or tendon exposures occurred in 55% had and there was a 35% rate of exposed lower limb fractures. The treatments employed were skin grafting (57.5%, local fasciocutaneous flap (15%, muscle flap (12.5%, cross-leg fasciocutaneous flap, reverse sural flap (12.5% and microsurgical flap (2.5%. Short-term evaluation showed that 35 patients had excellent or good results (87.5%, four had a regular result (10%, and one had an unsatisfactory result (2.5%. In the long term, of the 18 patients who answered the questionnaire, ten resumed walking, even with support, in the first three months after surgery (55.6%. Conclusion: young men involved in motorcycle accidents during leisure time represented the profile of patients with lower limb trauma requiring surgical reconstruction; the distal third of the leg was the most affected region. Grafting was the most used technique for reconstruction and postoperative functional evaluation showed that, despite complex lesions, most patients evolved with a favorable healing process and successful functional evolution.

  19. Diversity of CTX-M beta-lactamases and their promoter regions from Enterobacteriaceae isolated in three Parisian hospitals.

    Science.gov (United States)

    Saladin, Michèle; Cao, Van Thi Bao; Lambert, Thierry; Donay, Jean-Luc; Herrmann, Jean-Louis; Ould-Hocine, Zahia; Verdet, Charlotte; Delisle, Françoise; Philippon, Alain; Arlet, Guillaume

    2002-04-01

    Nine clinical isolates of Enterobacteriaceae (six Escherichia coli and three Proteus mirabilis) isolated in three Parisian hospitals between 1989 and 2000 showed a particular extended-spectrum cephalosporin-resistance profile characterized by resistance to cefotaxime and aztreonam but not to ceftazidime. CTX-M-1, CTX-M-2, CTX-M-9, CTX-M-14 and two novel plasmid-mediated CTX-M beta-lactamases (CTX-M-20, and CTX-M-21) were identified by polymerase chain reaction and isoelectric focusing (pI>8) and were associated in eight cases with TEM-1 (pI=5.4) or TEM-2 (pI=5.6) beta-lactamases. We used internal ISEcp1 and IS26 forward primers and the CTX-M consensus reverse primer to characterize the CTX-M beta-lactamase promoter regions and showed their high degree of structure diversity. We found upstream of some bla(CTX-M) genes, a 266-bp sequence 100% identical to the sequence upstream of the Kluyvera ascorbata beta-lactamase gene, suggesting that this chromosomal enzyme is the progenitor of the CTX-M-2/5 cluster.

  20. The evaluation of the patients who admitted to a regional hospital emergency service with suspect of rabies

    Directory of Open Access Journals (Sweden)

    Nurettin Tunç

    2012-09-01

    Full Text Available Objectives: Rabies is one of the highest mortality ratesinfectious disease. The aim was the evaluation of the patientswho admitted to The Batman Regional State HospitalEmergency Service with suspect of rabies in the datesbetween June 2011 and November 2011.Materials and methods: Totally, 166 cases who admittedto our center was recorded according to the followingdata: place of residence (rural/urban, contact type andwound information, time after the contact, whether vaccineor immunoglobulin is applied or not and also the species,breed and being owned of suspected animal.Results: Our study population consisted of a total of 166cases including 38 women (23%, 128 men (77% withthe mean age of 22.01 ± 17.90 years. Of all subjects, 105(63% lived in urban and 61 (37% lived in rural areas.Eighty-five percent of suspicious animals (51% had anowner, while 81 animals were unattended.Conclusions: Our results showed that all admitted patientswere vaccinated and the ones contacted with petsor had a surface wound were vaccinated with 3 doses.Moreover, since the 49% of our cases were contactedwith animals which cannot be follow-up, our study obviouslyreveals that in our country deficiencies in the controlof waifs still is a public health problem and increases thecost of vaccination. J Clin Exp Invest 2012; 3 (3: 383-386Key words: Rabies, suspected bite, rabies prophylaxis

  1. Interconnection France-England; Interconnexion France-Angleterre

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-07-01

    These documents defines the interconnection France-England rules for the 2000 MW DC submarine cable directly linking the transmission networks of England and Wales and France. Rights to use Interconnector capacity from 1 April 2001 are to be offered through competitive tenders and auctions, full details of which are set out in the Rules. The contract and a guide to the application form are provided. (A.L.B.)

  2. [Nurse anesthetist in France].

    Science.gov (United States)

    Mizuno, Ju; Yann, Douchy; De Almeida, Sylvie; Deckert, Christine; Gauss, Tobias; Bonneville, Claire Tae; Merckx, Paul; Mantz, Jean

    2006-12-01

    We present the system of nurse anesthetist (Infirmier Anesthésiste Diplômé d'Etat: IADE) in France to the community of Japanese anesthesiologists. This French system with 70 years' history is older than the Japan Society of Anesthesiologists itself. There are 7000 nurse anesthetists in France now and the number of nurse anesthetists increases by 450-500 each year. Training to become a nurse anesthetist requires at least two years' experience as a general nurse and the general nurse must pass an examination after two years' special training in an anesthetistic nurse school to acquire the national certification. The nurse anesthetist's profession is regulated by French law. They work in a team with certified anesthesiologists. They can perform many kinds of anesthetic tasks including tracheal intubation and insertion of arterial catheter under the responsibility and supervision of certified anesthesiologists. The nurse anesthetists are not allowed to perform spinal, epidural, conduction and local anesthesia, although they can maintain these anesthesia and control these methods, e.g., by injecting local anesthetic agents through epidural catheter, following a specified prescription. The nurse anesthetists are not allowed to insert central venous and pulmonary artery catheters, although they can manage them. They are allowed to administer inhalation anesthetic agents, and inject venous anesthetic agents, muscle relaxants, their antagonists, and opioids by their own initiatives, but the decision for the use of catecholamine and emergency drugs is reserved to certified anesthesiologists. The nurse anesthetists perform other tasks preparing and checking anesthetic agents and equipment such as anesthetic machine, monitor, and defibrillator everyday, and sometimes use autologous blood recovery systems. The relationship between the certified anesthesiologist and the nurse anesthetist is marked by mutual respect, confidence and cooperation at each step of the anesthetic

  3. A high space-time resolution dataset linking meteorological forcing and hydro-sedimentary response in a mesoscale Mediterranean catchment (Auzon) of the Ardèche region, France

    Science.gov (United States)

    Nord, Guillaume; Boudevillain, Brice; Berne, Alexis; Branger, Flora; Braud, Isabelle; Dramais, Guillaume; Gérard, Simon; Le Coz, Jérôme; Legoût, Cédric; Molinié, Gilles; Van Baelen, Joel; Vandervaere, Jean-Pierre; Andrieu, Julien; Aubert, Coralie; Calianno, Martin; Delrieu, Guy; Grazioli, Jacopo; Hachani, Sahar; Horner, Ivan; Huza, Jessica; Le Boursicaud, Raphaël; Raupach, Timothy H.; Teuling, Adriaan J.; Uber, Magdalena; Vincendon, Béatrice; Wijbrans, Annette

    2017-03-01

    A comprehensive hydrometeorological dataset is presented spanning the period 1 January 2011-31 December 2014 to improve the understanding of the hydrological processes leading to flash floods and the relation between rainfall, runoff, erosion and sediment transport in a mesoscale catchment (Auzon, 116 km2) of the Mediterranean region. Badlands are present in the Auzon catchment and well connected to high-gradient channels of bedrock rivers which promotes the transfer of suspended solids downstream. The number of observed variables, the various sensors involved (both in situ and remote) and the space-time resolution ( ˜ km2, ˜ min) of this comprehensive dataset make it a unique contribution to research communities focused on hydrometeorology, surface hydrology and erosion. Given that rainfall is highly variable in space and time in this region, the observation system enables assessment of the hydrological response to rainfall fields. Indeed, (i) rainfall data are provided by rain gauges (both a research network of 21 rain gauges with a 5 min time step and an operational network of 10 rain gauges with a 5 min or 1 h time step), S-band Doppler dual-polarization radars (1 km2, 5 min resolution), disdrometers (16 sensors working at 30 s or 1 min time step) and Micro Rain Radars (5 sensors, 100 m height resolution). Additionally, during the special observation period (SOP-1) of the HyMeX (Hydrological Cycle in the Mediterranean Experiment) project, two X-band radars provided precipitation measurements at very fine spatial and temporal scales (1 ha, 5 min). (ii) Other meteorological data are taken from the operational surface weather observation stations of Météo-France (including 2 m air temperature, atmospheric pressure, 2 m relative humidity, 10 m wind speed and direction, global radiation) at the hourly time resolution (six stations in the region of interest). (iii) The monitoring of surface hydrology and suspended sediment is multi-scale and based on nested

  4. Lower extremity reconstruction: epidemiology, management and outcomes of patients of the Federal District North Wing Regional Hospital.

    Science.gov (United States)

    Macedo, Jefferson Lessa Soares; Rosa, Simone Corrêa; Botelho, Daniel Lobo; Santos, Clendes Pereira Dos; Queiroz, Murilo Neves DE; Gomes, Tabatha Gonçalves Andrade Castelo Branco

    2017-01-01

    to evaluate the management of lower limbs complex traumatic injuries by analyzing their characteristics, types, conduct and evolution, with emphasis on surgical treatment. we conducted a prospective study of patients treated by Plastic Surgery at a regional hospital of the Federal District during a one-year period. We collected data through serial evaluations and telephone contact records. we studied 40 patients, with a mean age of 25.6 years, predominantly male (62.5%). The most frequent wounds were of the distal third of the lower limb (37.5%). Bone or tendon exposures occurred in 55% had and there was a 35% rate of exposed lower limb fractures. The treatments employed were skin grafting (57.5%), local fasciocutaneous flap (15%), muscle flap (12.5%), cross-leg fasciocutaneous flap, reverse sural flap (12.5%) and microsurgical flap (2.5%). Short-term evaluation showed that 35 patients had excellent or good results (87.5%), four had a regular result (10%), and one had an unsatisfactory result (2.5%). In the long term, of the 18 patients who answered the questionnaire, ten resumed walking, even with support, in the first three months after surgery (55.6%). young men involved in motorcycle accidents during leisure time represented the profile of patients with lower limb trauma requiring surgical reconstruction; the distal third of the leg was the most affected region. Grafting was the most used technique for reconstruction and postoperative functional evaluation showed that, despite complex lesions, most patients evolved with a favorable healing process and successful functional evolution. avaliar o tratamento de feridas traumáticas complexas de membros inferiores analisando suas características, tipos, condutas e evolução, com ênfase no tratamento cirúrgico. estudo prospectivo de pacientes tratados pela Cirurgia Plástica em um hospital regional do Distrito Federal no período de um ano. Os dados foram coletados através de avaliações seriadas e registro de

  5. Income Tax in France

    CERN Multimedia

    HR Department

    2009-01-01

    Memorandum from the HR and FP Departments and the Legal Service concerning the annual internal taxation certificate and the declaration of income for 2008 You are reminded that each year the Organization levies an internal tax on the financial and family benefits it pays to the members of the personnel (see Chapter V, Section 2 of the Staff Rules and Regulations) and that members of the personnel are thus exempt from external taxation on salaries and emoluments paid by CERN. This memorandum is intended to provide members of the personnel residing in France with information on how salaries and emoluments paid by CERN should be indicated in the 2008 income declaration form. For any other income, they are invited to comply with the instructions attached to the form. I - Annual internal taxation certificate for 2008 The annual certificate of internal taxation for 2008, issued by the FP Department, has been available since 1st March 2009 (see Bulletin No. 11-12/2009). It is int...

  6. Income tax in France

    CERN Multimedia

    HR Department

    2009-01-01

    Memorandum from the HR and FP Departments and the Legal Service concerning the annual internal taxation certificate and the declaration of income for 2008 You are reminded that each year the Organization levies an internal tax on the financial and family benefits it pays to the members of the personnel (see Chapter V, Section 2 of the Staff Rules and Regulations) and that members of the personnel are thus exempt from external taxation on salaries and emoluments paid by CERN. This memorandum is intended to provide members of the personnel residing in France with information on how salaries and emoluments paid by CERN should be indicated in the 2008 income declaration form. For any other income, they are invited to comply with the instructions attached to the form. I - Annual internal taxation certificate for 2008 The annual certificate of internal taxation for 2008, issued by the FP Department, has been available since 1st March 2009 (see Bulletin No. 11-12/2009). It is int...

  7. [How to make regional medicine revive from the medical crisis or collapse due to the severe paucity of medical doctors: a plan with "the magnet hospital"].

    Science.gov (United States)

    Itoh, Tsunetoshi

    2009-01-01

    In 2002-2003, the practice of doctors lending their names to appear as "staff" of hospitals became known. Problems regarding funds from public hospitals were also revealed. Tohoku University asked regional societies how to improve the medical situation, and redefined its responsibilities. The Educational Development Center for Local Medicine and Department of Local Medical Service System were set up (2005-2008). A severe shortage of medical doctors prevails in Japan: the number of doctors per population is at the 4th lowest among OECD countries, and the number per hospital bed is the lowest. We have no nursing homes whose beds are not counted as hospital beds. The number of faculty staff in Japanese medical schools is 1/3 to those of Western countries. The reported number of doctors working in hospitals and offices surpasses that by census for medical doctors by >40,000. Japanese doctors work for >60 hours per week. I propose essential plans to improve Japanese situation for medical service: 1. Immediately increase the number of doctors by at least 50%. Based on our calculation, we need 450,000 doctors. 2. When the shortage of doctors is severe, establish a magnet hospital with c.a. 500 beds for every 200,000 population, capable of treating highly emergency patients and attracting doctors who need medical training. Hospitals should not belong to each city or town. 3. Establish a comprehensive organization to nurture doctors on a long-term basis. It should consist of a medical school, hospitals, and the prefectural government. It should help doctors to move between hospitals, and be responsible both for designing doctors' career paths and for allocating them appropriately.

  8. The "Casa" of Sevres, France.

    Science.gov (United States)

    Waltuch, Margot

    1996-01-01

    Discusses the author's teaching experiences during the 1930s at "La Maison des Enfants," a Montessori school in Sevres, France. Provides photographs and descriptions of the school day, outdoor activities, gardening, cooking and eating, practical activities, and creative activities. (MDM)

  9. France Welcome Chinese Business Delegation

    Institute of Scientific and Technical Information of China (English)

    Guo Yan

    2009-01-01

    @@ According to the Press Communiqu(e) between China and France issued on 1st April,both sides decided to conduct high-level contact and strategic dialogue at a proper time to enhance bilateral cooperation in various fields and promote a harmonious and steady growth in Sino-France relations.Since then,the high officials from both countries experienced a frequent meet period.

  10. Tour of France by foot

    CERN Multimedia

    Papini

    1982-01-01

    Monsieur Papini(nom juste?) et sa femme, tous les deux journalistes, découvrent avec leur 2 enfants, agés de 16 mois et 3 ans, ainsi qu'avec un âne, la vie nomade en parcourant la France pendant un an et demie à pied: comment être un nomade en France? Sa femme a écrit deux ouvrages concernant ce voyage.

  11. Compliance of district hospitals in the Center Region of Cameroon with WHO/IATSIC guidelines for the care of the injured: a cross-sectional analysis.

    Science.gov (United States)

    Chichom-Mefire, Alain; Mbarga-Essim, Nicole Therese; Monono, Martin Ekeke; Ngowe, Marcelin Ngowe

    2014-10-01

    Injuries are a major cause of death and disability worldwide. Low-income countries, particularly in Africa, are disproportionately affected. The burden of injuries can be alleviated by preventive measures and appropriate management of injury cases. African countries generally lack trauma care systems based on reliable and affordable guidelines. The aim of this study was to assess the compliance of some district hospitals in Cameroon with World Health Organization/International Association for Trauma and Intensive Care (WHO/IATSIC) guidelines for care of the injured. This cross-sectional descriptive survey used items from the WHO/IATSIC "Guidelines for Essential Trauma Care" to develop a checklist for inspection of physical equipment and a questionnaire assessing human resources and organizational capabilities in 25 district hospitals of the Center Region of Cameroon. All hospitals surveyed had at least one doctor available. Each reported treating a mean of 338 ± 214 injury cases every year. Most hospitals (n = 22) were globally either not compliant or partly compliant with the guidelines. Staff generally had received the appropriate basic training but had no additional training specifically directed toward trauma management. Skills for managing specific injuries (e.g., chest injuries) were poor. Availability and utilization of equipment was globally inadequate, and organizational capabilities were almost nonexistent. District hospitals of the Center Region of Cameroon still lack compliance with the WHO/IATSIC guidelines for essential trauma care but have significant potential for improvement. It seems possible to optimize the utilization of existing facilities.

  12. The roles of teaching hospitals, insurance status, and race/ethnicity in receipt of adjuvant therapy for regional-stage breast cancer in Florida.

    Science.gov (United States)

    Richardson, Lisa C; Tian, Lili; Voti, Lydia; Hartzema, Abraham G; Reis, Isildinha; Fleming, Lora E; Mackinnon, Jill

    2006-01-01

    We examined the roles of teaching hospitals, insurance status, and race/ ethnicity in women's receipt of adjuvant therapy for regional-stage breast cancer. Data were taken from the Florida Cancer Data System for cases diagnosed from July 1997 to December 2000. We evaluated the impact of health insurance status and hospital type on use of adjuvant therapy (after adjustment for age, race/ethnicity, and marital status). Interaction terms for hospital type, insurance status, and race/ethnicity were entered in each model. Teaching facilities diagnosed 12.5% of the cases; however, they cared for a disproportionate percentage (21.3%) of uninsured and Medicaid-insured women. Among women who received adjuvant chemotherapy only, those diagnosed in teaching hospitals were more likely than those diagnosed in nonteaching hospitals to receive therapy regardless of insurance status or race/ethnicity. Among women who received chemotherapy with or without hormonal therapy, Hispanics were more likely than White non-Hispanic women to receive therapy, whereas women with private insurance or Medicare were less likely than uninsured and Medicaid-insured women to receive this type of therapy. Teaching facilities play an important role in the diagnosis and treatment of regional-stage breast cancer among Hispanics, uninsured women, and women insured by Medicaid.

  13. [Infant botulism in France, 1991-2009].

    Science.gov (United States)

    King, L-A; Popoff, M-R; Mazuet, C; Espié, E; Vaillant, V; de Valk, H

    2010-09-01

    Infant botulism is caused by the ingestion of spores of Clostridium botulinum and affects newborns and infants under 12 months of age. Ingested spores multiply and produce botulinum toxin in the digestive tract, which then induces clinical symptoms. A single French case was described in the literature prior to 1991. We describe the cases of infant botulism identified in France between 1991 and 2009. All clinical suspicions of botulism must be declared in France. Biological confirmation of the disease is provided by the National reference laboratory for anaerobic bacteria and botulism at the Pasteur Institute. During this period, 7 cases of infant botulism were identified, 1 per year from 2004 to 2008 and 2 in 2009. The median age of affected infants was 119 days and all were female. All infants presented with constipation and oculomotor symptoms. All were hospitalized and required mechanical ventilation. The infants recovered from their botulism. The diagnosis of infant botulism was biologically confirmed for all patients. One 4-month-old infant was treated with a single dose of the human-derived botulism antitoxin specific for infant botulism types A and B (BabyBIG®). The infants all had different feeding habits ranging from exclusive breast feeding to a mix of formula feeding and solid food consumption. The consumption of honey, the only documented risk food for this disease, was reported for 3 of the infants. The honey had been placed on the pacifier of 2 infants and directly in the mouth of the 3rd by the mother. Infant botulism, a form of botulism that was previously rarely recognized in France, has been reported more frequently during the last 6 years. This disease remains rare but nonetheless severe. In light of recent epidemiological data, efforts to raise awareness among parents of infants and health professionals on the danger of infant botulism and particularly, its association with honey consumption seems necessary.

  14. Nonadherence and factors affecting adherence of diabetic patients to anti-diabetic medication in Assela General Hospital, Oromia Region, Ethiopia

    Directory of Open Access Journals (Sweden)

    Ashebir Kassahun

    2016-01-01

    Full Text Available Background: Diabetes mellitus is a major global health problem covering approximately 347 million persons worldwide. Glycemic control has a main role in its management which mainly depends upon patient adherence to the treatment plan. Accurate assessment of medication adherence is necessary for effective management of diabetes. Objective: To assess nonadherence and factors affecting adherence of diabetic patients to anti-diabetic medication in Assela General Hospital (AGH, Oromia Region, Ethiopia. Materials and Methods: A descriptive cross-sectional study was conducted on patients seeking anti-diabetic drug treatment and follow-up at AGH using structured questionnaire and reviewing the patient record card using check list from January 24, 2014 to February 7, 2014. Descriptive analysis was used to describe the percentages and number of distributions of the variables in the study; and association was identified for categorical data. P ≤ 0.05 was considered as statistically significant. Result: Of all respondents, 149 (52.3% and 136 (47.7% were female and male, respectively. The majority of the study participants 189 (66.3% were in the age group of 30–60 years. Two-hundred nineteen (76.8% of respondents were married currently. The majority, 237 (83.2% of respondents did not have blood glucose self-monitoring equipment (glucometer. A total of 196 (68.8% respondents were adhered to anti-diabetic medication. There was a significant association between adherence to the medication and side effect, level of education, monthly income and presence of glucometer at home (P < 0.05. Conclusion: The participants in the area of study were moderately adherent to their anti-diabetic medications with nonadherence rate of 31.2%. Different factors of medication nonadherence were identified such as side effect and complexity of regimen, failure to remember, and sociodemographic factors such as educational level and monthly income.

  15. Clinical characteristics of patients with atrial fibrillation at a tertiary care hospital in the central region of Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Salih A Bin Salih

    2011-01-01

    Full Text Available Objective: To report on the clinical presentation, etiology, and laboratory features of acute and chronic atrial fibrillation (AF in a tertiary hospital in Riyadh, Saudi Arabia. Materials and Methods: We retrospectively studied records of 720 patients with AF seen in outpatients and inpatients departments at King Abdulaziz Medical City, Riyadh, during the period of 1 January 2002 to 31 August 2008. Results: Documented acute and chronic AF was present in 157 (21.8% and 563 (78.1% patients, respectively. Palpitations, dizziness and syncope were the most frequent symptoms in acute AF, while dyspnea and palpitations were the most common symptoms in the chronic type. Acute respiratory problems and acute myocardial infarction were significantly more common in acute AF, while congestive heart failure and acute respiratory problems (chest infection, bronchial asthma, and pulmonary embolism were significantly more common in chronic AF. The most common causes of both types of AF were diabetes mellitus (DM in 68.8%, hypertension (HTN in 59.3%, chronic lung diseases (bronchial asthma, chronic obstructive pulmonary disease and interstitial lung disease in 31.8%, valvular heart disease in 23.6%, and ischemic heart disease (IHD in 23.1%. In 9 (1.3% patients, no cause was detected. The echocardiographic findings of left ventricular hypertrophy, valve lesions, and depressed left ventricular function were significantly more common in chronic AF (P<0.01. Conclusions : Nowadays, DM, HTN, and IHD are becoming the most common predisposing factors for AF in the central region of Saudi Arabia and require prevention and control

  16. Estudio descriptivo de la enfermedad cerebrovascular en el Hospital Regional Docente de Ica-Perú 2003 - 2006

    Directory of Open Access Journals (Sweden)

    J. Jhonnel Alarco

    2009-01-01

    Full Text Available Objetivo, Determinar algunas características epidemiológicas de la enfermedad cerebro vascular (ECV, describir las características de la población estudiada según sexo, edad, procedencia, raza, forma de inicio, ubicación, tipos y subtipos, síntomas, antecedentes patológicos y mortalidad intrahospitalaria. Materiales y métodos, estudio descriptivo. Lugar, Hospital Regional Docente de Ica. Criterios de inclusión, pacientes ingresados con diagnóstico de accidente cerebrovascular. Intervenciones, revisión de historias clínicas de archivo entre los años 2003 y 2006 Principales medidas de resultados, análisis estadístico, porcentajes y medidas de tendencia central, tabuladas en una base de datos con ayuda del programa Microsoft Excel 2003 para Windows®. Resultados, de 152 pacientes ingresados al servicio de Medicina 119 fueron casos de ECV isquémico, 33 casos fueron ECV hemorrágico. El principal antecedente patológico fue la hipertensión arterial con un 75.0 %. El síntoma más frecuente fue el trastorno motor con 80.3% seguido por alteraciones del lenguaje con 55.9%. El mayor número fue encontrado entre la séptima y octava décadas de la vida. La edad mínima fue de 17 y máxima de 102 años. La mortalidad global fue de 18 casos obteniéndose una tasa de letalidad específica para el ECV isquémico de 0,8% y de 51,5% para el ECV hemorrágico. Conclusiones: Se distingue a la HTA como el principal antecedente modificable, cuya prevención reduciría notablemente su mortalidad.

  17. Knowledge translation lessons from an audit of Aboriginal Australians with acute coronary syndrome presenting to a regional hospital

    Directory of Open Access Journals (Sweden)

    Emma Haynes

    2016-07-01

    Full Text Available Objective: Translation of evidence into practice by health systems can be slow and incomplete and may disproportionately impact disadvantaged populations. Coronary heart disease is the leading cause of death among Aboriginal Australians. Timely access to effective medical care for acute coronary syndrome substantially improves survival. A quality-of-care audit conducted at a regional Western Australian hospital in 2011–2012 compared the Emergency Department management of Aboriginal and non-Aboriginal acute coronary syndrome patients. This audit is used as a case study of translating knowledge processes in order to identify the factors that support equity-oriented knowledge translation. Methods: In-depth interviews were conducted with a purposive sample of the audit team and further key stakeholders with interest/experience in knowledge translation in the context of Aboriginal health. Interviews were analysed for alignment of the knowledge translation process with the thematic steps outlined in Tugwell’s cascade for equity-oriented knowledge translation framework. Results: In preparing the audit, groundwork helped shape management support to ensure receptivity to targeting Aboriginal cardiovascular outcomes. Reporting of audit findings and resulting advocacy were undertaken by the audit team with awareness of the institutional hierarchy, appropriate timing, personal relationships and recognising the importance of tailoring messages to specific audiences. These strategies were also acknowledged as important in the key stakeholder interviews. A follow-up audit documented a general improvement in treatment guideline adherence and a reduction in treatment inequalities for Aboriginal presentations. Conclusion: As well as identifying outcomes such as practice changes, a useful evaluation increases understanding of why and how an intervention worked. Case studies such as this enrich our understanding of the complex human factors, including

  18. Anemia y deficiencia de hierro en mujeres en edad reproductiva usuarias del Hospital Regional de Villa Hayes, Paraguay

    Directory of Open Access Journals (Sweden)

    Jessica Riveros

    2015-08-01

    Full Text Available La anemia es un problema de salud pública a nivel mundial. En Paraguay, existen datos limitados sobre la frecuencia de anemia en mujeres en edad reproductiva no gestantes. Este estudio piloto descriptivo de corte transverso tuvo como objetivo determinar la frecuencia de anemia y deficiencia de hierro, el estado nutricional, hábitos alimentarios y tóxicos en 99 mujeres no gestantes en edad reproductiva de 18 a 48 años que acudieron al Hospital Regional de Villa Hayes en Octubre del 2.014. La anemia se determinó tomando como punto de corte una concentración de hemoglobina <12 g/dL. La deficiencia de hierro se evaluó según la saturación de la transferrina. Además, se evaluó el índice de masa corporal (IMC y los hábitos nutricionales a través de una encuesta. La frecuencia de anemia fue de 15,1% (IC95% 8,7-23,8%, de éste el 33,3% (IC95% 12,8-61,6% correspondió a anemia ferropénica. Se observó asociación entre la presencia de anemia y los niveles disminuidos tanto del hematocrito (<38% como del número de glóbulos rojos (<4,2x 106/uL. Todas las mujeres con anemia ferropénica tenían peso <64 kg e IMC <24,5 kg/m2. Además, se detectó una alta frecuencia de sobrepeso y obesidad (45,4%, alto consumo de grasas, y bajo consumo de legumbres, frutas y verduras. A partir de estos resultados, se sugiere mantener la vigilancia e implementar programas que incluyan a estas mujeres, tanto para evitar deficiencias nutricionales como excesos.

  19. Insuficiencia renal aguda en pacientes de la Unidad de Cuidados Intensivos, Hospital Regional de Cuilapa, Santa Rosa, Guatemala

    Directory of Open Access Journals (Sweden)

    Ronald J. Ajcalon

    2017-03-01

    Full Text Available La insuficiencia renal aguda, es una condición común en la Unidad de Cuidados Intensivos de Adultos (UCIA y probablemente una consecuencia de la enfermedad crítica que se asocia a resultados clínicos adversos, altos costos y una mortalidad de más del 50%, sobre todo si se requiere tratamiento de reemplazo renal. El objetivo fue determinar la incidencia de insuficiencia renal aguda en pacientes ingresados a la UCIA. El estudio fue prospectivo, longitudinal, observacional, en 101 pacientes ingresados en la UCIA del Hospital Regional de Cuilapa. Se diagnosticaron 101 pacientes durante el periodo de estudio con insuficiencia renal aguda represento el 27.4% del total de pacientes internados (368 en el servicio en un año. La incidencia de mortalidad en pacientes que requieren terapia de reemplazo renal y se encuentran en ventilación mecánica es del 100%. Del total de pacientes estudiados, según la escala Akin, se encontró que el 49.5% de los pacientes correspondían a grado II, aunque el grado I también fue frecuente (29%, y que el 22 % de los pacientes correspondían a grado III. La patología que mayormente se asoció al desarrollo de insuficiencia renal aguda fue sepsis grave con un 31%, seguido de pacientes sometidos a cirugía mayor e hipovolemia con el 21 y 18% respectivamente. Se halló una incidencia aumentada de insuficiencia renal aguda comparado con estadísticas internacionales, cuya etiología fue mayormente causada por procesos sépticos.

  20. Male Breast Cancer: 20 Years Experience of a Tertiary Hospital from the Middle Black Sea Region of Turkey.

    Science.gov (United States)

    Serarslan, Alparslan; Gursel, Bilge; Okumus, Nilgun Ozbek; Meydan, Deniz; Sullu, Yurdanur; Gonullu, Guzin

    2015-01-01

    Male breast cancer is a rare neoplasm, and its treatments are based on those of female breast cancer. This study aimed to analyze 20 years of male breast cancer clinical characteristics and treatment results from the Middle Black Sea Region of Turkey. A retrospective analysis of 16 male breast cancer patients treated in our tertiary hospital between 1994 and 2014 was performed. Epidemiologic data, tumor characteristics, and treatments were recorded and compared with 466 female breast cancer ((premenopausal; n=230)+(postmenopausal n=236)) patients. The 5-year disease-free and overall survival rates were calculated. Male breast cancer constituted 0.1% of all malignant neoplasms in both sexes, 0.2% of all malignant neoplasms in males, and 0.7% of all breast cancers. The mean patient age in this study was 59.8±9.5 (39-74) years. The mean time between first symptom and diagnosis was 32.4±5.3 (3-60) months. Histology revealed infiltrative ductal carcinoma in 81.3% of patients. The most common detected molecular subtype was luminal A, in 12 (75%) patients. Estrogen receptor rate (93.8%) in male breast cancer patients was significantly higher than that in female breast cancer (70.8% in all females, p=0.003; 68.2% in postmenopausal females, p=0.002) patients. Most of the tumors (56.3%) were grade 2. Tumor stage was T4 in 50% of males. The majority (56.3%) of the patients were stage III at diagnosis. Surgery, chemotherapy, radiotherapy and endocrine-therapy were applied to 62.5%, 62.5%, 81.2% and 73.3%, respectively. Loco-regional failure did not occur in any of the cases. All recurrences were metastastic. The 5-year disease-free and overall survival rates in male breast cancer patients were 58% and 68%, respectively. Tumors found in male breast cancer patients were similar in size to tumors found in females, but they advanced to T4 stage more rapidly because of the lack of breast parenchymal tissues. The rate of estrogen receptor expression tended to be higher in male

  1. [Regional differences in hospitalisations for complications of chronic hepatitis C in 2012].

    Science.gov (United States)

    Rotily, Michel; Abergel, Armand; Branchoux, Sébastien; Akremi, Raoudha; de Léotoing, Lucie; Vainchtock, Alexandre; Gaudin, Anne-Françoise

    2017-04-27

    Objective: Only limited recent information is available concerning the regional incidence and prevalence of chronic hepatitis C (CHC), but this information is critical for optimal definition of public health policies for the management of hepatitis C. The objective of this study was to evaluate the feasibility of mapping potential regional differences in the prevalence of CHC and its complications using data from a health administrative database. Methods: The 2012 PMSI MCO hospital database contains information on diagnosis and healthcare resource use, essentially related to all hospitalisations in France. Hospital stays related to CHC were identified on the basis of ICD-10 disease codes. Hospital stays were classified according to stage of liver disease: non-cirrhotic liver disease, compensated cirrhosis, decompensated cirrhosis or hepatocellular carcinoma (HCC). All study variables were documented for each French administrative region in 2012. Results: In 2012, 12,040 patients were hospitalised in France for a reason related to CHC, corresponding to a standardised age- and gender- adjusted prevalence rate of 19.3/100,000 persons. The highest prevalences of CHC and HCC were observed in the Ile de France, Alsace and Provence-Alpes-Côte-d’Azur regions. Conclusions: This study demonstrates the feasibility of using the PMSI database to identify regional differences in the prevalence of CHC. This information may be useful for planning regional healthcare resource provision for CHC.

  2. Etiolog??a microbiana y sensibilidad a los antibi??ticos de las infecciones urinarias en pacientes de la Unidad de Rehabilitaci??n de un hospital regional

    OpenAIRE

    Guti??rrez-Soto, M.; Salinas-Asensio, Mar??a del Mar; Salinas-Asensio, M.; Ferr??-Fern??ndez, C.; Navarro-Mar??, Jos?? Mar??a; Guti??rrez Fern??ndez, Jos??

    2013-01-01

    Objetivos: Conocer los resultados del estudio microbiol??gico de las muestras de orina de pacientes de la Unidad de Rehabilitaci??n de un hospital regional, incluyendo los datos locales de sensibilidad antibi??tica. Material y m??todos: Se analiz?? la base de datos del Laboratorio de Microbiolog??a del Hospital Universitario Virgen de las Nieves con los estudios microbiol??gicos de las muestras de orinas realizados durante el a??o 2012. Se investig?? la etiolog??a y la sensibilida...

  3. High temperature and risk of hospitalizations, and effect modifying potential of socio-economic conditions: A multi-province study in the tropical Mekong Delta Region.

    Science.gov (United States)

    Phung, Dung; Guo, Yuming; Nguyen, Huong T L; Rutherford, Shannon; Baum, Scott; Chu, Cordia

    2016-01-01

    The Mekong Delta Region (MDR) in Vietnam is highly vulnerable to extreme weather related to climate change. However there have been hardly any studies on temperature-hospitalization relationships. The objectives of this study were to examine temperature-hospitalization relationship and to evaluate the effects of socio-economic factors on the risk of hospitalizations due to high temperature in the MDR. The Generalized Linear and Distributed Lag Models were used to examine hospitalizations for extreme temperature for each of the 13 provinces in the MDR. A random-effects meta-analysis was used to estimate the pooled risk for all causes, and for infectious, cardiovascular, and respiratory diseases sorted by sex and age groups. Random-effects meta-regression was used to evaluate the effect of socio-economic factors on the temperature-hospitalization association. For 1°C increase in average temperature, the risk of hospital admissions increased by 1.3% (95% CI, 0.9-1.8) for all causes, 2.2% (95% CI, 1.4-3.1) for infectious diseases, and 1.1% (95% CI, 0.5-1.7) for respiratory diseases. However the result was inconsistent for cardiovascular diseases. Meta-regression showed population density, poverty rate, and illiteracy rate increased the risk of hospitalization due to high temperature, while higher household income, houses using safe water, and houses using hygienic toilets reduced this risk. In the MDR, high temperatures have a significant impact on hospitalizations for infectious and respiratory diseases. Our findings have important implications for better understanding the future impacts of climate change on residents of the MDR. Adaptation programs that consider the risk and protective factors should be developed to protect residents from extreme temperature conditions.

  4. [Pediatric renal transplantation in France. Introduction].

    Science.gov (United States)

    Deschênes, Georges; Fila, Marc

    2011-12-01

    Pediatric nephrology is a relatively recent medical speciality. The first French center opened in January 1969 at the Hospital des Enfants-Malades. In 2008, according to the Réseau Épidémiologie et Information en Néphrologie (REIN), the annual incidence of end stage renal disease (ESRD) was of 7,8 children/million children below the age of 20, which equals a prevalence of 49 pediatric ESRD patients/million inhabitants. The frequency of causative factors of ESRD varies according to the geographic and ethnic origin of the patients. Many challenges still lay ahead of ESRD management. The children's physical, psychological and social development has to be well taken care of until adulthood and the transition from pediatric to adult unit has to be handled with special care. The set up of pediatric nephrology departments helped to the access of patients to renal replacement therapy, in particular the pediatric priority for kidney donors below 30 years of age. In the 2000s period, the annual rate of pediatric renal transplantation was 70 to 75 grafts per year in France, half of which performed in the Paris area. This article presents the historical background of pediatric nephrology and pediatric renal transplantation in France.

  5. Possible application of the Environmental Relative Moldiness Index in France: A pilot study in Brittany

    Science.gov (United States)

    Our goal was to determine if the US Environmental Relative Moldiness Index (ERMI) scale might have application in France. Twenty homes in Brittany, north western region of France were classified by inspection as “Moldy” or “Non-Moldy”. Dust and air samples were collected (MiTest ...

  6. Infection control in anaesthesia in regional, tertiary and central hospitals in KwaZulu-Natal. Part 3: Decontamination practices

    National Research Council Canada - National Science Library

    Samuel, RA; Gopalan, PD; Coovadia, Y; Samuel, R

    2013-01-01

    .... Results: Thirty-four anaesthesia nurses were interviewed. Results revealed that decontamination of anaesthetic equipment and other infection control practices were inadequate or inappropriate in several of the hospitals...

  7. Hospitals, Published in 2008, 1:1200 (1in=100ft) scale, North Georgia Regional Development Center.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Hospitals dataset, published at 1:1200 (1in=100ft) scale, was produced all or in part from Field Survey/GPS information as of 2008. Data by this publisher are...

  8. An analysis of hospital preparedness capacity for public health emergency in four regions of China: Beijing, Shandong, Guangxi, and Hainan

    Directory of Open Access Journals (Sweden)

    Huang Jianshi

    2008-09-01

    Full Text Available Abstract Background Hospital preparedness is critical for the early detection and management of public health emergency (PHE. Understanding the current status of PHE preparedness is the first step in planning to enhance hospitals' capacities for emergency response. The objective of this study is to understand the current status of hospital PHE preparedness in China. Methods Four hundred hospitals in four city and provinces of China were surveyed using a standardized questionnaire. Data related to hospital demographic data; PHE preparation; response to PHE in community; stockpiles of drugs and materials; detection and identification of PHE; procedures for medical treatment; laboratory diagnosis and management; staff training; and risk communication were collected and analyzed. Results Valid responses were received from 318 (79.5% of the 400 hospitals surveyed. Of the valid responses, 264 (85.2% hospitals had emergency plans; 93.3% had command centres and personnel for PHE; 22.9% included community organisations during the training for PHE; 97.4% could transport needed medical staff to a PHE; 53.1% had evaluated stockpiles of drugs; 61.5% had evaluated their supply systems; 55.5% had developed surveillance systems; and 74.6% could monitor the abnormity(See in appendix. Physicians in 80.2% of the analyzed hospitals reported up-to-date knowledge of their institution's PHE protocol. Of the 318 respondents, 97.4% followed strict laboratory regulations, however, only about 33.5% had protocols for suspected samples. Furthermore, only 59.0% could isolate and identify salmonella and staphylococcus and less than 5% could isolate and identify human H5N1 avian flu and SARS. Staff training or drill programs were reported in 94.5% of the institutions; 50.3% periodically assessed the efficacy of staff training; 45% had experts to provide psychological counselling; 12.1% had provided training for their medical staff to assess PHE-related stress. All of the above

  9. Charbonnages de France group. Annual report 99; Groupe Charbonnages de France. Rapport annuel 99

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-07-01

    This 1999 annual report of the French national collieries 'Charbonnages de France' (CDF) presents the turnover and financial data of the group, the situation of coal mining in France, the management of manpower, the rehabilitation of abandoned mine and plant sites, the impact of power market deregulation on the activities of the coal-fired power plants and cogeneration units of the national society of electric and thermal power (SNET) and of the SIDEC company, and the management of the real estate patrimony of the group in mining regions. Some conference texts written by engineers of the group are added at the end of the document and present the competences of CDF in environmental engineering (valorization of coal fly ash, cleansing of polluted sites, phyto-remediation) and development of biomass energy. (J.S.)

  10. Are medical outliers associated with worse patient outcomes? A retrospective study within a regional NHS hospital using routine data.

    Science.gov (United States)

    Stylianou, Neophytos; Fackrell, Robin; Vasilakis, Christos

    2017-05-09

    To explore the quality and safety of patients' healthcare provision by identifying whether being a medical outlier is associated with worse patient outcomes. A medical outlier is a hospital inpatient who is classified as a medical patient for an episode within a spell of care and has at least one non-medical ward placement within that spell. Secondary data from the Patient Administration System of a district general hospital were provided for the financial years 2013/2014-2015/2016. The data included 71 038 medical patient spells for the 3-year period. This research was based on a retrospective, cross-sectional observational study design. Multivariate logistic regression and zero-truncated negative binomial regression were used to explore patient outcomes (in-hospital mortality, 30-day mortality, readmissions and length of stay (LOS)) while adjusting for several confounding factors. Univariate analysis indicated that an outlying medical in-hospital patient has higher odds for readmission, double the odds of staying longer in the hospital but no significant difference in the odds of in-hospital and 30-day mortality. Multivariable analysis indicates that being a medical outlier does not affect mortality outcomes or readmission, but it does prolong LOS in the hospital. After adjusting for other factors, medical outliers are associated with an increased LOS while mortality or readmissions are not worse than patients treated in appropriate specialty wards. This is in line with existing but limited literature that such patients experience worse patient outcomes. Hospitals may need to revisit their policies regarding outlying patients as increased LOS is associated with an increased likelihood of harm events, worse quality of care and increased healthcare costs. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  11. Register study of migrants’ hospitalization in Norway: world region origin, reason for migration, and length of stay

    OpenAIRE

    Elstad, Jon Ivar

    2016-01-01

    Background The proportion of migrants and refugees increase in many populations. Health planners have to consider how migration will influence demand for health care. This study explores how migrants’ geographical origin, reason for migration, and duration of residence are associated with admission rates to somatic hospitals in Norway. Methods Sociodemographic information on all individuals residing in Norway at the start of 2008 was linked to data on all admissions to somatic hospitals durin...

  12. FOREIGN DRIVING LICENCES IN FRANCE

    CERN Multimedia

    Service des relations avec les Pays Hôtes

    2000-01-01

    1. PERSONS RESIDING IN FRANCE1.1 National driving licences from countries belonging to the EEAa) ValidityCurrent national driving licences issued by a country belonging to the European Economic Area (here inafter called EEA) are, in principle, valid in France. N.B. : The countries belonging to the EEA are Austria, Belgium, Denmark, Finland, France, Germany, Greece, Iceland, Ireland, Italy, Liechtenstein, Luxembourg, Netherlands, Norway, Portugal, Spain, Sweden and the United Kingdom.b)\tRegistrationTo ensure that all the conditions of validity in France have been met, holders of driving licences issued by a country belonging to the EEA, who reside in France (i.e. hold a residence permit issued by a Préfecture, or a carte spéciale issued by the French Ministry of Foreign Affairs, which is equivalent to a residence permit), can have their licences registered with the Préfecture of the department where they live (for Ain, call 04 74 32 30 00, for Haute Savoie call 04 50 33 ...

  13. France: High and stable fertility

    Directory of Open Access Journals (Sweden)

    Clémentine Rossier

    2008-07-01

    Full Text Available The current total fertility rate in France is around 1.9 children per woman. This is a relatively high level by current European standards and makes France an outlier, despite the fact that its other demographic trends, especially conjugal behaviour, and social and economic trends are not very different from other Western European countries. France can serve as a counterfactual test case for some of the hypotheses advanced to explain the current low level of fertility in most European countries (delay in fertility, decline in marriage, increased birth control, greater economic uncertainty. France's fertility level can be partly explained by its active family policy introduced after the Second World War, and adapted in the 1980s to accommodate women's entry into the labour force. This policy is the result of a battle, fuelled by pro-natalism, between the conservative supporters of family values and the promoters of state-supported individual equality. French family policy thus encompasses a wide range of measures based on varying ideological backgrounds, and it is difficult to classify in comparison to the more precisely focused family policies of other European welfare states. The active family policy seems to have created especially positive attitudes towards two- or three child families in France.

  14. [Hospital-territorial services and integration of health care: the Protected Discharge program in the Umbria Region from 2005 to 2010].

    Science.gov (United States)

    Pasquini, Rossana; Angeli, Giuseppe; Marzulli, Tiziana; Duca, Emilio; Minelli, Liliana

    2013-01-01

    In order to address the management of patients with chronic diseases, national and international regulatory guidelines have developed policies and operational tools aimed at integration and implementation of pathways of continuity of health care between different healthcare settings. "Protected Discharge" programs have been developed for the organized transfer of patients from one setting of care (hospital) to another (territory) in order to ensure their continuity of care and assistance. The aim of this study was to assess the degree of implementation the program in the context of continuity of healthcare in the Umbria region (Italy). An analysis of the regional archive of hospital discharge records was performed to examine trends of the various types of hospital discharges during the years 2005 to 2010. A slow but steady increase of protected discharges was observed from 2005 (0.9%) to 2010 (1.9%). The percentages observed are higher than those at the national level (except for transfer to RSA); however, results indicate insufficient implementation of hospital-territorial services integration and hence of the principle of continuity of health and social care.

  15. Analysis of clinical symptoms and selected hematological indices in hospitalized children with Ascaris lumbricoides infection from the northeastern region of Poland.

    Science.gov (United States)

    Wasilewska, Jolanta; Kaczmarski, Maciej G; Sawicka-Zukowska, Małgorzata; Tomaszewska, Barbara; Majewska, Anna; Plewa, Katarzyna; Ołdak, Elzbieta; Debkowska, Katarzyna

    2011-01-01

    Ascariasis is the most common soil-transmitted helminth infection in the world. The objective of this study was to analyze the clinical symptoms and selected hematological indices of ascariasis in hospitalized children from the northeastern region of Poland. Patients in the Pediatric Ward hospitalized in the Regional Hospital in Dabrowa Białostocka in the period of 2005-2007 were included in this retrospective study. The intestinal stage of ascariasis was diagnosed on the basis of positive coprological survey performed using the decantation technique. A total of 938 patients were included in the study, 1801 stool samples were evaluated, and A. lumbricoides-positive tests were obtained from 252 children. Ascaris-positive young children (Ascaris lumbricoides. Significant predictors of intestinal stage ascariasis in a multivariate logistic regression model were: abdominal pain as a reason for hospital admission (OR-2.19; 95% CI 1.62-2.95; p < 0.001) and age from 4 to 7 years (OR-2.0; 95% CI 1.41-2.80; p < 0.001). The prevalence rate of ascariasis was not higher in the group of patients with atopic diseases (bronchial asthma, allergic rhinitis, atopic dermatitis) and co-existing ascariasis did not affect the eosinophil counts in the peripheral blood. Ascariasis is still a current pediatric clinical problem characterized by non-specific clinical manifestations, which should be taken into consideration in the differential diagnosis of children's diseases.

  16. Legal Preparedness for Hurricane Sandy: Authority to Order Hospital Evacuation or Shelter-in-Place in the Mid-Atlantic Region.

    Science.gov (United States)

    McGinty, Meghan D; Burke, Thomas A; Resnick, Beth A; Smith, Katherine C; Barnett, Daniel J; Rutkow, Lainie

    2016-01-01

    Hospitals were once thought to be places of refuge during catastrophic hurricanes, but recent disasters such as Hurricanes Katrina and Sandy have demonstrated that some hospitals are unable to ensure the safety of patients and staff and the continuity of medical care at key times. The government has a duty to safeguard public health and a responsibility to ensure that appropriate protective action is taken when disasters threaten or impair the ability of hospitals to sustain essential services. The law can enable the government to fulfill this duty by providing necessary authority to order preventive or reactive responses--such as ordering evacuation of or sheltering-in-place in hospitals--when safety is imperiled. We systematically identified and analyzed state emergency preparedness laws that could have affected evacuation of and sheltering-in-place in hospitals in order to characterize the public health legal preparedness of 4 states (Delaware, Maryland, New Jersey, and New York) in the mid-Atlantic region during Hurricane Sandy in 2012. At that time, none of these 4 states had enacted statutes or regulations explicitly granting the government the authority to order hospitals to shelter-in-place. Whereas all 4 states had enacted laws explicitly enabling the government to order evacuation, the nature of this authority and the individuals empowered to execute it varied. We present empirical analyses intended to enhance public health legal preparedness and ensure these states and others are better able to respond to future natural disasters, which are predicted to be more severe and frequent as a result of climate change, as well as other hazards. States can further improve their readiness for catastrophic disasters by ensuring explicit statutory authority to order evacuation and to order sheltering-in-place, particularly of hospitals, where it does not currently exist.

  17. Estudio descriptivo de la enfermedad cerebrovascular en el Hospital Regional Docente de Ica-Perú 2003 – 2006

    Directory of Open Access Journals (Sweden)

    J. Jhonnel Alarco

    2010-09-01

    Full Text Available Objetivo: Determinar algunas características epidemiológicas de la enfermedad cerebro vascular (ECV, describir las características de la población estudiada según sexo, edad, procedencia, raza, forma de inicio, ubicación, tipos y subtipos, síntomas, antecedentes patológicos y mortalidad intrahospitalaria. Materiales y métodos: estudio descriptivo. Lugar: Hospital Regional Docente de Ica. Criterios de inclusión: pacientes ingresados con diagnóstico de accidente cerebrovascular. Intervenciones: revisión de historias clínicas de archivo entre los años 2003 y 2006. Principales medidas de resultados: análisis estadístico: porcentajes y medidas de tendencia central, tabuladas en una base de datos con ayuda del programa Microsoft Excel 2003 para Windows®. Resultados: de 152 pacientes ingresados al servicio de Medicina 119 fueron casos de ECV isquémico, 33 casos fueron ECV hemorrágico. El principal antecedente patológico fue la hipertensión arterial con un 75.0 %. El síntoma más frecuente fue el trastorno motor con 80.3% seguido por alteraciones del lenguaje con 55.9%. El mayor número fue encontrado entre la séptima y octava décadas de la vida. La edad mínima fue de 17 y máxima de 102 años. La mortalidad global fue de 18 casos obteniéndose una tasa de letalidad específica para el ECV isquémico de 0,8% y de 51,5% para el ECV hemorrágico. Conclusiones: Se distingue a la HTA como el principal antecedente modificable, cuya prevención reduciría notablemente su mortalidad. Palabras clave:  accidente cerebrovascular, epidemiología, hospitales, Perú.

  18. Prevalence of malaria, prevention measures, and main clinical features in febrile children admitted to the Franceville Regional Hospital, Gabon

    Directory of Open Access Journals (Sweden)

    Maghendji-Nzondo Sydney

    2016-01-01

    Full Text Available Recently, major progress has been made in controlling malaria in Africa. However, in Gabon, little information is available on the role of malaria in childhood febrile syndromes, the use and efficacy of preventive measures, and Plasmodium species distribution. Here, we characterized malaria in febrile children in Franceville, Gabon through a cross-sectional study at the pediatric unit of the Franceville Regional Hospital. We registered 940 febrile children. Their general condition was markedly altered in 11.7% of cases (n = 89/760; among them 19 (21.4% had a severely altered condition. Malaria was the second most frequent etiology (22.0%; n = 162/738, after respiratory tract infections (37.3%; n = 275/738. Children with malaria (63 ± 39 months were older than children without malaria (40 ± 37 months (p = 0.0013. Hemoglobin, red blood cell, white blood cell, and platelet values were lower in children with malaria than in those without malaria (p < 0.0001. Anemia was the most common feature of severe malaria (70.6%; n = 12/17, followed by neurological involvement (23.5%; n = 4/17. The prevalence of malaria was significantly higher in children older than 60 months than in younger children (40% vs. 15.5%; p < 0.0001. Plasmodium falciparum accounted for 97.5% of cases (158/162, followed by Plasmodium malariae (2.5%; n = 4/162. Bed net use was high (74.4%; n = 697/936 and contributed to malaria prevention (p = 0.001. Good basic knowledge of malaria also had a preventive effect (p < 0.0001. The prevalence of malaria in children in Franceville did not decrease significantly from 2009 to 2012, remaining at about 20%, highlighting that preventive measures should be reinforced.

  19. Beginning of Viniculture in France

    Science.gov (United States)

    McGovern, Patrick E.; Luley, Benjamin P.; Rovira, Nuria; Mirzoian, Armen; Callahan, Michael P.; Smith, Karen F.; Hall, Gretchen R.; Davidson, Theodore; Henkin, Joshua M.

    2013-01-01

    Chemical analyses of ancient organic compounds absorbed into the pottery fabrics of imported Etruscan amphoras (ca. 500-475 B.C.) and into a limestone pressing platform (ca. 425-400 B.C.) at the ancient coastal port site of Lattara in southern France provide the earliest biomolecular archaeological evidence for grape wine and viniculture from this country, which is crucial to the later history of wine in Europe and the rest of the world. The data support the hypothesis that export of wine by ship from Etruria in central Italy to southern Mediterranean France fueled an ever-growing market and interest in wine there, which, in turn, as evidenced by the winepress, led to transplantation of the Eurasian grapevine and the beginning of a Celtic industry in France. Herbal and pine resin additives to the Etruscan wine point to the medicinal role of wine in antiquity, as well as a means of preserving it during marine transport.

  20. New Phase Between China and France

    Institute of Scientific and Technical Information of China (English)

    Guo Yan

    2009-01-01

    @@ In recent years,the economic cooperation between China and France has developed rapidly.In despite of the bilateral relationship was fluctuating last year,two countries kept on making their efforts to improve the relation.The 15th China-France Economic Seminar was held on April 8 and 9,in Beijing.The theme of this seminar is "Challenges and Opportunities:Beginning New Cooperation between China and France",after a statement concerning "France fully recognizes 'the importance and sensitivity of the Tibet issue' and that France refuses to support any form of Tibet independence"issued by China and France on April 1.

  1. “Sistema de extracción de material particulado en la construcción del Hospital Regional Docente Ambato

    OpenAIRE

    Adriano Villa, Elena del Rocío

    2016-01-01

    This research arises from the need to reduce absenteeism, caused for respiratory diseases that present the workers of the Army Corps of Engineers-Group Ambato. Workers are building Regional Teaching Hospital Ambato. Therefore the aim is to implement a system to remove particulate matter generated when executing tasks of cutting materials, for example: block, pavers and porcelain with the use of grinders, reducing occupational hazards for operators of this power tool as well as for the tec...

  2. Factors Contributing To The Sustainability Of 5S Programmes In Government Hospitals In Regional Director Of Health Services Area Kurunegala

    Directory of Open Access Journals (Sweden)

    Dr. K.W.C.U.K Kendangamuwa

    2015-03-01

    Full Text Available Abstract Introduction 5S is the stepping stone for many quality improvement concepts and its roots date back to 16th century. When successfully implemented 5S gives many benefits to the organization as well as its stakeholders. Though 5S itself has a tool to sustain most of the organizations find it difficult to sustain the 5S practice over the time. Therefore the objective of this study was to find out the factors contributing to sustainability of 5S programmes in Government Hospitals in RDHS area Kurunegala. Methodology This study was a descriptive cross sectional study with two components. First component was to identify the 5S sustaining hospitals from not sustaining hospitals by validated evaluation sheet. Second component was to determine the factors contributing to sustainability of 5S programmes in selected study setting. Self-administrated questionnaire was used for this purpose. Total study population was 543 employees of all the categories of hospital staff. Calculated sample size was 422 and 375 were responded to the questionnaire giving response rate of 88.9. Results The study revealed that the implemented 5S programmes were sustaining in eight hospitals out of ten i.e. sustaining rate was 80. When it considered the degree of sustainability 50 of the selected hospitals reported more than 70 sustainability. This was considered as favourable trend in government health sector in healthcare quality point of view. Ten factors were studied as contributing factors for the 5S sustainability. Socio- demographic factors were also considered. Those ten factors were top management commitment leadership of the organization commitment of middle amp frontline managers commitment amp satisfaction of employees training amp changing attitude of employees motivation of employees organizational culture group cohesiveness community participation and customer satisfaction. Study revealed that organizational leadership customer satisfaction community

  3. Environmental risk mapping of canine leishmaniasis in France

    Directory of Open Access Journals (Sweden)

    Ready Paul

    2010-04-01

    Full Text Available Abstract Background Canine leishmaniasis (CanL is a zoonotic disease caused by Leishmania infantum, a Trypanosomatid protozoan transmitted by phlebotomine sandflies. Leishmaniasis is endemic in southern France, but the influences of environmental and climatic factors on its maintenance and emergence remain poorly understood. From a retrospective database, including all the studies reporting prevalence or incidence of CanL in France between 1965 and 2007, we performed a spatial analysis in order to i map the reported cases in France, and ii produce an environment-based map of the areas at risk for CanL. We performed a Principal Component Analysis (PCA followed by a Hierarchical Ascendant Classification (HAC to assess if the locations of CanL could be grouped according to environmental variables related to climate, forest cover, and human and dog densities. For each group, the potential distribution of CanL in France was mapped using a species niche modelling approach (Maxent model. Results Results revealed the existence of two spatial groups of CanL cases. The first group is located in the Cévennes region (southern Massif Central, at altitudes of 200-1000 m above sea level, characterized by relatively low winter temperatures (1.9°C average, 1042 mm average annual rainfall and much forest cover. The second group is located on the Mediterranean coastal plain, characterized by higher temperatures, lower rainfall and less forest cover. These two groups may correspond to the environments favoured by the two sandfly vectors in France, Phlebotomus ariasi and Phlebotomus perniciosus respectively. Our niche modelling of these two eco-epidemiological patterns was based on environmental variables and led to the first risk map for CanL in France. Conclusion Results show how an ecological approach can help to improve our understanding of the spatial distribution of CanL in France.

  4. Stepfamilies in Denmark and France

    DEFF Research Database (Denmark)

    Toulemon, Laurent; Knudsen, Lisbeth B.

    2006-01-01

    In both Denmark and France, the past decades have shown profound changes in the patterns of fertility as well as in family formation and family dissolution, with no related decline in overall fertility. Using very large data sets (380,000 respondents in the French survey, 1.3 million women...... in Danish Register data), we built synthetic indexes to show the frequency of stepfamilies in both countries. It is more frequent in Denmark than in France. We then analyse fertility of stepfamilies, compared to couples without any child born before the union, with controlling for age, duration of union...

  5. Stepfamilies in Denmark and France

    DEFF Research Database (Denmark)

    Toulemon, Laurent; Knudsen, Lisbeth B.

    2006-01-01

    In both Denmark and France, the past decades have shown profound changes in the patterns of fertility as well as in family formation and family dissolution, with no related decline in overall fertility. Using very large data sets (380,000 respondents in the French survey, 1.3 million women...... in Danish Register data), we built synthetic indexes to show the frequency of stepfamilies in both countries. It is more frequent in Denmark than in France. We then analyse fertility of stepfamilies, compared to couples without any child born before the union, with controlling for age, duration of union...

  6. Interconnection France-Italy; Interconnexion France-Italie

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-07-01

    These documents presents the rules, defined by RTE, of the attribution of electric power transportation capacity between France and Italy. The contract form and the general principles are given in annexes. A guide to the application form is provided. (A.L.B.)

  7. A Quality Improvement Approach to Reducing the Caesarean section Surgical Site Infection Rate in a Regional Hospital

    LENUS (Irish Health Repository)

    O’ Hanlon, M

    2016-09-01

    Surgical site infection (SSI) rates are used extensively by hospitals as a basis for quality improvement. A 30-day post-discharge SSI programme for Caesarean section operations has been implemented in Our Lady of Lourdes Hospital since 2011. It has been shown that skin antisepsis and antibiotic prophylaxis are key factors in the prevention of SSI. Using quality improvement methodology, an infection prevention bundle was introduced to address these two factors. Skin antisepsis was changed from povidone-iodine to chlorhexidine-alcohol. Compliance with choice of antibiotic prophylaxis increased from 89.6% in 2014 to 98.5% in 2015. Compliance with timing also improved. The SSI rate of 7.5% was the lowest recorded to date, with the majority of SSIs (64%) diagnosed after hospital discharge. The level of variation was also reduced. However, the continued presence of variation and possibility of lower infection rates from the literature imply that further improvements are required.

  8. [Child victims of house fires in France. Mortality, morbidity, prevention].

    Science.gov (United States)

    Leveque, B; Lareng, L; Julien, H; Lavaud, J; Wassermann, D; Latarjet, J

    1993-10-01

    Children injuries by house fires in France are the cause of a severe mortality (sixty deaths in average each year) and of a morbidity for the survival due to smoke toxicity (oxygen deprivation and inhalation of toxic gases--CO and HCN) and to thermal burns. Epidemiological studies show that young children (0 to 4) are specially concerned by this threat and that the deaths occurred more often in some part of France (Nord-Pas-de-Calais Region). A special strategy for this prevention should be applied in France, the same available in USA, Sweden and UK, including information on the behavior one should have with children: never leave them alone and escape with them as soon as possible out of the smoke. The usefulness of smoke detectors should be confirmed by French administration and recommended to the public, since they have had effective results in other countries.

  9. Gaz de France 2006 sustainable development report; Gaz de France 2006 rapport developpement durable

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2006-07-01

    A major European energy utility, the Gaz de France Group produces, purchases, transports, distributes and sells natural gas, electricity and related services for its residential, corporate and local government customers. this report presents the actions implemented by the group to incorporate sustainable development into its strategy. From the point of view of risks and opportunities, the group analyzes what it takes to ensure development that respects people and the environment, and it implements them in all its business lines and management systems. Content: Gaz de France, portrait of a major energy utility, highlights of 2006, challenges and strategy (defining strategy and sustainable development policy, specific risks and opportunities, activities of the Gaz de France group: challenges, impact for stakeholders, transparency and independence in governing), ranking and implementing (defining sustainable development policy: reviewing priorities, meeting all the challenges, publicizing and defending positions, increasing awareness, overseeing and monitoring results), results of the 2004-2006 sustainable development action plan, dialogue and action with stakeholders, performance assessment, performance in response to challenges: energy challenges (guaranteeing regular supplies, controlling atmospheric emissions, promoting energy conservation, developing renewable energy), industrial challenges (ensuring health and safety, limiting the overall environmental impact of group activities), social responsibility challenges (advocating corporate social responsibility, promoting human rights and fighting corruption, encouraging commitment to solidarity, promoting regional development through local initiatives, reconciling acquisitions, procurement and sustainable development, ensuring transparency in natural gas rates, providing shareholders with quality information, promoting diversity, a source of enrichment, making working conditions a performance factor), indicators and

  10. Hurricane Frances Poster (September 5, 2004)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Hurricane Frances poster. Multi-spectral image from NOAA-17 shows Hurricane Frances over central Florida on September 5, 2004. Poster dimension is approximately...

  11. Intensidade de ruído em hospital de 222 leitos na 18ª Regional de Saúde - PR Noise level in a 222 bed hospital in the 18th health region - PR

    Directory of Open Access Journals (Sweden)

    Marcelo Henrique Otenio

    2007-04-01

    Full Text Available A poluição sonora ambiental torna-se hoje onipresente e beira o intolerável. Nos hospitais, os avanços tecnológicos trazem, como conseqüência, níveis de ruído potencialmente danosos. Muito do ruído no hospital provém mais de dentro, do que de fora desse ambiente, sendo as principais causas de ruído em Unidade de Terapia Intensiva, por exemplo, os equipamentos e a conversação entre a equipe hospitalar. O objetivo deste trabalho foi avaliar o nível de ruído nos diversos ambientes hospitalares, em Hospital de 222 leitos na 18ª RS de Saúde - PR. MATERIAIS E MÉTODOS: Conduziu-se, em março de 2005 no período de 24 horas, em dez setores. Forma de Estudo: Aferição do nível de ruído ambiental utilizando um Decibelímetro modelo 1350. RESULTADOS: O nível de ruído encontrado em nosso estudo apresentou média total de 63,7 dB(A, que excede os valores máximos permitidos de 45 dB recomendados pela Associação Brasileira de Normas Técnicas (1987. CONCLUSÃO: Nos setores analisados, o nível de ruído encontrado neste está consideravelmente acima do recomendado. A equipe hospitalar deve estar consciente do ruído e dos efeitos deste, para que possa atuar de maneira mais efetiva na redução da poluição sonora, beneficiando assim a função laborativa dos profissionais e recuperação dos pacientes.Environment noise pollution is common place today, at intolerable levels. In hospitals, technological developments have, as a consequence, potentially harmful noise levels. Much of the hospital noise comes from inside, rather than outside, and the major source of such noise is the Intensive Care Unit, for example equipment and hospital staff talk. Our goal with the present study was to investigate the noise level present in the different hospital environments, within a 222 bed hospital located at the 18th health zone, PR. MATERIALS AND METHODS: The study was carried out in March, 2005, during a period of 24 hours, in tem different

  12. Modeling Spread of KPC-Producing Bacteria in Long-Term Acute Care Hospitals in the Chicago Region, USA

    NARCIS (Netherlands)

    Haverkate, Manon R.; Bootsma, Martin C. J.; Weiner, Shayna; Blom, Donald; Lin, Michael Y.; Lolans, Karen; Moore, Nicholas M.; Lyles, Rosie D.; Weinstein, Robert A.; Bonten, Marc J. M.; Hayden, Mary K.

    2015-01-01

    OBJECTIVE. Prevalence of bla(KPC)-encoding Enterobacteriaceae (KPC) in Chicago long-term acute care hospitals (LTACHs) rose rapidly after the first recognition in 2007. We studied the epidemiology and transmission capacity of KPC in LTACHs and the effect of patient cohorting. METHODS. Data were avai

  13. Modeling spread of KPC-producing bacteria in long-term acute care hospitals in the Chicago region, USA

    NARCIS (Netherlands)

    Haverkate, Manon R; Bootsma, Martin C J; Weiner, Shayna; Blom, Donald; Lin, Michael Y; Lolans, Karen; Moore, Nicholas M; Lyles, Rosie D; Weinstein, Robert A; Bonten, Marc J M; Hayden, Mary K

    2015-01-01

    OBJECTIVE: Prevalence of bla KPC-encoding Enterobacteriaceae (KPC) in Chicago long-term acute care hospitals (LTACHs) rose rapidly after the first recognition in 2007. We studied the epidemiology and transmission capacity of KPC in LTACHs and the effect of patient cohorting. METHODS: Data were avail

  14. Education in France: Number 41.

    Science.gov (United States)

    French Embassy, New York, NY. French Cultural Services.

    The history and modernization of the French nursery and elementary schools are the focal points of this review of educational trends in France. One major section discussed the "Ecole Maternelle", kindergarten, nursery schools, the "Jardin d'Enfants", and new math. Another section treats: (1) "Les Ecoles Primaires",…

  15. Pyemotes ventricosus Dermatitis, Southeastern France

    OpenAIRE

    Del Giudice, Pascal; Blanc-Amrane, V?ronique; Bahadoran, Philippe; Caumes, Eric; Marty, Pierre; Lazar, Maril?na; Boissy, Christian; Desruelles, Fran?ois; Izri, Arezki; Ortonne, Jean-Paul; Counillon, Evelyne; Chosidow, Olivier; Delaunay, Pascal

    2008-01-01

    We investigated 42 patients who had unusual pruritic dermatitis associated with a specific clinical sign (comet sign) in 23 houses in southeastern France from May through September 2007. Pyemotes ventricosus, a parasite of the furniture beetle Anobium punctatum, was the cause of this condition.

  16. Pyemotes ventricosus dermatitis, southeastern France.

    Science.gov (United States)

    Del Giudice, Pascal; Blanc-Amrane, Véronique; Bahadoran, Philippe; Caumes, Eric; Marty, Pierre; Lazar, Mariléna; Boissy, Christian; Desruelles, François; Izri, Arezki; Ortonne, Jean-Paul; Counillon, Evelyne; Chosidow, Olivier; Delaunay, Pascal

    2008-11-01

    We investigated 42 patients who had unusual pruritic dermatitis associated with a specific clinical sign (comet sign) in 23 houses in southeastern France from May through September 2007. Pyemotes ventricosus, a parasite of the furniture beetle Anobium punctatum, was the cause of this condition.

  17. Education in France: Number 41.

    Science.gov (United States)

    French Embassy, New York, NY. French Cultural Services.

    The history and modernization of the French nursery and elementary schools are the focal points of this review of educational trends in France. One major section discussed the "Ecole Maternelle", kindergarten, nursery schools, the "Jardin d'Enfants", and new math. Another section treats: (1) "Les Ecoles Primaires", (2) village schools, (3) the…

  18. Education in France: Number 41.

    Science.gov (United States)

    French Embassy, New York, NY. French Cultural Services.

    The history and modernization of the French nursery and elementary schools are the focal points of this review of educational trends in France. One major section discussed the "Ecole Maternelle", kindergarten, nursery schools, the "Jardin d'Enfants", and new math. Another section treats: (1) "Les Ecoles Primaires",…

  19. Benefit of hospital pharmacy intervention on the current status of dry powder inhaler technique in patients with asthma and COPD: a study from the Central Development Region, Nepal

    Directory of Open Access Journals (Sweden)

    Poudel RS

    2016-12-01

    Full Text Available Ramesh Sharma Poudel,1 Rano Mal Piryani,2 Shakti Shrestha,3 Aastha Prajapati1 1Hospital Pharmacy, 2Department of Internal Medicine, Chitwan Medical College Teaching Hospital, 3Department of Pharmacy, Shree Medical and Technical College, Chitwan, Nepal Background: The majority of patients with asthma and chronic obstructive pulmonary disease (COPD have been known to perform inhaler technique inadequately. We aimed to evaluate the benefit of hospital pharmacy intervention on the current status of dry powder inhaler (Rotahaler® technique in such patients and the factors associated with the correct use. Methods: A pre–post interventional study was conducted at the outpatient pharmacy in a teaching hospital of the Central Development Region, Nepal, in patients with asthma and COPD currently using a Rotahaler device. Patients’ demographics and Rotahaler technique were assessed before intervention. Those who failed to demonstrate the correct technique were educated and trained by the pharmacist, and their technique was reassessed after 2 weeks of intervention. Descriptive statistics, including Wilcoxon signed rank test, Mann–Whitney U test, Spearman’s correlations and Kruskal–Wallis test, were performed for statistical analysis. Results: Before intervention, only 5.7% (10 of 174 of the patients demonstrated the correct Rotahaler technique and the most common errors observed were failure to breathe out gently before inhalation (98.8% and failure to hold breath for about 10 seconds after inhalation (84.8%. After the intervention (n=164, 67.1% of the patients showed their technique correctly (p≤0.001 and failure to breathe out gently before inhalation was the most common error (27.44%. Age (p=0.003, previous instruction (p=0.007, patient’s education level (p=0.013 and source of instruction (p<0.001 were associated with an appropriate technique before intervention, while age (p=0.024, duration of therapy (p=0.010 and gender (p=0.008 were

  20. Hydrogen and fuel cell activity report - France 2010; Rapport d'activites Hydrogene et Piles a combustible - France 2010

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2010-07-01

    The report gathers the main outstanding facts which occurred in France in the field of hydrogen and fuel cells in 2010. After having noticed some initiatives (the Grenelle II law, an investment package, the new role of the CEA, the new role of the IFP), the report presents several projects and programs regarding hydrogen: ANR programs, creation of a national structure (the HyPaC platform), regional initiatives and local actions, colloquiums and meetings in France and in the world, research projects (photo-synthesis as a new electric energy source), a technical-economic investigation (HyFrance3), demonstrator projects (the Althytude project by GDF and Suez, the Plathee hybrid locomotive by the SNCF, the H2E project, the Zero CO{sub 2} sailing boat, and the Myrte project), educational applications, activity in small and medium-sized enterprises (CETH, SAGIM, HYCAN, McPhy, N-GHY).

  1. [The experience of managing the risk due to the manual lifting of patients in the hospital reality of Local Health Screening Unit Enterprise 18, the Veneto region].

    Science.gov (United States)

    Torri, P; Liboni, D; Milan, F; Piccoli, R

    1999-01-01

    The possibility of accidents and diseases connected with manual handling of patients can be considered as one of the major risks in hospital environments for nursing, non-nursing and technical staff. Health surveillance of exposed workers has revealed numerous cases of back disorders with consequent temporary or permanent limitations of working activity. This involves not only heavy costs for the hospital but also a reduction in the quality of the assistance due to the difficulty in replacing or increasing staff. For these reasons the hospitals of the Local Health and Social Services Unit 18 of the Regione Veneto drew up a plan of interventions in order to address this problem and reduce exposure to manual handling of patients. Details of the costs borne by the hospital due to this risk factor are reported; after the implementation of the improvement plan (health surveillance, introduction of aids, training of staff) it is shown how a reduction in costs was achieved, thus demonstrating the efficacy of the measures taken (reduction of 39.2% in days of staff absence due to back disorders).

  2. Characterization of the large fire regime in SE France

    Science.gov (United States)

    Anne Ganteaume; Marielle Jappiot

    2015-01-01

    Southeastern France is the most wildfire prone region of the country, covering 14.7 percent of its land area-entire country, is the region most affected by wildfires, with 55 percent of the total number of fires recorded in the whole country from 2006 to 2008. It is a typical Mediterranean climate with hot and dry summers, often with strong NW wind, and includes plant...

  3. Determination of antibiotics in sewage from hospitals, nursery and slaughter house, wastewater treatment plant and source water in Chongqing region of Three Gorge Reservoir in China

    Energy Technology Data Exchange (ETDEWEB)

    Chang Xiaosong [Department of Environmental Hygiene, School of Military Preventive Medicine, Third Military Medical University, Chongqing 400038 (China); Meyer, Michael T. [United States Geological Survey, 4821 Quail Crest Place, Lawrence, Kansas 66049 (United States); Liu Xiaoyun [Center for Disease Prevention and Control, Lanzhou Military Region, Lanzhou 730020 (China); Zhao Qing; Chen Hao; Chen Jian; Qiu Zhiqun; Yang Lan [Department of Environmental Hygiene, School of Military Preventive Medicine, Third Military Medical University, Chongqing 400038 (China); Cao Jia [Department of Military Toxicology, School of Military Preventive Medicine, Third Military Medical University, Chongqing 400038 (China); Shu Weiqun, E-mail: xm0630@sina.co [Department of Environmental Hygiene, School of Military Preventive Medicine, Third Military Medical University, Chongqing 400038 (China)

    2010-05-15

    Sewage samples from 4 hospitals, 1 nursery, 1 slaughter house, 1 wastewater treatment plant and 5 source water samples of Chongqing region of Three Gorge Reservoir were analyzed for macrolide, lincosamide, trimethoprim, fluorouinolone, sulfonamide and tetracycline antibiotics by online solid-phase extraction and liquid chromatography-tandem mass spectrometry. Results showed that the concentration of ofloxacin (OFX) in hospital was the highest among all water environments ranged from 1.660 mug/L to 4.240 mug/L and norfloxacin (NOR, 0.136-1.620 mug/L), ciproflaxacin (CIP, ranged from 0.011 mug/L to 0.136 mug/L), trimethoprim (TMP, 0.061-0.174 mug/L) were commonly detected. Removal range of antibiotics in the wastewater treatment plant was 18-100% and the removal ratio of tylosin, oxytetracycline and tetracycline were 100%. Relatively higher removal efficiencies were observed for tylosin (TYL), oxytetracycline (OXY) and tetracycline (TET)(100%), while lower removal efficiencies were observed for Trimethoprim (TMP, 1%), Epi-iso-chlorotetracycline (EICIC, 18%) and Erythromycin-H{sub 2}O (ERY-H{sub 2}O, 24%). Antibiotics were removed more efficiently in primary treatment compared with those in secondary treatment. - This study give the first insight into the concentration of antibiotics in receiving waters from 4 hospitals, 1 nursery, 1 slaughter house, 1 wastewater treatment plant and 5 source water of Chongqing region of Three Gorge Reservoir

  4. Association between salinity and hospital admission for hypertension: an ecological case-control study in the Mekong Delta Region in Vietnam.

    Science.gov (United States)

    Talukder, Mohammad Radwanur Rahman; Rutherford, Shannon; Chu, Cordia; Hieu Nguyen, Trung; Phung, Dung

    2017-04-13

    Drinking water in the Mekong Delta Region (MDR) is highly vulnerable to salinity intrusion and this problem is expected to increase with the projected climate change and sea level rise. Despite this, research on health effects of saline contaminated water is scarce in this region. This study examines the risk of hospital admission for hypertension in salinity-affected areas of the MDR. Cases and controls were obtained from national/provincial hospital admission records for 2013. The cases were adult patients whom hypertension (ICD10-code: I10-I15) was primary diagnosis for admission. Of the 13 provinces in the MDR, we identified seven as 'salinity exposed' and the remaining as 'non-exposed' areas. A multi-level logistic regression model was used to examine the association between salinity exposure and hypertension outcome. Of the total 573 650 hospital admissions, 22 382 (~3.9%) were hypertensive cases. The multi-level logistic model combining both individual and ecological factors showed a 9% increase in risk (95% CI: 3-14%) of hypertension admission among individuals in exposed areas compared to those in non-exposed areas. In order to develop and promote appropriate adaptation strategies, further research is recommended to identify the salt exposure pathways and consumption behaviours in the salinity exposed areas.

  5. The educational integration of separated minors: a comparison of the situations in France and Quebec

    Directory of Open Access Journals (Sweden)

    Eva Lemaire

    Full Text Available This article proposes to investigate the educational experiences of thirty-two separated children (unaccompanied minors seeking refuge in two different regions: the Ile-de-France (Paris region of France and the province of Quebec in Canada. It allow for a better understanding of the role and the actual place that education has in the integration process of these vulnerable young migrants.

  6. [Cancer of the organs of the pancreatoduodenal region (based on autopsy data from 2 hospitals in the city of Donetsk)].

    Science.gov (United States)

    Mikhaĭlichenko, V A

    1979-01-01

    The incidence of cancer of the pancreatoduodenal organs (the pancreas, major duodenal papilla, extrahepatic bile ducts, duodenum) is reported according to the autopsy findings obtained at two clinical hospitals (provincial and municipal) of Donetsk city during the period from 1957 to 1973. There is a tendency to the increased mortality due to cancer of the localization concerned against the background of the reduced total mortality.

  7. Reducing inappropriate emergency department attendances--a review of ambulance service attendances at a regional teaching hospital in Scotland.

    Science.gov (United States)

    Patton, Gareth Gordon; Thakore, Shobhan

    2013-06-01

    Emergency Departments (ED) in the UK have seen increasing attendance rates in recent years. Departments are now seeking strategies to reduce their attendances. A review of all ambulance attendances to the ED at Ninewells Hospital was conducted to identify if patients presenting by ambulance could be seen and treated more appropriately in other parts of the health service. A retrospective review of ambulance attendances to the ED at Ninewells Hospital over 7 non-consecutive days. The ambulance patient report form and the ED notes were reviewed by the duty consultant to deem whether it was appropriate for the patient to be presented to the ED. If inappropriate, an alternative destination was suggested. Additional data was collected on the source of the ambulance call. There were 910 attendances in the 7 days. 295 (32%) presented by ambulance. 32 had incomplete data and were excluded. 185 (70%) and 179 (68%) of the 263 were deemed appropriate from review of the patient report form and notes respectively. Of the inappropriate, 74.4% and 79.7% had primary care suggested as an alternative. Patients who call for their own ambulance and NHS24 had higher rates of inappropriate attendances. The ambulance services present one-third of the patients to the ED at Ninewells Hospital. 30%-32% were found to be attending inappropriately and 74%-80% of these could have been managed in primary care. Reducing inappropriate ambulance attendances could reduce the departmental patient load by 11%.

  8. Hauts-de-France. A pioneer in the French energy transition; Hauts-de-France. Vorreiter in der franzoesischen Energiewende

    Energy Technology Data Exchange (ETDEWEB)

    Falk, Thomas

    2016-08-15

    France had established in advance of last year's climate summit in Paris on ambitious energy policy goals. Especially the 2016 newly formed Region Hauts-de-France stands out as a pioneer here. There one drives innovation and investments with the objective of fulfilling by 2050 their own needs completely by renewable sources. The orientation to supplies Jeremy Rifkin idea of the third industrial revolution. If successful, the region would be on climate protection well ahead of the national targets, the 2050 ''only'' provide a CO{sub 2} emission reduction of 75%. In addition to the Research and development (R and D) to many future ideas in Hauts-de-France but also some major projects for Security of European energy supplies are realized that show the local agility. [German] Frankreich hatte sich im Vorfeld des letztjaehrigen Pariser-Klimagipfels auf ambitionierte Energiewendeziele festgelegt. Insbesondere die 2016 neu gebildete Region Hauts-de-France sticht dabei als Vorreiter heraus. Dort treibt man Innovationen und Investitionen mit dem Ziel an, bis 2050 den Eigenbedarf vollstaendig mittels erneuerbarer Quellen zu decken. Die Orientierung dazu liefert Jeremy Rifkins Idee der dritten industriellen Revolution. Im Erfolgsfall laege die Region beim Klimaschutz deutlich vor den nationalen Zielen, die bis 2050 ''nur'' eine CO{sub 2}-Emissionsreduktion von 75 % vorsehen. Neben der Forschung und Entwicklung (F and E) zu vielen Zukunftsideen werden in Hauts-de-France aber auch einige Grossprojekte zur Absicherung der europaeischen Energieversorgung realisiert, die Ausweis der dortigen Agilitaet sind.

  9. A comprehensive regional clinical and educational ECPR protocol decreases time to ECMO in patients with refractory out-of-hospital cardiac arrest.

    Science.gov (United States)

    Grunau, Brian; Carrier, Sarah; Bashir, Jamil; Dick, William; Harris, Luke; Boone, Robert; Kalla, Dan; Scheuermeyer, Frank; Twaites, Brian; Straight, Ron; Abel, James; McDonald, Ken; MacRedmond, Ruth; Agulnik, David; Finkler, Joe; MacLeod, Jeanne; Christenson, Jim; Cheung, Anson

    2017-08-16

    Extracorporeal membrane oxygenation within CPR (ECPR) may improve survival for refractory out-of-hospital cardiac arrest (OHCA). We developed a prehospital, emergency department (ED), and hospital-based clinical and educational protocol to improve the key variable of time-to-ECPR (TTE). In a single urban health region we involved key prehospital, clinical, and administrative stakeholders over a 2-year period, to develop a regional ECPR program with destination to a single urban tertiary care hospital. We developed clear and reproducible inclusion criteria and processes, including measures of program efficiency. We conducted seminars and teaching modules to paramedics and hospital-based clinicians including monthly simulator sessions, and performed detailed reviews of each treated case in the form of report cards. In this before-and-after study we compared patients with ECPR attempted prior to, and after, protocol implementation. The primary outcome was TTE, defined as the time of initial professional CPR to establishment of extracorporeal circulation. We compared the median TTE for patients in the two groups using the Wilcoxon signed rank test. Four patients were identified prior to the protocol and managed in an ad hoc basis; for nine patients the protocol was utilized. Overall favourable neurological outcomes among ECPR-treated patients were 27%. The median TTE was 136 minutes (IQR 98 - 196) in the pre-protocol group, and 60 minutes (IQR 49 - 81) minutes in the protocol group (p=0.0165). An organized clinical and educational protocol to initiate ECPR for patients with OHCA is feasible and significantly reduces the key benchmark of time-to-ECPR flows.

  10. An Audit of Medical Autopsy: Experience at the University of Uyo Teaching Hospital (UUTH, Niger Delta Region, Nigeria

    Directory of Open Access Journals (Sweden)

    Ekpo Memfin Dan

    2011-01-01

    Full Text Available Background: Autopsy is an essential auditing tool in clinical practice. ObjectiveS: The study set out to review all autopsies that were performed over a four-year period in order to determine the rate, indications, as well as the age and sex distribution of dead bodies, which autopsies were performed on them in the Hospital. Setting and Design: This was a retrospective study that was undertaken at the department of Pathology of the University of Uyo Teaching Hospital (UUTH, Uyo, Nigeria between January 2007 and December 2010. Materials and Methods: All the cases of death that underwent pathological autopsies in the UUTH were reviewed. The autopsy records, clinical case notes, gross and histopathological specimens as well as slides were retrieved and examined. Results: A total of 1679 dead bodies were received at the mortuary of the institution studied during the 4-year period. Autopsies were performed in 78 cases giving a request rate of 4.7%. Coroner′s autopsy was commonly performed, and this accounted for 60 (76.9% cases, while the remaining 18 (23.1% were clinical autopsies. Autopsies were commonly performed on male bodies more than females (M: F = 2.6:1.0 with the majority having died at their second decade of life. It was observed that the majority (57.7% of the request for autopsies were from peripheral centers outside the teaching hospital, while the remaining 42.3% cases were drawn from various clinical departments in the teaching hospital. Road traffic accident was the leading indication for coroner′s autopsy (51.7%, while gastroenteritis and chronic liver disease were the two most common indications for clinical autopsy, 27.8% and 22.2% respectively. The concordance rate between clinical diagnosis and autopsy diagnosis was found to be 72.2% (13/18 cases. Conclusion: The rate of request for Autopsy at the University of Uyo Teaching Hospital during the period of this study was low, similar to other previous reports.

  11. 2035: a no nuclear France; 2035: une France sans nucleaire

    Energy Technology Data Exchange (ETDEWEB)

    Dupin, L.; Chandes, C.; James, O.; Moragues, M.

    2011-06-15

    The authors propose a prospective scenario: the newly elected French president decides of a 20-year program to give up nuclear energy production. First, the Fessenheim and Gravelines reactors are closed. The others are to be closed by 2035. Investments are decided for offshore wind energy production, methanation projects, housing thermal insulation. Employees of the nuclear energy sector are taken into account. The authors describe the situation in 2020: energy supply problems, 5 more years of lifetime awarded to some nuclear power stations, decision to build only positive energy buildings, mandatory housing renovation, job creation, decision to develop carbon capture and storage projects. In 2025: the dismantling of nuclear reactors is going on and its cost is assessed, always more electrical vehicles, drastic cost reduction for lithium batteries. In 2035: renewable energies represent the half of the energy mix, the dismantling activity is a success for Areva. In parallel, current figures are given for energy consumption per year and per person in France and Germany, for energy French exports and imports, for electricity cost associated with the different energy sources, for the energy mix in France, for the number of jobs in the nuclear sector. In an interview, a member of the CEA comments the Italian, German and Swiss decisions to give up nuclear energy, the possibilities of its replacement by renewable energies, and the challenges associated with such a decision in France

  12. "Franklin: Science, Politics and France"

    Science.gov (United States)

    McClellan, James E., III

    2003-04-01

    This presentation traces Benjamin Franklin's career as a "civic scientist" in Old-Regime France. It outlines the initial - and not always positive - reception of Franklin's work on electricity by the community of French scientists in the 1750s. It sketches Franklin's subsequent elevation into the pantheon of French Enlightenment heros, and it details his work as a "civic scientist" while American envoy to France in the 1770s and 1780s, notably his service on the government-sponsored commissions that repudiated the scientific and medical claims of Franz Anton Mesmer. This presentation concludes by examining a few features of Franklin's career that are not completely congruent with our notion of what a "civic scientist" might be, a contrast that is intended to illuminate both Franklin and the concept of "civic scientist."

  13. Regional Variation in Diabetic Outcomes by Country-of-Origin and Language in an Urban Safety Net Hospital.

    Science.gov (United States)

    Wilhelm, April K; Jacobson, Debra J; Guzman-Corrales, Laura; Fan, Chun; Baker, Karen; Njeru, Jane W; Wieland, Mark L; Boehm, Deborah H

    2016-08-01

    Adherence to diabetic care guidelines among US immigrants remains low. This study assesses adherence to diabetic care guidelines by country-of-origin and language among a limited English-proficient (LEP) population. Timely completion of diabetic measures and acceptable levels of hemoglobin A1c (A1c), low density lipoprotein (LDL) cholesterol, and blood pressure (BP) were compared between LEP and English-proficient (EP) patients in this 2013 retrospective cohort study of adult diabetics. More LEP patients met BP targets (83 vs. 68 %, p safety net hospital in improving diabetes management among diverse populations.

  14. Drug utilization review of ciprofloxacin in the outpatient department of Boru Meda Hospital, South Wollo Zone, Amhara Region, Ethiopia

    Directory of Open Access Journals (Sweden)

    Tessema Tsehay Biru

    2014-02-01

    Conclusions: Due From the retrospective Drug Use Evaluation (DUE study, it was identified that there was inappropriate ciprofloxacin use in the outpatient department of Boru Meda hospital even though the drug’s use regarding indications was a better performance and dosing practices were almost appropriate as per the criteria used for the study (assuming that there were no dose adjustments. There was a great problem concerning the duration of ciprofloxacin drug therapy. Ciprofloxacin use along with potentially interacting drugs and against contraindications was also another problem indicated in the study. [Int J Basic Clin Pharmacol 2014; 3(1.000: 171-178

  15. [Epidemiology of burns in France].

    Science.gov (United States)

    Latarjet, Jacques; Ravat, François

    2012-01-01

    As with most traumas, the epidemiology of the "burn" health-event has long been neglected by public health doctors and rarely considered by burns specialists. There were therefore few verified data and many approximations and preconceived ideas. The gathering of information recently undertaken in France enables the reliability of the data to be improved and the diagnostic and demographic elements relating to hospitalised patients with burns to be established.

  16. THE ADMINISTRATIVE SYSTEM IN FRANCE

    OpenAIRE

    2012-01-01

    According to the Constitution promulgated on the 6th of October 1958, with the latest amendments made in 1999, France is a presidential republic. The three authority branches are broadly represented in the French administration: the judicial branch – French courts of law are divided into: judicial courts and administrative courts. Judicial courts are under the supreme authority of the Court of Cassation with jurisdiction to cancel judgments passed courts on inferior hierarchy levels and plays...

  17. Embarazadas con lupus eritematoso sistémico en el hospital Clínico Regional de Concepción, Chile

    OpenAIRE

    Sabat A,Susana; Vinet M,Michelle; Sanhueza F,Camila; Galdames G,Andrea; Castro E,Irene; Caballero E,Andrés

    2014-01-01

    Antecedentes: El lupus eritematoso sistémico (LES) afecta principalmente a mujeres en edad fértil. El embarazo en estas pacientes puede asociarse con múltiples complicaciones. Objetivo: Caracterizar a las embarazadas con LES durante 10 años en el Hospital Clínico Regional de Concepción. Métodos: Se realizó un estudio descriptivo retrospectivo que consistió en la revisión de fichas clínicas. Se analizaron las variables: edad, años de enfermedad desde el diagnóstico, historia obstétrica, presen...

  18. Perfil epidemiológico dos pacientes com glaucoma congênito atendidos no Hospital Regional de São José

    OpenAIRE

    Deyse Bianca Campos Brink; Marília Bastos Quirino Brasil; Günther Bernardes Brink

    2015-01-01

    Objetivo Delinear um perfil epidemiológico de pacientes com glaucoma congênito atendidos no serviço de Oftalmologia do Hospital Regional de São José, bem como a evolução destes pacientes com os tratamentos empregados. Métodos Foi realizado um estudo longitudinal, retrospectivo, descritivo que avaliou 32 pacientes com glaucoma congênito atendidos em ambulatório, desde a primeira consulta quando ingressaram no serviço e consultaram pelo men...

  19. CONDUCTA TERAPEUTICA DE LA CRISIS EPILEPTICA TARDIA EN EL SERVICIO DE EMERGENCIA DEL HOSPITAL REGIONAL DE CHIMBOTE. ENERO 2012 - AGOSTO 2013

    OpenAIRE

    ACEVEDO ORELLANO, CÉSAR AUGUSTO

    2014-01-01

    En el presente estudio se revisaron 258 historias clínicas del servicio de emergencia del hospital regional de Chimbote en el período comprendido de enero 2012 – agosto 2013, con la finalidad de determinar si la conducta terapéutica es adecuada en los pacientes con diagnóstico de crisis epiléptica tardía, de los cuales solo 39 pacientes cumplieron con los criterios de edad mayor de 15 años, que no estén tomando fármacos antiepiléptico y que hallan presentado una primera crisis epiléptica. ...

  20. Consumo dietario de calcio y su relación con la enfermedad hipertensiva en gestantes del hospital regional de Huancavelica marzo-octubre 2014

    OpenAIRE

    Cubas Romero, Fiorella

    2015-01-01

    El principal objetivo de esta investigación trata sobre las enfermedades hipertensivas del embarazo, por ser la principal causa y complicación de muerte materna y perinatal, ya que el estudio realizado trata sobre el consumo dietario de calcio y su relación con la enfermedad hipertensiva en gestantes del Hospital Regional de Huancavelica durante el período marzo-octubre de 2014. Dicho estudio retrospectivo transversal de observación analítico de casos y controles, se realizó en 120 gestantes ...

  1. The Maine electronic document delivery project: a cooperative project of Maine hospital libraries and the NN/LM New England Region.

    Science.gov (United States)

    Goldstein, Mark; Sibley, Debbie

    2003-01-01

    The article discusses an Ariel document delivery project with seven Maine hospital libraries, the University of Massachusetts Medical School Library (UMass), and the New England Regional office of the National Network of Libraries of Medicine. Funding was awarded to six network members to purchase equipment or Ariel software. UMass served as a document provider. During the test, libraries received documents from UMass via Ariel or via the Web as a PDF document. This form of document delivery was faster than standard service with better quality of delivered articles. The column describes the project and outlines possible future steps.

  2. The Role of Bokavirus and Metapneumovirus in Development Acute Respiratory Infections in Hospitalized Patients in 2011—2014 years in Penza Region

    Directory of Open Access Journals (Sweden)

    I. A. Malova

    2016-01-01

    Full Text Available The article presents the results of a comparative analysis of the clinical data, laboratory and instrumental examination methods in patients with bokavirus (HBoV and metapnevmovirus (HMPV infections, hospitalized in the infectious disease Department of MSU № 59 Zarechnyj sity Penza region. From 713 patients with verified diagnosis with 42 (5.89% PCR revealed metapnevmovirus infection, at 18 (2.52% bokavirus, at 34 (4.77% mixed infection, most often by HBoV on and HMPV were children up to 7 years, were accompanied by lesions of the upper and lower respiratory tract infections, fever, intoxication, adenopathy.

  3. Enteropatógenos predominantes en diarreas agudas y variables asociadas en niños atendidos en el Hospital Regional Lambayeque, Perú

    OpenAIRE

    Silva-Díaz, Heber; Laboratorio de Parasitología-Metaxénicas y Zoonosis, Hospital Regional Lambayeque. Lambayeque, Perú.; Bustamante-Canelo, Olinda; Laboratorio de Bacteriología, Hospital Regional Lambayeque. Lambayeque, Perú.; Aguilar-Gamboa, Franklin-Rómulo; Laboratorio de inmunología y Virología, Hospital Regional Lambayeque. Lambayeque, Perú.; Mera-Villasis, Katya; Laboratorio de inmunología y Virología, Hospital Regional Lambayeque. Lambayeque, Perú.; Ipanaque-Chozo, Jhonatan; Seclen-Bernabe, Eberth; Facultad de Ciencias Biológicas, Universidad Nacional Pedro Ruíz Gallo. Lambayeque, Perú.; Vergara-Espinoza, Martha; Facultad de Ciencias Biológicas, Universidad Nacional Pedro Ruíz Gallo. Lambayeque, Perú.

    2017-01-01

    Objetivo: Determinar el tipo y frecuencia de enteropatógenos predominantes en diarreas agudas y sus características asociadas en niños atendidos en el Hospital Regional Lambayeque (HRL) – Perú.Materiales y métodos: Se realizó un estudio analítico transversal entre marzo y mayo del 2015 en 70 muestras fecales. Las muestras se estudiaron mediante coprocultivo e inmunocromatografía para la detección de bacterias y virus enteropatógenos respectivamente. Mientras que los enteroparásitos se buscaro...

  4. [Hospital information system performance for road traffic accidents analysis in a hospital recruitment based area].

    Science.gov (United States)

    Jannot, A-S; Fauconnier, J

    2013-06-01

    Road traffic accidents in France are mainly analyzed through reports completed by the security forces (police and gendarmerie). But the hospital information systems can also identify road traffic accidents via specific documentary codes of the International Classification of Diseases (ICD-10). The aim of this study was therefore to determine whether hospital stays consecutive to road traffic accident were truly identified by these documentary codes in a facility that collects data routinely and to study the consistency of results from hospital information systems and from security forces during the 2002-2008 period. We retrieved all patients for whom a documentary code for road traffic accident was entered in 2002-2008. We manually checked the concordance of documentary code for road traffic accident and trauma origin in 350 patient files. The number of accidents in the Grenoble area was then inferred by combining with hospitalization regional data and compared to the number of persons injured by traffic accidents declared by the security force. These hospital information systems successfully report road traffic accidents with 96% sensitivity (95%CI: [92%, 100%]) and 97% specificity (95%CI: [95%, 99%]). The decrease in road traffic accidents observed was significantly less than that observed was significantly lower than that observed in the data from the security force (45% for security force data against 27% for hospital data). Overall, this study shows that hospital information systems are a powerful tool for studying road traffic accidents morbidity in hospital and are complementary to security force data. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  5. Foreign driving licences in France

    CERN Multimedia

    HR Department

    2009-01-01

    The following information is subject to possible amendments decided by the competent French authorities. Those wishing to undertake the necessary steps with the prefectural services of the Departments of the Ain and Haute-Savoie may obtain information by calling the following numbers: + 33 4 74 32 30 65 for the Ain and + 33 4 50 33 60 00 for Haute-Savoie. 1. PERSONS RESIDING IN FRANCE 1.1 Driving licences issued by a State belonging to the EU or the EEA a) Recognition on French territory All currently valid driving licences issued by States belonging to the European Union (EU) or to the European Economic Area (EEA) are generally valid for driving on French territory. However, if the licence was originally obtained in exchange for a licence issued by a State not belonging to the EU or to the EEA and with which France has not concluded a reciprocity agreement, it will be recognised for a maximum of one year following the date of establishment of normal residence in France ...

  6. FOREIGN DRIVING LICENCES IN FRANCE

    CERN Document Server

    DSU Unit

    2008-01-01

    The following information is provided subject to possible amendments decided by the competent French authorities. Those wishing to undertake the necessary steps with the prefectural services of the Departments of Ain and Haute-Savoie may obtain information by calling the following numbers: + 33 474 32 30 65 for Ain and + 33 450 33 60 00 for Haute-Savoie. 1. PEOPLE RESIDING IN FRANCE 1.1 Driving licences issued by a state belonging to the EU or the EEA a) Recognition on French territory All currently valid driving licences issued by States belonging to the European Union (EU) or to the European Economic Area (EEA) are generally valid for driving on French territory. However, if the licence was originally obtained in exchange for a licence issued by a State not belonging to the EU or to the EEA with which France has not concluded a reciprocity agreement, it is recognised only up to one year following the date of establishment of normal residence in France (date of the first special residence permit issu...

  7. Referral patterns and clinical characteristics of subjects referred to substance abuse clinic of a regional hospital in Hong Kong.

    Science.gov (United States)

    Tang, A; Liang, H J; Ungvari, G S; Tang, W K

    2011-03-01

    To examine the clinical characteristics of subjects referred to the Substance Abuse Clinic of the Prince of Wales Hospital between 1 January 2007 and 31 December 2009 in Hong Kong. A chart review of 131 subjects referred to the Substance Abuse Clinic during the study period was carried out. Psychiatric diagnoses were made by a psychiatrist, according to the 10th edition of the International Classification of Diseases. Social workers were increasingly a main source of referrals, accounting for 34% of referrals during the entire study period (and 43% in 2009). Another important referral source was the Hospital Authority system in Hong Kong, which accounted for 38% of referrals over the 3-year study period. Ketamine, methamphetamine, and cough mixtures were the most common drugs of primary misuse, the proportion of users being 34%, 24% and 12%, respectively. In these referals, the most common psychiatric diagnosis was substance-induced psychotic disorder, followed by depressive disorder, made in 44% and 22% of the subjects, respectively. Among Hong Kong substance abusers, psychotic and depressive disorders are common, and ketamine is the most commonly misused drug.

  8. How do hospital-specialty characteristics influence health system responsiveness? An empirical evaluation of in-patient care in the Italian region of Emilia-Romagna.

    Science.gov (United States)

    Fiorentini, Gianluca; Robone, Silvana; Verzulli, Rossella

    2017-06-29

    Studies of health system responsiveness mostly focus on the demand side by investigating the association between sociodemographic characteristics of patients and their reported level of responsiveness. However, little is known about the influence of supply-side factors. This paper addresses that research gap by analysing the role of hospital-specialty characteristics in explaining variations in patients' evaluation of responsiveness from a sample of about 38,700 in-patients treated in public hospitals within the Italian Region of Emilia-Romagna. The analysis is carried out by adopting a 2-step procedure. First, we use patients' self-reported data to derive 5 measures of responsiveness at the hospital-specialty level. By estimating a generalised ordered probit model, we are able to correct for variations in individual reporting behaviour due to the health status of patients and their experience of being in pain. Second, we run cross-sectional regressions to investigate the association between patients' responsiveness and potential supply-side drivers, including waiting times, staff workload, the level of spending on non-clinical facilities, the level of spending on staff education and training, and the proportion of staff expenditure between nursing and administrative staff. Results suggest that responsiveness is to some extent influenced by the supply-side drivers considered. Copyright © 2017 John Wiley & Sons, Ltd.

  9. The 2011 Great East Japan earthquake: a report of a regional hospital in Fukushima Prefecture coping with the Fukushima nuclear disaster.

    Science.gov (United States)

    Irisawa, Atsushi

    2012-05-01

    A catastrophic undersea megathrust earthquake of magnitude 9.0 off the coast of Japan occurred at 14:46 JST on Friday, 11 March 2011. The earthquake triggered powerful tsunami waves, and the tsunami precipitated Fukushima nuclear accidents. After the terrible earthquake, many people fled from the nuclear accident and arrived at places far from the nuclear power plant. In this article, I present a story of one measure devised to deal with the problem of the Fukushima nuclear accident at a regional hospital of Fukushima prefecture, Aizu General Hospital, which is located far from the Fukushima nuclear plant. In addition, I briefly report the current situation of Fukushima prefecture after the 2011 Great East Japan earthquake. In our hospital, the countermeasure headquarters was established to supply medical care for those who had been injured by tsunami waves and the Fukushima nuclear accident. Especially, the screening for radioactive exposure using a dosimeter to take decontamination measures for cases of external exposure was extremely important task. Nevertheless, because the accurate knowledge related to radioactive contamination didn't provide, most medical staff fell into confusion. Fukushima prefecture has been 'shrinking' since the nuclear accident. However, today, although some hot spots remain in residential areas, the radioactive contamination is decreasing little by little. Many people in Fukushima Prefecture advance as one, facing forward. Recently, decontamination projects started. Efforts must be continued over a long period.

  10. A New Approach to Identify High Burnout Medical Staffs by Kernel K-Means Cluster Analysis in a Regional Teaching Hospital in Taiwan

    Directory of Open Access Journals (Sweden)

    Yii-Ching Lee PhD

    2016-11-01

    Full Text Available This study uses kernel k-means cluster analysis to identify medical staffs with high burnout. The data collected in October to November 2014 are from the emotional exhaustion dimension of the Chinese version of Safety Attitudes Questionnaire in a regional teaching hospital in Taiwan. The number of effective questionnaires including the entire staffs such as physicians, nurses, technicians, pharmacists, medical administrators, and respiratory therapists is 680. The results show that 8 clusters are generated by kernel k-means method. Employees in clusters 1, 4, and 5 are relatively in good conditions, whereas employees in clusters 2, 3, 6, 7, and 8 need to be closely monitored from time to time because they have relatively higher degree of burnout. When employees with higher degree of burnout are identified, the hospital management can take actions to improve the resilience, reduce the potential medical errors, and, eventually, enhance the patient safety. This study also suggests that the hospital management needs to keep track of medical staffs’ fatigue conditions and provide timely assistance for burnout recovery through employee assistance programs, mindfulness-based stress reduction programs, positivity currency buildup, and forming appreciative inquiry groups.

  11. Where are the radioactive wastes in France? Brochure no 5; Ou sont les dechets radioactifs en France? Brochure no 5

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2004-07-01

    This document is one of the 6 regional brochures which make the geographical inventory of radioactive wastes in France. For each region, a table lists the recorded sites and a regional map localizes those having a detailed descriptive file. These files mention the most important waste owners (medical, research, nuclear and military industries), the type of waste and the type of management. The polluted sites are also mentioned, even if they are already decontaminated. The volume no 5 concerns the Languedoc-Roussillon and Provence-Alpes-Cote d'Azur regions, Corsica, and the overseas departements and territories. (J.S.)

  12. Where are the radioactive wastes in France? Brochure no 4; Ou sont les dechets radioactifs en France? Brochure no 4

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2004-07-01

    This document is one of the 6 regional brochures which make the geographical inventory of radioactive wastes in France. For each region, a table lists the recorded sites and a regional map localizes those having a detailed descriptive file. These files mention the most important waste owners (medical, research, nuclear and military industries), the type of waste and the type of management. The polluted sites are also mentioned, even if they are already decontaminated. The volume no 4 concerns the Auvergne and Rhone-Alpes regions. (J.S.)

  13. Where are the radioactive wastes in France? Brochure no 6; Ou sont les dechets radioactifs en France? Brochure no 6

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2004-07-01

    This document is one of the 6 regional brochures which make the geographical inventory of radioactive wastes in France. For each region, a table lists the recorded sites and a regional map localizes those having a detailed descriptive file. These files mention the most important waste owners (medical, research, nuclear and military industries), the type of waste and the type of management. The polluted sites are also mentioned, even if they are already decontaminated. The volume no 6 concerns the Aquitaine, Limousin, Midi-Pyrenees and Poitou-Charentes regions. (J.S.)

  14. Where are the radioactive wastes in France? Brochure no 2; Ou sont les dechets radioactifs en France? Brochure no 2

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2004-07-01

    This document is one of the 6 regional brochures which make the geographical inventory of radioactive wastes in France. For each region, a table lists the recorded sites and a regional map localizes those having a detailed descriptive file. These files mention the most important waste owners (medical, research, nuclear and military industries), the type of waste and the type of management. The polluted sites are also mentioned, even if they are already decontaminated. The volume no 2 concerns the Bretagne (Brittany), Pays de la Loire, Haute-Normandie, Basse-Normandie and Centre regions. (J.S.)

  15. Where are the radioactive wastes in France? Brochure no 3; Ou sont les dechets radioactifs en France? Brochure no 3

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2004-07-01

    This document is one of the 6 regional brochures which make the geographical inventory of radioactive wastes in France. For each region, a table lists the recorded sites and a regional map localizes those having a detailed descriptive file. These files mention the most important waste owners (medical, research, nuclear and military industries), the type of waste and the type of management. The polluted sites are also mentioned, even if they are already decontaminated. The volume no 3 concerns the Nord-Pas-de-Calais, Picardie, Champagne-Ardenne, Bourgogne, Alsace, Lorraine, Franche-Comte regions. (J.S.)

  16. Tensions of network security and collaborative work practice: understanding a single sign-on deployment in a regional hospital.

    Science.gov (United States)

    Heckle, Rosa R; Lutters, Wayne G

    2011-08-01

    Healthcare providers and their IT staff, working in an effort to balance appropriate accessibility with stricter security mandates, are considering the use of a single network sign-on approach for authentication and password management. Single sign-on (SSO) promises to improve usability of authentication for multiple-system users, increase compliance, and help curb system maintenance costs. However, complexities are introduced when SSO is placed within a collaborative environment. These complexities include unanticipated workflow implications that introduce greater security vulnerability for the individual user. OBJECTIVES AND METHODOLOGY: In this work, we examine the challenges of implementing a single sign-on authentication technology in a hospital environment. The aim of the study was to document the factors that affected SSO adoption within the context of use. The ultimate goal is to better inform the design of usable authentication systems within collaborative healthcare work sites. The primary data collection techniques used are ethnographically informed - observation, contextual interviews, and document review. The study included a cross-section of individuals from various departments and varying rolls. These participants were a mix of both clinical and administrative staff, as well as the Information Technology group. The field work revealed fundamental mis-matches between the technology and routine work practices that will significantly impact its effective adoption. While single sign-on was effective in the administrative offices, SSO was not a good fit for collaborative areas. The collaborative needs of the clinical staff unearthed tensions in its implementation. An analysis of the findings revealed that the workflow, activities, and physical environment of the clinical areas create increased security vulnerabilities for the individual user. The clinical users were cognizant of these vulnerabilities and this created resistance to the implementation due

  17. Knowledge of carbohydrate counting and insulin dose calculations among hospital staff in a regional general paediatrics unit.

    Science.gov (United States)

    O'Gorman, Jennifer R; O'Leary, Orla; Finner, Natalie; Quinn, Anne; O'Gorman, Clodagh S

    2015-01-01

    The aim of this study was to assess the carbohydrate and insulin knowledge of the staff at Children's Ark at the University Hospital, Limerick. Carbohydrate counting and insulin dose calculations based on carbohydrates and blood sugars are integral to intensive insulin management of type 1 diabetes mellitus (T1DM). The PedCarbQuiz, a validated questionnaire, was modified, and applied to the staff on our general paediatrics ward. 48/70 eligible staff responded (rate 68 %). Overall knowledge was good: 75.5 % was the average score for correctly identifying foods containing carbohydrate. However, poor scores were obtained for calculating multiple items and meal values (average score 29 %), and exact values of insulin required (average score 38 %). These results highlight the need for re-education among staff on a general paediatrics ward, to empower ward staff to contribute effectively to the education and management of patients with T1DM.

  18. Manejo hospitalario del paciente pediátrico con quemaduras de segundo y tercer grados, en un hospital regional

    OpenAIRE

    2015-01-01

    Antecedentes: las quemaduras en la población pediátrica son el segundo trauma más frecuente; la atención debe guiarse por evidencia científica que promueva un manejo adecuado. El objetivo del estudio fue determinar el manejo hospitalario de las quemaduras de 2º y 3º grados, en pacientes pediátricos. Métodos: revisión de expedientes clínicos de pacientes con diagnóstico de quemadura de 2º y 3º grados, durante el periodo 2010 - 2012, en el Servicio de Cirugía Pediátrica, Hospital Dr. Enrique Ba...

  19. [Improvement in health care quality for patients from the thoracic/chest pain unit in a regional hospital].

    Science.gov (United States)

    Castellano Ortega, M A; Romero de Castilla, R J; Rus Mansilla, C; Cortez Quiroga, G A; Bayona Gómez, A J; Duran Torralba, M C

    2011-01-01

    The evaluation of an improvement cycle in patients suffering thoracic/chest pain in hospital emergencies, especially in those who could benefit from the early Bruce Treadmill Test. A multidisciplinary group care protocol was designed, which identified improvement opportunities and gave priority to the fact that «an early Bruce Treadmill Test was carried out on fewer occasions than recommended». Causes were analysed (Ishikawa diagram) and six quality criteria were defined. These criteria were evaluated in a random sample of 30 patients out of the total of 180 who used the ergometer at the Hospital in the first six months of 2007, as well as questionnaire for the doctors. Corrective measures were introduced: circulation, accessibility through intranet and explicit information for new employees (doctors). The second evaluation was carried out during the first six-months of 2008 using another random sample of 30 patients from a total of 120. In the first evaluation, the classification of the risk according to the protocol was very low (100% non-compliance) and patients whose admission to the Chest Pain Unit was recommended and an early Bruce Treadmill Test (74% criteria failure) were referred to cardiology clinics. After implementation of the corrective measures, we obtain a general improvement in all the criteria, but very significant from the previous ones, with non-compliances being reduced to 17% in classification and to the 23% in referrals. The structured cycle has helped resolve the priority problem in the short-term. The adopted measures have mainly been organisational, dependent on the professionals involved, and at a very low cost. Simple but organised methodological approaches should be taken into account before the incorporation of higher cost technologies. Copyright © 2010 SECA. Published by Elsevier Espana. All rights reserved.

  20. Long-Term Results of Percutaneous Management of Liver Hydatid Cysts: - Experience of a University Hospital in Endemic Region

    Directory of Open Access Journals (Sweden)

    Younès Cherradi

    2016-12-01

    Full Text Available Background and objective: Surgery was considered for years the standard treatment for all stages of liver hydatid cysts (LHC. Percutaneous treatment has becomes a fast, reliable and more efficient method in selected cases. The purpose of this study is to evaluate the effectiveness of percutaneous treatment of LHC on the basis of our department long-term results. Patients and Methods: This study includes all patients who benefited from percutaneous treatment for LHC from December 1998 to April 2012. Puncture aspiration, injection, and re-aspiration (PAIR were used for hydatid cysts smaller than 6 cm. Larger cysts, infected cysts and those with biliary fistula were treated by puncture associated to drainage (PA-PD. Absolute alcohol was used as sclerosing agent. Reduction of the size of the cyst more than 50%, pseudo-tumour echo pattern and disappearance of the cyst at the follow-up were retained as criteria of treatment efficacy. Results: Two hundred thirty patients (136 female and 94 male; mean age: 35 years old with 278 LHC underwent percutaneous treatment. Mean initial cyst diameter was 76.8 mm [20-180 mm]. According to Gharbi’s classification, types I and II LHC accounted for 74% and 25% respectively. Fourteen patients (6% presented with an infected cavity and 27 patients (12% had a biliary fistula at diagnosis (12%. PA-PD was initially performedin 23 patients. No mortality, abdominal dissemination, or tract seeding occurred. Minor complications like urticaria, cutaneous rash and fever were reported in 24 patients (10%. One case of anaphylactic shock was reported with good evolution. Mean hospitalization time was 3 days ± 1.5 for uncomplicated cases and 16.5 days± 4.2 for complicated cases. 229 out of 230 patients were cured, whereas one recurrence has been reported. Conclusion: Percutaneous treatmentis efficient and safe and offers complete cure in selected patients with the advantage of short hospitalization.

  1. Beta Cell Pancreas Dysfunction and Hyperglycemia in Patient Schizophrenia that Uses Haloperidol at Region Special Dadi Hospital Province South Sulawesi

    Directory of Open Access Journals (Sweden)

    Rahmawati

    2016-01-01

    Full Text Available Schizophrenic patients at high risk for development of type 2 diabetes as a side effect of the antipsychotic medication This research is aimed to find out (1 the level of HbA1c and the description of hyperglycemia incidence, (2 the value of HOMA-β and the description of beta cell dysfunction incidence, (3 the correlation between HOMA-β value with HbA1c level, (4 the duration correlation between the use of haloperidol with the HOMA-β value and the HbA1c level, (5 the duration correlation the use of haloperidol and the HbA1c level through HOMA-β value. This study was conducted at the inpatient ward of Dadi Hospital, South Sulawesi Province using quantitative method with cross sectional study. By using total sampling way, 64 were chosen. The data were then analyzed by using frequency distribution test and Spearman correlation. The result of the study indicates that sufferer schizophrenia at Dadi Hospital who use haloperidol have problems of hyperglycemia (HbA1c >5,5%. The longer the use of haloperidol the more the excelsior level of HbA1c found. About 4,3% hyperglycemia in use of haloperidol 1 year. The mechanism the hyperglycemia incidence mentioned above suffered through dysfunction of beta cell. The longer the use of haloperidol the lower the HOMA-β value. It reaches 28,3% dysfunction of beta cell in use of haloperidol 1 year. The dysfunction of beta cell has relation with the duration in the use of haloperidol. The lower HOMA-β value level the more the excelsior level of HbA1c. The incidence of Hyperglycemia is correlated with the dysfunction of beta cell.

  2. Energy statistics France - June 2008; Statistiques energetiques France - juin 2008

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2008-07-01

    This document summarizes in a series of tables and graphics the energy statistics for France for the last decades and up to 2007: resources, uses, prices, net imports and domestic market consumption for petroleum, natural gas, electricity, and solid mineral fuels (coal, lignite, coke). 2007 statistics are presented separately for each energy source (availability, uses). The evolution of the domestic energy production and consumption and the end-use consumption per sector is also summarized for the last decades. Some primary consumption forecasts are given for 2030. (J.S.)

  3. Qualitative Inquiry into Challenges Experienced by Registered General Nurses in the Emergency Department: A Study of Selected Hospitals in the Volta Region of Ghana

    Science.gov (United States)

    Adatara, Peter

    2016-01-01

    Registered General Nurses (RGNs) play crucial roles in emergency departments (EDs). EDs in Ghana are primarily staffed by RGNs who have had no additional formal education in emergency care. Additionally, basic, master's, or doctoral level nursing education programs provide limited content on the complexities of emergency nursing. Nurses in EDs are affected by many challenges such as growing patient population, financial pressures, physical violence, verbal abuse, operational inefficiencies, overcrowding, and work overload. There is a paucity of research on challenges experienced by RGNs in EDs in the Volta Region of Ghana. In this qualitative study, twenty RGNs in EDs from three selected hospitals in the Volta Region of Ghana were interviewed. All recorded interviews were transcribed, reviewed several times by researchers and supervisors, and analyzed using content analysis. Five thematic categories were identified. These thematic categories of challenges were lack of preparation for ED role, verbal abuse from patients relatives, lack of resources in ED, stressful and time consuming nature of ED, and overcrowding in ED. Formal education of RGNs in the advanced role of emergency care, adequate supply of resources, increased hospital management support, and motivations for RGNs working in ED are necessary to improve the practice of emergency care. PMID:27885343

  4. Prevalence of [i]Legionella pneumophila[/i] in water distribution systems in hospitals and public buildings of the Lublin region of eastern Poland

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    Agnieszka Sikora

    2015-05-01

    Full Text Available Objective. The aim of this study was to determine the prevalence of [i]L. pneumophila[/i] in water supply systems, hospitals and public buildings in the Lublin region of eastern Poland. Material and methods. The study was carried out in 26 different objects in the Lublin region. The number of [i]Legionella[/i] bacteria in water samples was determined by the membrane filtration method and/or by surface inoculation in accordance with the standards. Results. The study showed the presence of[i] L. pneumophila[/i] in 166 hot water samples (74.77%. In 34.33% (n=57 of water samples the count of tested bacteria exceeded the acceptable level of >100 CFU/100 ml. Of the samples where an acceptable level of bacteria was exceeded, 49 samples had an average level of [i]L. pneumophila[/i] (100–1,000 CFU/100 ml, and the level in 8 samples was high (>1,000 CFU/100 ml. Conclusions. The water samples collected form the hot water supply system of hospitals and public buildings showed exceeded counts of[i] L. pneumophila[/i], indicating the risk of infection. The constant monitoring of water distribution systems is an important element of the control of infections caused by these organisms.

  5. Sales of antidepressants, suicides and hospital admissions for depression in Veneto Region, Italy, from 2000 to 2005: an ecological study.

    Science.gov (United States)

    Guaiana, Giuseppe; Andretta, Margherita; Griez, Eric; Biancosino, Bruno; Grassi, Luigi

    2011-09-30

    Increased prescription of antidepressants has been consistently associated with a decrease in suicide rates in several countries. The aim of this study is to explore antidepressant consumption, suicide rates and admission for depression in the Veneto Region, Italy, in order to see whether the same pattern could be detected. Data from the Italian Ministry of Health (admissions for depression), the Pharmacy Service of a Local Health Unit (antidepressant prescribing) and from the Epidemiological System of the Veneto region (suicide rates) were collected from 2000 to 2005 for the Veneto region. Suicide rates did not show any marked increase but were stable in males and females. Antidepressant prescribing increased exponentially over the period examined, whilst admissions for depression markedly decreased. The trend for an exponential increase in antidepressant prescribing in the Veneto region is shared with other countries and locales. It is possible that the increase in antidepressant prescribing might be associated with earlier treatment of depression, thus decreasing the likelihood of aggravation of depression.

  6. Sales of antidepressants, suicides and hospital admissions for depression in Veneto Region, Italy, from 2000 to 2005: an ecological study

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    Biancosino Bruno

    2011-09-01

    Full Text Available Abstract Background Increased prescription of antidepressants has been consistently associated with a decrease in suicide rates in several countries. The aim of this study is to explore antidepressant consumption, suicide rates and admission for depression in the Veneto Region, Italy, in order to see whether the same pattern could be detected. Methods Data from the Italian Ministry of Health (admissions for depression, the Pharmacy Service of a Local Health Unit (antidepressant prescribing and from the Epidemiological System of the Veneto region (suicide rates were collected from 2000 to 2005 for the Veneto region. Results Suicide rates did not show any marked increase but were stable in males and females. Antidepressant prescribing increased exponentially over the period examined, whilst admissions for depression markedly decreased. The trend for an exponential increase in antidepressant prescribing in the Veneto region is shared with other countries and locales. Conclusions It is possible that the increase in antidepressant prescribing might be associated with earlier treatment of depression, thus decreasing the likelihood of aggravation of depression.

  7. Apendicitis aguda en el adulto mayor, resultados del tratamiento quirúrgico en un hospital regional Acute appendicitis in the elderly and the results of surgical treatment in a regional hospital

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    Radamés Isaac Adefna Pérez

    2011-09-01

    Full Text Available Introducción: el 55 % de las personas que llegan a 60 años requerirán al menos una operación, y el 50 % son urgentes, y dentro de las principales causas se encuentra la apendicitis aguda. Objetivo: conocer las características epidemiológicas y clínicas de la apendicitis aguda en el adulto mayor, con el propósito de intentar mejorar el diagnóstico y los resultados del tratamiento quirúrgico en ellos. Métodos: estudio observacional descriptivo, del tipo de serie de casos, de carácter retrospectivo, desde el 1º de enero de 2005 hasta el 31 de diciembre de 2008, en el Hospital Clinicoquirúrgico Docente "Miguel Enríquez". Se incluyeron a todos los enfermos mayores de 60 años operados de apendicitis aguda. Resultados: la incidencia de apendicitis aguda en el adulto mayor fue de 4,7 %. El grupo más afectado fue de 60 a 69 años. De los síntomas predominó el dolor abdominal y las náuseas y vómitos. El dolor típico predominó en el grupo de 60-69 años, y a medida que aumentó la edad predominó el denominado dolor atípico. Son significativas las cifras de inflamación apendicular avanzada: perforaciones (13,5 %, gangrena (13,5 % y la supuración (21,1 %. La morbilidad global fue de 28,8 %. No existió mortalidad en esta serie. Conclusiones: la apendicitis en el adulto mayor muestra logros en términos de tratamiento y resultados en nuestra institución. Continúa con presentaciones atípicas y morbilidad significativa. Quedan acciones por realizar, en el área de diagnóstico y tratamiento quirúrgico, para lograr perfeccionar y mejorar todavía más los resultados.Introduction: the 55 % of the persons arriving to 60 years old will require at the least one operation and the 50% are urgent and within the leading causes is the acute appendicitis. Objective: to know the epidemiological and clinical features of the acute appendicitis in the elderly, to trying of improve the diagnosis and the results of surgical treatment in them

  8. [I.P.P.B. therapy at home in chronic respiratory insufficiency in France. I. Survey method. Description of the prescribers. 1960-1977 prescription evolution (author's transl)].

    Science.gov (United States)

    Drouet, D; Kauffmann, F; Brille, D; Hatzfeld, C; Liot, F; Kompalitch, M

    1979-01-01

    In order to assess the usage of IPPB therapy at home in chronic respiratory insufficiency in France, a mail survey has been conducted among 2,062 chest physicians and physicians involved in intensive care. The response rate was 57%. Among those caring for chronic respiratory insufficient patients, 296, i.e. 38%, have prescribed IPPB to 3,778 patients from 1960 till 1977. A study among a sample of the non-spontaneous-responders allows the estimation of about 400 physicians who prescribed IPPB on the whole for France at this time. Those who prescribed, worked more often in hospital though 4% had only a private practice. Those involved in intensive care prescribed more often than the chest physicians (47% versus 37%). The development of this therapy was different according to the different regions in France. But, in a general way, the prescription of IPPB at home particularly spread out since 1975, 65% of all the prescriptions have been done in 1975, 76, 77.

  9. A geographical method to assess technological hazards.The example of the storage and the distribution of the fuel oils in the urban region of Ile-de-France

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    Sandrine Glatron

    2001-07-01

    Full Text Available Les risques technologiques majeurs sont pris en compte dans la planification urbaine par le biais d’une limitation de l’usage des sols autour des établissements dangereux, car le niveau du risque dépend en grande partie de l’occupation des sols. Dans les régions à forte densité urbaine, cette restriction justifie la volonté du planificateur de délocaliser les établissements dangereux. Mais c’est faire peu de cas des éventuels transferts de risques vers un autre maillon de la chaîne industrielle : le transport des matières dangereuses. Avec l’aide d’un SIG, qui décrit précisément l’usage des sols, une méthode est développée pour comparer les risques- site (autour d’un établissement industriel dangereux et les risques-transport (le long du parcours des véhicules livrant les matières dangereuses. Cette méthode permet de comptabiliser les dommages survenant à l’intérieur des espaces potentiellement touchés par les conséquences d’un accident et de travailler à l’échelle régionale (aire de chalandise. Il autorise les calculs réitérés d’où la possibilité de simuler les risques pour différentes implantations d’un établissement dangereux et, ainsi, de vérifier la pertinence des propositions de délocalisation. Le stockage et la distribution par la route des carburants ont été pris comme exemple car ils concernent de vastes régions urbaines comme l’Ile-de-France.

  10. Ecology of leishmaniasis in the South of France. 22. Reliability and representativeness of 12 Phlebotomus ariasi, P. perniciosus and Sergentomyia minuta (Diptera: Psychodidae) sampling stations in Vallespir (eastern French Pyrenees region)

    Science.gov (United States)

    Rioux, Jean-Antoine; Carron, Stéphane; Dereure, Jacques; Périères, José; Zeraia, Lamri; Franquet, Evelyne; Babinot, Michel; Gállego, Montserrat; Prudhomme, Jorian

    2013-01-01

    This study was conducted around Céret (Pyrénées-Orientales, mean elevation 200 m) to test the statistical reliability of 12 stations devoted to sampling the Leishmania infantum vectors Phlebotomus ariasi and P. perniciosus in the South of France. Each station included a retaining wall and the surrounding phytoecological environment (total area: 2,000 m2). The wall had rectangular drainage cavities (weep holes) in which flight interception traps (sticky paper) were inserted and stretched every 10 days from May to October. For both vector species, the statistical analysis of 10-day and annual frequencies led to the following conclusions: (1) P. ariasi densities were significantly higher than P. perniciosus densities, (2) densities per species were significantly different at the 12 stations : none of them could be considered as representative of local vector densities, which depend on the wall structure (exposure, shade, vertebrate hosts), (3) the 10-day variation trends were not significantly different between stations, indicating that these variations are not determined by the station structure but rather by a common external factor (likely meteorological) and (4) the phytoecological features at the stations were not correlated with the sandfly densities. Most of the observations obtained with P. ariasi and P. perniciosus are also relevant for the non-vectorial species S. minuta. In conclusion, future research on the dynamics of leishmaniasis outbreaks relative to climate change and agricultural-silvicultural modifications should be very cautiously carried out, while focusing especially on the vector sampling quality and the use of phytoecological maps as vector density indicators. PMID:24112589

  11. Events - France. Stock exchange. International; Actualite - France. Bourse. International

    Energy Technology Data Exchange (ETDEWEB)

    Anon.

    2000-10-01

    These columns made of short articles report on facts and events in the oil and gas industry in France and worldwide: 1 - France: increase of the production capacity of the ethylene oxide unit of BP's Lavera plant; the 'Plateaux-du-Vexin' gas pipeline crosses the Seine river; completion of the pumping of the front wreckage of the Erika tanker ship; Total inaugurates a vapor recovery unit at the Gonfreville l'Orcher refinery; a national energy saving plan for the abatement of the greenhouse effect; Sercel, a daughter company of Compagnie Generale de Geophysique (CGG), acquires Mark Products division of Shaw industries; the oil prices shoot the international trade; 2 - stock exchange: trend of market values in the context of oil crisis; 3 - international: important oil and gas strike made by TotalFinaElf and OKIOC (Offshore Kazakhstan International Operating Company) in Kazakhstan; communication: a new look for BP; status of Lukoil reserves in Russia; next round for the exploration of the Norwegian North Sea; Transocean Sedco Forex absorbs R and B Falcon Corp and becomes the first drilling contractor; ENI (Italy) becomes operator on the development of South Pars gas field (Iran) for the phases 4 and 5; Shell Overseas Investments BV, BP and Exxon Mobil have signed strategic alliance agreements with China Petroleum and Chemical Corp (Sinopec); first exploration permits for the Faeroe islands; different gas pricing rules for the industrialists in the different European countries. (J.S.)

  12. Studying in France,Serving at Home

    Institute of Scientific and Technical Information of China (English)

    1997-01-01

    DEAR EDITOR, I am a 75-year-old retired primary school teacher. I published my new work The Work-Study Movement of Young Chinese in France (1912-1930) three years ago, expressing my fondness of history, especially China’s history. Currently, I pay more attention to the Chinese women who came to France for studies in their early years, Could you publish some precise information on their situations before and after returning to China? GABRIELLE REYGNER FRANCE