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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. Enterovirus infections in hospitals of Ile de France region over 2013.

    Science.gov (United States)

    Molet, Lucie; Saloum, Kenda; Marque-Juillet, Stéphanie; Garbarg-Chenon, Antoine; Henquell, Cécile; Schuffenecker, Isabelle; Peigue-Lafeuille, Hélène; Rozenberg, Flore; Mirand, Audrey

    2016-01-01

    The monitoring and genotyping of Enterovirus (EV) infections can help to associate particular or severe clinical manifestations with specific EV types and to identify the aetiology of infectious outbreaks. To describe the epidemiological features of EV infections diagnosed during the year 2013 in the Greater Paris area (Ile de France). During 2013, 2497 samples taken from 470 patients in 33 hospitals of Ile-de France were tested for EV genome by RT-PCR. EV genotyping was performed by the National Reference Centre (NRC) laboratories. EV infections were retrospectively reviewed by retrieving clinical and genotyping data from the NRC database. Of the 2497 samples, 490 (19.6%) was positive for EV genome detection. These EV infections represented 88.7% and 24.1%, respectively, of all reported regional and national infections. Twenty-seven different genotypes were identified. Echovirus 30 (E-30) accounted for 54.1% of all characterized strains and caused a large outbreak. Four severe neonatal infections were reported, of which two were caused by EV-A71. Respiratory infections involving EV-D68 were observed in two adults. One fatal case of Coxsackievirus A2-associated myocarditis was reported. Monitoring EV infections in combination with EV genotyping via the French EV network characterized the epidemiology of EV infections in the Ile de France region in 2013 and documented severe EV infections associated with EV-A71 or CV-A2. Copyright © 2015 Elsevier B.V. All rights reserved.

  3. Being treated in higher volume hospitals leads to longer progression-free survival for epithelial ovarian carcinoma patients in the Rhone-Alpes region of France

    OpenAIRE

    Huguet, Marius; Perrier, Lionel; Bally, Olivia; Benayoun, David; De Saint Hilaire, Pierre; Beal Ardisson, Dominique; Morelle, Magali; Havet, Nathalie; Joutard, Xavier; Meeus, Pierre; Gabelle, Philippe; Provençal, Jocelyne; Chauleur, Céline; Glehen, Olivier; Charreton, Amandine

    2018-01-01

    Background To investigate the relationship between hospital volume activities and the survival for Epithelial Ovarian Carcinoma (EOC) patients in France. Methods This retrospective study using prospectively implemented databases was conducted on an exhaustive cohort of 267 patients undergoing first-line therapy during 2012 in the Rhone-Alpes Region of France. We compared Progression-Free Survival for Epithelial Ovarian Carcinoma patients receiving first-line therapy in high- (i.e. ≥ 12 cases/...

  4. Regional indexes for France. Methodology

    International Nuclear Information System (INIS)

    2006-01-01

    According to the U.S. Department of Energy, an estimated 25% of the GNP is affected by weather-related events. The variations in temperature - even small ones - can also have long-lasting effects on the operational results of a company. Among other, the Energy supply sector is sensitive to weather risks: a milder or harsher than usual winter leads to a decrease or increase of energy consumption. The price of electricity on power trading facilities like Powernext is especially sensitive to odd changes in temperatures. Powernext and Meteo-France (the French meteorological agency) have joined expertise in order to promote the use of weather indices in term of decision making or underlying of hedging tools to energy actors, end users from any other sector of activity and specialists of the weather risk hedging. The Powernext Weather indices are made from information collected by Meteo-France's main observation network according to the norms of international meteorology, in areas carefully selected. The gross data are submitted to a thorough review allowing the correction of abnormalities and the reconstitution of missing data. Each index is fashioned to take into account the economic activity in the various regions of the country as represented by each region's population. This demographic information represents a fair approximation of the weight of the regional economic activity. This document presents the calculation methodology of regional weather indexes for France. Each regional index covers an homogenous area in terms of temperature represented by the biggest city. Five reference cities are used to represent the 22 economical regions of France (Paris Orly, Lyon, Marignane, Bordeaux and Strasbourg). (J.S.)

  5. Improving radiotherapy quality and safety: a common objective of A.S.N. and the Ile de France Regional Hospital Agency. Thoughts on successful cooperation in Ile de France

    International Nuclear Information System (INIS)

    Solier, N.

    2009-01-01

    Radiotherapy recent development in cancer treatment needs strong procedures and quality assessment to improve safety both for patients and professionals. In Ile de France territory, a coordinated action between ASN inspectors and medical doctors specialized in public health (MISP), working as civil servants in health administration, was initiated at the end of 2007. An inspection guideline was implemented in a workshop between ASN and Regional Hospital Agency (ARH). The MISP as health administrator has to verify if care organisation responds to treatment cancer regulatory framework: as a doctor he is authorized to access to patient records to know which treatment was chosen. He has to assure if the therapeutic guidelines are respected. His comprehensive approach is essentially patient-oriented. The MISP inspection coordinated with ASN inspectors is a very pertinent pluri-disciplinary approach, undeniably necessary in such a medical technic. The effectiveness of the radiotherapy pluri-disciplinary team is funded on sharing procedures and experiences, respecting different knowledge and practices in daily work. This on site audit'. seems to be very fertile both for the radiotherapy team, the MISP and ASN inspectors. Continuous quality improvement in radiotherapy in the Ile de France region is a fertile issue between ANS and ARH teams. Confronting knowledge and procedures during the 'on site audit' in a transparent way will contribute improving radiotherapy for the 30.000 Francilian patients which receive this treatment each year. This challenge is our main concern to facilitate the patients access to the best standards treatments. (author)

  6. [Hospital fluoroquinolone prescription habits in northern France].

    Science.gov (United States)

    Levent, T; Cabaret, P

    2010-09-01

    The aim of the study was to assess the good use organization and fluoroquinolone prescription habits in cases of bone and joint, urinary, pulmonary, and digestive infections. A declarative survey was made (questionnaire for the hospital and for the prescriber). Thirty percent (44/145) of hospitals participated with 274 prescribers. Eighty percent had prescription protocols, 71 % of clinicians had access to epidemiologic data. A percentage of 30.7 (853/2,771) of prescriptions included a fluoroquinolone, 44.5 % (380/853) among these had not been recommended. The excessive prescription reached 24.4 % (116/474) in case of bone and joint infection, 14.6 % (107/731), and 20 % (157/779) in cases of digestive and respiratory infection respectively. Prescriptions for urinary infection were adequate in 47.6 % (375/787) of cases. Inadequate prescriptions were made because of bad knowledge of bacteria resistance epidemiology and pharmacology (insufficient dose, monotherapy at risk of selection), and non-application of good practice recommendations. This study justifies the rationalization of antibiotic prescription. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  7. Epidemiology of Endometriosis in France: A Large, Nation-Wide Study Based on Hospital Discharge Data

    Directory of Open Access Journals (Sweden)

    Peter von Theobald

    2016-01-01

    Full Text Available We aimed to assess the prevalence of hospitalization for endometriosis in the general population in France and in each French region and to describe temporal trends, rehospitalization rates, and prevalence of the different types of endometriosis. The analyses were carried out on French hospital discharge data and covered the period 2008–2012 and a population of 14,239,197 women of childbearing age. In this population, the prevalence of hospitalization for endometriosis was 0.9%, ranging from 0.4% to 1.6% between regions. Endometriosis affected 1.5% of hospitalized women of childbearing age, ranging from 1.0% to 2.4% between regions. The number of patients hospitalized for endometriosis significantly increased over the study period (p<0.01. Of these, 4.2% were rehospitalized at least once at one year: ranging from 2.7% to 6.3% between regions. The cumulative rehospitalization rate at 3 years was 6.9%. The types of endometriosis according to the procedures performed were as follows: ovarian (40–50%, peritoneal (20–30%, intestinal (10–20%, and ureteral or bladder (<10%, with significant differences between regions. This is the first detailed epidemiological study of endometriosis in France. Further studies are needed to assess the reasons for the increasing prevalence of endometriosis and for the significant differences in regional prevalence of this disease.

  8. Energy in the regions. [Of France

    Energy Technology Data Exchange (ETDEWEB)

    The present document is primarily intended to put together and present in a coherent fashion information about the energy in the regions in as complete and up-to-date manner as possible. Data come from: - the general census of the population of 1982, conducted by INSEE; - the enquiry on the receipts and expenses of agricultural undertakings (ERDEXA) which was completed by the Ministry of Agriculture concerning the year 1981; - the annual enquiry on the energy consumption in industry (EACE) covering the year 1982 which was carried out by the Ministry of Industry and Research; the transport enquiry, effected in 1982 by INSEE at the request of the Institute of Research into Transport. The year of reference is therefore as far as possible 1982. These four enquiries form the basis of the four chapters devoted to the residential sector, to agriculture, to industry and to transport. The tertiary, the predominant economic sector which represents over half the jobs, is unfortunately largely unknown as regards energy consumption. It has not been possible to deal with it. The first two chapters give on the one hand the essential economic data on a national and regional level (e.g. the population, employment, income and the GNP) and on the other hand the principal figures concerning production and consumption of energy as well as the distribution systems.

  9. Clinical negligence in hospitals in France and England.

    Science.gov (United States)

    Kelly, Michael J; de Bono Q C, John; Métayer, Patrice

    2015-12-01

    This article arose from the back-to-back presentations by Michael Kelly and Patrice Métayer to the Anglo-French Medical Society in 2013 on the French and English legal systems handling a case of alleged clinical negligence as it proceeds from complaint to settlement or judgment in the two jurisdictions. Both systems have a hospital-based first stage with various avenues being available for amicable resolution, the French version being more regulated and prescribed than the English one. In both jurisdictions fewer than 5% cases go down the criminal route. Before the court is involved, in England there is an elaborate lawyer-controlled phase involving negotiations between the two sides and their experts which is expensive but often leads to pre-trial settlement for significant sums of money. Medical experts are central to all of this. In England they are largely unregulated and entirely advisory in an open market, in France they are both regulated and supervised by judges, being placed on official lists. These experts take a major inquisitorial role in a Debate between the two sides, combining the functions of Single Joint Expert (SJE), arbiter and mentor. If agreement is not reached, a second Debate before a different Expert is arranged. In both countries fewer than 5% cases reach a court for a hearing before a judge. In England a trial is an elaborate lengthy, expensive adversarial contest where all of the issues are rehearsed in full with factual and expert evidence, whereas in France in a contested case the judge reviews the reports of the two Debates with the lawyers who were involved (and not the experts, factual witnesses or parties). © The Author(s) 2015.

  10. [Hospital length-of-stay after childbirth in France].

    Science.gov (United States)

    Coulm, B; Blondel, B

    2013-02-01

    To study hospital length-of-stay (LOS) after childbirth and its determinants and to describe home care offered after discharge. We studied 10,302 women with vaginal delivery from the 2010 French National Perinatal Survey. Maternal, newborn, maternity unit characteristics and the region of birth were considered. Simple and polytomial regression analyses were used to study determinants of postpartum LOS. Maternity units that offered routinely home visits by midwives after discharge were described. Around 29,0% of women had a LOS ≤ 3 days, with significant variations between regions. LOS ≤ 3 days was more common among multiparas and women who bottle-fed their newborn. In the Greater Parisian Region, LOS ≤ 3 days ranged from 16,6% in private units women who had a LOS ≤ 3 days, only 19,7% were in a unit, which offered home visits routinely. LOS varies mainly according to the place of delivery. The trends towards short LOS are likely to continue due to economic pressures and home care services should be developed to ensure continuity of care for all mothers after discharge. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  11. Hospital investment policy in France: pathways to efficiency and the efficiency of the pathways.

    Science.gov (United States)

    Guerrero, Isabelle; Mossé, Philippe R; Rogers, Vaughan

    2009-11-01

    This article examines the ambivalent notion of New Public Management as applied to health policy in France, by investigating the implementation of the efficiency-driven hospital investment plan, Hôpital 2012, conceived at national level, but implemented through regional hospital authorities (ARHs), with formal responsibility for selecting successful funding applications. The methodology combines qualitative and quantitative analysis, in order to highlight and explain discrepancies between goals and results. Despite formal adherence to objective efficiency indicators, certain decisions were based on incomplete information and others on considerations out with initially established criteria. Competition from the private sector was perceived as a threat to public hospitals and the public sector emerged as a major beneficiary of the investment plan. Central ministerial intervention emphasising financial and quantitative considerations led the ARHs to focus more on individual hospital performance than on wider healthcare needs. Data-production became almost an end in itself, threatening to undermine the objectives it sought to pursue. Nonetheless, extended deadlines entailed by ministerial intervention were appropriated as a resource by local actors, leading to ARH decisions which deviated from the official efficiency model, but resulted in increased effectiveness, taking fuller account of local conditions.

  12. France

    International Nuclear Information System (INIS)

    Hourcade, J.C.

    1990-01-01

    The French energy system, like that of most energy-importing nations, was profoundly transformed by the first oil shock. But France was more vulnerable than any other industrialized country besides Japan to oil supply disruption: in 1973, the nation imported 77 percent of total primary energy requirements of 7.6 EJ, and 98 percent of its petroleum. Two imperatives have since formed the 'French response' to the threat of external energy supply disruptions: augmentation of the rate of energy self-sufficiency, and minimization of major macroeconomic dislocations. These two objectives displaced a high priority in France in the early 1970s - protection of the natural environment. Because France has embraced nuclear power, it is often viewed by its European neighbors as having feeble ecological sensibility. At that time, France had a rather advanced policy in this field: sulfur emissions laws were enacted in 1967 and a Ministry of Environment was created in January 1971. Now that environmental concerns have re-emerged as an important force, France finds itself with a plausible greenhouse response in a mix of policies - without environmental protection having been the objective envisioned

  13. France

    International Nuclear Information System (INIS)

    Schubert, K.

    1991-01-01

    The grandeur of the nation is the most important national concern in the France of the Fifth Republic. National independence and maximum world status have been (and still are) characteristic imperatives of French policy. Any asset or resource which promises to strengthen the nation, which seems suitable for improving the global status and glory of France, becomes a worthwhile policy device. Of course, the sots incurred in the pursuit of these objectives are frequently the subject of critical discussion, but all in all these costs are accepted. This has been the case with numerous prestige projects including the French nuclear deterrent, the force de frappe. This paper reports that an analysis of the French ambition to possess nuclear weapons must begin with the complete loss of world status which France suffered as a consequence of World War II. Throughout the post-war period, French political leaders have concentrated their efforts on reversing this loss of status and on preventing a similar occurrence

  14. 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

  15. methanization development in Ile-de-France - Ile-de-France region. Synthesis. The Regional Council strategy for methanization development

    International Nuclear Information System (INIS)

    2013-06-01

    A first document reports the study of methanization development in the Ile-de-France region by addressing biomass produced on the region territory. It aimed at identifying and assessing the existing and potential physical resource while introducing mobilisation rates in order to define different scenarios. A situational analysis of operated and projected methanization installations has also been performed. These projects have been classified according to a typology, and analysed according to the proposed scenarios. The position of methanization with respect to other biomass valorisation sectors, as well as the impact of mobilisation with respect to a return-to-soil of organic matters have also been discussed. A second document proposes a synthetic version of this study. The third document presents the Regional Council's policy and strategy regarding methanization development: challenges and prospective scenarios, importance of a sustainable methanization at the service of territory development, regulation for a call for projects, project assessment and selection, project footprint, inputs qualities and supplies, energetic and agronomic valorisation, and grid for project analysis. An appendix contains a synthetic version of the first document

  16. [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.

  17. 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.

  18. Hospital reforms in France under a Socialist government.

    Science.gov (United States)

    De Pouvourville, G

    1986-01-01

    French health care faced the dual crises of rising costs and excess physicians. No government, whether left or right, could avoid focusing reform on the extensive public hospital system. Many differences introduced by the Socialists after 1981 were rhetorical and relational--matters of "democratization" of governance and "control" of physicians. Paradoxically, the two major structural reforms, "departmentalization" and "global budgeting," were extensions of actions begun under preceding governments. Neither has come to fruition yet.

  19. [Hospital-based health technology assessment in France: how to proceed to evaluate innovative medical devices?].

    Science.gov (United States)

    Martelli, N; van den Brink, H; Denies, F; Dervaux, B; Germe, A F; Prognon, P; Pineau, J

    2014-01-01

    Innovative medical devices offer solutions to medical problems and greatly improve patients' outcomes. Like National Health Technology Assessment (HTA) agencies, hospitals face numerous requests for innovative and costly medical devices. To help local decision-makers, different approaches of hospital-based HTA (HB-HTA) have been adopted worldwide. The objective of the present paper is to explore HB-HTA models for adopting innovative medical devices in France and elsewhere. Four different models have been conceptualized: "ambassador" model, "mini-HTA" model, "HTA unit" model and "internal committee". Apparently, "HTA unit" and "internal committee" (or a mixture of both models) are the prevailing HB-HTA models in France. Nevertheless, some weaknesses of these models have been pointed out in previous works. Only few examples involving hospital pharmacists have been found abroad, except in France and in Italy. Finally, the harmonization of the assessment of innovative medical devices in France needs a better understanding of HB-HTA practices. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  20. 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.

  1. [Clinical research outside of teaching hospitals: Current situation in north-eastern France].

    Science.gov (United States)

    Goetz, C; Dupoux, A; Déloy, L; Hertz, C; Jeanmaire, T; Parneix, N

    2015-04-01

    Most clinical research in France takes place in teaching hospitals. There are, however, many advantages to developing it in other hospitals: access to innovative treatments, improvement in healthcare quality, attractiveness of hospitals, increased trial inclusion rates and reduced selection bias. The objectives of our study were to report on the current situation of clinical research outside teaching hospitals. A three-stage survey was conducted between January 2012 and May 2013 in non-teaching hospitals of north-eastern France. First, questionnaires were sent to administrative and medical boards of all hospitals with more than 100 beds, then to head doctors of every department in hospitals with more than 300 beds and finally meetings were organized with members of 20 selected hospitals. The administrative and medical boards of 85 hospitals participated in the first stage of the survey; half of these hospitals were engaged in clinical research activities and for 10 the internal structuring was cross-disciplinary. Answers from 178 departments were obtained during the second stage; 47% reported a clinical research activity. Meetings with research teams in 20 hospitals allowed us to identify difficulties concerning research funding, transversal organization and sponsoring. Clinical research existed in more than half of the respondent non-teaching hospitals. Obstacles to its development can be grouped in three categories: 1) internal structuring of clinical research, 2) access to information and knowledge of how clinical research functions and to interlocutors outside the hospital and 3) access to skills necessary to sponsor clinical research. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  2. 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. Copyright 2000 The Hospital Infection Society.

  3. National Trends in Patients Hospitalized for Stroke and Stroke Mortality in France, 2008 to 2014.

    Science.gov (United States)

    Lecoffre, Camille; de Peretti, Christine; Gabet, Amélie; Grimaud, Olivier; Woimant, France; Giroud, Maurice; Béjot, Yannick; Olié, Valérie

    2017-11-01

    Stroke is the leading cause of death in women and the third leading cause in men in France. In young adults (ie, stroke was observed at a local scale between 1985 and 2011. After the implementation of the 2010 to 2014 National Stroke Action Plan, this study investigates national trends in patients hospitalized by stroke subtypes, in-hospital mortality, and stroke mortality between 2008 and 2014. Hospitalization data were extracted from the French national hospital discharge databases and mortality data from the French national medical causes of death database. Time trends were tested using a Poisson regression model. From 2008 to 2014, the age-standardized rates of patients hospitalized for ischemic stroke increased by 14.3% in patients hemorrhagic stroke was stable (+2.0%), irrespective of age and sex. The proportion of patients hospitalized in stroke units substantially increased. In-hospital mortality decreased by 17.1% in patients with ischemic stroke. From 2008 to 2013, stroke mortality decreased, except for women between 45 and 64 years old and for people aged ≥85 years. An increase in cardiovascular risk factors and improved stroke management may explain the increase in the rates of patients hospitalized for ischemic stroke. The decrease observed for in-hospital stroke mortality may be because of recent improvements in acute-phase management. © 2017 American Heart Association, Inc.

  4. [Hospital pharmacy residency in France in 2014: to a recognition of the specialization?].

    Science.gov (United States)

    Slimano, F; Gervais, F; Massé, C; Langrée, B

    2014-09-01

    The current format of French residency in hospital pharmacy was created in 1983 and is a 4-year specialized training. So far, training has not been recognized as a prerequisite for hospital pharmacy practice. Since 2011, pharmacy residents and hospital pharmacists representative structures have lobbied for that recognition and the government has worked in that direction. The ideology of the concept was validated after a period of probation and the regulatory procedure began late 2012. Two key elements were initially identified as obstacles: first the European legislation on recognition of professional qualifications and then the fear that there might not be enough hospital pharmacists trained in order to complete the care missions in hospital pharmacies in France. The European legislation has now been amended in order to recognize professional qualifications and a demographic analysis of hospital pharmacists leads to the conclusion that these items are no longer obstacles. In 2014, hospital pharmacy residency, through the Specialized Studies degree, should be recognized as a prerequisite for hospital pharmacy practice. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  5. 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.

  6. 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

  7. Mastery of energy, decentralization and regional planning in France - a challenge

    Energy Technology Data Exchange (ETDEWEB)

    Ripert, C.; Lagarde, R.

    1986-01-01

    Attempting to bring together the people involved in setting-up energy control policies, supporting regional authorities in their efforts for regional energy planning and establishing close cooperation with regional executive authorities... in other words, Regionalizing France - isn't this the great gamble being taken in a field which has been historically marked by strong centralization. This is the challenge which the AFME, the French Agency for the Mastery of Energy, has accepted.

  8. 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.

  9. Reassessing gallo as a regional language in France

    DEFF Research Database (Denmark)

    Nolan, John Shaun

    2011-01-01

    emancipation is to be socio-politically acceptable, some degree of care has to be exercised in the manner in which it is presented and what facets are emphasized in the French context. Indeed, through their long established activism in favor of regional languages in the education system, regional language...... movements and not least the Gallo movement are already well-positioned to promote one of the main and most compelling arguments for contemporary language emancipation: this is that an active knowledge of two or more languages, including a regional language, is beneficial to the individual and to society...

  10. Perception of the energy question in different regions of France

    International Nuclear Information System (INIS)

    Fouque, B.; Villaret, J.M.

    1982-01-01

    The authors first outline the main variables which account for regional differences in the perception of the energy question, and go on to discuss these differences and the factors underlying them [fr

  11. Tackling regional health inequalities in france by resource allocation : a case for complementary instrumental and process-based approaches?

    Science.gov (United States)

    Bellanger, Martine M; Jourdain, Alain

    2004-01-01

    This article aims to evaluate the results of two different approaches underlying the attempts to reduce health inequalities in France. In the 'instrumental' approach, resource allocation is based on an indicator to assess the well-being or the quality of life associated with healthcare provision, the argument being that additional resources would respond to needs that could then be treated quickly and efficiently. This governs the distribution of regional hospital budgets. In the second approach, health professionals and users in a given region are involved in a consensus process to define those priorities to be included in programme formulation. This 'procedural' approach is employed in the case of the regional health programmes. In this second approach, the evaluation of the results runs parallel with an analysis of the process using Rawlsian principles, whereas the first approach is based on the classical economic model.At this stage, a pragmatic analysis based on both the comparison of regional hospital budgets during the period 1992-2003 (calculated using a 'RAWP [resource allocation working party]-like' formula) and the evolution of regional health policies through the evaluation of programmes for the prevention of suicide, alcohol-related diseases and cancers provides a partial assessment of the impact of the two types of approaches, the second having a greater effect on the reduction of regional inequalities.

  12. Regional meetings on energy 2008. Ile-de-France facing the energy stakes. Conference proceedings

    International Nuclear Information System (INIS)

    Lamy, Marie-Laure; Rocher, Philippe; Falque-Masset, Marie-Laure; Cazas, Judith; Labrousse, Muriel; Gorges, Pascale; Boulet, Sophie; Petit-Tesson, Christophe

    2009-01-01

    This document proposes a synthesis of the conference. It presents an assessment of the regional plan for energy management and development of local and renewable energies. The first part gives an overview of regional actions (in the Ile de France region) performed by the ADEME, or within the regional plan. The second part presents ROSE (a network for the statistical survey of energy and of greenhouse gas emissions in Ile de France) and its activity. Some remarkable actions are briefly presented: energy management by the city of Montreuil, energy management and sensitisation in a secondary school, a zero-energy building (a school in Limeil-Brevannes), geothermal energy in Orly, solar energy in social dwelling, and wood-heat network in Cergy-Pontoise

  13. Prevalence, characteristics and risk factors of pressure ulcers in public and private hospitals care units and nursing homes in France.

    Science.gov (United States)

    Barrois, Brigitte; Colin, Denis; Allaert, François-André

    2018-02-01

    The aim of this study conducted in 2014 was to describe the prevalence of pressure ulcers in different types of French hospital unit at the national level to compare them with data from the 1994 and 2004 study. This cross-sectional study was conducted over a single day. All care units were invited to participate by drawing lots stratified by region in successive waves until 1,200 agreements were obtained. Lots were drawn for towns with more than 10,000 inhabitants. All public- and private-sector hospital facilities in each town drawn by lot were invited to participate in the survey. 776 hospital services throughout France took part and accommodated 21,538 patients: 12,752 women (59.2%) and 8,786 men (40.8%). Of these patients, 1,753 (8.1%; IC95% = 7.7; 8.5) had pressure ulcers. The pressure-ulcer rate was 7.8% (IC95% = [7.3; 8.3] (n = 997)) for hospitalized women and 8.6% (IC95% = [8.0; 9.2] (n = 756)) for men (p = 0.0381). The 8.1% level reported in 2014 therefore points to a reduction in pressure-ulcer prevalence; 8.6% in 1994 and 8.9% in 2004. The actions performed daily by healthcare professionals to prevent pressure ulcers, supported by research and training programs, including those by PERSE, are having a real impact over time.

  14. Impacts of climate change on wind energy resources in France: a regionalization study

    International Nuclear Information System (INIS)

    Najac, J.

    2008-11-01

    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)

  15. France and The European Charter for Regional or Minority Languages: Dilemma without Solution

    Directory of Open Access Journals (Sweden)

    Ella V. Ermakova

    2015-01-01

    Full Text Available There are more than seven thousand of unique languages nowadays, that reflect the uniqueness of the living conditions, the worldview and cultural traditions of different peoples. According to UNESCO, 75 languages in Europe and Asia Minor and about 115 languages in the United States over the past five centuries have been lost. The regional or minority languages are part of the national heritage and play leading role in the process of national identity as bearers and guarantors of national culture and national identity, that is why the value of regional languages is constantly increasing. However, the danger of the growth of nationalism and separatism makes politicians wary of measures to protect the national languages. The article deals with the political debate in France around the ratification of the European Charter for Regional or Minority Languages, adopted by the Council of Europe on 25 June 1992, which purpose was to protect the historical regional languages of the EU, some of which are in danger of eventual extinction.. The author provides analysis of the historical preconditions of the current debate as well as of the stance taken by the French leadership on this issue. The study is based on a set of scientific methods and approaches - the principle of scientific objectivity and system of historical research. The main methods are problematic and historical-comparative analysis, classification and comparison of the political and historical concepts. Modern France de jure firmly follows linguistic traditions laid down by previous regimes, as defined in its constitution as the principles of the indivisibility of the Republic and the unity of the French people. According to Article 2 of the Constitution of the Fifth Republic, French language is the only official. However, in addition to the French 75 languages are being spoken all over the Overseas Departments and Territories of France, including 24 languages of the indigenous population of

  16. Prevalence of Toxoplasma gondii in small mammals from the Ardennes region, France.

    Science.gov (United States)

    Afonso, Eve; Poulle, Marie-Lazarine; Lemoine, Mélissa; Villena, Isabelle; Aubert, Dominique; Gilot-Fromont, Emmanuelle

    2007-11-01

    Serum samples from 218 small mammals trapped in forest and grassland in the Ardennes region (North-eastern France) were tested for antibodies to Toxoplasma gondii. Using the modified agglutination test, positive results were found in 4/92 Apodemus sp., 3/64 Clethrionomys glareolus, 0/26 Microtus agrestis, 0/4 Micromys minutus, 3/5 Sorex sp., 2/9 Arvicola terrestris, and 7/18 Talpa europaea. Toxoplasma gondii was not isolated from the heart of seropositive individuals after bioassay in mice. Seroprevalence was significantly higher in large fossorial mammals living in grassland than in small forest mammals, probably related to ecological factors.

  17. 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)

  18. [Disclosure of conflicts of interest in hospital pharmacy posters in France: we still have a long way to go].

    Science.gov (United States)

    Édouard, B; Toth, K; Descout, J

    2013-05-01

    Since 1995, disclosure of conflicts of interest in international scientific publications became systematic, but, in France, there is yet no obligation to mention them in oral communications or posters of pharmacy. To assess the rate of posters in hospital pharmacy meetings which mention potential conflicts of interest. A prospective study. All abstracts presented in printed poster format were evaluated during three hospital pharmacy meetings organized in France between November 2011 and March 2012 for the presence of the conflicts of interest disclosure, even if there were no conflicts of interest. The main outcome was the rate of posters with mentions of potential conflicts of interest. A subgroup analysis was conducted about geographic origin of authors. On 294 announced posters, 263 were displayed, 252 did not mention any conflict of interest, 11 mentioned the possibility or not of conflict of interest (4.2%): the rate ranged from 1.1 to 25% according to the meeting. Posters from France disclosed less often conflicts of interest (40%). The rate of spontaneous disclosure of conflicts of interest is very low within French pharmacists. The instructions given by French meeting organizers should be more directive on the matter. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  19. Inter-regional competition and quality in hospital care.

    Science.gov (United States)

    Aiura, Hiroshi

    2013-06-01

    This study analyzes the effect of episode-of-care payment and patient choice on waiting time and the comprehensive quality of hospital care. The study assumes that two hospitals are located in two cities with different population sizes and compete with each other. We find that the comprehensive quality of hospital care as well as waiting time of both hospitals improve with an increase in payment per episode of care. However, we also find that the extent of these improvements differs according to the population size of the cities where the hospitals are located. Under the realistic assumptions that hospitals involve significant labor-intensive work, we find the improvements in comprehensive quality and waiting time in a hospital located in a small city to be greater than those in a hospital located in a large city. The result implies that regional disparity in the quality of hospital care decreases with an increase in payment per episode of care.

  20. 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.

  1. 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.

  2. [Analysis of hospital mortality at a regional hospital].

    Science.gov (United States)

    Sánchez Bisonó, J R; Gómez Rosich, A; Amor Gea, J F; García Sánchez, M J; Campoy Domene, L F; Peña Migallón-Sánchez, P

    1997-02-01

    The hospital mortality rate in our centre es 2.34% (264 deaths from a total of 11,336 discharges between 1991 and 1993). The most frequent causes are acute myocardial infarction and cerebrovascular accidents, followed in descending order by pneumonia, chronic bronchitis, congestive heart failure, upper GI haemorrhage, GI tumours, liver cirrhosis, lung tumours and arrhythmias. Our analysis reflects a mortality pattern of a rural population with an age pyramid in which 52% of the patients are older than 45 years. The pattern also reflects the little impact of accidents on our mortality. A 87% of the deaths were older than 65 years with a male to female ratio of 1, 6 and a Swaroop index of 93% and 94% for males and females respectively.

  3. Climate in France during the 21. century - Regionalized scenarios - Reference indices for the metropolitan region - Evolution at sea level

    International Nuclear Information System (INIS)

    Peings, Yannick; Planton, Serge; Deque, Michel; Jamous, Marc; Le Treut, Herve; Gallee, Hubert; Li, Laurent; Jouzel, J.

    2011-01-01

    After some comments on climate modelling (models, scenarios, uncertainties, regional predictions), the first part reports the study of several temperature indices (minimum, average and maximum daily temperature, number of days with abnormally high or low temperature, number of days of heat wave, number of days with negative temperatures, and so on.), precipitation indices (daily and extreme precipitations, dry periods, snow falls). It also discusses soil humidity index, strong wind index, river flow rate, and sea level. The second part reports simulation results for indices in metropolitan France according to the French Aladin-Climat, LMDZ and MAR models. The third volume reports evolutions and predictions of average sea level at the planet scale and along the French coasts, and discusses impacts related to sea level change (coast erosion, submersion, salt intrusion)

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

    Science.gov (United States)

    Héquet, Delphine; Rouzier, Roman

    2017-01-01

    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. 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. 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. 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-based programs, can help improve coverage rates.

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

    Directory of Open Access Journals (Sweden)

    Delphine Héquet

    Full Text Available 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.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.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.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-based programs, can help improve coverage

  6. Characteristics and health of homeless families: the ENFAMS survey in the Paris region, France 2013.

    Science.gov (United States)

    Vandentorren, Stéphanie; Le Méner, Erwan; Oppenchaim, Nicolas; Arnaud, Amandine; Jangal, Candy; Caum, Carme; Vuillermoz, Cécile; Martin-Fernandez, Judith; Lioret, Sandrine; Roze, Mathilde; Le Strat, Yann; Guyavarch, Emmanuelle

    2016-02-01

    The objectives were to estimate the size of homeless family population in Paris region, to describe their living conditions and health and to analyse the impact of homelessness on children's growth and development, which was never investigated in France. A cross-sectional survey was conducted on a random sample of homeless sheltered families in 2013. Families were interviewed in 17 languages and a nurse took anthropometric measures, blood samples and collected health data from child health reports. The population size was estimated at 10 280 families. Half were single-parent female families and 94% were born outside France. Most families had experienced housing instability and 94% were living below the poverty line (828 euros/month). Malnutrition was a major problem: the prevalence of food insecurity was high (77% of parents and 69% of children), as well as anaemia (50% of mothers and 38% of children), overweight (38% of mothers and 22% of children) and obesity (32% of mothers and 4% of children). High rates of depressive disorders were found in 30% of homeless mothers and 20% of children had signs of possible mental health disorders. These first results highlight the important number of families among the homeless population in Paris region. Families differed from other homeless people regarding social characteristics such as birthplace, single-parent status and residential instability that are likely to influence schooling, social ties, health and access to care. These results demonstrate the need for urgent actions targeting homeless families, in terms of reducing housing instability and providing adequate care, especially for children. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  7. Food Insecurity in Homeless Families in the Paris Region (France: Results from the ENFAMS Survey

    Directory of Open Access Journals (Sweden)

    Judith Martin-Fernandez

    2018-02-01

    Full Text Available The number of families living in shelters in the Paris region (France has increased by a factor of three in 10 years. In 2013, a survey was performed on homeless families in order to characterize their living conditions, their health needs, and the developmental problems in children. This probability survey was conducted in 17 languages among 801 homeless families sheltered in emergency centers for asylum-seekers, emergency housing centers, social rehabilitation centers, and social hotels in the Paris region. Among the 772 families that provided data on food security only 14.0% were with food security, whereas 43.3% were with low food security and 9.8% with very low food security (a situation where children are also affected. Stratified multivariate robust Poisson models showed that some characteristics are associated with a higher risk of food insecurity and/or of falling into very low food security, such as residential instability, single parenthood, having more than three children, depressive symptoms, housing in social hostels, and difficult access to cheap or free food locally. Given the wealth of the Paris region, resources and programs should be concentrated on improving the living situation of this vulnerable population. It needs better detection of these families, a closer social follow-up, and an increase in food aid.

  8. Food Insecurity in Homeless Families in the Paris Region (France): Results from the ENFAMS Survey

    Science.gov (United States)

    Martin-Fernandez, Judith; Lioret, Sandrine; Vuillermoz, Cécile; Vandentorren, Stéphanie

    2018-01-01

    The number of families living in shelters in the Paris region (France) has increased by a factor of three in 10 years. In 2013, a survey was performed on homeless families in order to characterize their living conditions, their health needs, and the developmental problems in children. This probability survey was conducted in 17 languages among 801 homeless families sheltered in emergency centers for asylum-seekers, emergency housing centers, social rehabilitation centers, and social hotels in the Paris region. Among the 772 families that provided data on food security only 14.0% were with food security, whereas 43.3% were with low food security and 9.8% with very low food security (a situation where children are also affected). Stratified multivariate robust Poisson models showed that some characteristics are associated with a higher risk of food insecurity and/or of falling into very low food security, such as residential instability, single parenthood, having more than three children, depressive symptoms, housing in social hostels, and difficult access to cheap or free food locally. Given the wealth of the Paris region, resources and programs should be concentrated on improving the living situation of this vulnerable population. It needs better detection of these families, a closer social follow-up, and an increase in food aid. PMID:29495563

  9. Food Insecurity in Homeless Families in the Paris Region (France): Results from the ENFAMS Survey.

    Science.gov (United States)

    Martin-Fernandez, Judith; Lioret, Sandrine; Vuillermoz, Cécile; Chauvin, Pierre; Vandentorren, Stéphanie

    2018-02-28

    The number of families living in shelters in the Paris region (France) has increased by a factor of three in 10 years. In 2013, a survey was performed on homeless families in order to characterize their living conditions, their health needs, and the developmental problems in children. This probability survey was conducted in 17 languages among 801 homeless families sheltered in emergency centers for asylum-seekers, emergency housing centers, social rehabilitation centers, and social hotels in the Paris region. Among the 772 families that provided data on food security only 14.0% were with food security, whereas 43.3% were with low food security and 9.8% with very low food security (a situation where children are also affected). Stratified multivariate robust Poisson models showed that some characteristics are associated with a higher risk of food insecurity and/or of falling into very low food security, such as residential instability, single parenthood, having more than three children, depressive symptoms, housing in social hostels, and difficult access to cheap or free food locally. Given the wealth of the Paris region, resources and programs should be concentrated on improving the living situation of this vulnerable population. It needs better detection of these families, a closer social follow-up, and an increase in food aid.

  10. A tourism and cultural regional case study of the link between transportation and tourism: South of France

    Directory of Open Access Journals (Sweden)

    Jocelyne Napoli

    2017-05-01

    Full Text Available The article discusses the evolving role of transportation, and more especially air transport enabling tourism access to regions in the South of France. Historically, British citizens visited France by train, coach or car as the cost of air travel was restrictive and routes were only established in larger cities. ith the advent of the Channel Tunnel and Low Cost Carriers (LCCs in Europe, British tourism has increased within numerous destinations in France. These new means of transportation have filled the gap by providing easy access to smaller towns and allowing British tourists the French quality of life in the countryside. There is a shift in visitation numbers from the north of France to the south due to the wider range of travel choices. The South of France is becoming more attractive to British tourism because of the comparatively inexpensive cost of housing, the historical links between the two countries, and the cultural heritage of tradition. Other attractions include landscapes, the Mediterranean climate, restored medieval castles and villages, and the abundance of traditional French cuisine with regional wines. Due to the availability of LCCs some British tourists have chosen to settle and enjoy the historical links that are famous between the two countries. Many are now able to enjoy the tourist life for extended periods in the South of France by purchasing a second home. It’s also now possible to keep working in England as the LCCs make it affordable and possible to commute between their intercontinental homes. Through a review of issues and literature, the article will discuss the evolving air transportation heritage related to British tourism in the South of France

  11. Occurrence of currently used pesticides in ambient air of Centre Region (France)

    Science.gov (United States)

    Coscollà, Clara; Colin, Patrice; Yahyaoui, Abderrazak; Petrique, Olivier; Yusà, Vicent; Mellouki, Abdelwahid; Pastor, Agustin

    2010-10-01

    Ambient air samples were collected, from 2006 to 2008 at three rural and two urban sites in Centre Region (France) and analyzed for 56 currently used pesticides (CUPs), of which 41 were detected. The four CUPs most frequently detected were the herbicides trifluralin, acetochlor and pendimethalin and the fungicide chlorothalonil, which were found with frequencies ranging between 52 and 78%, and with average concentrations of 1.93, 1.32, 1.84 and 12.15 ng m -3, respectively. Among the detected pesticides, concentrations of eight fungicides (spiroxamine, fenpropimorph, cyprodinil, tolyfluanid, epoxiconazole, vinchlozolin, fluazinam, fludioxinil), two insecticides (propargite, ethoprophos), and one herbicide (oxyfluorfen) are, to our knowledge, reported for the first time in the literature. The majority of the CUPs showed a seasonal trend, with most of the detections and the highest concentrations occurring during the spring and early summer. The most important pesticides detected were related to arable crops and fruit orchards, the main cultures in this region, highlighting the fact that the main sources come from local applications. Minor differences were found in the profiles of pesticides within rural areas and between rural and urban areas.

  12. 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.

  13. Pesticides analysed in rainwater in Alsace region (Eastern France): Comparison between urban and rural sites

    Science.gov (United States)

    Scheyer, Anne; Morville, Stéphane; Mirabel, Philippe; Millet, Maurice

    Current-used pesticides commonly applied in Alsace region (Eastern France) on diverse crops (maize, vineyard, vegetables, etc.) were analysed, together with Lindane, in rainwater between January 2002 and June 2003 simultaneously on two sites situated in a typical rural (Erstein, France) and urban area (Strasbourg, France). Rainwater samples were collected on a weekly basis by using two automatic wet only collectors associated with an open collector for the measurement of rainwater height. Pesticides were analysed by GC-MSMS and extracted from rainwater by SPME. Two runs were performed. The first one was performed by using a PDMS (100 μm) fibre for pesticides where direct injection into GC is possible (alachlor, atrazine, azinphos-ethyl, azinphos-methyl, captan, chlorfenvinphos, dichlorvos, diflufenican, α- and β-endosulfan, iprodione, lindane, metolachlor, mevinphos, parathion-methyl, phosalone, phosmet, tebuconazole, triadimefon and trifluralin). The second run was performed by using PDMS/DVB fibre and this run concerns pesticides where a preliminary derivatisation step with pentafluorobenzylbromide (PFBBr) is required for very low volatiles (bromoxynil,2,4-MCPA, MCPP and 2,4-D) or thermo labiles (chlorotoluron, diuron and isoproturon) pesticides. Results showed that the more concentrated pesticides detected were those used as herbicides in large quantities in Alsace region for maize crops (alachlor, metolachlor and atrazine). Maximum concentrations for these herbicides have been measured during intensive applications periods on maize crops following by rapid decrease immediately after use. For Alachlor, most important peaks have been observed between 21 and 28 April 2003 (3327 ng L -1 at Erstein and 5590 ng L -1 at Strasbourg). This is also the case for Metolachlor where most important peak was observed during the same week. Concentrations of pesticides measured out of application periods were very low for many pesticides and some others where never detected

  14. Experimental and statistical characterization of Volatile Organic Compounds (VOC) within the ile-de-France region

    International Nuclear Information System (INIS)

    Baudic, Alexia

    2016-01-01

    Volatile organic compounds (VOCs) play a key role within the atmospheric system acting as precursors of ground-level ozone and secondary organic aerosols (causing health and climatic impacts); hence the growing interest of better characterizing them. Significant uncertainties are still associated with compounds speciation, quantification and respective contributions from the different emission sources. This thesis proposes, through several laboratory and intensive field campaigns, a detailed characterization of VOCs and their main emissions sources within the Ile-de-France region. We used methods based on the determination of speciation profiles indicative of road traffic, wood burning and natural gas sources obtained from near-field investigations (inside a tunnel, at a fireplace and from a domestic gas flue). These different source profiles were used as chemical fingerprints for the identification of the main VOC emission sources, which respective contributions were estimated using the Positive Matrix Factorization (PMF) source-receptor model applied to one-year VOCs (including NMHC+OVOC) measurements in Paris. This thesis allowed, for the first time, to evaluate the seasonal variability of VOCs and their main emission sources. Road traffic-related emissions are major VOC local/regional sources in Paris (contributing to a quarter of total annual emissions). The important impact of wood burning in winter (50 % of the VOC total mass) was observed. Results obtained from this approach were compared with the regional emissions inventory provided by the air quality monitoring network Airparif. Finally, a good agreement was found between our observations and the inventory for road traffic and wood burning-related sources. This independent assessment of inventories is of great interest because they are currently used as input data within air quality prediction models. (author) [fr

  15. France [National and regional programmes on the production of hydrogen using nuclear energy

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2013-03-15

    Consumption of primary energy in France amounted to 278 Mtoe in 2005, with an average increase of 1.3%/a between 1990 and 2005. The breakdown of primary energy is 42% nuclear energy, 33% oil, 15% natural gas, 6% renewables and 4% coal. France is comparatively poor in domestic energy resources. French coal production, which was still around 40 million t/a at the end of the 1970s, was terminated in 2004. Also, domestic natural gas contributes not more than 2% of France's primary energy production. With the general objectives being to control energy demand, diversify sources of energy, increase research into energy, and provide methods of transporting and storing energy, the French energy policy has given priority to the development of a national energy supply with a strong focus on nuclear energy and renewable energies. These energies are seen to provide a reliable long term supply without GHG emissions and to ensure stable electricity prices. The first nuclear power plants built in France were gas cooled reactors and the country also participated in the OECD Dragon project. Today France is the world's second largest producer of nuclear energy (after the USA) with an electricity share of 78%. France operates 58 nuclear power stations with a total capacity of 63.2 GW. One Gen- III reactor (EPR) is currently under construction. Since nuclear energy is not always fully used, interest is growing in using excess nuclear electricity, apart from export, for hydrogen production to regulate the electricity production.

  16. A queuing application to the radiology service at Hotel Dieu de France hospital (Lebanon)

    International Nuclear Information System (INIS)

    Shaib, Ali Hani

    1995-08-01

    Engineering management is becoming a vital element for the success of any service or industry. Managerial tools are being used to enhance the quality of a service or an industry and decrease its cost. Hospital services all over the world are making use of the tools in order to provide better and cheaper health care. In Lebanon, most services, including hospitals, are poorly taking advantage of the available managerial tools. this research will provide an example of applying queuing theory to the radiology service at a hospital. Supported by data from a field study, it will provide a model to predict the behavior of the service and suggest strategies that can enhance the service and increase profit. (author)

  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. Hepatitis E in liver transplant recipients in the Rhône-Alpes region in France.

    Science.gov (United States)

    Buffaz, C; Scholtes, C; Dron, A-G; Chevallier-Queyron, P; Ritter, J; André, P; Ramière, C

    2014-06-01

    In developed countries, hepatitis E virus (HEV) is considered an emerging pathogen, but prevalence seems highly variable according to previous European studies. As HEV can lead to chronic infections in immunosuppressed patients, it is thus essential to evaluate the prevalence and incidence of this infection. We determined retrospectively, in a cohort of 206 pediatric and adult liver transplant recipients from the Rhône-Alpes region in France, pre-transplant anti-HEV-IgG prevalence and incidence of HEV infections during post-transplant follow-up (HEV IgG and IgM ± HEV-RNA). Transplantations were carried out between 2005 and 2012 and mean post-transplant follow-up was 32.8 months. Global pre-transplant prevalence of anti-HEV IgG was 29%, increasing regularly with age from 7% for children under 15 to 49% for patients older than 60. From the 142 seronegative patients before transplant, 11 seroconversions (7.7%) were observed during follow-up (incidence of 2.83 cases per 100 person-years). HEV RNA-tested at transaminases peak or randomly-was detected in only one case of seroconversion. For at least 2 HEV-seropositive patients, who had negative RNAemia before transplantation, viral RNA was detected chronically during follow-up, suggesting reinfection with HEV. Acute infections were largely more frequent than chronic infections and were asymptomatic or misdiagnosed, suggesting that liver transplant patients may not be particularly prone to developing severe HEV hepatitis. In addition, the presence of IgG anti-HEV may not protect against re-infection. Serological testing, therefore, appears to be of limited interest for the diagnosis of HEV infections in liver transplant recipients.

  19. Air pollution and children's asthma-related emergency hospital visits in southeastern France.

    Science.gov (United States)

    Mazenq, Julie; Dubus, Jean-Christophe; Gaudart, Jean; Charpin, Denis; Nougairede, Antoine; Viudes, Gilles; Noel, Guilhem

    2017-06-01

    Children's asthma is multifactorial. Environmental factors like air pollution exposure, meteorological conditions, allergens, and viral infections are strongly implicated. However, place of residence has rarely been investigated in connection with these factors. The primary aim of our study was to measure the impact of particulate matter (PM), assessed close to the children's homes, on asthma-related pediatric emergency hospital visits within the Bouches-du-Rhône area in 2013. In a nested case-control study on 3- to 18-year-old children, each control was randomly matched on the emergency room visit day, regardless of hospital. Each asthmatic child was compared to 15 controls. PM 10 and PM 2.5 , meteorological conditions, pollens, and viral data were linked to ZIP code and analyzed by purpose of emergency visit. A total of 68,897 visits were recorded in children, 1182 concerning asthma. Short-term exposure to PM 10 measured near children's homes was associated with excess risk of asthma emergency visits (adjusted odds ratio 1.02 (95% CI 1.01-1.04; p = 0.02)). Male gender, young age, and temperature were other risk factors. Conversely, wind speed was a protective factor. PM 10 and certain meteorological conditions near children's homes increased the risk of emergency asthma-related hospital visits in 3- to 18-year-old children in Bouches-du-Rhône. What is Known: • A relationship between short-term exposure to air pollution and increase in emergency room visits or hospital admissions as a result of increased pollution levels has already been demonstrated. What is New: • This study confirms these results but took into account confounding factors (viral data, pollens, and meteorological conditions) and is based on estimated pollution levels assessed close to the children's homes, rather than those recorded at the hospital. • The study area, the Mediterranean, is favorable to creation of secondary pollutants in these sunny and dry seasons.

  20. Geriatric injuries among patients attending a regional hospital in ...

    African Journals Online (AJOL)

    Data was collected using a pre-tested, coded questionnaire and analyzed using SPSS computer system. A total of 94 geriatric trauma patients constituting 22.7% of all trauma admissions ... Pre-hospital care was recorded in 5.3% of cases. The musculoskeletal (72.3%) and head (66.0%) regions were commonly affected.

  1. Assessment of preventive measures for accidental blood exposure in operating theaters: a survey of 20 hospitals in Northern France.

    Science.gov (United States)

    Tarantola, Arnaud; Golliot, Franck; L'Heriteau, François; Lebascle, Karin; Ha, Catherine; Farret, Danièle; Bignon, Sylvie; Smaïl, Amar; Doutrellot-Philippon, Catherine; Astagneau, Pascal; Bouvet, Elisabeth

    2006-08-01

    Accidental exposures to blood of body fluids (ABE) expose health care workers (HCW) to the risk of occupational infection. Our aim was to assess the prevention equipment available in the operating theater (OT) with reference to guidelines or recommendations and its use by the staff in that OT on that day and past history of ABE. Correspondents of the Centre de Coordination de la Lutte contre les Infections Nosocomiales (CCLIN) Paris-Nord ABE Surveillance Taskforce carried out an observational multicenter survey in 20 volunteer French hospitals. In total, 260 operating staff (including 151 surgeons) were investigated. Forty-nine of the 260 (18.8%) staff said they double-gloved for all patients and procedures, changing gloves hourly. Blunt-tipped suture needles were available in 49.1% of OT; 42 of 76 (55.3%) of the surgeons in these OT said they never used them. Overall, 60% and 64% of surgeons had never self-tested for HIV and hepatitis C virus (HCV), respectively. Fifty-five surgeons said they had sustained a total of 96 needlestick injuries during the month preceding the survey. Ten of these surgeons had notified of 1 needlestick injury each to the occupational health department of their hospital (notification rate, 10.4%). The occurrence of needlestick injury remained high in operating personnel in France in 2000. Although hospitals may improve access to protective devices, operating staff mindful of safety in the OT should increase their use of available devices, their knowledge of their own serostatus, and their ABE notification rate to guide well-targeted prevention efforts.

  2. Conversion of coal mining regions of France. La reconversion de la mineria del carbon en Francia

    Energy Technology Data Exchange (ETDEWEB)

    Torres, A.

    1990-08-01

    This programme of drastic reduction in coal mining in France has been made possible by the Economic Conversion Plan for the Coalfields. The Plan takes account of all areas of work affected by the reduction in coal mining and will assist in maintaining or even increase economic activity in the areas involved.

  3. Puumala hantavirus infection in humans and in the reservoir host, Ardennes region, France.

    Science.gov (United States)

    Sauvage, F; Penalba, C; Vuillaume, P; Boue, F; Coudrier, D; Pontier, D; Artois, M

    2002-12-01

    We compared the occurrence of nephropathia epidemica cases, over a multi-annual population cycle, in northeastern France with the hantavirus serology for bank voles captured in the same area. We discuss hypotheses to explain the pattern of infection in both humans and rodents and their synchrony.

  4. Open letter to Mr Christian Bataille, Deputy of Nord region, France. Open letter on nuclear energy

    International Nuclear Information System (INIS)

    Delacroix P

    2007-02-01

    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.)

  5. 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

    2018-01-01

    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.

  6. [Orientation of patients referred by their general practionner to the public or private hospital sector in France: A prospective epidemiologic study].

    Science.gov (United States)

    Reuter, P-G; Kernéis, S; Turbelin, C; Souty, C; Arena, C; Gavazzi, G; Sarazin, M; Blanchon, T; Hanslik, T

    2012-12-01

    In-patients characteristics generate cost differences between hospitals. In France, there are few data on the characteristics on the patients referred to hospitals by their general practitioners (GPs) and none on the predictors of referral to the public or for-profit hospitals. The aim of this study was to analyze those characteristics and the predictors of referral to the public or for-profit hospitals. We collected, prospectively, the request for hospitalizations made by the GPs of the Sentinelles network in France, from 2007 to 2009. Patients' characteristics and also the reasons for that request were analyzed. A logistic regression was used to compare the population between local hospitals. Ten thousand seven hundred and eighteen statements were collected. The median age was 73 years. Patients were women in 51% of the cases, and only 14% of the hospitalizations had been planned. Hospitalization in the public sector was preferred for young children and the elderly (Pprivate sector, patients addressed to the public sector were more often seen for emergencies (OR: 2.3 [2.0-2.8]), by a doctor different from their referring GP (OR: 1.7 [1.4-2.1]) and out of the GP's office. The reasons for hospital admission were different depending on the sector of hospitalization (Ppublic sector hospitals presented with greater comorbidity or more complex diagnosis (for example: feeling ill, fainting or syncope and fever) or a greater disability (for example: stroke, neurological and psychiatric diseases). This study suggests that GPs send their patients to the public or for-profit hospitals according to criteria of severity, comorbidity and disability. Copyright © 2012 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  7. Hospital-Based Coalition to Improve Regional Surge Capacity

    Directory of Open Access Journals (Sweden)

    James M. Learning

    2012-12-01

    Full Text Available Introduction: Surge capacity for optimization of access to hospital beds is a limiting factor in response to catastrophic events. Medical facilities, communication tools, manpower, and resource reserves exist to respond to these events. However, these factors may not be optimally functioning to generate an effective and efficient surge response. The objective was to improve the function of these factors.Methods: Regional healthcare facilities and supporting local emergency response agencies developed a coalition (the Healthcare Facilities Partnership of South Central Pennsylvania; HCFP¬SCPA to increase regional surge capacity and emergency preparedness for healthcare facilities. The coalition focused on 6 objectives: (1 increase awareness of capabilities and assets, (2 develop and pilot test advanced planning and exercising of plans in the region, (3 augment written medical mutual aid agreements, (4 develop and strengthen partnership relationships, (5 ensure National Incident Management System compliance, and (6 develop and test a plan for effective utilization of volunteer healthcare professionals.Results: In comparison to baseline measurements, the coalition improved existing areas covered under all 6 objectives documented during a 24-month evaluation period. Enhanced communications between the hospital coalition, and real-time exercises, were used to provide evidence of improved preparedness for putative mass casualty incidents.Conclusion: The HCFP-SCPA successfully increased preparedness and surge capacity through a partnership of regional healthcare facilities and emergency response agencies.

  8. Generation-distribution of electric power in France and in its regions in 2004 and 2005

    International Nuclear Information System (INIS)

    2007-09-01

    This report presents the temporary results for the year 2005 of the power generation and transportation/distribution in France. Power generation data come from the official exhaustive annual inquiry acknowledged by the national council of statistical information (CNIS). It concerns all power producers, like EDF, Compagnie Nationale du Rhone (CNR), Societe Nationale d'Electricite et de Thermique (SNET), Societe Hydroelectrique du Midi (SHEM), and some independent producers who generate electricity for their own needs or for the supply of the grid (about 3000 companies). Data relative to power transportation and distribution are established by another administrative annual inquiry addressed to utilities (EDF-Reseau de Distribution, local distribution companies) and to the power transportation network manager (RTE EDF-Transport). The statistical results presented in this document are established from data settled on June 11, 2007. In a context of market liberalization, these two inquiries are of particular importance. They represent a measurement tool of the public authorities' action in favor of the security of supplies, and they allow to have available a detailed, reliable and regularly updated description of France's power generation and transportation facilities by energy source and by geographical area. (J.S.)

  9. 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.

  10. Regional hospital improves efficiency with co-generation retrofit.

    Science.gov (United States)

    Knutson, D; Anderson, L

    1999-11-01

    Feasibility analysis of the co-generation retrofit of the Red Deer Regional Hospital pointed to a reasonable payback of capital cost and increased efficiency in operation of the facility. Budget restrictions nearly stopped the project from proceeding. Innovative construction procedures proposed by the Facility Management Group, in particular, Mr Keith Metcalfe, Director of Maintenance, allowed a worthwhile project to reach successful completion. We feel that this model can perhaps be used by similar facilities in the future to achieve their energy efficiency goals.

  11. 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.

  12. Understanding the patient multidimensional experience: a qualitative study on coping in hospitals of Assistance Publique-Hôpitaux de Paris, France

    Directory of Open Access Journals (Sweden)

    Reach G

    2015-04-01

    Full Text Available Gérard Reach,1 Denis Fompeyrine,2 Carole Mularski21Department of Endocrinology, Diabetes and Metabolic Diseases, Avicenne Hospital APHP and EA 3412, CRNH-IdF, Paris 13 University, Bobigny, France; 2Direction des Patients, Usagers et Associations, Assistance Publique-Hôpitaux de Paris, Paris, FranceObjective: Time spent in hospitals is complex and entails a number of distinct phases that fluctuate depending on many variables. Attempts to understand patients’ experiences often involve focusing on their needs using self-evaluation, but this does not clearly highlight the complexity of coping. Questionnaires based on telephone surveys and emails do not facilitate a sufficient assessment of the coping effort. However, when patients express themselves through spontaneous narration, different dimensions may emerge in their experience at the hospital. This qualitative study explores the various forms of coping among patients with a hospital experience.Methods: Interviews were conducted with 75 patients in six hospital departments. Transcripts from interviews were thematically analyzed and a conceptual, multidimensional model was developed to explain the relationship between patient experience and coping complexity.Results: Patients used a set of about 50 different terms to describe their experiences in the hospital. They described with the greatest number of words the aspects that triggered their stress or distress and forced them to cope. Stress resulting from the experienced situation was classifiable into five dimensions: trauma, environment, medical, interpersonal affective, and social impact, which constitute invariants that may require individual complex coping strategies.Conclusion: Patient experience is hard to evaluate, and this represents a permanent challenge for medical teams. Considering the five coping dimensions delineated in this study may be helpful in improving the patient’s hospital experience.Keywords: patient experience

  13. Molecular Characterization of Glycopeptide-Resistant Enterococci from Hospitals of the Picardy Region (France

    Directory of Open Access Journals (Sweden)

    M. Biendo

    2010-01-01

    Full Text Available We studied 138 glycopeptide-resistant enterococci (GRE strains, consisting of 131 glycopeptide-resistant Enterococcus faecium (GREfm and 7 glycopeptide-resistant Enterococcus faecalis (GREfs. The GREfm strains were resistant to penicillin, ampicillin, vancomycin, and teicoplanin, while the GREfs strains were only resistant to vancomycin and teicoplanin. The van A gene was the only glycopeptide determinant present in all GRE isolates investigated. Genes coding for Hyl and Hyl+ Esp were detected in 39 (29.8% and 92 (70.2% of the 131 GREfm isolates, respectively. Three of the 7 GREfs were positive for gelE+asa 1 genes, 3 for gel E gene, and 1 for asa 1 gene. The genetic relationship between the 138 GRE was analyzed by pulsed-field gel electrophoresis (PFGE and multilocus sequence typing (MLST. GREfm isolates were clustered in a single genogroup (pulsotype A, and GREfs were clustered in six genogroups (pulsotypes B-G. Among the isolates investigated by MLST, only 18 PCR products were sequenced (12 E. faecium and 6 E. faecalis, and 9 sequence types (STs were identified.

  14. Measuring Job Satisfaction Patterns in Saudi ArabiaÕs Southern Regions Hospitals: Implications for Hospital Staff Retention

    OpenAIRE

    Alshahrani Bander Sayaf

    2015-01-01

    Saudi Arabia Southern Region hospitals have shortage of health professionals especially doctors. Retention of quality doctors and minimizing staff turnover has, therefore, become a major priority for hospitals. Job satisfaction is recognized as key factor influencing retention of doctors. In our paper special emphasis is put on doctors working is Southern Region hospitals of Saudi Arabia. By conducting correlation analysis we determine the most important factors conducive to job satisfaction....

  15. Indoor activity of Culicoides associated with livestock in the bluetongue virus (BTV) affected region of northern France during autumn 2006.

    Science.gov (United States)

    Baldet, T; Delécolle, J C; Cêtre-Sossah, C; Mathieu, B; Meiswinkel, R; Gerbier, G

    2008-10-15

    In August 2006, bluetongue virus (BTV) was detected in the Netherlands, Belgium, western Germany, Luxembourg and northern France for the first time. Consequently, a longitudinal entomological study was conducted in the affected region of northern France (Ardennes) throughout the autumn of 2006. Data on the spatio-temporal distribution of Culicoides (Diptera: Ceratopogonidae) associated with livestock were collected and an attempt was made to identify the vector(s) involved in BTV transmission by means of virus detection in wild-caught biting midges. Weekly sampling using standardized Onderstepoort-type blacklight traps were performed simultaneously both outdoors and indoors in one BTV-free and three BTV-affected farms between September and December 2006. Culicoides were sorted according to farm, location (outdoors vs. indoors), time point (in weeks), species and physiological stage. BTV detection was conducted by RT-PCR on monospecific pools of non-bloodfed parous female Culicoides. The principal results showed: (i) the absence of the Mediterranean vector, C. imicola, (ii) the relatively low abundance of C. dewulfi and C. pulicaris, (iii) the widespread occurrence and abundance of C. obsoletus/C. scoticus with longevity and behaviour compatible with BTV transmission, and (iv) all Culicoides pools tested for BTV were negative. In France, the very low levels of BTV-8 circulation were probably due to the limited introduction of the virus from affected neighbouring countries, and not due to the absence of local vector populations. A key finding has been the substantiation, for the first time, that Culicoides, and particularly the potential vectors C. obsoletus/C. scoticus and C. dewulfi, can be active at night inside livestock buildings and not only outside, as originally believed. The endophagic tendencies of members of the Obsoletus group are discussed in light of the prolonged period of BTV transmission during the autumn of 2006 and the risk of BTV overwintering and

  16. 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.

  17. 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 R.; 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.

  18. Investigating the Influence of Climate Changes on Rodent Communities at a Regional-Scale (MIS 1-3, Southwestern France.

    Directory of Open Access Journals (Sweden)

    Aurélien Royer

    Full Text Available Terrestrial ecosystems have continuously evolved throughout the Late Pleistocene and the Holocene, deeply affected by both progressive environmental and climatic modifications, as well as by abrupt and large climatic changes such as the Heinrich or Dansgaard-Oeschger events. Yet, the impacts of these different events on terrestrial mammalian communities are poorly known, as is the role played by potential refugia on geographical species distributions. This study examines community changes in rodents of southwestern France between 50 and 10 ky BP by integrating 94 dated faunal assemblages coming from 37 archaeological sites. This work reveals that faunal distributions were modified in response to abrupt and brief climatic events, such as Heinrich events, without actually modifying the rodent community on a regional scale. However, the succession of events which operated between the Late Pleistocene and the Holocene gradually led to establishing a new rodent community at the regional scale, with intermediate communities occurring between the Bølling and the Allerød.

  19. High-resolution inventory of NO emissions from agricultural soils over the Ile-de-France region

    Energy Technology Data Exchange (ETDEWEB)

    Rolland, M.-N. [INRA, AgroParisTech, UMR 1091 Environnement et Grandes Cultures, F-78850 Grignon (France); Gabrielle, B., E-mail: Benoit.Gabrielle@agroparistech.f [INRA, AgroParisTech, UMR 1091 Environnement et Grandes Cultures, F-78850 Grignon (France); Laville, P.; Cellier, P. [INRA, AgroParisTech, UMR 1091 Environnement et Grandes Cultures, F-78850 Grignon (France); Beekmann, M. [Laboratoire Inter-universitaire des Systemes Atmospheriques - CNRS, Universites Paris-Est and Paris 7, F-94 010 Creteil (France); Gilliot, J.-M.; Michelin, J.; Hadjar, D. [INRA, AgroParisTech, UMR 1091 Environnement et Grandes Cultures, F-78850 Grignon (France); Curci, G. [Dipartimento di Fisica - CETEMPS, Universita' degli Studi dell' Aquila, 67010 Coppito, L' Aquila (Italy)

    2010-03-15

    Arable soils are a significant source of nitric oxide (NO), a precursor of tropospheric ozone, and thereby contribute to ozone pollution. However, their actual impact on ozone formation is strongly related to their spatial and temporal emission patterns, which warrant high-resolution estimates. Here, we combined an agro-ecosystem model and geo-referenced databases to map these sources over the 12 000 km{sup 2} administrative region surrounding Paris, France, with a kilometric level resolution. The six most frequent arable crop species were simulated, with emission rates ranging from 1.4 kg N-NO ha{sup -1} yr{sup -1} to 11.1 kg N-NO ha{sup -1} yr{sup -1}. The overall emission factor for fertilizer-derived NO emissions was 1.7%, while background emissions contributed half of the total NO efflux. Emissions were strongly seasonal, being highest in spring due to fertilizer inputs. They were mostly sensitive to soil type, crops' growing season and fertilizer N rates. - The use of an agro-ecosystem model at regional scale makes it possible to map the emissions of nitric oxide from arable soils at a resolution compatible with tropospheric ozone models.

  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. 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.

  2. 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.

  3. 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.

  4. Financial Performance of Hospitals in the Mississippi Delta Region Under the Hospital Readmissions Reduction Program and Hospital Value-based Purchasing Program.

    Science.gov (United States)

    Chen, Hsueh-Fen; Karim, Saleema; Wan, Fei; Nevola, Adrienne; Morris, Michael E; Bird, T Mac; Tilford, J Mick

    2017-11-01

    Previous studies showed that the Hospital Readmissions Reduction Program (HRRP) and the Hospital Value-based Purchasing Program (HVBP) disproportionately penalized hospitals caring for the poor. The Mississippi Delta Region (Delta Region) is among the most socioeconomically disadvantaged areas in the United States. The financial performance of hospitals in the Delta Region under both HRRP and HVBP remains unclear. To compare the differences in financial performance under both HRRP and HVBP between hospitals in the Delta Region (Delta hospitals) and others in the nation (non-Delta hospitals). We used a 7-year panel dataset and applied difference-in-difference models to examine operating and total margin between Delta and non-Delta hospitals in 3 time periods: preperiod (2008-2010); postperiod 1 (2011-2012); and postperiod 2 (2013-2014). The Delta hospitals had a 0.89% and 4.24% reduction in operating margin in postperiods 1 and 2, respectively, whereas the non-Delta hospitals had 1.13% and 1% increases in operating margin in postperiods 1 and 2, respectively. The disparity in total margins also widened as Delta hospitals had a 1.98% increase in postperiod 1, but a 0.30% reduction in postperiod 2, whereas non-Delta hospitals had 1.27% and 2.28% increases in postperiods 1 and 2, respectively. The gap in financial performance between Delta and non-Delta hospitals widened following the implementation of HRRP and HVBP. Policy makers should modify these 2 programs to ensure that resources are not moved from the communities that need them most.

  5. In-Hospital Economic Burden of Metastatic Renal Cell Carcinoma in France in the Era of Targeted Therapies: Analysis of the French National Hospital Database from 2008 to 2013.

    Directory of Open Access Journals (Sweden)

    Rana Maroun

    Full Text Available The aim of this study was to assess the economic burden of hospitalisations for metastatic renal cell carcinoma (mRCC, to describe the patterns of prescribing expensive drugs and to explore the impact of geographic and socio-demographic factors on the use of these drugs.We performed a retrospective analysis from the French national hospitals database. Hospital stays for mRCC between 2008 and 2013 were identified by combining the 10th revision of the International Classification of Diseases (ICD-10 codes for renal cell carcinoma (C64 and codes for metastases (C77 to C79. Incident cases were identified out of all hospital stays and followed till December 2013. Descriptive analyses were performed with a focus on hospital stays and patient characteristics. Costs were assessed from the perspective of the French National Health Insurance and were obtained from official diagnosis-related group tariffs for public and private hospitals.A total of 15,752 adult patients were hospitalised for mRCC, corresponding to 102,613 hospital stays. Of those patients, 68% were men and the median age at first hospitalisation was 69 years [Min-Max: 18-102]. Over the study period, the hospital mortality rate reached 37%. The annual cost of managing mRCC at hospital varied between 28M€ in 2008 and 42M€ in 2012 and was mainly driven by inpatient costs. The mean annual per capita cost of hospital management of mRCC varied across the study period from 8,993€ (SD: €8,906 in 2008 to 10,216€ (SD: €10,527 in 2012. Analysis of the determinants of prescribing expensive drugs at hospital did not show social or territorial differences in the use of these drugs.This study is the first to investigate the in-hospital economic burden of mRCC in France. Results showed that in-hospital costs of managing mRCC are mainly driven by expensive drugs and inpatient costs.

  6. Gastrointestinal malignancies at five regional referral hospitals in ...

    African Journals Online (AJOL)

    The distribution of oesophageal, liver, stomach and colorectal cancers diagnosed per year across the five referral hospitals was ... Conclusion: Oesophageal, liver, stomach and colorectal cancer remain the most common gastrointestinal malignancies and their rate is .... intake, poor dietary patterns such as consumption of a.

  7. Determining the Organizational Intelligence Level of Hospitals in Our Region

    Directory of Open Access Journals (Sweden)

    Khayat Moghadam S

    2013-10-01

    Full Text Available Objectives: A new and unique tool for survival of organizations among their competitors is the use of organizational intelligence; Organizational intelligence means having a comprehensive knowledge of all the environmental factors that affect on the organization. This research  is one of the few studies with the aim of determine the organizational intelligence level of hospitals and ranking of organizational intelligence components to enable administrators to provide more accurate identification of strengths and weaknesses and take more effective steps to improve service delivery. Materials and Methods: This is a descriptive-analytical and applicable study performed in the 2012 at 12 General Hospital related to Mashhad University of Medical Sciences. Data collection was performed by Albrecht organizational intelligence questionnaire. The data gathering tool was the questionnaire Albrecht Organizational Intelligence. The collected Data were analyzed using T-test and Smirnov test with SPSS-16 software. The significance level for all tests was considered 0.05. Results: All components of organizational intelligence were in the optimum status. Component of Shared fate gained the first rank and component of knowledge Deployment gained the last rank. Conclusion: Ranking of organizational intelligence components is different in hospitals of the province and the county; representing different features and conditions. Considering the importance of organizational intelligence role in the promotion of organization, hospital managers can take active steps to improve organizational intelligence based on done rankings.

  8. The role of the Salon-Cavaillon fault in the structural framework of Provence region (SE France)

    Science.gov (United States)

    Molliex, Stéphane; Bellier, Olivier; Terrier, Monique; Lamarche, Juliette; Martelet, Guillaume; Espurt, Nicolas

    2010-05-01

    The Provence region is located in the South-East France Basin, in the foreland domain of the Pyrenean and the Alpine mountain belts. The structural pattern of Provence is characterized by W-trending ramp anticlines and N- to NE-trending oblique reverse strike-slip faults. It results from the superimposition of Pyrenean (late Cretaceous to Eocene) and Alpine (Miocene to present-day) compressional tectonic regimes. In addition, extensional tectonics affected the region during Oligocene (W to NW-trending σ3). The Salon-Cavaillon strike-slip fault (SCF) separates two main E-trending ridges (Alpilles to the West and Luberon to the East). A structural study has been realized in order to characterize the post-Oligocene deformation of this domain. Field data and balanced cross-sections show that the post-Oligocene deformation drastically differs on both sides of the SCF. The Luberon ridge results from a fault propagation-fold developed on a S-verging ramp. Laterally, the western anticline termination is bended as a drag fold along the SCF. The Alpilles ridge results from a less developed fault propagation fold. Its eastern termination was affected by a rigid counter-clockwise rotation around a vertical axis, driven by a major curved right- lateral fault. In addition, we integrated gravity data and reprocessed seismic reflection sections to image the sub-surface structures to the West of the SCF at a larger scale. It permits to precise the regional tectonic framework in term of structure and chronology and to detect several hidden E-trending S-verging ramp anticline. The main shortening episode in Provence occurred during pyreneo-provençal phase from Late Cretaceous to Eocene, with 65 % of the total shortening to the East of the SCF and 95 % to the West. Alpine (Miocene to Present-day) shortening differs drastically on both sides of the SCF (2 km of shortening to the East, for less than 0.4 km to the West). This underlines the major role of the SCF in the transfer of

  9. Efficacy of doramectin injectable against Oestrus ovis and gastrointestinal nematodes in sheep in the southwestern region of France.

    Science.gov (United States)

    Dorchies, P; Jacquiet, P; Bergeaud, J P; Duranton, C; Prévot, F; Alzieu, J P; Gossellin, J

    2001-03-20

    A study was conducted to evaluate the therapeutic efficacy of doramectin administered intramuscularly at a dose rate of 200 microg/kg to sheep harbouring naturally acquired infections of gastrointestinal nematodes and Oestrus ovis in the southwestern region of France. On day 0, 24 sheep were selected on the basis of positive faecal egg counts (>100 EPG) and positive assessment of O. ovis infection (including positive O. ovis antibody level and positive clinical score). The sheep were randomly allocated to a non-medicated control group (T1) or a doramectin-treated group (T2) of 12 animals each. On day 0, sheep in group T2 received a single intramuscular injection of doramectin (200 microg/kg), whereas those in group T1 received an intramuscular injection of saline solution (sodium chloride, 0.02ml/kg). Individual faecal egg counts were performed on days 0, 1, 2, 3, 4, 5, 6, 7, and 14. Between days 14 and 16, all sheep were slaughtered, and worm and O. ovis burdens were determined. In doramectin-treated sheep, faecal egg counts had decreased to zero by day 4 for all recovered types of nematode eggs: strongyles, Nematodirus sp., Trichuris sp., and Rhabditidae sp. For strongyles, Nematodirus sp., and Rhabditidae, the percentage reductions in faecal egg counts (geometric means) of doramectin-treated sheep, compared to the non-medicated control sheep were 100% from days 4-7. For Trichuris sp., they were 100, 99.7, 99.9, and 100% on days 4, 5, 6, and 7, respectively. On day 14, percentage reductions were 100% for Nematodirus sp. and Rhabditidae, and 99.8 and 99.1% for strongyles and Trichuris sp., respectively. At necropsy, only adult nematodes and mainly first-stage O. ovis larvae were recovered. Doramectin was highly efficacious against the adult stages of Teladorsagia circumcincta (100%), Nematodirus battus (100%), Nematodirus filicollis (99.9%), Oesophagostomum venulosum (99.8%), and Trichuris sp. (99.3%). It was also 100% efficacious against first-stage larvae of O

  10. Risks predicting prolonged hospital discharge boarding in a regional acute care hospital.

    Science.gov (United States)

    Shaikh, Sajid A; Robinson, Richard D; Cheeti, Radhika; Rath, Shyamanand; Cowden, Chad D; Rosinia, Frank; Zenarosa, Nestor R; Wang, Hao

    2018-01-30

    Prolonged hospital discharge boarding can impact patient flow resulting in upstream Emergency Department crowding. We aim to determine the risks predicting prolonged hospital discharge boarding and their direct and indirect effects on patient flow. Retrospective review of a single hospital discharge database was conducted. Variables including type of disposition, disposition boarding time, case management consultation, discharge medications prescriptions, severity of illness, and patient homeless status were analyzed in a multivariate logistic regression model. Hospital charges, potential savings of hospital bed hours, and whether detailed discharge instructions provided adequate explanations to patients were also analyzed. A total of 11,527 admissions was entered into final analysis. The median discharge boarding time was approximately 2 h. Adjusted Odds Ratio (AOR) of patients transferring to other hospitals was 7.45 (95% CI 5.35-10.37), to court or law enforcement custody was 2.51 (95% CI 1.84-3.42), and to a skilled nursing facility was 2.48 (95% CI 2.10-2.93). AOR was 0.57 (95% CI 0.47-0.71) if the disposition order was placed during normal office hours (0800-1700). AOR of early case management consultation was 1.52 (95% CI 1.37-1.68) versus 1.73 (95% CI 1.03-2.89) for late consultation. Eighty-eight percent of patients experiencing discharge boarding times within 2 h of disposition expressed positive responses when questioned about the quality of explanations of discharge instructions and follow-up plans based on satisfaction surveys. Similar results (86% positive response) were noted among patients whose discharge boarding times were prolonged (> 2 h, p = 0.44). An average charge of $6/bed/h was noted in all hospital discharges. Maximizing early discharge boarding (≤ 2 h) would have resulted in 16,376 hospital bed hours saved thereby averting $98,256.00 in unnecessary dwell time charges in this study population alone. Type of disposition, case

  11. 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

  12. Hospital management training for the Eastern Mediterranean Region: time for a change?

    Science.gov (United States)

    Rabbani, Fauziah; Hashmani, Farah Naz; Mukhi, Aftab A Ali; Gul, Xaher; Pradhan, Nousheen; Hatcher, Peter; Farag, Mounir; Abbas, Farhat

    2015-01-01

    The WHO Eastern Mediterranean Regional Office has emphasized health system strengthening among the top five strategic priorities. One of the integral elements of health systems are the hospitals. The purpose of this paper is to review the need for formalized training in hospital management to improve the quality of care. Literature review and hands on experience of conducting a regional training in hospital management for Eastern Mediterranean Region (EMR) countries. Majority of patients in EMR bypass Primary Health Care facilities due to inadequate quality of services and prefer seeking specialized care at a tertiary level. There is mounting evidence of mediocre to poor patient satisfaction due to inefficient health care practices in hospitals of EMR. Strengthening the management capacity of the hospitals through a formal training programme is therefore necessary for improving the performance of health care delivery and the overall health system. Hospital management encompasses hospital planning and operational activities including development and implementation of organizational strategies to ensure adequate numbers and quality of trained human resources and effective financial management, disaster management, health management information system utilization, support services, biomedical engineering, transport and waste management. Such training will prepare health care professionals with leadership skills to deliver quality hospital services. This is one of the first papers emphasizing the need for a formal structured regional training in hospital management for the countries of EMR. A modular incremental training approach developing an EMR Credit Transfer and Accumulation system is proposed.

  13. 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

  14. Auditing stillbirths at Lower Umfolozi War Memorial Regional Hospital

    African Journals Online (AJOL)

    on stillbirths in developing countries and rural settings, where the majority of such births occur. ... The stillbirth rate at LUWMRH is much higher than that at other regional ... deaths, stillbirths, early and late neonatal deaths, cases of birth.

  15. [After the Action T4 : "Regionalized euthanasia" in the Günzburg Psychiatric Hospital].

    Science.gov (United States)

    Söhner, F; V Cranach, M; Fangerau, H; Becker, T

    2017-09-01

    In Bavarian psychiatric hospitals approximately 15,000 people with mental handicaps and mental illnesses were killed after the so-called Action T4. The Heil- und Pflegeanstalt (psychiatric hospital) Günzburg was a so-called Zwischenanstalt (interim institution). The aim of the study was to analyze its role in carrying out "regionalized euthanasia". Based on defined criteria the patient records of deceased patients at the Günzburg Psychiatric Hospital between July 1941 and December 1943 were analyzed to establish whether criteria for "regionalized euthanasia" were fulfilled. During the study period 45 patients at the Günzburg Psychiatric Hospital probably died following actions by direct or indirect intention to kill using malnutrition, neglect, medication overdose or a combination of these actions. The Günzburg Psychiatric Hospital was involved in "regionalized euthanasia".

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

    International Nuclear Information System (INIS)

    Monnier, J.L.; Hinguant, S.; Gebhardt, A.; Marguerie, D.; Molines, N.; Morzadec, H.; Hallegouet, B.; Laurent, M.; Auguste, P.; Bahain, J.J.; Falgueres, C.; Yokoyama, Y.

    1994-01-01

    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

  17. 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.

  18. care unit in a regional hospital in the Western Cape, South Africa

    African Journals Online (AJOL)

    Neonatal deaths occur due to asphyxia, preterm delivery, sepsis and tetanus.[2] A country's ... The study was conducted at the large regional hospital in Worcester,. SA. Worcester .... 45% very low birth weight and 10% had an extremely low ...

  19. Evaluation of nutritional support in a regional hospital.

    Science.gov (United States)

    Morán López, Jesús Manuel; Hernández González, Miriam; Peñalver Talavera, David; Peralta Watt, María; Temprano Ferreras, José Luis; Redondo Llorente, Cristina; Rubio Blanco, María Yolanda

    2018-05-08

    Disease-related malnutrition (DRM) is highly prevalent in Spanish hospitals (occurring in 1 out of every 4 patients). The 'Más Nutridos' Alliance has developed an action plan to detect and treat DRM. In Extremadura (Spain), the public health system has included nutritional screening as the only mechanism to fight malnutrition. The results of this strategy are evaluated here. An agreement study was conducted in standard clinical practice. Variables collected included the following rates: nutritional screening at entry, coded nutritional diagnoses, nutritional status assessment, nutritional requirements, successful nutritional therapy, weight and height at entry and discharge, referral to a nutritional support unit (NSU). Standards to comparison based on the results of the Netherland Program to Fight Malnutrition. Nutritional screening rate at entry was 20.5% (95% CI: 18.00-21.00). Coding and nutritional status assessment rate at entry was 13%. Weight and height were both measured in 16.5% of patients at entry and 20% at discharge. Nutritional requirements were estimated in 30% and were poorly monitored (13.3%). Only 15% of patients were referred to a NSU. Significantly lower values were found for all indicators as compared to standards, with kappa values lower than 0.2 in all cases. Data analysis showed poorer results when patients referred to the NSU were excluded. A strategy to fight malnutrition based on nutritional screening alone is highly inefficient in hospitals such as HVP. Copyright © 2018 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.

  20. Effect of Regional Hospital Competition and Hospital Financial Status on the Use of Robotic-Assisted Surgery.

    Science.gov (United States)

    Wright, Jason D; Tergas, Ana I; Hou, June Y; Burke, William M; Chen, Ling; Hu, Jim C; Neugut, Alfred I; Ananth, Cande V; Hershman, Dawn L

    2016-07-01

    Despite the lack of efficacy data, robotic-assisted surgery has diffused rapidly into practice. Marketing to physicians, hospitals, and patients has been widespread, but how this marketing has contributed to the diffusion of the technology remains unknown. To examine the effect of regional hospital competition and hospital financial status on the use of robotic-assisted surgery for 5 commonly performed procedures. A cohort study of 221 637 patients who underwent radical prostatectomy, total nephrectomy, partial nephrectomy, hysterectomy, or oophorectomy at 1370 hospitals in the United States from January 1, 2010, to December 31, 2011, was conducted. The association between hospital competition, hospital financial status, and performance of robotic-assisted surgery was examined. The association between hospital competition was measured with the Herfindahl-Hirschman Index (HHI), hospital financial status was estimated as operating margin, and performance of robotic-assisted surgery was examined using multivariate mixed-effects regression models. We identified 221 637 patients who underwent one of the procedures of interest. The cohort included 30 345 patients who underwent radical prostatectomy; 20 802, total nephrectomy; 8060, partial nephrectomy; 134 985, hysterectomy; and 27 445, oophorectomy. Robotic-assisted operations were performed for 20 500 (67.6%) radical prostatectomies, 1405 (6.8%) total nephrectomies, 2759 (34.2%) partial nephrectomies, 14 047 (10.4%) hysterectomies, and 1782 (6.5%) oophorectomies. Use of robotic-assisted surgery increased for each procedure from January 2010 through December 2011. For all 5 operations, increased market competition (as measured by the HHI) was associated with increased use of robotic-assisted surgery. For prostatectomy, the risk ratios (95% CIs) for undergoing a robotic-assisted procedure were 2.20 (1.50-3.24) at hospitals in moderately competitive markets and 2.64 (1.84-3.78) for highly competitive markets

  1. [Ocular syphilis: A retrospective study of 27 cases in Nantes University Hospital (France) from 2000 to 2013].

    Science.gov (United States)

    Carbonnière, C; Couret, C; Guillouzouic, A; Lefebvre, M; Lebranchu, P; Weber, M

    2015-11-01

    Syphilis may manifest as several distinct ophthalmological forms. The main objective of our study was to describe the diagnostic, therapeutic data and prognosis of ocular syphilis. We retrospectively analysed the cases of syphilitic uveitis diagnosed in the University Hospital of Nantes between 2000 and 2013. Twenty-seven patients were included in our study. Their mean age was 53.1 years. Bilateral uveitis was the most frequent clinical presentation (67%). The average diagnostic delay after the first symptoms was 2.8 months. Three patients (11%) presented with an anterior uveitis and 24 (89%) with a posterior uveitis, panuveitis or papillitis. The most frequent clinical signs were papillar lesion (44%), multifocal choroiditis (33%) and chorio-retinitis (37%). Ninety-three percent of the patients were treated with benzathine penicillin intravenously, one patient was treated by intramuscular penicillin injections and another by ceftriaxone intramuscularly. Ocular manifestations alone were sufficient to make the diagnosis of syphilis in 25 patients (93%) and of HIV seroconversion in 3 patients (11%). Forty-one percent of the patients benefited from an adjuvant therapy with corticosteroids. The treatment allowed a visual improvement of -0.48 log MAR (Psyphilis makes systematic screening in uveitis of a great value. Copyright © 2015 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  2. Mael-e(st-France

    Directory of Open Access Journals (Sweden)

    Le Mée, Mael

    2016-09-01

    Full Text Available A performance of Mael Le Mée and France Geoffroy Photos and videos (France: Denis Louis Photo (Montreal: Alexandre Cv France Geoffroy’s assistant: Rosalie Chrétien Production: Espace Projet and Dorsa Barlow Performance co-developed within the project BIOGRAPHIES, with the support of CNC – DICRéAM, Aquitaine Regional Council and the City of Bordeaux.

  3. 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

    2014-01-01

    Objectives To explore the prevalence and associated factors of burnout among five different medical professions in a regional teaching hospital. Design Cross-sectional study. Setting Hospital-based survey. Participants 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. Primary and secondary outcome measures 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. Results 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. Conclusions 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. PMID:24568961

  4. Risk factors for colonization and infection by Pseudomonas aeruginosa in patients hospitalized in intensive care units in France

    Science.gov (United States)

    Hoang, S.; Georget, A.; Asselineau, J.; Venier, A-G.; Leroyer, C.; Rogues, A. M.; Thiébaut, R.

    2018-01-01

    Pseudomonas aeruginosa (P.aeruginosa) remains a prominent nosocomial pathogen responsible for high morbi-mortality in intensive care units (ICUs). P.aeruginosa transmission is known to be partly endogenous and exogenous. Main factors have been highlighted but the precise role of environment in regard to antibiotics use remained unclear. Objective To assess the role of environment, medical care and individual risks factors for P. aeruginosa colonization and infection. Study design and setting A French multicentric prospective study involved ten ICUs for a five months period. Every adult patient newly hospitalized in ICUs with no P. aeruginosa carriage up to 48 hours after admission was included and weekly screened before discharge or death. Screening swabs were either rectal, sputum or oropharyngeal samples. Hydric environment was also sampled each week. Data on patient clinical features, environmental and device exposures, and antibiotics supports were regularly collected. Multivariate analysis was performed with a multistate model. Results The overall prevalence of P. aeruginosa carriage was 15.3% (201/1314). Risk factors associated with patient colonization were: use of inactive antibiotics against P. aeruginosa (HR = 1.60 [1.15–2.21] pinfection (HR = 0.64 [0.41–1.01] p = 0.05). Interaction between hydric environment antibiotics support was not statistically associated with patient colonization. Conclusion Hydric contamination and antibiotics pressure seem to remain key independent risk factors in P. aeruginosa colonization. These results advocate the need to carry on preventive and targeted interventions toward healthcare associated infections. PMID:29522559

  5. Lower limb fracture presentations at a regional hospital.

    Science.gov (United States)

    Holloway, K L; Yousif, D; Bucki-Smith, G; Hosking, S; Betson, A G; Williams, L J; Brennan-Olsen, S L; Kotowicz, M A; Sepetavc, A; Pasco, J A

    2017-08-28

    We found that lower limb fractures, which were largely the result of minimal trauma, had high levels of hospitalisation, length of stay and surgery. It is therefore important to prevent fractures at all sites to avoid the associated morbidity and mortality. Hip fractures are a major cause of morbidity and mortality, particularly in older women. In comparison, less is known about the epidemiology and burden of other lower limb fractures. The study aimed to investigate the epidemiology and burden of these fractures. Incident fractures of the hip, femur, tibia/fibula, ankle and foot in women (≥ 20 years) managed through the University Hospital Geelong, Australia, were ascertained from 1 Jan. 2014 to 31 Dec. 2014 from radiology reports. Age, cause of fracture, post-fracture hospitalisation, surgery, length of stay and discharge location were ascertained from medical records. We identified 585 fractures of the lower limb (209 hip, 42 femur, 41 tibia/fibula, 162 ankle, 131 foot). Most fractures were sustained by women aged ≥ 50 years. Fractures were largely a result of minimal trauma. Most women with hip or femur fractures were hospitalised; fewer were hospitalised for fractures at other sites. Surgery for fracture followed the same pattern as hospitalisations. Length of stay was the highest for hip and femur fractures and the lowest for foot fractures. Women with hip or femur fractures were discharged to rehabilitation more often than home. Fractures at other sites were most commonly discharged home. Fractures of the lower limb occurred frequently in older women. Hospitalisation and subsequent surgery were common in cases of hip and femur fractures. It is important for prevention strategies to target fractures at a range of skeletal sites to reduce costs, hospitalisations, loss of independence and reduced quality of life.

  6. [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.

  7. Specialized consultant in radiological safety to the Salamanca regional hospital, PEMEX. III. - September of 2001

    International Nuclear Information System (INIS)

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

    2002-01-01

    The 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)

  8. Specialized consultant in radiological safety to the Salamanca regional hospital, PEMEX. V. - November of 2001

    International Nuclear Information System (INIS)

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

    2002-01-01

    The 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)

  9. Specialized consultant in radiological safety to the Salamanca regional hospital, PEMEX. VI. - December of 2001

    International Nuclear Information System (INIS)

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

    2002-01-01

    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)

  10. Specialized consultant in radiological safety to the Salamanca regional hospital, PEMEX. I. - July of 2001

    International Nuclear Information System (INIS)

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

    2001-09-01

    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)

  11. Specialized consultant in radiological safety to the Salamanca regional hospital, PEMEX. IV. - October of 2001

    International Nuclear Information System (INIS)

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

    2002-01-01

    The 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)

  12. Specialized consultant in radiological safety to the Salamanca regional hospital, PEMEX. II. - August of 2001

    International Nuclear Information System (INIS)

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

    2002-01-01

    The 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)

  13. [Regional differences in the development of hospitalizations : An effect of different demographic trends?

    Science.gov (United States)

    Nowossadeck, Enno; Prütz, Franziska

    2018-03-01

    Population aging and population decline in many regions of the Federal Republic of Germany are key elements of demographic change. In the regions concerned there is a rising number of older people and, simultaneously, a declining population. So far, the consequences of regional shrinkage and growth for inpatient care don't seem to have been analysed very well. This paper analyses the influence of population aging and declining/increasing population (demographic factors) as well as other, non-demographic factors on the number of hospitalizations in Germany and the Federal States since 2000.One result of the analysis is that there are major differences between the Federal States. The analysis shows, for example, an increase of hospitalizations in Berlin while in Saxony-Anhalt the number of hospitalizations declines. The increase in Berlin was the result of population aging and, to a lower extent, an increase in population. In Saxony-Anhalt the declining population resulted in a decreasing number of hospitalizations. Population aging and non-demographic factors were not able to compensate this trend.Overall, the effect of demographic factors on the number of hospitalizations remains constant over time. Short-term changes of hospitalizations are due to non-demographic factors, such as epidemiological trends, (for example trends of incidence or prevalence), or structural changes of health care service (for example patients shifting between different sectors of health care or the introduction of new reimbursement systems).

  14. Investigating Performance Installation of Hospital Room Surgery of Six Hospitals in Special Region of Yogyakarta by Using Data Envelopment Analysis Model Constant Return to Scale

    OpenAIRE

    Bhimo Rizky Samudro; Yogi Pasca Pratama

    2018-01-01

    This study aims to investigate the efficiency level of hospital surgery hospital installation in Special Region of Yogyakarta Province. Research conceptual constructs are based on input and output performance in institutional performance processes. This research approach uses positivist pattern and is derived by quantitative method. This is to explain the efficiency pattern of the installation of hospital and private hospital surgery rooms. The quantitative method chosen is the concept of Dat...

  15. [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.

  16. Extracorporeal cardiopulmonary resuscitation after out-of-hospital cardiac arrest in a Danish health region.

    Science.gov (United States)

    Fjølner, J; Greisen, J; Jørgensen, M R S; Terkelsen, C J; Ilkjaer, L B; Hansen, T M; Eiskjaer, H; Christensen, S; Gjedsted, J

    2017-02-01

    Extracorporeal Cardiopulmonary Resuscitation (ECPR) has emerged as a feasible rescue therapy for refractory, normothermic out-of-hospital cardiac arrest (OHCA). Reported survival rates vary and comparison between studies is hampered by heterogeneous study populations, differences in bystander intervention and in pre-hospital emergency service organisation. We aimed to describe the first experiences, treatment details, complications and outcome with ECPR for OHCA in a Danish health region. Retrospective study of adult patients admitted at Aarhus University Hospital, Denmark between 1 January 2011 and 1 July 2015 with witnessed, refractory, normothermic OHCA treated with ECPR. OHCA was managed with pre-hospital advanced airway management and mechanical chest compression during transport. Relevant pre-hospital and in-hospital data were collected with special focus on low-flow time and ECPR duration. Survival to hospital discharge with Cerebral Performance Category (CPC) of 1 and 2 at hospital discharge was the primary endpoint. Twenty-one patients were included. Median pre-hospital low-flow time was 54 min [range 5-100] and median total low-flow time was 121 min [range 55-192]. Seven patients survived (33%). Survivors had a CPC score of 1 or 2 at hospital discharge. Five survivors had a shockable initial rhythm. In all survivors coronary occlusion was the presumed cause of cardiac arrest. Extracorporeal cardiopulmonary resuscitation is feasible as a rescue therapy in normothermic refractory OHCA in highly selected patients. Low-flow time was longer than previously reported. Survival with favourable neurological outcome is possible despite prolonged low-flow duration. © 2016 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  17. Diabetic patients served at a regional level hospital: What is their ...

    African Journals Online (AJOL)

    Objectives: We describe the demographics, diabetic characteristics, diabetic control and complications in the diabetes service in Edendale Regional Hospital, Pietermaritzburg, in this study. Diabetes mellitus, together with its complications, is increasing at an alarming rate worldwide. Good glycaemic control translates into ...

  18. 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...

  19. Investigating Performance Installation of Hospital Room Surgery of Six Hospitals in Special Region of Yogyakarta by Using Data Envelopment Analysis Model Constant Return to Scale

    Directory of Open Access Journals (Sweden)

    Bhimo Rizky Samudro

    2018-03-01

    Full Text Available This study aims to investigate the efficiency level of hospital surgery hospital installation in Special Region of Yogyakarta Province. Research conceptual constructs are based on input and output performance in institutional performance processes. This research approach uses positivist pattern and is derived by quantitative method. This is to explain the efficiency pattern of the installation of hospital and private hospital surgery rooms. The quantitative method chosen is the concept of Data Envelopment Analysis (DEA. The results showed that 1 the installation of a private hospital surgery room tends to be more efficient than government property; 2 the installation of a special hospital surgical hospital is not absolutely more efficient than a public hospital. As a recommendation, this research provides scenario for setting input usage for efficient performance.

  20. [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.

  1. Survey of safety practices among hospital laboratories in Oromia Regional State, Ethiopia.

    Science.gov (United States)

    Sewunet, Tsegaye; Kebede, Wakjira; Wondafrash, Beyene; Workalemau, Bereket; Abebe, Gemeda

    2014-10-01

    Unsafe working practices, working environments, disposable waste products, and chemicals in clinical laboratories contribute to infectious and non-infectious hazards. Staffs, the community, and patients are less safe. Furthermore, such practices compromise the quality of laboratory services. We conducted a study to describe safety practices in public hospital laboratories of Oromia Regional State, Ethiopia. Randomly selected ten public hospital laboratories in Oromia Regional State were studied from Oct 2011- Feb 2012. Self-administered structured questionnaire and observation checklists were used for data collection. The respondents were heads of the laboratories, senior technicians, and safety officers. The questionnaire addressed biosafety label, microbial hazards, chemical hazards, physical/mechanical hazards, personal protective equipment, first aid kits and waste disposal system. The data was analyzed using descriptive analysis with SPSS version16 statistical software. All of the respondents reported none of the hospital laboratories were labeled with the appropriate safety label and safety symbols. These respondents also reported they may contain organisms grouped under risk group IV in the absence of microbiological safety cabinets. Overall, the respondents reported that there were poor safety regulations or standards in their laboratories. There were higher risks of microbial, chemical and physical/mechanical hazards. Laboratory safety in public hospitals of Oromia Regional State is below the standard. The laboratory workers are at high risk of combined physical, chemical and microbial hazards. Prompt recognition of the problem and immediate action is mandatory to ensure safe working environment in health laboratories.

  2. 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

  3. Tripartite Evolutionary Game Analysis on Selection Behavior of Trans-Regional Hospitals and Patients in Telemedicine System

    Directory of Open Access Journals (Sweden)

    Yuxuan Gao

    2017-01-01

    Full Text Available This study applies the game theory to the discussion and analysis of trans-regional Telemedicine System, builds the game model of the selection strategies of trans-regional hospitals and patients and analyzes evolving paths, equilibrium states and influencing factors of the three parties. It is derived that medical insurance reimbursement proportion of specialized hospitals, government support for general hospitals and medical expenses in specialized hospitals, operating costs of general hospitals are the influential factors in the Telemedicine System. Finally, a numerical stimulation is conducted with Matlapb based on the data from ligChina Health and Family Planning Statistical Yearbook 2015l/ig.

  4. 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

    2017-04-01

    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

  5. The southern region renal transplant program at armed forces hospital, khamis mushayt.

    Science.gov (United States)

    Mohammed, A S; Al-Hashemy, A; Addous, A J; Ismail, G

    1996-01-01

    The Southern Region renal transplant program was established in February 1989. The appointment of a transplant co-ordinator and creation of a waiting list for the Southern Region as well as tissue typing of all patients in the region were important early steps. Between February 1989 and December 1995, 155 transplants were performed on 152 patients at the Armed Forces Hospital, Southern Region (AFHSR). Of them, 52 were cadaveric donor transplants and the remaining were from living related donors. The overall five-year actuarial patient and graft survival was 93% and 78% respectively. Of the 152 patients who were transplanted, 79 patients were from other hospitals in the region and 73 were from AFHSR. Maintenance immunosuppression consisted of cyclosporin, azathioprine and prednisolone. Use of the spouse as a donor was an early feature of this program. Our results compare favorably with results published from other centers. To cope with the increasing demand of transplantation in the Southern Region, we have to look into ways of increasing our transplant numbers to match the needs.

  6. Characterizing and modelling river channel migration rates at a regional scale: Case study of south-east France.

    Science.gov (United States)

    Alber, Adrien; Piégay, Hervé

    2017-11-01

    An increased awareness by river managers of the importance of river channel migration to sediment dynamics, habitat complexity and other ecosystem functions has led to an advance in the science and practice of identifying, protecting or restoring specific erodible corridors across which rivers are free to migrate. One current challenge is the application of these watershed-specific goals at the regional planning scales (e.g., the European Water Framework Directive). This study provides a GIS-based spatial analysis of the channel migration rates at the regional-scale. As a case study, 99 reaches were sampled in the French part of the Rhône Basin and nearby tributaries of the Mediterranean Sea (111,300 km 2 ). We explored the spatial correlation between the channel migration rate and a set of simple variables (e.g., watershed area, channel slope, stream power, active channel width). We found that the spatial variability of the channel migration rates was primary explained by the gross stream power (R 2  = 0.48) and more surprisingly by the active channel width scaled by the watershed area. The relationship between the absolute migration rate and the gross stream power is generally consistent with the published empirical models for freely meandering rivers, whereas it is less significant for the multi-thread reaches. The discussion focused on methodological constraints for a regional-scale modelling of the migration rates, and the interpretation of the empirical models. We hypothesize that the active channel width scaled by the watershed area is a surrogate for the sediment supply which may be a more critical factor than the bank resistance for explaining the regional-scale variability of the migration rates. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. 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...

  8. Depression and Associated Factors among Adult Inpatients at Public Hospitals of Harari Regional State, Eastern Ethiopia

    Directory of Open Access Journals (Sweden)

    Haile Tilahun

    2018-01-01

    Full Text Available Introduction. Globally, depression is one of the three leading causes of disease and it will be the second leading cause of world disability by 2030. The prevalence of depression in Sub-Saharan Africa ranges from 15 to 30%. In Ethiopia, depression was found to be the seventh leading cause of disease burden and its prevalence has been increased in hospital compared to community setting because hospital environment itself is stressful. Yet, no study was done in Eastern Ethiopia, where substance use like Khat is very rampant. Objective. To assess depression and associated factors among adult inpatients at public hospitals of Harari Regional State, Eastern Ethiopia, from February 01 to 28, 2017. Methodology. Hospital based cross-sectional study design was employed on 492 admitted adult patients in Harari region hospitals. Consecutive sampling method was used to include study population. The data were collected by interviewee and analyzed by SPSS version 20.0. Bivariate and multivariate logistic regression analyses were employed. p value of 0.05 or less was considered to be statistically significant. Result. A total of 489 patients were interviewed with response rate of 99.4%. Having duration of 1-2 weeks in the hospital [AOR = 2.02, 95% CI: (1.28, 3.19], being diagnosed with chronic morbidity [AOR = 4.06, 95% CI: (2.23, 7.40], being users of psychoactive drugs [AOR = 2.24, 95% CI: (1.18, 4.24], and having been admitted to surgical ward [AOR = 0.50, 95% CI: (0.31, 0.81] were significantly associated with depression. Conclusion and Recommendation. Prevalence of depression among admitted inpatients was high. Therefore, increasing the awareness of benefits of early diagnosis of patients to prevent major form of depression and strengthening the clinical set-up and establishing good referral linkage with mental health institutions was considered to be cost-effective method to reduce its prevalence.

  9. Safe injections and waste management among healthcare workers at a regional hospital in northern Tanzania.

    Science.gov (United States)

    Nilsson, Josefine; Pembe, Andrea B; Urasa, Miriam; Darj, Elisabeth

    2013-01-01

    Unsafe injections and substandard waste management are public health issues exposing healthcare workers and the community to the risk of infections. The objective of this study was to assess the knowledge and practice of safe injections and health care waste management among healthcare workers at a regional hospital in northern Tanzania. This cross sectional descriptive study was conducted in a regional hospital in northern Tanzania. Data was collected through a self-administered questionnaire with additional observations of the incinerator, injections, waste practices, and the availability of medical supplies. Data was analysed in SPSS descriptive statistics and chi-square tests were performed. A total of 223 of 305 (73%) healthcare workers from different cadres were included in the study. The majority of healthcare workers had adequate knowledge and practice of safe injections, but inadequate knowledge about waste management. The majority of the staff reported knowledge of HIV as a risk factor, however, had less knowledge about other blood-borne infections. Guidelines and posters on post exposure prophylaxes and waste management -were present at the hospital, however, the incinerator had no fence or temperature gauge. In conclusion, healthcare workers reported good knowledge and practice of injections, and high knowledge of HIV transmission routes. However, the hospital is in need of a well functioning incinerator and healthcare workers require sufficient medical supplies. There was a need for continual training about health care waste management and avoidance of blood-borne pathogens that may be transmitted through unsafe injections or poor health care waste management.

  10. Advancing obstetric and neonatal care in a regional hospital in Ghana via continuous quality improvement.

    Science.gov (United States)

    Srofenyoh, Emmanuel; Ivester, Thomas; Engmann, Cyril; Olufolabi, Adeyemi; Bookman, Laurel; Owen, Medge

    2012-01-01

    To reduce maternal and neonatal death at a large regional hospital through the use of quality improvement methodologies. In 2007, Kybele and the Ghana Health Service formed a partnership to analyze systems and patient care processes at a regional hospital in Accra, Ghana. A model encompassing continuous assessment, implementation, advocacy, outputs, and outcomes was designed. Key areas for improvement were grouped into "bundles" based on personnel, systems management, and service quality. Primary outcomes included maternal and perinatal mortality, and case fatality rates for hemorrhage and hypertensive disorders. Implementation and outcomes were evaluated tri-annually between 2007 and 2009. During the study period, there was a 34% decrease in maternal mortality despite a 36% increase in patient admission. Case fatality rates for pre-eclampsia and hemorrhage decreased from 3.1% to 1.1% (Pcontinuous quality improvement were developed and employed. Copyright © 2011 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  11. 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

  12. 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.

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

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    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.

  14. 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.

  15. Human coronavirus NL63, France

    NARCIS (Netherlands)

    Vabret, Astrid; Mourez, Thomas; Dina, Julia; van der Hoek, Lia; Gouarin, Stéphanie; Petitjean, Joëlle; Brouard, Jacques; Freymuth, François

    2005-01-01

    The human coronavirus NL63 (HCoV-NL63) was first identified in The Netherlands, and its circulation in France has not been investigated. We studied HCoV-NL63 infection in hospitalized children diagnosed with respiratory tract infections. From November 2002 to April 2003, we evaluated 300 respiratory

  16. Variation in Surgical Quality Measure Adherence within Hospital Referral Regions: Do Publicly Reported Surgical Quality Measures Distinguish among Hospitals That Patients Are Likely to Compare?

    Science.gov (United States)

    Safavi, Kyan C; Dai, Feng; Gilbertsen, Todd A; Schonberger, Robert B

    2014-01-01

    Objective To determine whether surgical quality measures that Medicare publicly reports provide a basis for patients to choose a hospital from within their geographic region. Data Source The Department of Health and Human Services' public reporting website, Medicare Claims Processing Manual Baltimore, MD CMS http://www.medicare.gov/hospitalcompare. Study Design We identified hospitals (n = 2,953) reporting adherence rates to the quality measures intended to reduce surgical site infections (Surgical Care Improvement Project, 1–3) in 2012. We defined regions within which patients were likely to compare hospitals using the hospital referral regions (HRRs) from the Dartmouth Atlas of Health Care Project. We described distributions of reported SCIP adherence within each HRR, including medians, interquartile ranges (IQRs), skewness, and outliers. Principal Findings Ninety-seven percent of HRRs had median SCIP-1 scores ≥95 percent. In 93 percent of HRRs, half of the hospitals in the HRR were within 5 percent of the median hospital's score. In 62 percent of HRRs, hospitals were skewed toward the higher rates (negative skewness). Seven percent of HRRs demonstrated positive skewness. Only 1 percent had a positive outlier. SCIP-2 and SCIP-3 demonstrated similar distributions. Conclusions Publicly reported quality measures for surgical site infection prevention do not distinguish the majority of hospitals that patients are likely to choose from when selecting a surgical provider. More studies are needed to improve public reporting's ability to positively impact patient decision making. PMID:24611578

  17. Pharmacy education in France.

    Science.gov (United States)

    Bourdon, Olivier; Ekeland, Catherine; Brion, Françoise

    2008-12-15

    In France, to practice as a pharmacist, one needs a "diplome d'état de Docteur en Pharmacie" This degree is awarded after 6 or 9 years of pharmacy studies, depending on the option chosen by the student. The degree is offered only at universities and is recognized in France as well as throughout the European Union. Each university in France is divided into faculties called Unité de Formation et de Recherche (UFR). There are 24 faculties of pharmacy or UFRs de pharmacie. A national committee develops a pharmacy education program at the national level and each faculty adapts this program according to its specific features and means (eg, faculty, buildings). The number of students accepted in the second year is determined each year by a Government decree (numerus clausus). Successive placements, totalling 62 weeks, progressively familiarize the student with professional practice, and enable him/her to acquire the required competencies, such as drug monitoring and educating and counselling patients. Challenges facing community pharmacies in the next 10 years are patient education, home health care, and orthopaedics; in hospital pharmacies, empowering pharmacists to supervise and validate all prescriptions; and finally, research in pharmacy practice.

  18. ANALYSIS OF PREVALENCE, HOSPITALIZATION RATE AND MORTALITY LEVELS RELATED TO GASTROINTESTINAL DISORDERS IN THE MOSCOW REGION

    Directory of Open Access Journals (Sweden)

    A. N. Gurov

    2015-01-01

    Full Text Available Rationale: According to prognosis made by World Health Organization experts, by mid-21st century gastrointestinal disorders will be among the leaders, partially due to lifestyle of a modern man (stress, unhealthy diet, lack of physical exercise, unhealthy habits, environmental pollution, genetically modified and low quality foods.Aim: To provide informational support of activities aimed at improvement of organization of medical care to patients with gastrointestinal disorders and at further development of specialized gastroenterological care to the population of the Moscow Region, its better availability and higher efficacy and quality.Materials and methods: We calculated and analyzed gastrointestinal morbidity in 2014 (according to referrals among the main age categories (children, adolescents, adults of the population of the Moscow Region, as well as hospitalization rates and in-hospital mortality. The information was taken from the Federal Statistical Surveillance report forms # 12 and # 14.Results: In 2014, the highest prevalence of gastrointestinal disorders was registered in adolescents, being by 42.7% higher than that in adults and by 11.7% higher than that in children. The leading causes of referrals in all age categories were gastritis and duodenitis, as well as gall bladder and bile tract disorders. The structure of morbidity was characterized by a high proportion of pancreatic disorders, stomach and duodenal ulcers in adults. The rate of hospitalizations due to gastrointestinal disorders was 17.8 cases per 1000 patients, being 17.4‰ in adults and 19.8‰ in children and adolescents. The main reasons for hospitalization in adults were diseases of pancreas (23.9% of all hospitalization due to gastrointestinal disorders, gall bladder and bile tract disorders (16.3%. In children and adolescents, the main reasons for hospitalizations were intestinal disorders (36.4%, gastritis and duodenitis (17.9%. In-hospital mortality from

  19. Air pollution exposure, cause-specific deaths and hospitalizations in a highly polluted Italian region.

    Science.gov (United States)

    Carugno, Michele; Consonni, Dario; Randi, Giorgia; Catelan, Dolores; Grisotto, Laura; Bertazzi, Pier Alberto; Biggeri, Annibale; Baccini, Michela

    2016-05-01

    The Lombardy region in northern Italy ranks among the most air polluted areas of Europe. Previous studies showed air pollution short-term effects on all-cause mortality. We examine here the effects of particulate matter with aerodynamic diameter ≤10µm (PM10) and nitrogen dioxide (NO2) exposure on deaths and hospitalizations from specific causes, including cardiac, cerebrovascular and respiratory diseases. We considered air pollution, mortality and hospitalization data for a non-opportunistic sample of 18 highly polluted and most densely populated areas of the region in the years 2003-2006. We obtained area-specific effect estimates for PM10 and NO2 from a Poisson regression model on the daily number of total deaths or cause-specific hospitalizations and then combined them in a Bayesian random-effects meta-analysis. For cause-specific mortality, we applied a case-crossover analysis. Age- and season-specific analyses were also performed. Effect estimates were expressed as percent variation in mortality or hospitalizations associated with a 10µg/m(3) increase in PM10 or NO2 concentration. Natural mortality was positively associated with both pollutants (0.30%, 90% Credibility Interval [CrI]: -0.31; 0.78 for PM10; 0.70%, 90%CrI: 0.10; 1.27 for NO2). Cardiovascular deaths showed a higher percent variation in association with NO2 (1.12%, 90% Confidence Interval [CI]: 0.14; 2.11), while the percent variation for respiratory mortality was highest in association with PM10 (1.64%, 90%CI: 0.35; 2.93). The effect of both pollutants was more evident in the summer season. Air pollution was also associated to hospitalizations, the highest variations being 0.77% (90%CrI: 0.22; 1.43) for PM10 and respiratory diseases, and 1.70% (90%CrI: 0.39; 2.84) for NO2 and cerebrovascular diseases. The effect of PM10 on respiratory hospital admissions appeared to increase with age. For both pollutants, effects on cerebrovascular hospitalizations were more evident in subjects aged less than

  20. Factors associated with excessively lengthy treatment of tuberculosis in the eastern Paris region of France in 2004

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    Valin Nadia

    2010-08-01

    Full Text Available Abstract Background Few data are available on prescriber adherence to tuberculosis (TB treatment guidelines. In particular, excessively long treatment carries a risk of avoidable adverse effects and represents a waste of healthcare resources. We examined factors potentially associated with excessively long treatment. Methods We reviewed the medical records of patients diagnosed with TB in 2004 in the eastern Paris region. Sociodemographic and clinical factors associated with excessively long treatment were identified by logistic regression analyses. Based on contemporary guidelines, excessively long treatment was defined as more than 6 months of a four-drug regimen for thoracic TB with full sensitive strains, and more than 12 months for patients with extrathoracic TB. Results Analyses concerned 478 patients with a median age of 36.0 ± 13.5 years, of whom 48% were living in precarious conditions (i.e. poor living conditions and/or no health insurance, 80% were born abroad, and 17% were HIV-seropositive. TB was restricted to the chest in 279 patients (isolated pulmonary, pleuropulmonary, and isolated pleural TB in 245, 13, and 21 patients, respectively, exclusively extrathoracic in 115 patients, and mixed in the remaining 84 patients. Treatment was prescribed by a chest specialist in 211 cases (44.1% and 295 patients (61.7% were managed in a single institution. The treatment duration complied with contemporary guidelines in 316 cases (66.1% and was excessively long in 162 cases (33.9%. The median duration of excessively long treatment was 313 days (IQR: 272-412. In multivariate analysis, isolated thoracic TB, previous TB, HIV infection, a prescriber other than a chest specialist, and management in more than one healthcare center during treatment were independently associated with excessively lengthy treatment. Conclusion One-third of TB patients received excessively long treatment, reflecting inadequate awareness of management guidelines or

  1. Wind power in France

    International Nuclear Information System (INIS)

    Tuille, F.; Courtel, J.

    2015-01-01

    After 3 years of steady decreasing, wind power has resumed growth in 2014 in France and the preliminary figures of 2015 confirm this trend. About 1100 MW were installed in 2014 which was almost twice as much as it was installed the year before. This renaissance is mostly due to the implementation of Brottes' law that eases the installations of wind farms by suppressing the wind power development areas (that were interfering with regional wind power schemes) and by suppressing the minimum number of 5 turbines for any new wind farms. Another important incentive measure was the announcement in January 2015 of a new financial support scheme in replacement of the policy of guaranteed purchase price for the electricity produced. In 2014 the total wind power produced in mainland France reached 17 TW which represented 3.1% of the production of electricity. (A.C.)

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

    Directory of Open Access Journals (Sweden)

    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.

  3. Disability, residential environment and social participation: factors influencing daily mobility of persons living in residential care facilities in two regions of France.

    Science.gov (United States)

    Rapegno, Noémie; Ravaud, Jean-François

    2017-09-29

    Despite the context of individualization of public policies and promotion of independent living, residential care facilities (RCFs) (called "établissements medico-sociaux" in France) still represent the main system used by disabled people. Through a study of their daily mobility, this article proposes a geographical approach to the examination of factors influencing the social participation of disabled persons with motor impairments who live in residential care facilities. The data were collected in three stages from several sources. We first carried out 24 semi-directive interviews among supervisory staff in all the institutions in two regions of France (Greater Paris and Upper Normandy) to better understand the nature of services offered by medico-social facilities. We next did field work in greater detail in 10 of these institutions. We selected residents by random sampling. These first stages then allowed us to study the mobility of residents and record their perceptions. We conducted participant observation and interviews with 81 disabled residents within the 10 RCF. Data analysis enabled consideration not only of the role of the residential environment in people's daily mobility, but the role of the institutions as well. We identified three typical profiles of mobility practices depending on the facilities: "the islanders", living in isolated facilities far from public transportation, or in so-called "difficult" neighborhoods; people who alternate individual and group mobility in a more or less large area; and "the navigators" who have high mobility over a very large area, often living in facilities located in urban areas. The study also enabled an analysis of the obstacles and facilitators inside and outside the residential facilities. These place restrictions on social participation by disabled adults. However, possibilities for individual negotiation may enable bypassing some obstacles. The three ideal-type profiles of mobility analyzed constitute

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

    Directory of Open Access Journals (Sweden)

    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.

  5. Dementia in older people admitted to hospital: a regional multi-hospital observational study of prevalence, associations and case recognition

    Science.gov (United States)

    Timmons, Suzanne; Manning, Edmund; Barrett, Aoife; Brady, Noeleen M.; Browne, Vanessa; O’Shea, Emma; Molloy, David William; O'Regan, Niamh A.; Trawley, Steven; Cahill, Suzanne; O'Sullivan, Kathleen; Woods, Noel; Meagher, David; Ni Chorcorain, Aoife M.; Linehan, John G.

    2015-01-01

    Background: previous studies have indicated a prevalence of dementia in older admissions of ∼42% in a single London teaching hospital, and 21% in four Queensland hospitals. However, there is a lack of published data from any European country on the prevalence of dementia across hospitals and between patient groups. Objective: to determine the prevalence and associations of dementia in older patients admitted to acute hospitals in Ireland. Methods: six hundred and six patients aged ≥70 years were recruited on admission to six hospitals in Cork County. Screening consisted of Standardised Mini-Mental State Examination (SMMSE); patients with scores dementia; with 29% in public hospitals. Prevalence varied between hospitals (P dementia had a previous diagnosis. Patients with dementia were older and frailer, with higher co-morbidity, malnutrition and lower functional status (P dementia (57%) on admission. Conclusion: dementia is common in older people admitted to acute hospitals, particularly in acute medical admissions, and rural hospitals, where services may be less available. Most dementia is not previously diagnosed, emphasising the necessity for cognitive assessment in older people on presentation to hospital. PMID:26420638

  6. [Public health impact of a remote diagnosis system implemented in regional and district hospitals in Paraguay].

    Science.gov (United States)

    Galván, Pedro; Velázquez, Miguel; Benítez, Gualberto; Ortellado, José; Rivas, Ronald; Barrios, Antonio; Hilario, Enrique

    2017-06-08

    Determine the viability of a remote diagnosis system implemented to provide health care to remote and scattered populations in Paraguay. The study was conducted in all regional and general hospitals in Paraguay, and in the main district hospitals in the country's 18 health regions. Clinical data, tomographic images, sonography, and electrocardiograms (ECGs) of patients who needed a diagnosis by a specialized physician were entered into the system. This information was sent to specialists in diagnostic imaging and in cardiology for remote diagnosis and the report was then forwarded to the hospitals connected to the system. The cost-benefit and impact of the remote diagnosis tool was analyzed from the perspective of the National Health System. Between January 2014 and May 2015, a total of 34 096 remote diagnoses were made in 25 hospitals in the Ministry of Health's telemedicine system. The average unit cost of remote diagnosis was US$2.6 per ECG, tomography, and sonography, while the unit cost of "face-to-face" diagnosis was US$11.8 per ECG, US$68.6 per tomography, and US$21.5 per sonography. As a result of remote diagnosis, unit costs were 4.5 times lower for ECGs; 26.4 times lower for tomography, and 8.3 times lower for sonography. In monetary terms, implementation of the remote diagnosis system during the 16 months of the study led to average savings of US$2 420 037. Paraguay has a remote diagnosis system for electrocardiography, tomography, and sonography, using low-cost information and communications technologies (ICTs) based on free software that is scalable to other types of remote diagnostic studies of interest for public health. Implementation of remote diagnosis helped to strengthen the integrated network of health services and programs, enabling professionals to optimize their time and productivity, while improving quality, increasing access and equity, and reducing costs.

  7. 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

  8. [Hospital emergencies arising from nursing homes in a region: evolution, characteristics and appropriateness].

    Science.gov (United States)

    Sánchez-Pérez, Inma; Comes Garcia, Nuri; Romero Piniella, Lola; Prats Martos, Gemma; Arnau Bataller, Gemma; Coderch, Jordi

    Hospital emergencies (HE) arising from nursing homes (NH) are on the rise. We analyse the evolution, characteristics and appropriateness of HE of NH residents in a region, as well as resulting hospital admissions. Retrospective descriptive study between 2010 and 2013 of institutionalised residents of 11 NH located in Baix Empordà (704 beds) and Palamós Hospital. Gender, age, morbidity and relative weight according to clinical risk groups (CRG), NH, length of stay, diagnosis of the emergency, appropriateness of HE according to Bermejo's criteria and the HE appropriateness protocol (HEAP), and appropriateness of hospitalisations according to the Appropriateness Evaluation Protocol (AEP). Sample to evaluate appropriateness: 159 HE and 91 hospitalisations. frequency, mean, standard deviation, percentiles, Fisher's exact test and ANOVA, with a confidence interval of 95% and using IBM SPSS Statistics 23. 1,474 people were enrolled, of which 73% were women. Group ≥85 years increased to 60.3% and the mean weight of morbidity was 3.2 to 4.0 (p <0.001). 1,805 HE were generated. The annual rate per 1,000 stays arising from NH increased from 1.64 to 2.05, of which 90.6% were appropriate according to Bermejo's criteria and 93.7% according to the HEAP. Of these, 502 involved hospitalisation. The annual rate per 10 emergencies fell from 2.96 to 2.64 and 98.9% were appropriate according to the AEP. Hospital emergencies and hospitalisations of NH residents are increasing and are appropriate. Increasing age and disease burden could explain this phenomenon. NH and hospitals should react appropriately, considering the specific needs of this population sector. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  9. Auditing stillbirths at Lower Umfolozi War Memorial Regional Hospital: A 12-month review.

    Science.gov (United States)

    Govender, I

    2017-11-27

    Although the total number of stillbirths worldwide was estimated at 2.6 million in 2009, there is currently a dearth of literature on stillbirths in developing countries and rural settings, where the majority of such births occur. The 'Hands Up' Mortality and Morbidity Extraction Tool (HUMMET), developed at Lower Umfolozi War Memorial Regional Hospital (LUWMRH) in 2010, outlines a systematic approach to summarising individual cases of adverse perinatal outcomes. To depict the HUMMET form by describing the detailed demographic and obstetric profile of patients who delivered a stillborn infant at LUWMRH, as well as risk factors associated with these stillbirths between 1 April 2014 and 31 March 2015. The findings add to a global initiative advanced by the Lancet series on stillbirths, aimed at raising awareness of stillbirth statistics in low- and middle-income countries. A total of 310 detailed stillbirth case summaries of 305 patients were collected during the study period, representing 90% of the total number of stillborn infants delivered at LUWMRH. A retrospective audit of the HUMMET forms was conducted and the cases were further summarised in a Microsoft Excel spreadsheet that allowed for a univariate analysis of the variables. The stillbirth rate at LUWMRH is much higher than that at other regional hospitals owing to the number of at-risk referrals and emergency cases from surrounding clinics and district hospitals. Referrals were from local clinics (49%) and district hospitals (45%), 35% of stillbirths were due to abruptio placentae and a large proportion were associated with gestational hypertension, pre-eclampsia and/or eclampsia. Avoidable factors were predominantly a late patient response to reduced fetal movements and delays in transfer to hospital. Twenty percent of stillbirths were associated with inappropriate monitoring or management of the obstetric condition at the district hospital. The HUMMET form provides a systematic approach to analysing cases

  10. Prevalence, Clinical Presentation, and Factors Associated With Diabetic Foot Ulcer in Two Regional Hospitals in Cameroon.

    Science.gov (United States)

    Tindong, Maxime; Palle, John N; Nebongo, Daniel; Aminde, Leopold Ndemnge; Mboue-Djieka, Yannick; Mbarga, Nicole T Fouda; Dehayem, Mesmin Y; Choukem, Siméon-Pierre

    2018-03-01

    This study aimed to determine the prevalence of diabetic foot ulcer and high risk for ulceration, describe the clinical presentation, and identify factors associated with diabetic foot ulcer in the Southwest regional hospitals of Cameroon. In this cross-sectional study, data were collected using a structured questionnaire administered to consecutive patients with diabetes. Findings from detailed foot examination were recorded. Diabetic foot ulcer was diagnosed according to the International Working Group on Diabetic Foot (IWGDF) definition. Data were analyzed with Stata IC version 12. Of the 203 participants included, 63.1% were females. Age ranged from 26 to 96 years. The median duration of diabetes was 4.0 years (interquartile range 1.0-8.0 years). The prevalence of diabetic foot ulcer was 11.8% (24), of whom 29.2% (7) had high grade (grades 2 to 4), and most of the ulcers 58.3% (14) were located at the plantar region. The prevalence of high risk for ulceration was 21.8% (39). Loss of protective sensation (OR = 3.73, 95% CI = 1.43-9.71; P = .007), and peripheral arterial disease (OR = 3.48, 95% CI = 1.14-10.56; P = .028) were independently associated with diabetic foot. Diabetic foot ulcer is a common complication among patients with diabetes attending these regional hospitals. Loss of protective sensation, and peripheral arterial disease increase the odds of having diabetic foot ulcer, and we suggest them as the main target of interest for prevention.

  11. [Integration of district psychiatric hospitals into the development of regional community psychiatry networks--the actual state. Results of a survey among medical directors of Bavarian district hospitals].

    Science.gov (United States)

    Welschehold, Michael; Kraus, Eva

    2004-11-01

    In this study, the medical directors of all Bavarian district psychiatric hospitals evaluated certain aspects of the integration of their hospitals into the development of regional community psychiatry networks ("Gemeindepsychiatrische Verbunde" - GPVs). They were asked to rate the actual quantity of cooperation between their hospitals and diverse community based services and to express their requests concerning the quality of cooperation. An estimation of possible advantages of the hospitals' integration in GPVs and expectations to future perspectives of GPV development were also investigated. The data were collected by a written questionnaire. The results of the survey indicate that a high relevance is attached to GPV: inspite of current heterogenous developments and inspite of existing skepticism concerning the feasibility of a complete GPV structure, medical directors strongly approve of seeing their hospitals actively engaged in the further development of community psychiatry networks.

  12. 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.

  13. 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.

  14. Cephalic region war injuries in children: Experience in French NATO hospital in Kabul Afghanistan.

    Science.gov (United States)

    Chehab, Hussam El; Agard, Emilie; Dot, Corinne

    2018-06-09

    The NATO KAIA Hospital (Kabul International Airport), under French command, provided medical support for NATO forces in the Kabul region from 2009 to 2014. Medical assistance to civilians was an additional mission which included support for children who were war injured. The objective of this study was to analyze characteristics of cephalic injuries in children victims of war trauma. A retrospective study was conducted and commenced with the hospital opening (July 2009) to March 2012 on all children (<15years) with war trauma. We distinguished cephalic lesions in cranial (neuro-surgical), ophthalmological and neck regions. We analyzed mechanism, region, severity score, surgeries and resuscitation efforts. 217 children were operated on with 81 war traumas (mean age 10.2years). 36 children (44.4%) had a cephalic injury. 52.9% of the injured had an ophthalmological injury, 38.2% a cranial region injury and 29.4% a neck lesion. Mortality rate was 5.6% (1 hemorrhagic shock and 1 cerebral wound) in this cephalic lesion group. Ophthalmic injuries were the most common of cephalic injuries; 19 children of which 7 had a bilateral injury (26 eyes). In this group, fragmentary injuries were the most frequent (64% of eyes). In cerebral lesion group, the lesions were linked to a bullet or a shrapnel in 9 of 13 children. This mechanism systematically caused a crania-cerebral wound. Explosion (fragmentary and shrapnel) was the most important in the neck lesions (7 children of 10). The cephalic lesions were the second most common region in children during our experience in Afghanistan. Lack of protection (helmet) in children may explain the frequency of cephalic wounds. Copyright © 2018 Elsevier Ltd. All rights reserved.

  15. 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.

  16. Prevention of hospital-onset Clostridium difficile infection in the New York metropolitan region using a collaborative intervention model.

    Science.gov (United States)

    Koll, Brian S; Ruiz, Rafael E; Calfee, David P; Jalon, Hillary S; Stricof, Rachel L; Adams, Audrey; Smith, Barbara A; Shin, Gina; Gase, Kathleen; Woods, Maria K; Sirtalan, Ismail

    2014-01-01

    The incidence, severity, and associated costs of Clostridium difficile (C. difficile) infection (CDI) have dramatically increased in hospitals over the past decade, indicating an urgent need for strategies to prevent transmission of C. difficile. This article describes a multifaceted collaborative approach to reduce hospital-onset CDI rates in 35 acute care hospitals in the New York metropolitan region. Hospitals participated in a comprehensive CDI reduction intervention and formed interdisciplinary teams to coordinate their efforts. Standardized clinical infection prevention and environmental cleaning protocols were implemented and monitored using checklists. Monthly data reports were provided to hospitals for facility-specific performance evaluation and comparison to aggregate data from all participants. Hospitals also participated in monthly teleconferences to review data and highlight successes, challenges, and strategies to reduce CDI. Incidence of hospital-onset CDI per 10,000 patient days was the primary outcome measure. Additionally, the incidence of nonhospital-associated, community-onset, hospital-associated, and recurrent CDIs were measured. The use of a collaborative model to implement a multifaceted infection prevention strategy was temporally associated with a significant reduction in hospital-onset CDI rates in participating New York metropolitan regional hospitals. © 2013 National Association for Healthcare Quality.

  17. Quality of Care: A Review of Maternal Deaths in a Regional Hospital in Ghana.

    Science.gov (United States)

    Adusi-Poku, Yaw; Antwil, Edward; Osei-Kwakye, Kingsley; Tetteh, Chris; Detoh, Eric Kwame; Antwi, Phyllis

    2015-09-01

    The government of Ghana and key stakeholders have put into place several interventions aimed at reducing maternal deaths. At the institutional level, the conduct of maternal deaths audit has been instituted. This also contributes to reducing maternal deaths as shortcomings that may have contributed to such deaths could be identified to inform best practice and forestall such occurrences in the future. The objective of this study was to review the quality of maternal care in a regional hospital. A review of maternal deaths using Quality of Care Evaluation Form adapted from the Komfo Anokye Teaching Hospital (KATH) Maternal Death Audit Evaluation Committee was used. About fifty-five percent, 18 (55%) of cases were deemed to have received adequate documentation, senior clinicians were involved in 26(85%) of cases. Poor documentation, non-involvement of senior clinicians in the management of cases, laboratory related issues particularly in relation to blood and blood products as well as promptness of care and adequacy of intensive care facilities and specialists in the hospital were contributory factors to maternal deaths . These are common themes contributing to maternal deaths in developing countries which need to be urgently tackled. Maternal death review with emphasis on quality of care, coupled with facility gap assessment, is a useful tool to address the adequacy of emergency obstetric care services to prevent further maternal deaths.

  18. [Outsourcing of nursing human resources from ethical to management: a survey in a Lazio Region Hospital].

    Science.gov (United States)

    d'Amore, Maurizia; Peroni, Antonia

    2008-01-01

    In 2006, 279 nurses of a Lazio Region Hospital were assessed to verify whether certain Human Resources decisions, such as outsourcing, can negatively influence their working motivation and sense of belonging to a health organization and whether any dissatisfaction can be attributed to poor ethical information within the health service. The research method had a descriptive basis and for data collection a questionnaire with 35 questions was issued. Results showed that nurses felt strongly involved in the study and interesting aspects for management of human resources emerged, depicting an organization lacking in motivation : this confirmed one of the aspects of the study : poor levels of motivation and sense of belonging can be correlated to insufficient ethical information in local health organizations. The main working needs that emerged among the nurses of this hospital regarded economical retribution (90%), security and success (88%) , belonging (86%) and self-satisfaction (77%): the need for power was relatively low (40%). The strong points of the study were : the strong involvement of nurses, the value of the information gathered regarding working motivation, sense of belong to a nursing organization , working needs , ethical information in health environments, organization according to targets. The limits of the study were: limited number of nurses in outsourcing at the time of the study (12%), impossibility of comparing the results with data prior to the outsourcing choices made by the hospital in question.

  19. 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.

  20. Hospitals

    DEFF Research Database (Denmark)

    Mullins, Michael

    2013-01-01

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

  1. [Regional anaesthesia as advantage in competition between hospitals. Strategic market analysis].

    Science.gov (United States)

    Heller, A R; Bauer, K R; Eberlein-Gonska, M; Albrecht, D M; Koch, T

    2009-05-01

    The German Social Act V section sign 12 is aimed towards competition, efficiency and quality in healthcare. Because surgical departments are billing standard diagnosis-related group (DRG) case costs to health insurance companies, they claim best value for money for internal services. Thus, anaesthesia concepts are being closely scrutinized. The present analysis was performed to gain economic arguments for the strategic positioning of regional anaesthesia procedures into clinical pathways. Surgical procedures, which in 2005 had a relevant caseload in Germany, were chosen in which regional anaesthesia procedures (alone or in combination with general anaesthesia) could routinely be used. The structure of costs and earnings for hospital services, split by types and centres of cost, as well as by underlying procedures are contained in the annually updated public accessible dataset (DRG browser) of the German Hospital Reimbursement Institute (InEK). For the year 2005 besides own data, national anaesthesia staffing costs are available from the German Society of Anaesthesiology (DGAI). The curve of earnings per DRG can be calculated from the 2005 InEK browser. This curve intersects by the cost curve at the point of national mean length of stay. The cost curve was calculated by process-oriented distribution of cost centres over the length of stay and allows benchmarking within the national competitive environment. For comparison of process times data from our local database were used. While the InEK browser lacks process times, the cost positions 5.1-5.3 (staffing costs anaesthesia) and the national structure adjusted anaesthesia staffing costs 2005 as published by the DGAI, were used to calculate nationwide mean available anaesthesia times which were compared with own process times. Within the portfolio diagram of lengths of stay for each DRG and process times most procedures are located in the economic lower left, in particular those with high case mix (length of stay and

  2. Nutritional assessment and follow-up of residents with and without dementia in nursing homes in the Limousin region of France: a health network initiative.

    Science.gov (United States)

    Jesus, P; Desport, J C; Massoulard, A; Villemonteix, C; Baptiste, A; Gindre-Poulvelarie, L; Lorgueuilleux, S; Javerliat, V; Fraysse, J L; Preux, P M

    2012-05-01

    Limousin in France has the second oldest regional population in Europe, with people over 65-years-old who have Alzheimer's disease accounting for more than 9%. In France as a whole, a large number of residents in nursing homes (NH) have dementia, leading to many nutritional problems. LINUT is a health network that assesses the nutritional status of elderly NH residents and provides support where necessary. Aims of the present study were to use this network to evaluate the nutritional status of NH residents with and without dementia and to review changes after 4 months of intervention. A cross-sectional survey was conducted by a doctor and a dietician at baseline (T0) and 4 months (T4) among residents at the 26 NH in Limousin that agreed to take part. The evaluation criteria included presence of dementia, depression and autonomy, weight, height, body mass index, Mini Nutritional Assessement (MNA™), and a 3-day survey of food intake. The 346 residents assessed at T0 were aged 87.9±6.9 years, 83.4% were women, 66.8% had dementia, 53.3% were malnourished and 27.4% obese. Autonomy was not affected by obesity. Residents with dementia had a lower Activities of Daily Living score and a lower weight than non-demented individuals (2.2±1.2 vs. 2.7±1.7 p=0.03 and 60.1±16.3 vs. 64.7±20.0 kg p=0.03, respectively), were more often malnourished (56.1% vs. 46.4% p=0.004) and less often obese (22.0% vs. 39.1% p=0.004) but consumed more protein (62.6±17.8 vs. 58.2±16.9 g/d p=0.04, 1.1±0.4 vs. 1.0±0.4 g/kg/d p=0.005). Energy intake was at the lower limit of French recommendations (26.4±8.8 vs. >25.0 kcal/kg/d). Assessment of all residents at T4 showed improved MNA™ (+0.4 points/month p=0.02), protein intake (+3.3 g/d p=0.0007), and energy intake (+41.4 kcal/d p=0.01 and 0.1 kcal/kg/d p=0.03). Variations in prevalences of malnutrition and obesity were not statistically significant. MNA™ increased in the dementia group (+0.29±0.8 points/month p=0.003). All other changes

  3. 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

  4. National and Regional Representativeness of Hospital Emergency Department Visit Data in the National Syndromic Surveillance Program, United States, 2014

    Science.gov (United States)

    Coates, Ralph J.; Pérez, Alejandro; Baer, Atar; Zhou, Hong; English, Roseanne; Coletta, Michael; Dey, Achintya

    2016-01-01

    Objective We examined the representativeness of the nonfederal hospital emergency department (ED) visit data in the National Syndromic Surveillance Program (NSSP). Methods We used the 2012 American Hospital Association Annual Survey Database, other databases, and information from state and local health departments participating in the NSSP about which hospitals submitted data to the NSSP in October 2014. We compared ED visits for hospitals submitting 15 data with all ED visits in all 50 states and Washington, DC. Results Approximately 60.4 million of 134.6 million ED visits nationwide (~45%) were reported to have been submitted to the NSSP. ED visits in 5 of 10 regions and the majority of the states were substantially underrepresented in the NSSP. The NSSP ED visits were similar to national ED visits in terms of many of the characteristics of hospitals and their service areas. However, visits in hospitals with the fewest annual ED visits, in rural trauma centers, and in hospitals serving populations with high percentages of Hispanics and Asians were underrepresented. Conclusions NSSP nonfederal hospital ED visit data were representative for many hospital characteristics and in some geographic areas but were not very representative nationally and in many locations. Representativeness could be improved by increasing participation in more states and among specific types of hospitals. PMID:26883318

  5. Transmission of measles among healthcare Workers in Hospital W, Xinjiang Autonomous Region, China, 2016.

    Science.gov (United States)

    Jia, Haimei; Ma, Chao; Lu, Mengting; Fu, Jianping; Rodewald, Lance E; Su, Qiru; Wang, Huaqin; Hao, Lixin

    2018-01-12

    As China approaches the elimination of measles, outbreaks of measles continue to occur. Healthcare workers (HCWs) are known to be at high risk of infection and transmission of measles virus. A measles outbreak occurred in a hospital in Xinjiang Uighur Autonomous Region of the People's Republic of China. We report an investigation of this outbreak and its implications for measles elimination and outbreak preparedness. We conducted a retrospective search for measles cases using hospital records. Information on cases was collected by interview, and was used to determine epidemiological linkages. We surveyed HCWs to determine their demographic characteristics, disease history and vaccination status, and knowledge about measles. We identified 19 cases, ages 18 to 45 years, in Hospital W between December 2015 and January 2016; 14 were laboratory-confirmed, and 5 were epidemiologically linked. The primary case was a 25-year-old neurology department nurse who developed a rash on 22 December 2015 that was reported on 11 January 2016. She continued working and living with her workmates in a dormitory during her measles transmission period. Among the 19 infected HCWs, 2 had received a dose of measles-containing vaccine (MCV) before the outbreak, and 16 had unknown vaccination status. Outbreak response immunization activities were started on 8 January in a non-selective manner by offering vaccine regardless of vaccination history; 605(68%) of 890 HCWs were vaccinated. The HCW survey had a 73% response rate (646/890); 41% of HCWs reported that they had received MCV before outbreak, and 56% exhibited good knowledge of measles symptoms, transmission, complications, and vaccination. Low MCV coverage, low measles knowledge among HCWs, delayed reporting of measles cases, and absence of proper case management were associated with this outbreak. Training and vaccinating HCWs against measles are essential activities to prevent measles virus transmission among HCWs.

  6. Out-of-hospital cardiac arrest: the prospect of E-CPR in the Maastricht region.

    Science.gov (United States)

    Sharma, A S; Pijls, R W M; Weerwind, P W; Delnoij, T S R; de Jong, W C; Gorgels, A P M; Maessen, J G

    2016-02-01

    The current outcome of out-of-hospital cardiac arrest (OHCA) patients in the Maastricht region was analysed with the prospect of implementing extracorporeal cardiopulmonary resuscitation (E-CPR). A retrospective analysis of adult patients who were resuscitated for OHCA during a 24-month period was performed. 195 patients (age 66 [57-75] years, 82 % male) were resuscitated for OHCA by the emergency medical services and survived to admission at the emergency department. Survival to hospital discharge was 46.2 %. Notable differences between non-survivors and survivors were observed and included: age (70 [58-79] years) vs. (63 [55-72] years, p = 0.01), chronic heart failure (18 vs. 7 %, p = 0.02), shockable rhythm (67 vs. 99 %, p < 0.01), and return of spontaneous circulation (ROSC) at departure from the site of the arrest (46 vs. 99 %, p < 0.01) and on arrival to the emergency department (43 vs. 98 %, p < 0.01), respectively. Acute coronary syndrome was diagnosed in 32 % of non-survivors vs. 59 % among survivors, p < 0.01. Therapeutic hypothermia was provided in non-survivors (20 %) vs. survivors (43 %), p < 0.01. Percutaneous coronary intervention (PCI) was performed in 14 % of non-survivors while 52 % of survivors received PCI (p < 0.01). No statistical significance was observed in terms of gender, witnessed arrest, bystander CPR, or automated external defibrillator deployed among the cohort. At hospital discharge, moderately severe neurological disability was present in six survivors. These observations are compatible with the notion that a shockable rhythm, ROSC, and post-arrest care improve survival outcome. Potentially, initiating E-CPR in the resuscitation phase in patients with a shockable rhythm and no ROSC might serve as a bridge to definite treatment and improve survival outcome.

  7. A study on the indoor radon concentrations in hospitals in the Shillong region, Meghalaya

    International Nuclear Information System (INIS)

    Sharma, Yubaraj; Maibam, Deveshwori; Saxena, Atul; Ram, Priya P.; Walia, Devesh

    2015-01-01

    In this paper, we report our findings on radon survey in indoor environment which consists of around 105 rooms in 8 major hospitals in Shillong region and also present experimental estimates on the associated annual effective doses and life-time fatality risks. The survey has been undertaken using LR-115 Type 2 detectors. Radon activity concentration values were found to range from 65.66 Bq.m -3 to 783.77 Bq.m -3 with an arithmetic mean value of 260.4±138.3 Bq.m -3 and a geometric mean value of 228.4±1.67 Bq.m -3 . Distribution analysis of the radon activity concentration measured at the hospital rooms has been carried out. Of the total rooms surveyed, 60% have radon concentration more than the ICRP prescribed lower limit of 200 Bq.m -3 and about 4% of the rooms higher than the upper limit of 600 Bq.m -3 . Floor-wise study has been done and a decrease in radon concentration with increase in floor-number has been observed. (author)

  8. Instalaciones mecánicas para un hospital ubicado en la selva-hospital regional de pucallpa

    OpenAIRE

    Montoya Alcoser, Carlos Augusto; Montoya Alcoser, Carlos Augusto

    1986-01-01

    En un Hospital moderno» las Instalaciones y los Equipos por ellas accionado constituye la parte más importante; lo que se puede llamar la parte dinámica» la vida del Hospital. Las Instalaciones deben satisfacer las exigencias de los equipos utilizados en la medicina para el diagnóstico y tratamiento» así como los equipos pertenecientes a los servicios generales y auxiliares. En este caso la presente TESIS tiene como finalidad elaborar y proyectar, dentro de los aspectos técnicos y econó...

  9. [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.

  10. 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.

  11. Assessment of the Baby Friendly Hospital Initiative Implementation in the Eastern Mediterranean Region.

    Science.gov (United States)

    Al-Jawaldeh, Ayoub; Abul-Fadl, Azza

    2018-03-11

    The Baby-Friendly Hospital Initiative (BFHI) is a global program for promoting support and protection for breastfeeding. However, its impact on malnutrition, especially in countries of the Eastern Mediterranean region (EMR) that are facing the turmoil of conflict and emergencies, deserves further investigation. Having said that, this paper aims to discuss the status and challenges to BFHI implementation in the EMR countries. Data on BFHI implementation, breastfeeding practices, and nutritional status were collected from countries through structured questionnaires, personal interviews, and databases. The 22 countries of the EMR were categorized as follows: 8 countries in advanced nutrition transition stage (group I), 5 countries in early nutrition transition stage (group II), 4 countries with significant undernutrition (group III), and 5 countries in complex emergency (group IV). The challenges to BFHI implementation were discussed in relation to malnutrition. BFHI was not implemented in 22.7% of EMR countries. Designated Baby-Friendly hospitals totaled 829 (group I: 78.4%, group II: 9.05%; group III: 7.36%; group: IV5.19%). Countries with advanced nutrition transition had the highest implementation of BFHI but the lowest breastfeeding continuity rates. On the other hand, poor nutritional status and emergency states were linked with low BFHI implementation and low exclusive breastfeeding rates but high continuity rates. Early initiation and longer duration of breastfeeding correlated negatively with overweight and obesity ( p < 0.001). In countries with emergency states, breastfeeding continues to be the main source of nourishment. However, suboptimal breastfeeding practices prevail because of poor BFHI implementation which consequently leads to malnutrition. Political willpower and community-based initiatives are needed to promote breastfeeding and strengthen BFHI in the region.

  12. Assessment of the Baby Friendly Hospital Initiative Implementation in the Eastern Mediterranean Region

    Directory of Open Access Journals (Sweden)

    Ayoub Al-Jawaldeh

    2018-03-01

    Full Text Available The Baby-Friendly Hospital Initiative (BFHI is a global program for promoting support and protection for breastfeeding. However, its impact on malnutrition, especially in countries of the Eastern Mediterranean region (EMR that are facing the turmoil of conflict and emergencies, deserves further investigation. Having said that, this paper aims to discuss the status and challenges to BFHI implementation in the EMR countries. Data on BFHI implementation, breastfeeding practices, and nutritional status were collected from countries through structured questionnaires, personal interviews, and databases. The 22 countries of the EMR were categorized as follows: 8 countries in advanced nutrition transition stage (group I, 5 countries in early nutrition transition stage (group II, 4 countries with significant undernutrition (group III, and 5 countries in complex emergency (group IV. The challenges to BFHI implementation were discussed in relation to malnutrition. BFHI was not implemented in 22.7% of EMR countries. Designated Baby-Friendly hospitals totaled 829 (group I: 78.4%, group II: 9.05%; group III: 7.36%; group: IV5.19%. Countries with advanced nutrition transition had the highest implementation of BFHI but the lowest breastfeeding continuity rates. On the other hand, poor nutritional status and emergency states were linked with low BFHI implementation and low exclusive breastfeeding rates but high continuity rates. Early initiation and longer duration of breastfeeding correlated negatively with overweight and obesity (p < 0.001. In countries with emergency states, breastfeeding continues to be the main source of nourishment. However, suboptimal breastfeeding practices prevail because of poor BFHI implementation which consequently leads to malnutrition. Political willpower and community-based initiatives are needed to promote breastfeeding and strengthen BFHI in the region.

  13. Assessment of the Baby Friendly Hospital Initiative Implementation in the Eastern Mediterranean Region

    Science.gov (United States)

    Al-Jawaldeh, Ayoub; Abul-Fadl, Azza

    2018-01-01

    The Baby-Friendly Hospital Initiative (BFHI) is a global program for promoting support and protection for breastfeeding. However, its impact on malnutrition, especially in countries of the Eastern Mediterranean region (EMR) that are facing the turmoil of conflict and emergencies, deserves further investigation. Having said that, this paper aims to discuss the status and challenges to BFHI implementation in the EMR countries. Data on BFHI implementation, breastfeeding practices, and nutritional status were collected from countries through structured questionnaires, personal interviews, and databases. The 22 countries of the EMR were categorized as follows: 8 countries in advanced nutrition transition stage (group I), 5 countries in early nutrition transition stage (group II), 4 countries with significant undernutrition (group III), and 5 countries in complex emergency (group IV). The challenges to BFHI implementation were discussed in relation to malnutrition. BFHI was not implemented in 22.7% of EMR countries. Designated Baby-Friendly hospitals totaled 829 (group I: 78.4%, group II: 9.05%; group III: 7.36%; group: IV5.19%). Countries with advanced nutrition transition had the highest implementation of BFHI but the lowest breastfeeding continuity rates. On the other hand, poor nutritional status and emergency states were linked with low BFHI implementation and low exclusive breastfeeding rates but high continuity rates. Early initiation and longer duration of breastfeeding correlated negatively with overweight and obesity (p < 0.001). In countries with emergency states, breastfeeding continues to be the main source of nourishment. However, suboptimal breastfeeding practices prevail because of poor BFHI implementation which consequently leads to malnutrition. Political willpower and community-based initiatives are needed to promote breastfeeding and strengthen BFHI in the region. PMID:29534482

  14. Healthcare waste management practices and risk perceptions: findings from hospitals in the Algarve region, Portugal.

    Science.gov (United States)

    Ferreira, Vera; Teixeira, Margarida Ribau

    2010-12-01

    The management of healthcare wastes is receiving greater attention because of the risks to both human health and the environment caused by inadequate waste management practices. In that context, the objective of this study was to analyse the healthcare waste management practices in hospitals of the Algarve region, Portugal, and in particular to assess the risk perceptions of, and actual risk to, healthcare staff. The study included three of the six hospitals in the region, covering 41% of the bed capacity. Data were collected via surveys, interviews, and on-site observations. The results indicate that waste separation is the main deficiency in healthcare waste practice, with correct separation being positively related to the degree of daily contact with the waste. Risk perceptions of healthcare staff show the highest levels for the environment (4.24) and waste workers (4.08), and the lowest for patients (3.29) and visitors (2.80), again being positively associated with the degree of daily contact. Risk perceptions of healthcare staff are related to the difficulties of the correct separation of wastes and the lack of knowledge concerning the importance of that separation. The risk of infection with needlesticks/sharps is higher during patient care than during waste handling, and the frequency of these injuries is related to the daily tasks of each healthcare group (doctors, nurses, and housekeepers). Furthermore, legislative definitions and classifications of healthcare wastes appear to have conditioned the management practices associated with, and the perceptions of risk concerning, healthcare wastes. Copyright © 2010 Elsevier Ltd. All rights reserved.

  15. 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)

  16. 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)

  17. 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)

  18. 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)

  19. 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)

  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. 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)

  3. 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.)

  4. 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.

  5. Impact of an antimicrobial stewardship intervention on appropriateness of prescribing for community-acquired pneumonia in an Australian regional hospital.

    Science.gov (United States)

    Bond, Stuart E; Boutlis, Craig S; Yeo, Wilfred W; Miyakis, Spiros

    2017-05-01

    Community-acquired pneumonia (CAP) is the second commonest indication for antibiotic use in Australian hospitals and is therefore a frequent target for antimicrobial stewardship. A single-centre prospective study was conducted in a regional referral hospital comparing management of adult patients with CAP before and after an educational intervention. We demonstrated a reduction in duration of therapy and reduced inappropriate use of ceftriaxone-based regimens for non-severe CAP. © 2017 Royal Australasian College of Physicians.

  6. Specialized consultant in radiological safety to the Villahermosa regional hospital, PEMEX. IV. - November and December of 2002

    International Nuclear Information System (INIS)

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

    2003-02-01

    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)

  7. Specialized consultant in radiological safety to the Villahermosa regional hospital, PEMEX. III. - September and October of 2002

    International Nuclear Information System (INIS)

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

    2003-02-01

    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)

  8. Survey on changes of breast cancer radiotherapy in four hospitals within southeast coastal region of China

    International Nuclear Information System (INIS)

    Ji Yongling; Liu Jingjie; Tian Ye; Li Xianming; Zhu Yaqun; Yu De; Du Xianghui

    2010-01-01

    Objective: to explore the changes and the tendency of breast cancer radiotherapy in China within the past decade. Methods: A survey on breast cancer radiotherapy in 1999 and 2006 was conducted in 4 hospitals located within the southeast coastal region of China, including patients' clinical characteristics, the purpose of radiotherapy and its techniques. Results: The percentage of breast conservative treatment (BCT) increased from 3% in 1999 to 13% in 2006. For radiotherapy techniques in 2066 compared with 1999, the growth trend was found in use of breast immobilization devices (80% vs. 46%), treatment planning system (70% vs. 23%), and CT simulation (14% vs. 0). The frequency was increased in the chest wall irradiation after mastectomy (90% vs. 67%), but decreased in internal mammary region (30% vs. 76%) and axilla (37% vs. 69%) treatment. There were no differences in total dose and fractionation prescription. Conclusions: BCT was performed more frequently, but post-mastectomy radiotherapy was still essential option in China at present. Although some advanced techniques were applied frequently in clinical practice. Simulation, treatment planning, and irradiation target design were urgent for improvement and standardization. (authors)

  9. PRENATAL ASSESSMENT OF THEIR WOMEN OF REGIONAL HOSPITAL IN THE CITY OF TEFÉ-AM

    Directory of Open Access Journals (Sweden)

    Márcio Antônio Couto Ferreira

    2011-04-01

    Full Text Available With the objective of evaluating the quality of prenatal and analyse the epidemiological data of their women in the city of Tefé, in the interior of the Amazon, was a study descriptive and quantitative, secondary source documentation, by evaluation of the book of records that contain information about the card of their women who attended prenatal 93 in Tefé Regional Hospital of that city in April 2009. The results showed that the average age of women in labour was 23.3 years, most completed elementary education, and more than 50% have stable relationship, being three the number of children. Regarding prenatal assessment, 55% prenatal began until the fourth month, approximately 46% held six consultations during the prenatal,22.6% had 65.6% have 6 queries, at least 1 time basic examinations and 77% were immunized. The comparison of these results with other studies conducted in different regions of Brazil served as a tool to compare prenatal assessment in several Brazilian States. Is of great value the result of this research for improvement of care, since there are no records of assessment of quality of care provided during prenatal Amazonas State and also to encourage new research in the State.

  10. 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.

  11. 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

  12. Energy in France

    International Nuclear Information System (INIS)

    Benard, M.

    1992-01-01

    Geography and clear political leadership have combined to put France in the forefront of both nuclear and hydro-electric generation and energy efficiency so that about 90% of France's electricity is generated by non-fossil fuels. This article explains how and why France has developed its energy mix. (Author)

  13. Factors affecting performance of hospital nurses in Riyadh Region, Saudi Arabia.

    Science.gov (United States)

    Al-Ahmadi, Hanan

    2009-01-01

    The purpose of this paper is to identify factors influencing performance of hospital nurses in Riyadh Region, Saudi Arabia. Specific objectives were to estimate self-reported performance, and determine whether differences in employee demographics, job satisfaction, and organizational commitment, influenced performance. In total, 15 hospitals were randomly selected. The questionnaire was sent to all nurses (1,834) in these facilities and 923 nurses responded. Statistical analysis included correlation, t-test, and regression analysis. The study finds that job performance is positively correlated with organizational commitment, job satisfaction and personal and professional variables. Both job satisfaction and organizational commitment are strong predictors of nurses' performance. Job performance is positively related to some personal factors, including years of experience, nationality, gender, and marital status. Level of education is negatively related to performance. The findings of this study have a limited generalisability due to the fact that all measures used are based on self-reports. Future research may be directed to other objective measures of performance. Emphasis should be placed on effective supervision, empowerment, and a better reward system. Cultural diversity is a reality for most health organizations in Saudi Arabia; therefore, they need to adopt effective human resources strategies that aim to improve commitment and retention of qualified workers, and build a high performance organizational culture based on empowerment, open communication, and appreciation of impact of national culture on work attitudes. This study fulfills a research gap in the area of nursing performance, and its relationship with work attitudes in Saudi Arabia. The paper also highlights the impact of national culture on job performance and work attitude among nurses in Saudi Arabia, and other countries facing the issue of multi-national work force.

  14. [Clinical pharmacy: Evaluation of physician's satisfactions and expectations in a French regional hospital].

    Science.gov (United States)

    Jennings, P; Lotito, A; Baysson, H; Pineau-Blondel, E; Berlioz, J

    2017-03-01

    The purpose of the study was to evaluate physician's satisfaction with the clinical pharmacy activities in a French regional hospital. Data were collected by face-to-face interviews carried out by a public health intern with physicians from 14 different departments of medicine and surgery. A specifically designed questionnaire was used for this study. This contained 18 closed-ended questions, 3 open-ended questions and 6 questions relating to the multidisciplinary analysis of prescriptions of elderly patients. The questionnaire was proposed to 78 physicians, of which 62 replied (participation rate of 79%). Thirty-seven percent were interns (23/62), 19% were assistants (12/62) and 44% were senior physicians (27/62). Clinical pharmacy satisfaction levels were generally very high. In regard to clinical skills, 87% of the physicians were satisfied with pharmacists' competencies and 91% by the pertinence of transmitted information. Ninety-five percent of the physicians were also satisfied by the logistical aspect and the relationship with pharmacists (reactivity, availability and communication). Analysis of the open-ended questions showed that physicians were in favour of the increased presence of clinical pharmacists on the wards. This study shows a high level of physician satisfaction in relation to the clinical pharmacy activities in our hospital, and should be viewed as a strong endorsement of the work of the clinical pharmacy. This study highlights some areas of improvement such as increase presence of the clinical pharmacists on the wards. In order to assess periodically our activity, this study must be repeated in the future. Copyright © 2016 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

  15. [Lateral hostilities among emergency and critical care nurses. Survey in five hospitals of the Tuscany Region].

    Science.gov (United States)

    Bambi, Stefano; Becattini, Giovanni; Pronti, Fabio; Lumini, Enrico; Rasero, Laura

    2013-01-01

    Lateral hostilities among emergency and critical care nurses. Survey in five hospitals of Tuscany Region. Introduction. Lateral hostilities (LHs) are a kind of workplace violence. They are defined as varieties of cruel, rude, antagonistic interactions between people at the same hierarchical level. Nurses are affected by LH from 5.7% to 65%, leading to reduced work motivation, psycho-physical disorders, and in some cases, drop out of the nursing profession. Objective. To quantify the LHs among nurses in the emergency departments (ED) and intensive care units (ICU) in 5 hospitals of Tuscany (Italy). To show the impact on the quality of their psycho-physical and professional lives. Method. Exploratory-descriptive study, through closed-ended questionnaire. Results. 360/444 nurses (81%); 294 (81.6%) were victims of LHs during the past 12 months. Gossiping, complaints shared with others without discussing with the concerned person, and sarcastic comments were the most reported LHs. LHs occur more in EDs than ICUs (respectively 90% and 77%; p=0.0038). No statistically significant differences were observed for gender, age, or years of experience. The 17.7% of nurses asked to be moved from the ward, and 6.9% left it; 6.9% respondents had thought to leave the nursing profession; 235 (65.2%) experienced at least one LHs related disorder during the last year. Most reported symptoms were low morale, anxiety, and sleep disturbances. Conclusions. The incidence of LH and related disorders is high in EDs and ICUs, determining a low professional and psycho-physical quality of life.

  16. Candidemia in a major regional tertiary referral hospital – epidemiology, practice patterns and outcomes

    Directory of Open Access Journals (Sweden)

    Jocelyn Qi-Min Teo

    2017-03-01

    Full Text Available Abstract Background 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. Methods 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. Results 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 < 0.001 and higher SAPS II scores (p = 0.02, while prior exposure to echinocandins was associated with isolation of C. parapsilosis (p = 0.001. Echinocandins (73.3% were most commonly prescribed as initial treatment. The median (range time to initial treatment was 1 (0–9 days. The 30-day in-hospital mortality rate was 49.8%. High SAPS II score (Odds ratio, OR 1.08; 95% confidence interval, CI 1.05–1.11 and renal replacement therapy (OR 5.54; CI 2.80–10.97 were independent predictors of mortality, while drain placement (OR 0.44; CI 0.19–0.99 was protective. Conclusions Decreasing azole susceptibilities to C. tropicalis and the emergence of echinocandin resistance suggest that susceptibility

  17. The change in capacity and service delivery at public and private hospitals in Turkey: a closer look at regional differences.

    Science.gov (United States)

    Aksan, Hediye A D; Ergin, Işıl; Ocek, Zeliha

    2010-11-01

    Substantial regional health inequalities have been shown to exist in Turkey for major health indicators. Turkish data on hospitals deserves a closer examination with a special emphasis on the regional differences in the context of the rapid privatization of the secondary or tertiary level health services.This study aims to evaluate the change in capacity and service delivery at public and private hospitals in Turkey between 2001-2006 and to determine the regional differences. Data for this retrospective study was provided from Statistical Almanacs of Inpatient Services (2001-2006). Hospitals in each of the 81 provinces were grouped into two categories: public and private. Provinces were grouped into six regions according to a development index composed by the State Planning Organisation. The number of facilities, hospital beds, outpatient admissions, inpatient admissions (per 100 000), number of deliveries and surgical operations (per 10 000) were calculated for public and private hospitals in each province and region. Regional comparisons were based on calculation of ratios for Region 1(R1) to Region 6(R6). Public facilities had a fundamental role in service delivery. However, private sector grew rapidly in Turkey between 2001-2006 in capacity and service delivery. In public sector, there were 2.3 fold increase in the number of beds in R1 to R6 in 2001. This ratio was 69.9 fold for private sector. The substantial regional inequalities in public and private sector decreased for the private sector enormously while a little decrease was observed for the public sector. In 2001 in R1, big surgical operations were performed six times more than R6 at the public sector whereas the difference was 117.7 fold for the same operations in the same regions for the private sector. These ratios decreased to 3.6 for the public sector and 13.9 for the private sector in 2006. The private health sector has grown enormously between 2001-2006 in Turkey including the less developed

  18. The change in capacity and service delivery at public and private hospitals in Turkey: A closer look at regional differences

    Directory of Open Access Journals (Sweden)

    Ergin Işıl

    2010-11-01

    Full Text Available Abstract Background Substantial regional health inequalities have been shown to exist in Turkey for major health indicators. Turkish data on hospitals deserves a closer examination with a special emphasis on the regional differences in the context of the rapid privatization of the secondary or tertiary level health services. This study aims to evaluate the change in capacity and service delivery at public and private hospitals in Turkey between 2001-2006 and to determine the regional differences. Methods Data for this retrospective study was provided from Statistical Almanacs of Inpatient Services (2001-2006. Hospitals in each of the 81 provinces were grouped into two categories: public and private. Provinces were grouped into six regions according to a development index composed by the State Planning Organisation. The number of facilities, hospital beds, outpatient admissions, inpatient admissions (per 100 000, number of deliveries and surgical operations (per 10 000 were calculated for public and private hospitals in each province and region. Regional comparisons were based on calculation of ratios for Region 1(R1 to Region 6(R6. Results Public facilities had a fundamental role in service delivery. However, private sector grew rapidly in Turkey between 2001-2006 in capacity and service delivery. In public sector, there were 2.3 fold increase in the number of beds in R1 to R6 in 2001. This ratio was 69.9 fold for private sector. The substantial regional inequalities in public and private sector decreased for the private sector enormously while a little decrease was observed for the public sector. In 2001 in R1, big surgical operations were performed six times more than R6 at the public sector whereas the difference was 117.7 fold for the same operations in the same regions for the private sector. These ratios decreased to 3.6 for the public sector and 13.9 for the private sector in 2006. Conclusions The private health sector has grown

  19. Regional scheme for the connection to the grid of renewable energies: for the Hauts-de-France region, for the Nord-Pas-de-Calais region, for the Picardy region, the Alsace region, the Aquitaine region, the Auvergne region, the Lower-Normandy region, the Burgundy region, the Brittany region, the Centre-Val-de-Loire region, the Champagne-Ardennes region, the Franche-Comte region, the Upper Normandy region, the Ile-de-France region, the Languedoc-Roussillon region, the Lorraine region, the Midi-Pyrenees region, the Provence-Alps-Cote d'Azur region, the Pays-de-la-Loire region, the Poitou-Charentes region, the Rhone-Alps region. Technical and financial status of the scheme implementation

    International Nuclear Information System (INIS)

    2017-01-01

    This document gathers reports related to all French regions. Each one addresses the elaboration of the concerned regional scheme of connection of renewable energies to the distribution network (French acronym: S3REnR) which aims at anticipating and planning evolutions of electrical networks which are necessary for the integration of renewable energies. Illustrated by maps, tables and graphs, these reports propose indications of energy production locations, an identification of planned works, a presentation of the concerned region, of its existing grid and projects, an overview of the scheme content (initial status, results of consultations, adopted strategies, planned works), and an overview of the scheme implementation status

  20. Examining leadership as a strategy to enhance health care service delivery in regional hospitals in South Africa

    Science.gov (United States)

    Govender, Sagaren; Gerwel Proches, Cecile N; Kader, Abdulla

    2018-01-01

    Background Four public hospitals in South Africa, which render both specialized and nonspecialized services to thousands of patients, were examined to determine the impact of leadership on health care service delivery. These hospitals were inundated by various problems that were impacting negatively on health care service delivery. Purpose This research study aimed to gain a comprehensive understanding of the challenges, complexities and constraints facing public health care in KwaZulu-Natal (KZN) and to examine leadership as a strategy to enhance healthcare service delivery with a particular focus on four regional hospitals in the KZN Province. Methods The mixed-method research approach was utilized. Purposive sampling and stratified random sampling were employed in the research setting, and in-depth, semistructured interviews and questionnaires were used to collect data. Data were analyzed using the Nvivo computer software package for in-depth interviews and the Statistical Package for the Social Sciences (SPSS) software for the quantitative analysis. Results The research findings showed that the current leadership framework adopted by the health care leaders in regional hospitals in KZN is weak and is contributing to poor health care service delivery. Conclusion This study, therefore, aimed to address the current challenges and weaknesses that are impacting negatively on health care service delivery in regional hospitals in the KZN Province and made recommendations for improvement. PMID:29535529

  1. Examining leadership as a strategy to enhance health care service delivery in regional hospitals in South Africa.

    Science.gov (United States)

    Govender, Sagaren; Gerwel Proches, Cecile N; Kader, Abdulla

    2018-01-01

    Four public hospitals in South Africa, which render both specialized and nonspecialized services to thousands of patients, were examined to determine the impact of leadership on health care service delivery. These hospitals were inundated by various problems that were impacting negatively on health care service delivery. This research study aimed to gain a comprehensive understanding of the challenges, complexities and constraints facing public health care in KwaZulu-Natal (KZN) and to examine leadership as a strategy to enhance healthcare service delivery with a particular focus on four regional hospitals in the KZN Province. The mixed-method research approach was utilized. Purposive sampling and stratified random sampling were employed in the research setting, and in-depth, semistructured interviews and questionnaires were used to collect data. Data were analyzed using the Nvivo computer software package for in-depth interviews and the Statistical Package for the Social Sciences (SPSS) software for the quantitative analysis. The research findings showed that the current leadership framework adopted by the health care leaders in regional hospitals in KZN is weak and is contributing to poor health care service delivery. This study, therefore, aimed to address the current challenges and weaknesses that are impacting negatively on health care service delivery in regional hospitals in the KZN Province and made recommendations for improvement.

  2. Variation in the place of death among nursing home residents in France.

    Science.gov (United States)

    Morin, Lucas; Johnell, Kristina; Aubry, Régis

    2015-05-01

    recent studies have reported that hospitals have become a common place of death for nursing home residents. This study aimed to (i) measure variations in the proportion of in-hospital deaths across regions after adjustment for facility-level characteristics and (ii) identify environmental risk factors that might explain these variations in France. a cross-sectional retrospective survey was conducted in 2013. coordinating physicians in 3,705 nursing homes in France. a regression model was used to construct risk-adjusted rates of in-hospital deaths considering the facilities' characteristics. At the regional level, the outcome was defined as the difference between the observed rate of in-hospital deaths and the expected risk-adjusted rate. Values exceeding zero indicated rates that exceeded the national predicted rate of in-hospital deaths and thus highlighted regions in which the risk-adjusted probability for nursing home residents to die in a hospital was greater than average. among 70,119 nursing home decedents, 25.4% (n = 17,789) died in hospitals. The characteristics of the facilities had a significant influence on the proportion of in-hospital deaths among the nursing home decedents. However, after adjustment for these facility-level risk factors, the proportion of nursing homes that reported worse-than-average outcomes showed significant variation (range 26.0-79.6%). At the regional level, both the rate of acute hospital beds and the rate of general practitioners were found to be strongly correlated with the probability of reporting worse-than-average outcomes (P nursing home facilities. © The Author 2015. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  3. [Social skills in emergency and critical care professionals of a regional public hospital].

    Science.gov (United States)

    Leal Costa, C; Luján Cebrián, I; Gascón García, J; Ferrer Villalonga, L; Van-der Hofstadt Román, C J

    2010-01-01

    To assess the social skills of health care professionals in the emergency and critical care units of the regional hospital Vega Baja and analyze the association between a series of sociodemographic and professionals variables and social skills. A cross-sectional, descriptive study. Two evaluation tools were used. These included a sociodemographic and professional variables questionnaire, and the Elena Gismero's Social Skills Scale (SSS). A response rate of 82.6% was obtained. Considering the standards made by the author in SSS validation, it can be seen that the sample has obtained a medium-high score in each one of the aspects. Significant differences have been found when considering the sociodemographic variable gender as an independent variable with the complete score of SSS (F=6.555; p=0.013), and with the scale dimensions, self-expression in social situations (F=4.468; p=0.039) and making a demand (F=7.982; p=0.007). In each one of the SSS dimensions, the sample has obtained a slightly higher score than the standard sample and it within the 50-69 percentile. This indicates the existence of a medium-high level of Social Skill. The doctors score higher than the nurses, although these differences are not statistically significant. Copyright © 2010 Elsevier España, S.L. y SEEIUC. All rights reserved.

  4. Study of radiological risk at the Regional Hospital of Trujillo-Peru

    International Nuclear Information System (INIS)

    Regalado C, S.; Benavente A, T.; Celedonio O, E.; Vasquez A, M.

    1996-01-01

    The irradiation doses have been measured in operators, patients and members of public, who attend the diagnostic service of the Hospital Regional Docente in Trujillo, Peru by using TLD-100 and TLD-200. For cranium test, the results are 8,68 x 10 -3 mSv in operators and 7,8 x 10 -4 mSv in members of the public. It means a fatal cancer risk of 3,7 x 10 -7 and 3,9 x 10 -8 , respectively. For patients, the equivalent doses in the examined organs are 0,181 mSv in lung; 4,982 mSv in spine; 6,466 mSv in abdomen; 6,039 mSv in pelvis and 2,174 mSv in cranium. In order to maximize benefits for patients, a quality control program was carried out in x-ray equipment. It consisted in the measurement of an effective, average and maximum kilovoltage, as well as in the determination of the HVL, linearity, exposition time and coincidence between luminous and radiation fields. It was concluded that the measured doses are similar to the international ones reported. In the same way, it is indicated that it is possible to reduce risks in patients and operators by regulating kilo-voltages, adjusting the radiation fields and electronic calibration equipment. (authors). 4 refs., 2 tabs

  5. Malignant lymphomas in the material of the ENT Department of the Babinski Regional Hospital in Wroclaw

    International Nuclear Information System (INIS)

    Lewandowski, A.; Hejjamy, R.; Turek, W.; Gul, E.

    1994-01-01

    Two main groups of malignant lymphomas: Hodgkin's and non-Hodgkin's lymphomas have been presented as a poster. Their epidemiology has been discussed and attention has been called to the frequency of their occurrence in ENT diseases. Special attention has been also called to the significance of congenital and acquired immune deficiency syndromes and infectious factors in malignant lymphomas etiology. Histological classification has been described presenting difficulties in the division of non-Hodgkin's lymphomas and significance of the classification. in finding the appropriate way of treatment. Pathogenesis and diagnostic difficulties have been presented and attention to the significance of histologic diagnosis of lymphonodes taken as a whole from the neck. The aim of that was to avoid non-specific inflammatory changes which often occur in axillary and inguinal nodules described with special emphasis on out of nodules neoplastical changes. 23 cases of malignant lymphomas treated in the ENT Dept. of the Babinski Regional Hospital in Wroclaw in the years 1982-1992 have been presented. Special attention has been called to the correlation between advancement and ways of treatment. Two cases of lymphoma have been shown in the pictures. (author)

  6. [Neuromeningeal cryptococcosis in patients infected with HIV at Agadir regional hospital, (Souss-Massa, Morocco)].

    Science.gov (United States)

    Chadli, S; Aghrouch, M; Taqarort, N; Malmoussi, M; Ouagari, Z; Moustaoui, F; Bourouache, M; Oulkheir, S

    2018-03-01

    Neuromeningeal cryptococcosis (NMC) is a severe and fatal opportunistic infection. Lethality is frequent in the absence of treatment, especially in the presence of HIV co-infection. To determine the prevalence, epidemiological, clinical, biological and therapeutic aspects as well as the evolution of NMC for patients infected with HIV. This is a retrospective study of 40 cases of neuromeningeal cryptococcosis diagnosed in HIV-infected patients. Data are collected for 7 years (from January 2010 to December 2016) in the registers of the parasitology laboratory and the infectious diseases department at the regional hospital center in Agadir. A reduction in the prevalence of neuromeningeal cryptococcosis in HIV-infected patients was noted from 2010 to 2016 (3.66% to 0.83%). The overall prevalence of NMC was 1.53%. The mean age was 37±10 years old, with 90% of patients aged less than 45 years. The main clinical symptomatology was headache (75%). The main cytochemical abnormalities of cerebrospinal fluid analysis were hyperproteinorachy (60%), hypoglycorachy (63%) and lymphocytosis (50%). The mean CD4 cell count was 47/mm 3 . Patients were initially treated with amphotericin B, relayed with fluconazole. The overall lethality was 35%. Neuromeningeal cryptococcosis is a serious opportunistic infection in patients HIV-infected, and the lethality rate remains unacceptable. Fighting NMC in HIV+ patients requires early diagnosis, increased access to antiretrovirals, rapid introduction of appropriate treatment and the prescription of effective systemic antifungals. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  9. Presentations and Preceding factors of Drug Overdose amongst adolescents admitted to a Large Regional Hospital.

    LENUS (Irish Health Repository)

    Maduemem, KE

    2018-04-01

    Suicide is the third most common cause of death among adolescents globally, and poisoning is the leading method of attempted suicide. Survival after self-poisoning or drug overdose (OD) is common, providing an opportunity for secondary prevention. The aim of this study was to highlight pattern of presentations and preceding factors of OD in an adolescent population. We retrospectively evaluated the data of 85 adolescents presenting to a large regional hospital with OD over a 3-year period. The female-to-male ratio was 4.3:1. The median age of adolescents was 15.83 (range: 11.32 – 16.98) years. History of deliberate self-harm (DSH) was documented in 44.7%. Twenty-eight (33%) patients had been under the care of the CAMHS prior to index admission. Acetaminophen was the commonest drug used. Depression was the most common cause of mental illness in the study group. Substance abuse and conduct disorder were significantly commoner in males (p<0.05). Self-poisoning including OD in adolescence is a strong predictor of suicide; understanding the probable triggers can be significant in establishing appropriate prevention strategies.

  10. [Vaginal infections in pregnant women at the Regional Hospital of Sokode (Togo) in 2010 and 2011].

    Science.gov (United States)

    Tchelougou, D; Karou, D S; Kpotsra, A; Balaka, A; Assih, M; Bamoke, M; Katawa, G; Anani, K; Simpore, J; de Souza, C

    2013-01-01

    The aim of this study was to evaluate the prevalence of the major microorganisms causing vaginal infections in pregnant women consulting at the Regional Hospital of Sokodé and to assess their sensitivity to antibiotics. This prospective study took place from June 2010 through August 2011 and included 302 pregnant women from whom a sample was taken by a vaginal swab. Samples were processed for parasitic, bacterial, and fungal agents, by microscopic examination and culture. We isolated 273 germs, alone or in association in 221 women. These germs were distributed as follows: Gardnerella vaginalis (55.31%), Candida spp (30.77%), Staphylococcus aureus (5.49%), Enterobacteriaceae (4.40%), Trichomonas vaginalis (3.66%) and Mobiluncus spp (0.37%). No Streptococcus strain was isolated during the study. Over 40% of women had bacterial vaginosis and 23.08% of them were coinfected. The occurrence of coinfection was statistically influenced by the stage of pregnancy (P = 0.05). The susceptibility tests revealed that S. aureus developed a strong resistance to aminopenicillins (66.67%) and cephalosporins (>44.44%), while Enterobacteriaceae was resistant to cephalosporins and quinolones. (16.67%). This study showed that pregnant women in Sokode are still exposed to vaginal infection, caused mostly by G. vaginalis and Candida species. These results underline the need for at least one vaginal swab culture for each woman during pregnancy.

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

  13. 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

  14. Energy statistics France; Statistiques energetiques France

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-04-01

    This document presents statistical data on energy accounting in France compared to other european countries. Many tables and charts on energy consumption, energy invoice and prices are provided by sectors. (A.L.B.)

  15. 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......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......, 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...

  16. Rotavirus Infection in the Auckland Region After the Implementation of Universal Infant Rotavirus Vaccination: Impact on Hospitalizations and Laboratory Implications.

    Science.gov (United States)

    McAuliffe, Gary N; Taylor, Susan L; Drinković, Dragana; Roberts, Sally A; Wilson, Elizabeth M; Best, Emma J

    2018-01-01

    In July 2014, New Zealand introduced universal infant vaccination with RotaTeq (Merk & Co.) administered as 3 doses at 6 weeks, 3 and 5 months of age. We sought to assess the impact of rotavirus vaccination on gastroenteritis (GE) hospitalizations in the greater Auckland region and analyze changes in rotavirus testing in the period around vaccine introduction. Hospitalizations, laboratory testing rates and methods were compared between the pre-vaccine period (2009-2013), post-vaccine period (January 2015 to December 2015) and year of vaccine introduction (2014). There was a 68% decline in rotavirus hospitalizations of children Auckland region. However, continued rotavirus testing at pre-vaccine rates risks generating false positive results. Laboratories and clinicians should consider reviewing their testing algorithms before vaccine introduction.

  17. Climate index for France - Methodology

    International Nuclear Information System (INIS)

    2006-01-01

    According to the U.S. Department of Energy, an estimated 25% of the GNP is affected by weather-related events. The variations in temperature - even small ones - can also have long-lasting effects on the operational results of a company. Among other, the Energy supply sector is sensitive to weather risks: a milder or harsher than usual winter leads to a decrease or increase of energy consumption. The price of electricity on power trading facilities like Powernext is especially sensitive to odd changes in temperatures. Powernext and Meteo-France (the French meteorological agency) have joined expertise in order to promote the use of weather indices in term of decision making or underlying of hedging tools to energy actors, end users from any other sector of activity and specialists of the weather risk hedging. The Powernext Weather indices are made from information collected by Meteo-France's main observation network according to the norms of international meteorology, in areas carefully selected. The gross data are submitted to a thorough review allowing the correction of abnormalities and the reconstitution of missing data. Each index is fashioned to take into account the economic activity in the various regions of the country as represented by each region's population. This demographic information represents a fair approximation of the weight of the regional economic activity. This document presents the calculation methodology of average, minimum and maximum weather indexes with the winter and summer regression equations for the different economical regions of France. (J.S.)

  18. Increasing Regional Anesthesia Use in a Serbian Teaching Hospital through an International Collaboration

    Directory of Open Access Journals (Sweden)

    Curtis L. Baysinger

    2017-06-01

    Full Text Available Many low- and middle-income countries (LMICs report low rates of regional anesthesia (RA use for cesarean delivery (CD, despite its association with lower maternal major morbidity and mortality. Also, the prevalence of neuraxial analgesia for labor (NAL is often low in LMICs. We report on the results of a collaboration in clinical education over a multi-year period between Kybele Inc., an international non-profit organization, and Klinicki Centar Vojvodine (CCV, a teaching hospital in Novi Sad, Serbia, to increase RA use for CD and NAL at CCV. From late 2011 through 2015, teams from Kybele participated in annual to biannual didactic conferences and week-long bedside teaching efforts involving obstetric and anesthesia staff from CCV and surrounding hospitals. Ongoing contact occurred at least weekly between Kybele and the host to discuss progress. De-identified quality improvement data on total deliveries, numbers of elective and non-elective CDs, number of vaginal deliveries, type of anesthesia for CD, and the number of NALs were collected. RA use for CD increased to 25% in year 2015 versus 14% in base year 2011 [odds ratio (OR: 2.05; 95% confidence interval (CI: 1.73,2.42; p < 0.001]. NAL increased to 10.5% of laboring women in 2015 versus 1.2% in 2011 (OR: 9.6; 95% CI: 7.2, 12.8; p < 0.001. Greater increases for RA use during non-elective CD were observed between 2011 and 2015 (1.4 versus 7.5% of total CD; OR: 5.52; 95% CI: 2.63, 8.41; p < 0.001 relative to elective CD (12.5 versus 17.5% of total CD; OR: 1.48; 95% CI: 1.23, 1.77; p < 0.001. Overall, RA for CD increased during the 4 year collaboration but was not as great as reported in other countries with similar health-care demographics utilizing a similar program. Detailed descriptions of program interventions and barriers to change at CCV are presented.

  19. Increasing Regional Anesthesia Use in a Serbian Teaching Hospital through an International Collaboration.

    Science.gov (United States)

    Baysinger, Curtis L; Pujic, Borislava; Velickovic, Ivan; Owen, Medge D; Serafin, Joanna; Shotwell, Matthew S; Braveman, Ferne

    2017-01-01

    Many low- and middle-income countries (LMICs) report low rates of regional anesthesia (RA) use for cesarean delivery (CD), despite its association with lower maternal major morbidity and mortality. Also, the prevalence of neuraxial analgesia for labor (NAL) is often low in LMICs. We report on the results of a collaboration in clinical education over a multi-year period between Kybele Inc., an international non-profit organization, and Klinicki Centar Vojvodine (CCV), a teaching hospital in Novi Sad, Serbia, to increase RA use for CD and NAL at CCV. From late 2011 through 2015, teams from Kybele participated in annual to biannual didactic conferences and week-long bedside teaching efforts involving obstetric and anesthesia staff from CCV and surrounding hospitals. Ongoing contact occurred at least weekly between Kybele and the host to discuss progress. De-identified quality improvement data on total deliveries, numbers of elective and non-elective CDs, number of vaginal deliveries, type of anesthesia for CD, and the number of NALs were collected. RA use for CD increased to 25% in year 2015 versus 14% in base year 2011 [odds ratio (OR): 2.05; 95% confidence interval (CI): 1.73,2.42; p  < 0.001]. NAL increased to 10.5% of laboring women in 2015 versus 1.2% in 2011 (OR: 9.6; 95% CI: 7.2, 12.8; p  < 0.001). Greater increases for RA use during non-elective CD were observed between 2011 and 2015 (1.4 versus 7.5% of total CD; OR: 5.52; 95% CI: 2.63, 8.41; p  < 0.001) relative to elective CD (12.5 versus 17.5% of total CD; OR: 1.48; 95% CI: 1.23, 1.77; p  < 0.001). Overall, RA for CD increased during the 4 year collaboration but was not as great as reported in other countries with similar health-care demographics utilizing a similar program. Detailed descriptions of program interventions and barriers to change at CCV are presented.

  20. Key findings from a prospective trauma registry at a regional hospital in Southwest Cameroon.

    Directory of Open Access Journals (Sweden)

    Alain Chichom-Mefire

    Full Text Available Trauma is a leading cause of morbidity and mortality worldwide. Data characterizing the burden of trauma in Cameroon is limited. Regular, prospective injury surveillance can address the shortcomings of existing hospital administrative logs and medical records. This study aims to characterize trauma as seen at the emergency department (ED of Limbe Regional Hospital (LRH and assess the completeness of data obtained by a trauma registry.From January 2008 to October 2013, we prospectively captured data on injured patients using a strategically designed, context-relevant trauma registry instrument. Indicators around patient demographics, injury characteristics, delays in accessing care, and treatment outcomes were recorded. Descriptive, bivariate, and multivariate statistical analyses were conducted. About 5,617 patients, aged from 0.5-95years (median age of 26 years, visited the LRH ED with an injury; 67% were male. Students (27% were the most affected occupation category. Road traffic injuries (RTIs (56%, assault (22%, and domestic injuries (13% were the leading causes of injury. Two-thirds of RTIs were motorcycle-related. Working in transportation (AOR 4.42, p<0.001 and law enforcement (AOR 1.73, p = 0.004 were significant predictors of having a RTI. The trauma registry showed a significant improvement in completeness of all data (p<0.001 and it improved over time compared with previous administrative records. However, proportions of missing data still ranged from 0.5% to 8.2% and involved respiratory rate or Glasgow Coma scale.Implementation of a context-appropriate trauma registry in resource-constrained settings is feasible. Providing valuable, high-quality data, the trauma registry can inform trauma care quality improvement efforts and policy development. Study findings indicate the need for injury prevention interventions and policies that will prioritize high-risks groups, such as those aged 20-29 years, and those in occupations requiring

  1. 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.

  2. Hospital differences in rates of cesarean deliveries in the Sardinian region: An observational study

    Directory of Open Access Journals (Sweden)

    Massimo Cannas

    2014-11-01

    Full Text Available Background: The rates of cesarean deliveries have been increasing steadily in several European countries in recent decades, with Italy having the second-highest rate (38% in 2010, causing concern and debate about the appropriateness of many interventions. Moreover, some recent studies suggest that rates of common obstetric interventions are not homogeneous across hospitals, maybe not only because of patient case mix but also possibly because of different hospital practices and cultures. Thus, it is important to investigate whether the variation in rates of cesarean sections can be traced back to patient characteristics or whether it depends upon context variables at the hospital level. Objective and method: Using official hospital abstracts on deliveries that occurred in Sardinia over a two-year period, we implement multilevel logistic regression models in order to assess whether the observed differences in cesarean rates across hospitals can be justified by case-mix differences across hospitals. Results: The between-hospital variation in rates of cesarean delivery is estimated to be 0.388 in the model with only the intercept and 0.382 in the model controlling for the mother’s clinical and sociodemographic characteristics. Conclusions: The results show that taking into account the individual characteristics of delivered mothers is not enough to justify the observed variation across hospital rates, suggesting the important role of unobserved variables at the hospital level in determining cesarean section rates.

  3. 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.

  4. 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

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

    DEFF Research Database (Denmark)

    Heskestad, Ben; Baardsen, Roald; Helseth, Eirik

    2009-01-01

    it with previous Norwegian studies. METHODS: All head injured patients referred to Stavanger University Hospital during a one-year period (2003) were registered in a partly prospective and partly retrospective study. The catchment area for the hospital is strictly defined to a local population of 283...

  6. Inpatient antibiotic consumption in a regional secondary hospital in New Zealand.

    Science.gov (United States)

    Hopkins, C J

    2014-02-01

    Reporting of antibiotic consumption in hospitals is a crucial component of antibiotic stewardship, but data from Australasian secondary hospitals are scarce. The hypothesis of this audit is that antibiotic consumption in secondary hospitals would be lower than in tertiary centres. The study aims to present the first published audit of antibiotic consumption from a secondary hospital in New Zealand compared with two tertiary centres. Hospital population-level data were retrospectively accessed to identify all systemic antibiotics dispensed to adult inpatients at Taranaki District Health Board during 2011. Consumption was calculated in defined daily doses per 100 inpatient-days and per 100 admissions, stratified by drug class. Comparison was against published data from two tertiary centres. Total consumption was lower, but that of high-risk antibiotic classes was higher than both tertiary centres. The relative consumption of lincosamides was 4.0 and 2.6 times higher than the two tertiary centres, with an associated 14% incidence of Clostridium difficile associated diarrhoea within 3 months. Our secondary hospital appears to consume the wrong types of antibiotic rather than too much. Data from all Australasian hospitals, stratified by clinical service area and hospital level, are required for clinically relevant benchmarking. © 2014 The Author; Internal Medicine Journal © 2014 Royal Australasian College of Physicians.

  7. A case study of population health improvement at a Midwest regional hospital employer.

    Science.gov (United States)

    Long, D Adam; Sheehan, Paula

    2010-06-01

    This article reviews the population health improvement initiative of a Midwest regional hospital employer. Services included health risk assessments, health education, and motivational health coaching conducted telephonically. Outcomes categories for this program evaluation comprised participation rates, participant satisfaction, health status and behavior change, productivity change, health care claims savings, and return on investment. Participation rates varied widely with incentive structure, although retention of participants in coaching programs averaged 89%. The participant satisfaction rate for the last 14 months of interventions was 96%. Four years of population health status and behavior trending showed significant improvements in smoking status, dietary fat and fiber intake, exercise, mental health (ie, stress, effects depressive symptoms in the past year, life satisfaction), readiness to change (ie, diet, exercise, stress, smoking, body weight), perceptions of overall health, an index of good health habits, sum of lifestyle health risks, and sum of risks and chronic conditions. Body mass index showed nonsignificant improvements during the years of greatest participation (years 2 to 4). Indicators of productivity demonstrated improvements as well. These gains were noted for employees across all health risk statuses, which suggests population health improvement strategies can influence productivity even for healthy employees. Program year 3 was evaluated for health care claims savings using a 2-stage multivariate regression approach. Stage 1 was a computation of propensity-to-participate scores. Stage 2 was an estimation of per member per month (PMPM) claims savings for participant cohorts using a propensity score-weighted linear regression analysis. Participants averaged $40.65 PMPM savings over the control population. Program return on investment, including incentive costs and vendor fees, was 2.87:1.

  8. Post-Travel Consultations in a Regional Hub City Hospital, Japan.

    Science.gov (United States)

    Yaita, Kenichiro; Sakai, Yoshiro; Iwahashi, Jun; Masunaga, Kenji; Hamada, Nobuyuki; Watanabe, Hiroshi

    2016-01-01

    To clarify the characteristics of post-travel consultation services in Japan, particularly in the provinces, we analyzed our post-travel patients in the travel clinic of Kurume University Hospital located in Kurume City (a regional hub City in southwestern Japan). Sixty post-travel patients visited our clinic between April 2008 and October 2014 and participated in this study: 55 were Japanese and five were foreign. We summarized and compared the characteristics of the patients after dividing the Japanese participants into long-term travelers (>14 days) and short-term travelers (≤14 days). The foreign travelers were described in a separate analysis. Of the 55 Japanese travelers, the mean age (± standard deviation) was 37.3 ± 16.3 years, and 36 patients (65%) were men. Southeast Asia was the major destination (30/55, 55%), and business was stated as the major reason for travel (16/55, 29%). Post-exposure rabies prophylaxis (16/55, 29%) was the most common purpose for the consultations. There were 34 participants (62%) who were classified as short-term travelers. Fewer of the short-term travelers stated receiving pre-travel consultations compared with long-term travelers (11% vs. 79%, p=0.0002). The five foreign travelers included one dengue fever patient and two malaria patients. Most post-travel Japanese patients visited our clinic were short-term travelers who had not received any pre-travel consultation. One of the most common complaints, post-exposure rabies prophylaxis, could have been avoided to some extent by appropriate pre-travel consultations. The results of this study suggest that pre-travel consultations should therefore be encouraged for both long- and short-term travelers.

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

    Directory of Open Access Journals (Sweden)

    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

  10. Changing Trends of Skin Cancer: A Tertiary Care Hospital Study in Malwa Region of Punjab.

    Science.gov (United States)

    Lal, Sonal Tina; Banipal, Raja Paramjeet Singh; Bhatti, Deepak John; Yadav, Hanuman Prasad

    2016-06-01

    Skin cancer constitutes a small but significant proportion of patients with cancer. Although the presence of eumelanin in dark skin is protective against the development of skin cancer, it is increasingly being diagnosed in the Indian population. To study the profile of skin cancer patients presenting to a tertiary hospital in Malwa area of Punjab, India. Retrospective study was done to analyse the profile of skin cancer patients who attended the institution over one year from 1(st) December 2013 to 30(th) November 2014. A comprehensive review of aetiology and related risk factors was done to correlate the environmental factors with high skin cancer prevalence in this region. Skin cancer constituted (3.18%) 84 out of 2638 patients registered with cancer of all types. The age of the patients was 62±14.2 years and ranged from 27 to 92 yrs. Basal cell carcinoma (BCC) was the most common histological type(46/84, 54.76%) followed by squamous cell carcinoma (SCC) (31/84, 36.91%) and malignant melanoma (MM) (7/84, 8.33%). Male: female ratio was found to be 0.79:1. BCC showed higher female preponderance (phistory of prolonged exposure to sunlight. Skin cancer constitutes a small but significant proportion of patients with cancers. This study highlights a paradoxically increasing trend of BCC and female preponderance. Head and neck is the most common site involved. Exposure to Ultra Violet B (UVB) radiation and higher levels of arsenic in drinking water has been reported to be associated with skin cancers. Limited studies show that levels of arsenic and pesticides were higher in the samples of drinking water in Malwa area of Punjab. Therefore a multipronged strategy to provide safe drinking water supply and discouraging the indiscriminate use of pesticides is recommended.

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

    Science.gov (United States)

    2016-01-01

    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. PMID:28299158

  12. 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.

  13. [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

  14. In brief...France

    International Nuclear Information System (INIS)

    Anon.

    2008-01-01

    Among the different news we can find information about the situation of the radiation accidents at the hospital of Epinal in the east of France. The medical surveillance of the irradiated patients has allowed to find others cases of over exposure.These new cases add to a series of events enlightened in this service: 24 patients treated for a prostate cancer between may 2004 and august 2005 have been over exposed of about 20 % because of a bad use of the treatment planning software. 4 hundred patients treated for a prostate cancer between 2001 and 2006 have been over exposed of about 8% by an excessive use of the imaging controlling the positioning during the treatment. Among 4500 patients treated for different cancers between september 1987 and july 2000 and concerned by a programming error of an internal software, 312 patients have received an overexposure of about 7%. The Authority of nuclear safety and the Institute of radiation protection and nuclear safety (I.R.S.N.) publish the report of management 2006 on the Internet gate of the National network of environmental radioactivity measurements. The Internet site of the pluralist expertise group on the uranium mines sites of the Limousin opens at the address :www.gep-nucleaire.org. The high committee for the transparency and information on nuclear safety is officially created. The Asn has classified at the level 4+ of the experimental scale Asn-S.F.R.O. the accident occurred at the teaching hospital of Toulouse between the 11. april 2006 and the 18. april 2007 implying 145 patients treated by intracranial radiosurgery. (N.C.)

  15. Circulation of Pneumocystis dihydropteroate synthase mutants in France.

    Science.gov (United States)

    Le Gal, Solène; Damiani, Céline; Perrot, Maëla; Rouillé, Amélie; Virmaux, Michèle; Quinio, Dorothée; Moalic, Elodie; Saliou, Philippe; Berthou, Christian; Le Meur, Yann; Totet, Anne; Nevez, Gilles

    2012-10-01

    Data on the prevalence of Pneumocystis jirovecii (P. jirovecii) dihydropteroate synthase (DHPS) mutants in France are still limited. In this study, mutant prevalence in the Brest region (western France) was determined. Archival pulmonary specimens from 85 patients infected with P. jirovecii and admitted to our institution (University Hospital, Brest) from October 2007 to February 2010 were retrospectively typed at the DHPS locus using a polymerase chain reaction-restriction fragment length polymorphism assay. Type identification was successful in 66 of 85 patients. Sixty-four patients were infected with a wild type, whereas mutants were found in 2 patients (2/66, 3%). Medical chart analysis revealed that these 2 patients usually lived in Paris. Another patient usually lived on the French Riviera, whereas 63 patients were from the city of Brest. Thus, the corrected prevalence of mutants in patients who effectively lived in our geographic area was 0% (0/63). Taking into account that i) Paris is characterized by a high prevalence of mutants from 18.5% to 40%, ii) infection diagnoses were performed in the 2 Parisians during their vacation Paris to Brest through infected vacationers. The study shows that the usual city of patient residence, rather than the city of infection diagnosis, is a predictor of mutants and that P. jirovecii infections involving mutants do not represent a public health issue in western France. Copyright © 2012 Elsevier Inc. All rights reserved.

  16. Energy data book. France in the world

    International Nuclear Information System (INIS)

    Catz, H.

    1999-01-01

    This memento about energy provides a series of tables with numerical data relative to energy resources and uses in France, in the European Union and in the rest of the world: energy consumption and demand (primary energy demand, consumption, and efficiency per region and per source; forecasting, CO 2 emissions, energy independence, supplies, uses and imports, demand scenarios, energy savings..), power production (production per geopolitical region, in OECD countries and in France; peak load demand, power consumption and generation in France; hydro-power and thermal plants in France; total capacity, forecasts and exports), nuclear power (production, forecasting, reactors population, characteristics of French PWRs, uranium needs and fuel cycle), energy resources (renewable energies, fossil fuels and uranium reserves and production), economic data (gross national product, economic and energy indicators, prices and cost estimations), energy units and conversion factors (counting, calorific value of coals, production costs, energy units). (J.S.)

  17. MANEJO DE LOS RESIDUOS SOLIDOS HOSPITALARIOS EN EL SERVICIO DE ENFERMERIA, HOSPITAL REGIONAL HERMILIO VALDIZAN DE HUÁNUCO, 2015

    OpenAIRE

    Carbonelli Tuiro, Carbonelli Tuiro, Noemi Noemi

    2017-01-01

    Objetivo: Determinar el manejo de los residuos sólidos hospitalarios en el servicio de enfermería del Hospital Regional Hermilio Valdizan de Huánuco, 2015. Metodología: El presente Plan adopta la metodología descriptiva, prospectiva de corte transversal. Conclusiones: La cantidad de residuos hospitalarios según el área en el servicio de enfermería del Hospital Hermilio Valdizan fue mayor en el área de Emergencia con un promedio de residuos sólidos Biocontaminados al día de 11.56 kg; Res...

  18. The Spirit of France

    National Research Council Canada - National Science Library

    Greene, Jr, Philip

    1994-01-01

    .... Demonstrating unyielding perseverance to elevate France to a position of respect in the world arena, de Gaulle aggressively pursued national interest objectives to restore French national identity...

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

    Science.gov (United States)

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

    2015-08-01

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

  20. 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.

  1. Radioactive waste repositories and host regions: envisaging the future together. Synthesis of the FSC National workshop and community visit, Bar-le-Duc (France), 7-9 April 2009

    International Nuclear Information System (INIS)

    2010-01-01

    The 7. Forum on Stakeholder Confidence (FSC) National Workshop and Community Visit was held on 7-9 April 2009 in Bar-le-Duc, France. It was organised with the assistance of the CLIS (the Local Information and Oversight Committee of the Bure Laboratory) and the financial and logistical support of Andra, France's National Agency for the Management of Radioactive Waste. Amongst the participants were representatives of local and regional government (including six mayors and numerous local elected officials from five countries), civil society organisations, universities, waste management agencies, institutional authorities and some 20 FSC delegates from 13 countries and the European Commission. The workshop focused on the territorial implementation of France's high-level and long-lived intermediate-level waste management programme. Sessions addressed the French historical and legislative context, public information, reversibility, environmental monitoring and the issue of memory. The workshop also included a visit to the site of the underground laboratory located at Bure-Saudron, a reception by the Mayor of Bure and a dinner debate with the president of a local industry organisation. The synthesis is provided under the responsibility of the NEA Secretariat. It relies on verbatim notes taken during plenary sessions and accounts by assigned delegates (with thanks to Andra and to the Chairs of the round-table sessions). This synthesis has also been supported by the presentations and manuscripts kindly provided in good time by all the speakers. All these documents, in French or in English, are accessible online through the FSC web page (www.nea.fr/html/rwm/fsc/). (author)

  2. A hospital-based survey of primary hyperparathyroidism in the AsirRegion: Low prevalence or underdiagnosis

    International Nuclear Information System (INIS)

    Al-Shehri, Mohammed Y.

    1999-01-01

    The number of patients with primary hyperparathyroidism (PHP) seen at theAsir Central Hospital (ACH) is remarkably low. This observation has raisedthe question of whether there is a low prevalence of PHP in the Asir region,whether it is underdiagnosed, or perhaps a combination of other both factors.A survey of 15 hospitals in the Asir region was conducted for the cases ofPHP. All case notes of the patients with PHP are seen at ACH were reviewed.Also a sample of patients seen at ACH was chosen randomly. The charts ofthose found to have hypercalcemia were reviewed for the inclusion of PHP inthe diagnostic work-up. Only 13 patients with PHP were discovered. The eightpatients with PHP seen at ACH had advanced bone manifestations and seven ofthem had renal manifestations. Hypercalcemia was found in 39 out of 655patients seen at ACH. None of these had been investigated for PHP. The numberof patients with PHP seen in hospitals in the Asir region is very low.Underdiagnosis seems to be an important factor. Therefore, it is felt thatthere is a need for greater awareness of disease in the region. Furthermore,there is a need for national survey to measure the prevalence of PHP in SaudiArabia. (author)

  3. 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

  4. Outreach in southern France

    International Nuclear Information System (INIS)

    Jackson, D.

    1992-01-01

    France's Europort South community lives cheek by jowl with the chemical industry, with major complexes at For, Berre, and Lavera. Xavier Segond, technical adviser at the regional chemical industry association, Le Syndicat General des Industries Chimiques Provence-Alpes-Cote d'Azur Corse (SGIC), says a good relationship has grown over a period of 20 years. Segond describes Arco Chimie as an effective driving force for the Responsible Care effort in the region - partly because its US parent introduced the program on a worldwide basis in 1989, ahead of national industry association Union des Industries Chimiques (UIC; Paris). Arco's F2-billion ($373 million)/year Fos-sur-Mer site makes it a significant player. But in 1986 the company was a complete newcomer. We came to Fos as a US company, we had no Paris headquarters or French president, explains Dominique Lequeux, director/human resources. The community viewed the company with a mixture of curiosity and enthusiasm as a potential employer - about 330 people now work at the site. The day before the officials propylene oxide plant opening, we invited in local people, says Lequeux. That formed a good basis for its Responsible Care community outreach program. Now, schools, professional groups, and political groups make 20-25 plant visits each year

  5. 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.

  6. [Cooperation according to French Law "hospital, patients, health and territories": Pharmacists' involvement in Aquitaine region].

    Science.gov (United States)

    d'Elbée, M; Baumevieille, M; Dumartin, C

    2017-06-01

    In 2009, the French Act "Hospital, Patients, Health and Territories" (loi "Hôpital, Patients, Santé et Territoires") reorganized the outpatient care pathway and defined missions aimed at improving cooperation between pharmaceutical and medical professionals. Five years later, we conducted a survey among community pharmacists in order to assess the appropriation of these missions and the way cooperation was implemented. We also aimed to investigate factors that could hamper or ease the development of these activities in order to identify actions needed to improve pharmacists' involvement. In partnership with the local health authorities "Agence régionale de santé", we conducted a survey via an online questionnaire sent to pharmacy holders in July 2014 in Aquitaine region. Information was collected about the pharmacies, involvement in collaborative activities, and barriers to cooperation. Overall, 20% (249) of pharmacists responded to the survey. They owned predominantly rural pharmacies (46%) or neighborhood pharmacies (41%), with two pharmacists per pharmacy (48%). Regarding collaborative activities, the majority of pharmacists (78%) had conducted interviews with their patients taking vitamin K antagonist therapy and they were willing to continue (87%). The implication was less common concerning other actions such as referent pharmacist for nursing homes (19%) or activities relating to therapeutic educational programs for patients with chronic conditions (34%). The vast majority of respondents (85%) were not aware of opportunities to become a correspondent pharmacist. The main obstacles for engaging in these activities were the lack of time, lack of knowledge about these missions and the lack of remuneration. We identified differences in pharmacists' involvement in collaborative activities depending on selected characteristics of the pharmacies. The findings of this survey underlined pharmacists' acceptance of these missions and suggest that better information

  7. The France energy situation

    International Nuclear Information System (INIS)

    2006-01-01

    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.)

  8. Electronic health record use in an affluent region in India: Findings from a survey of Chandigarh hospitals.

    Science.gov (United States)

    Powell, Adam C; Ludhar, Jasmine K; Ostrovsky, Yuri

    2017-07-01

    To characterize the electronic health record (EHR) systems in use in an affluent region of India in order to understand the state-of-the-art within the Indian market. A survey on EHR features was created by combining an instrument developed by the Organisation for International Cooperation and Development and an instrument developed by an American team of researchers. An interviewer directly administered the survey to leaders from hospitals in greater Chandigarh which possessed electronic health information systems. Summary statistics from the survey are reported. 24 hospitals offering multi-specialty inpatient care were identified in greater Chandigarh. 18 of these hospitals had electronic health information systems, 17 of which were interviewed. Of the hospitals with systems, 17 (100%) could access patient demographic information internally, but 12 (71%) could not access vital sign, allergy, or immunization data internally. 11 (65%) of the systems were capable of sharing patient summaries internally, but 13 (76%) could not send electronic referrals internally. Among organizations which have adopted systems, major barriers tend to have been around financial and staff matters. Concerns over interoperability, privacy, and security were infrequently cited as barriers to adoption. EHRs are ubiquitous in at least one region of India. Systems are more likely to have capabilities for intra-organizational information sharing than for inter-organizational information sharing. The availability of EHR data may foster clinical research. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. France at CERN

    CERN Multimedia

    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 ...

  10. Working Hours of Surgical Residence: Perspective of a Group of Surgeons in a Regional Hospital in Hong Kong

    OpenAIRE

    Lo, Siu-Fai; Spurgeon, Peter

    2007-01-01

    The Accreditation Council for Graduate Medical Education and European working time directive have restricted residents' workweek to 80 and 48 hours, respectively. Impacts on resident's training and health services are under evaluation in western countries. However, relevant studies are deficient in Hong Kong. Methods: Surgeons in a regional hospital of Hong Kong were recruited. Opinions were collected by semi-structured questionnaire. Results: Response rate was 82%. Most respondents agr...

  11. Prevalence and Factors Associated with Hydatidiform Mole among Patients Undergoing Uterine Evacuation at Mbarara Regional Referral Hospital

    OpenAIRE

    Mulisya, Olivier; Roberts, Drucilla J.; Sengupta, Elizabeth S.; Agaba, Elly; Laffita, Damaris; Tobias, Tusabe; Mpiima, Derrick Paul; Henry, Lugobe; Augustine, Ssemujju; Abraham, Masinda; Hillary, Twizerimana; Mugisha, Julius

    2018-01-01

    Objective. We sought to determine the prevalence of and factors associated with hydatidiform molar gestations amongst patients undergoing uterine evacuation at Mbarara Regional Referral Hospital (MRRH), Mbarara, Uganda. Methods. This was a cross-sectional study carried out from November 2016 to February 2017. All patients admitted for uterine evacuation for nonviable pregnancy were included. The study registered 181 patients. Data were collected on sociodemographics, medical conditions, obste...

  12. Climate index for France - Methodology; Indice climatique France - Methodologie

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2006-07-01

    According to the U.S. Department of Energy, an estimated 25% of the GNP is affected by weather-related events. The variations in temperature - even small ones - can also have long-lasting effects on the operational results of a company. Among other, the Energy supply sector is sensitive to weather risks: a milder or harsher than usual winter leads to a decrease or increase of energy consumption. The price of electricity on power trading facilities like Powernext is especially sensitive to odd changes in temperatures. Powernext and Meteo-France (the French meteorological agency) have joined expertise in order to promote the use of weather indices in term of decision making or underlying of hedging tools to energy actors, end users from any other sector of activity and specialists of the weather risk hedging. The Powernext Weather indices are made from information collected by Meteo-France's main observation network according to the norms of international meteorology, in areas carefully selected. The gross data are submitted to a thorough review allowing the correction of abnormalities and the reconstitution of missing data. Each index is fashioned to take into account the economic activity in the various regions of the country as represented by each region's population. This demographic information represents a fair approximation of the weight of the regional economic activity. This document presents the calculation methodology of average, minimum and maximum weather indexes with the winter and summer regression equations for the different economical regions of France. (J.S.)

  13. The acceptability of volunteer, repeat blood donations in a hospital setting in the Adamaoua region of Cameroon.

    Science.gov (United States)

    Rolseth, S; Stange, P; Adamou, D; Roald, B; Danki-Sillong, F; Jourdan, P

    2014-12-01

    The knowledge of factors that may influence blood donation in Cameroon is limited. The objectives of this study are to assess the characteristics of previous and potential blood donors by exploring the religious beliefs, and knowledge and understanding of blood donations among individuals present at a district hospital. Forty-nine in-depth, semi-structured interviews were conducted among consenting, randomly selected 18 years or older community members present at a district hospital in the Adamaoua region during October and November 2011. Ninety-eight per cent (48/49) of the individuals present at this district hospital had heard of blood transfusions. Forty-seven per cent (23/49) had not previously been asked to donate blood; however, 94% (44/47) said that they would donate if given the opportunity. Thirty-three per cent (16/49) had previously donated blood to family members or for replacement, and 81% of these said they would repeat donations. The majority of both donors and non-donors were motivated to donate blood for altruistic reasons. The findings suggest that community members present at this district hospital in Cameroon may be recruited for repeat blood donations. Although the altruistic motivation to donate blood suggests that donors could be recruited from a district hospital population, targeted information about blood donations and accessible blood transfusion services need to be put in place. The study may add to the understanding of the preconditions for blood donations and the possibility to establish sustainable blood transfusion services in the Adamaoua region in Cameroon. © 2014 British Blood Transfusion Society.

  14. France looks to biomass

    Energy Technology Data Exchange (ETDEWEB)

    1982-03-22

    France's Solar Energy Commission has announced a series of measures it is backing to increase the country's production of energy from biomass. Following consultations on suitable equipment, it has decided to go ahead with experiments of 15 systems designed to produce methane from animal wastes. Its eventual target is the production of between 1 million and 1.5 million tons per year of oil equivalent (toe) from this source. Secondly, it has launched a tender for the supply of domestic and industrial heating equipment capable of functioning on straw. It has calculated that the amount of straw available for this end use is in the region of 6 million ton per year, equivalent to about 2 million tons per year toe. Finally, tests are to be carried out in 14 different areas to determine the best variety of Jerusalem artichoke for the production of ethanol. Together with the Institut Francais du Petrole the Commission is building a demonstration unit for the production of acetone/butyric acid by fermentation of sugars from Jerusamlem artichoke and beet roots.

  15. Prevalencia de anemia en gestantes, Hospital Regional de Pucallpa, Perú

    Directory of Open Access Journals (Sweden)

    Becerra César

    1998-01-01

    Full Text Available Las encuestas demográficas de salud y población del Perú indican que las tasas globales de fecundidad, la proporción de adolescentes embarazadas y la mortalidad maternoinfantil son más altas en la selva que en otras zonas del país. Las parasitosis intestinales endémicas agravan el riesgo de anemia ya generalmente presente en las embarazadas por deficiencias de hierro, ácido fólico y otros nutrientes. En muchos países latinoamericanos, esa es la complicación más frecuente del embarazo y está asociada con partos pretérmino, bajo peso al nacer y mortalidad perinatal. Los estudios realizados sobre este tema en la selva peruana son escasos y no se dispone de estimaciones confiables de la prevalencia de anemia durante la gestación. Los autores se propusieron determinar la prevalencia de anemia en mujeres gestantes que acudían al Hospital Regional de Pucallpa, en la selva del Perú, entre enero de 1993 y junio de 1995. El estudio de corte transversal se basó en los registros de control prenatal y de parto de 1 015 embarazadas y permitió estudiar la asociación entre la prevalencia de anemia y variables como edad cronológica, escolaridad, número de gestaciones previas y peso de la madre al inicio del embarazo. También se compararon los valores de la hemoglobina materna con el peso de los recién nacidos. La prevalencia de anemia en la población de gestantes fue de 70,1%, valor que no se modificó por efecto de la edad materna, la escolaridad ni el intervalo intergenésico. La prevalencia de anemia se asoció directamente con el número de gestaciones e inversamente con la ganancia de peso durante el embarazo. La tasa de mortalidad perinatal fue de 37,7 por 1 000 nacidos. Ni esta tasa ni el peso de los recién nacidos resultaron asociados con el grado de anemia de la madre. El análisis de regresión multivariado muestra que el peso de la madre al inicio de la gestación (P = 0,0001, el peso ganado durante la gestación (P = 0

  16. 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.

  17. France's seismic zoning

    International Nuclear Information System (INIS)

    Mohammadioun, B.

    1997-01-01

    In order to assess the seismic hazard in France in relation to nuclear plant siting, the CEA, EDF and the BRGM (Mine and Geology Bureau) have carried out a collaboration which resulted in a seismic-tectonic map of France and a data base on seismic history (SIRENE). These studies were completed with a seismic-tectonic zoning, taking into account a very long period of time, that enabled a probabilistic evaluation of the seismic hazard in France, and that may be related to adjacent country hazard maps

  18. Register study of migrants' hospitalization in Norway: world region origin, reason for migration, and length of stay.

    Science.gov (United States)

    Elstad, Jon Ivar

    2016-07-26

    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. Sociodemographic information on all individuals residing in Norway at the start of 2008 was linked to data on all admissions to somatic hospitals during 2008-2011. Migrants, age 30-69, who had come to Norway during 1970-2007 (N = 217,907), were classified into seven world region origins and compared with native Norwegians of the same age (N = 2,181,948). Any somatic hospital stay 2008-2011 and number of hospital admissions 2008-2011 per 1000 personyears for a set of somatic diagnoses were analyzed by age and gender standardized rates, linear probability models, and Poisson regression. In the native Norwegian sample, 28.7 % had at least one admission 2008-2011, and there were 116 admissions per 1000 personyears. Corresponding age and gender adjusted figures for the migrant sample were 27.0 % and 103 admissions. Admission rates varied with migrants' geographical origin, with relatively many admissions among migrants from West and South Asia and relatively few admissions among migrants from Western, East European, and Other Asian countries. Hospitalization varied strongly with reason for migration, with low admission rates for recent work migrants and high admission rates for recent refugees. Admission rates tended to move towards the level among native Norwegians with increasing length of stay. Among longstanding migrants (arrival period 1970-1989), admission rates were close to the levels of native Norwegians for most analyzed migrant categories. Both world region origin, reason for migration, and duration of residence are important sources for variations in migrants' utilization of somatic hospitals. Forecasts about migrants' use of

  19. Retrospective audit of antimicrobial prescribing practices for acute exacerbations of chronic obstructive pulmonary diseases in a large regional hospital.

    Science.gov (United States)

    Brownridge, D J; Zaidi, S T R

    2017-06-01

    Chronic obstructive pulmonary disease (COPD) is associated with significant morbidity and mortality, and frequent exacerbations are associated with an increased risk of death, deterioration in lung function and reduced quality of life. Current Australian guidelines developed by the Lung Foundation of Australia (the COPD-X Plan) recommends the use of a short course of corticosteroids and oral antibiotics (amoxycillin or doxycycline) as part of the treatment of an AECOPD; however, it was noted that clinical practice at the study hospital had deviated from these guidelines. To evaluate the antibiotic prescribing practices in acute exacerbations of chronic obstructive pulmonary disease (AECOPD) patients, and to compare the differences in clinical outcomes (primarily mean length of stay and the rate of unplanned readmissions) between patients who received broad- vs. narrow-spectrum antibiotics in a large regional hospital. Retrospective audit of medical records for patients admitted with uncomplicated AECOPD during January-September, 2014 in a 224 acute bed regional hospital in Victoria, Australia. Fifty-nine per cent of patients received broad-spectrum antibiotics (ceftriaxone), whereas only 10% of prescriptions were concordant with current Australian guideline recommendations. Patients receiving a broad-spectrum regimen were more likely to be older (74·9 vs. 69·9 years; P = 0·009), have a higher COPD severity score (i.e. BAP-65 score, 1·55 vs. 1·06; P = 0·002) and a higher CRP (59·2 vs. 25·5 mg/L; P = 0·003) on admission. The mean LOS was not significantly different between those who received ceftriaxone and those who did not (5·09 vs. 4·55 days; P = 0·47). There was no significant difference between the groups in rates of readmissions. The antibiotic prescribing patterns for AECOPD in rural and regional Australian hospitals have not previously been examined in the current literature. In the study hospital, the majority of patients received broad

  20. Contributions of local and regional anthropogenic sources of metals in PM2.5 at an urban site in northern France.

    Science.gov (United States)

    Ledoux, Frédéric; Kfoury, Adib; Delmaire, Gilles; Roussel, Gilles; El Zein, Atallah; Courcot, Dominique

    2017-08-01

    PM 2.5 have been related to various adverse health effects, mainly due to their ability to penetrate deeply and to convey harmful chemical components, such as metals inside the body. In this work, PM 2.5 were sampled at Saint-Omer, a medium-sized city located in northern France, in March-April 2011 and analyzed for their total carbon, water-soluble ions, major and trace elements. More specifically, the origin of 15 selected elements was examined using different tools including enrichment factors, conditional bivariate probability function (CBPF) representations, diagnostic ratios and receptor modelling. The results indicated that PM 2.5 metal composition is affected by both emissions of a local glassmaking factory and an integrated steelworks located at a distance of 35 km from the sampling site. For the first time, diagnostic ratios were proposed for the glassmaking activity. Therefore, metals in PM 2.5 could be attributed to the following anthropogenic sources: (i) local glassmaking industry for Sn, As, Cu and Cr, (ii) distant integrated steelworks for Ag, Fe, Cd, Mn, Rb and Pb, (iii) heavy fuel oil combustion for Ni, V and Co and (iv) non-exhaust traffic for Zn, Pb, Mn, Sb, and Cu. The impact of such sources on metal concentrations in PM 2.5 was assessed using a constrained receptor model. Despite their low participation to PM 2.5 concentration (2.7%), the latter sources were found as the main contributors (80%) to the overall concentration levels of the 15 selected elements in PM 2.5 . Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. 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.

  2. Geographic Region and Profit Status Drive Variation in Hospital Readmission Outcomes Among Inpatient Rehabilitation Facilities in the United States.

    Science.gov (United States)

    Daras, Laura Coots; Ingber, Melvin J; Deutsch, Anne; Hefele, Jennifer Gaudet; Perloff, Jennifer

    2017-12-22

    To examine whether there are differences in inpatient rehabilitation facilities' (IRFs') all-cause 30-day postdischarge hospital readmission rates vary by organizational characteristics and geographic regions. Observational study. IRFs. Medicare fee-for-service beneficiaries discharged from all IRFs nationally in 2013 and 2014 (N = 1166 IRFs). Not applicable. We applied specifications for an existing quality measure adopted by Centers for Medicare & Medicaid Services for public reporting that assesses all-cause unplanned hospital readmission measure for 30 days postdischarge from inpatient rehabilitation. We estimated facility-level observed and risk-standardized readmission rates and then examined variation by several organizational characteristics (facility type, profit status, teaching status, proportion of low-income patients, size) and geographic factors (rural/urban, census division, state). IRFs' mean risk-standardized hospital readmission rate was 13.00%±0.77%. After controlling for organizational characteristics and practice patterns, we found substantial variation in IRFs' readmission rates: for-profit IRFs had significantly higher readmission rates than did not-for-profit IRFs (Preadmission rates than did IRFs in New England that had the lowest rates. Our findings point to variation in quality of care as measured by risk-standardized hospital readmission rates after IRF discharge. Thus, monitoring of readmission outcomes is important to encourage quality improvement in discharge care planning, care transitions, and follow-up. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  3. The energy in France (without French overseas departments) in 2002; L'energie dans les regions francaises (hors DOM) en 2002

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2005-07-01

    This document brings tables and maps of 2002 statistical data on the primary energy consumption in french regions, the final energy consumption by type of energy, the final energy consumption by consumption sectors and the final consumption by residents. It provides also, for each french region, more details concerning the economic indicators (Gross domestic Product, transportation sector, lifestyle...) and energy indicators for the different energy sources. (A.L.B.)

  4. Profile of Epilepsy in a Regional Hospital in Al Qassim, Saudi Arabia

    Science.gov (United States)

    Hamdy, Nermin A; Alamgir, Mohammad Jawad; Mohammad, El Gamri E; Khedr, Mahmoud H; Fazili, Shafat

    2014-01-01

    Introduction Epilepsy is a diverse set of chronic neurological disorders characterized by seizures. It is one of the most common of the serious neurological disorders. About 3% of people will be diagnosed with epilepsy at some time in their lives. Objectives We aimed to address the commonest types of seizures, their aetiologies, EEG and neuroimaging results and prognosis of patients presented to neurology services of the King Fahad Specialist Hospital- AlQassim (KFSH). Methodology In this retrospective epidemiological study we investigated the medical records of patients with epilepsy, who attended the neurology services of KFSH, during the study period (26/10/2011–26/4/2012). Results The study included 341 patients; 189 (55.4%) males and 152 (44.6%) females. Their ages ranged between 12 and 85 years (mean ± SD = 31±16.9). The majority of patients had Generalised Tonic Clonic Seizures (76.2%), followed by Complex Partial Seizures (7.6%). 73% of our patients had idiopathic epilepsy. The commonest causes for symptomatic epilepsy were Cerebro Vascular Accidents and Head trauma. Hemiplegia, mental retardation and psychiatric illness were the commonest comorbidity. 69.3% of patients had controlled seizures. Patients with idiopathic epilepsy were significantly controlled than patients with symptomatic epilepsy (P=0.01), and those using one Anti Epileptic Drug were significantly controlled compared to patients using polytherapy (P=0.0001) there was no significant relation between controlled seizure and duration of illness or hospitalization or EEG changes. Conclusion Seizure types, aetiology, drug therapy, Comorbidities and outcome in a tertiary care hospital in Saudi Arabia are similar to previous local and international studies. 35.3% of patients were hospitalized, higher rates than previous studies. Seizure control was better in generalized seizures and idiopathic epilepsy compared to complex partial seizures or partial seizures with secondary generalization and

  5. [A program for optimizing the use of antimicrobials (PROA): experience in a regional hospital].

    Science.gov (United States)

    Ugalde-Espiñeira, J; Bilbao-Aguirregomezcorta, J; Sanjuan-López, A Z; Floristán-Imízcoz, C; Elorduy-Otazua, L; Viciola-García, M

    2016-08-01

    Programs for optimizing the use of antibiotics (PROA) or antimicrobial stewardship programs are multidisciplinary programs developed in response to the increase of antibiotic resistant bacteria, the objective of which are to improve clinical results, to minimize adverse events and to reduce costs associated with the use of antimicrobials. The implementation of a PROA program in a 128-bed general hospital and the results obtained at 6 months are here reported. An intervention quasi-experimental study with historical control group was designed with the objective of assessing the impact of a PROA program with a non-restrictive intervention model to help prescription, with a direct and bidirectional intervention. The basis of the program is an optimization audit of the use of antimicrobials with not imposed personalized recommendations and the use of information technologies applied to this setting. The impact on the pharmaceutical consumption and costs, cost per process, mean hospital stay, percentage of readmissions to the hospital are described. A total of 307 audits were performed. In 65.8% of cases, treatment was discontinued between the 7th and the 10th day. The main reasons of treatment discontinuation were completeness of treatment (43.6%) and lack of indication (14.7%). The reduction of pharmaceutical expenditure was 8.59% (P = 0.049) and 5.61% of the consumption in DDD/100 stays (P=0.180). The costs by processes in general surgery showed a 3.14% decrease (p=0.000). The results obtained support the efficiency of these programs in small size hospitals with limited resources.

  6. [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.

  7. 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.

  8. 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.

  9. 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.

  10. Case study - France

    International Nuclear Information System (INIS)

    Rabouhams, J.

    1986-01-01

    This lecture concerns the training of the personnel of the PWR 900 MW twin units nuclear power station which is located in the Guangdong Province of the People's Republic of China. The following points are covered: General organization of the training; preparation and recruitment of personnel trained in France; training and qualification of the personnel trained in France; complementary training in PRC for the above personnel; training of additional personnel in PRC; attended retraining. (orig.)

  11. Nuclear safety in France

    International Nuclear Information System (INIS)

    Queniart, D.

    1989-12-01

    This paper outlines the organizational and technical aspects of nuclear safety in France. From the organization point of view, the roles of the operator, of the safety authority and of the Institute for Protection and Nuclear Safety are developed. From the technical viewpoint, the evolution of safety since the beginning of the French nuclear programme, the roles of deterministic and probabilistic methods and the severe accident policy (prevention and mitigation, venting containment) in France are explained

  12. Mass balance and decontamination times of Polycyclic Aromatic Hydrocarbons in rural nested catchments of an early industrialized region (Seine River basin, France).

    Science.gov (United States)

    Gateuille, David; Evrard, Olivier; Lefevre, Irène; Moreau-Guigon, Elodie; Alliot, Fabrice; Chevreuil, Marc; Mouchel, Jean-Marie

    2014-02-01

    Accumulation of Polycyclic Aromatic Hydrocarbons (PAHs) in soils and their subsequent release in rivers constitute a major environmental and public health problem in industrialized countries. In the Seine River basin (France), some PAHs exceed the target concentrations, and the objectives of good chemical status required by the European Water Framework Directive might not be achieved. This investigation was conducted in an upstream subcatchment where atmospheric fallout (n=42), soil (n=33), river water (n=26) and sediment (n=101) samples were collected during one entire hydrological year. PAH concentrations in atmospheric fallout appeared to vary seasonally and to depend on the distance to urban areas. They varied between 60 ng·L(-1) (in a remote site during autumn) and 2,380 ng·L(-1) (in a built-up area during winter). PAH stocks in soils of the catchment were estimated based on land use, as mean PAH concentrations varied between 110 ng·g(-1) under woodland and 2,120 ng·g(-1) in built-up areas. They ranged from 12 to 220 kg·km(-2). PAH contamination in the aqueous phase of rivers remained homogeneous across the catchment (72 ± 38 ng·L(-1)). In contrast, contamination of suspended solid was heterogeneous depending on hydrological conditions and population density in the drainage area. Moreover, PAH concentrations appeared to be higher in sediment (230-9,210 ng·g(-1)) than in the nearby soils. Annual mass balance calculation conducted at the catchment scale showed that current PAH losses were mainly due to dissipation (biodegradation, photo-oxidation and volatilization) within the catchments (about 80%) whereas exports due to soil erosion and riverine transport appeared to be of minor importance. Based on the calculated fluxes, PAHs appeared to have long decontamination times in soils (40 to 1,850 years) thereby compromising the achievement of legislative targets. Overall, the study highlighted the major role of legacy contamination that supplied the bulk of

  13. Relationships between aeroallergen levels and hospital admissions for asthma in the Brussels-Capital Region: a daily time series analysis.

    Science.gov (United States)

    Guilbert, Ariane; Cox, Bianca; Bruffaerts, Nicolas; Hoebeke, Lucie; Packeu, Ann; Hendrickx, Marijke; De Cremer, Koen; Bladt, Sandrine; Brasseur, Olivier; Van Nieuwenhuyse, An

    2018-04-11

    Outdoor pollen grain and fungal spore concentrations have been associated with severe asthma exacerbations at the population level. The specific impact of each taxon and the concomitant effect of air pollution on these symptoms have, however, still to be better characterized. This study aimed to investigate the short-term associations between ambient concentrations of various aeroallergens and hospitalizations related to asthma in the Brussels-Capital Region (Belgium), an area recording especially high rates of admissions. Based on administrative records of asthma hospitalizations and regular monitoring of 11 tree/herbaceous pollen taxa and 2 fungal spore taxa, daily time series analyses covering the 2008-2013 period were performed. Effects up to 6 days after exposure were captured by combining quasi-Poisson regression with distributed lag models, adjusting for seasonal and long-term trends, day of the week, public holidays, mean temperature and relative humidity. Effect modification by age and air pollution (PM, NO 2 , O 3 ) was tested. A significant increase in asthma hospitalizations was observed for an interquartile range increase in grass (5.9%, 95% CI: 0.0, 12.0), birch (3.2%, 95% CI: 1.1, 5.3) and hornbeam (0.7%, 95% CI: 0.2, 1.3) pollen concentrations. For several taxa including grasses, an age modification effect was notable, the hospitalization risk tending to be higher in individuals younger than 60 years. Air pollutants impacted the relationships too: the risk appeared to be stronger for grass and birch pollen concentrations in case of high PM 10 and O 3 concentrations respectively. These findings suggest that airborne grass, birch and hornbeam pollen are associated with severe asthma exacerbations in the Brussels region. These compounds appear to act in synergy with air pollution and to more specifically affect young and intermediate age groups. Most of these life-threatening events could theoretically be prevented with improved disease diagnosis

  14. [Frequency and in vitro susceptibility antiparasitic of Blastocystis hominis from patients admitted to the Hospital Regional Lambayeque, Peru].

    Science.gov (United States)

    Silva-Díaz, Heber; Flores-Esqueche, Lorena; Llatas-Cancino, Dunalia; Guevara Vásquez, Génesis; Silva-García, Teresa

    2016-01-01

    To describe the frequency and antiparasitic in vitro susceptibility of Blastocystis hominis in patients admitted to theHospital Regional Lambayeque, Peru. A cross-sectional study was conducted from January to August 2015 at 313 patients of all ages. B. hominis detection was performed on serial fecal samples by direct microscopic examination and microculture in modified Locke solution. The in vitro susceptibility testing against the drug metronidazole, nitazoxanide, trimethoprim-sulfamethoxazole and erythromycin was performed in 24 strains of B. hominis, which grew up (microculture method) in 10 double concentrations of each antimicrobial (from 256 ug/ml to 0.5 ug/mL) plus a control. 46.3% (145/313) of the sample had B. hominis, also the age between 12 to 17 years and 60 years was associated with higher frequency of parasites (OR: 2.93 and 2.62). The minimum inhibitory concentration (MIC) 90 of metronidazole and nitazoxanide was 3.19 ug/mL and 11.19 ug/ml, respectively, whereas the MIC 90 of trimethoprim-sulfamethoxazole and erythromycin were above 256 ug/mL. B. hominis occurs in high frequency in patients admitted to the Hospital Regional in Lambayeque, proving to be an important problem of public health in the region. Also B. hominis isolated from these patients were shown to be susceptible in vitro to low concentrations of metronidazole and nitazoxanide so they could be chosen for treatment of this parasite.

  15. 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

  16. H Hospit tal was ste gen i neratio in Owe on and erri, Ni mana igeria ...

    African Journals Online (AJOL)

    sunny

    This study disposal/ma. 12 hospital. Owerri Mun beds, lengt average wa hazardous .... health-care waste by regions with Africa excluded. Also, ... reported for Sylhet city is in consistence to that of Dhaka ... France (2.5 kg/bed/day) (Sarkar et al., 2006; Rahman et ... wastes, particularly in developing countries, despite been.

  17. 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

  18. Classification of hospital pathways in the management of cancer: application to lung cancer in the region of burgundy.

    Science.gov (United States)

    Nuemi, G; Afonso, F; Roussot, A; Billard, L; Cottenet, J; Combier, E; Diday, E; Quantin, C

    2013-10-01

    The evaluation of national cancer plans is an important aspect of their implementation. For this evaluation, the principal actors in the field (doctors, nurses, etc.) as well as decision-makers must have access to information that is reliable, synthetic and easy to interpret, and which reflects the implementation process in the field. We propose here a methodology to make this type of information available in the context of reducing inequalities with regard to access to healthcare for patients with lung cancer in the region of Burgundy. We used the national medico-administrative DRG-type database, which gathers together all hospital stays. By using this database, it was possible to identify and reconstruct the care management history of these patients. That is, by linking together all attended hospitals, sorted chronologically. Eligible patients were at least 18 years old, whatever the gender and had undergone surgery for their lung cancer. They had to be residents of Burgundy at the time of the first operation between 2006 and 2008. Patient's pathway was defined as the sequence of all attended hospitals (hospital stays) during the year of follow up linked together using an anonymised patient identifier. We then constructed a pathway typology of pathway using an unsupervised clustering method, and conducted a spatial analysis of this typology. Between 2006 and 2008, we selected 495 patients in the 4 administrative departments of the Burgundy region. They accounted for a total of 3821 stays during the year of follow-up. There were 393 men (79%) and the mean age was 64 (95% confidence interval: 63-65) years. We reconstructed 94 pathways (about five per patient). Here, neighbourhood's cares accounted for 41% of them, while 44% included a surgical intervention outside the region of Burgundy. We constructed a pathway typology with five classes. Spatial analysis showed that the vast majority of initial surgeries took place in the major regional centres. The construction

  19. 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.

  20. Anemia y deficiencia de hierro en mujeres en edad reproductiva usuarias del Hospital Regional de Villa Hayes, Paraguay

    OpenAIRE

    Jessica Riveros; Gloria Echagüe; Santiago Evers; Laura Mendoza

    2015-01-01

    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 a...

  1. EXPERIENCIAS PSICOSEXUALES DE PACIENTES HISTERECTOMIZADAS DEL SERVICIO DE GINECOLOGÍA DEL HOSPITAL REGIONAL DOCENTE LAS MERCEDES – CHICLAYO 2013

    OpenAIRE

    Núñez Manayay, Tania Mercedes; Universidad Señor de Sipán; Vera Ñañez, Huendy Jame; Universidad Señor de Sipán

    2014-01-01

     La presente investigación cualitativa titulada Experiencias psicosexuales de pacientes histerectomizadas del servicio de Ginecología del Hospital Regional Docente las Mercedes – Chiclayo 2013 tuvo como objetivo describir las experiencias psicosexuales de pacientes histerectomizadas. Con diseño estudio de caso; la muestra conformada por siete pacientes post histerectomizadas de seis meses a un año; en la recolección de datos se utilizó la observación y la entrevista semiestructurada, las que ...

  2. THE ROLE OF REGIONAL CENTERS AND UNIVERSITY CHILDREN’S HOSPITAL IN DEVELOPMENT OF HOME MECHANICAL VENTILATION NETWORK

    Directory of Open Access Journals (Sweden)

    Rsovac Snezana

    2017-08-01

    Full Text Available Application of home mechanical ventilators represents the future in the treatment of children with chronic respiratory insufficiency. In this way patients are treated in the home environment, they have full support from their families, they are protected against nosocomial infections and their condition is monitored by medical staff. The role of regional centers is very important in the future development of the home mechanical ventilation network. Doctors in these centers under the full support of the University Children's Hospital physicians can assist and monitor the treatment of children on the household respirators.

  3. [Peri-viability: limits of prematurity in a regional hospital in the last 10 years].

    Science.gov (United States)

    Solís Sánchez, G; Pérez González, C; García López, E; Costa Romero, M; Arias Llorente, R P; Suárez Rodríguez, M; Fernández Colomer, B; Coto Cotallo, G D

    2014-03-01

    To determine the preterm viability between 22 and 25 gestational weeks in our hospital in last 10 years. A descriptive retrospective study was conducted on preterms between 22-25 gestational weeks born between 1-1-2002 and 12-31-2011. There were 121 newborns, 45 (37%) stillbirths and 76 (63%) live births (16 died in delivery room, and 60 admitted to neonatal intensive unit). Among the 60 admitted, 34 died before hospital discharge, and 26 survived (21% of total, 34% of live births and 43% of those admitted to neonatal intensive unit). The causes of death were: 16 therapeutic effort limitation in delivery room, 8 therapeutic effort limitation in neonatal ward, 7 nosocomial sepsis, 7 NEC, 4 respiratory problems, and 8 of unknown cause. There were no survivors below 24 gestational weeks. Of the 26 survivors, 4 had major neurological disorders, and 11 with a normal neurological outcome. No significant statistical differences were found in the mortality between the two five-year periods analysed. The peri-viability has important clinical and ethical problems for neonatologist. Copyright © 2012 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  4. Management of mycetomas in France.

    Science.gov (United States)

    Mattioni, S; Develoux, M; Brun, S; Martin, A; Jaureguy, F; Naggara, N; Bouchaud, O

    2013-07-01

    Mycetomas are chronic sub-cutaneous tropical infections in which exogenous causative agents, fungal (eumycetes) or bacterial (actinomycetes), generate grains. The typical presentation is multi-fistulized pseudotumors. This disease, particularly eumycetoma, is difficult to treat. It is a major health problem in tropical and subtropical countries. In France, the disease is rare, but patients have access to a broader range of treatments. The authors had for objective to present the cases of mycetomas diagnosed in developed country and their management. A retrospective study was made on the clinical presentation and management of mycetomas from 1995 to 2011, in the Bobigny Avicenne teaching hospital. Six patient files were studied. The patients were men with a median age of 31 years (16-70). Five patients were from Sub Saharan Africa, one from Sri Lanka. The etiologies were one actinomycetoma and five eumycetomas. There was bone involvement in five cases. There was one atypical presentation: a primary intra-osseous mycetoma. Three patients were cured including two by surgical management and one by medical treatment (actinomycetoma). Antifungal therapy failed (four patients) in every case (voriconazole, itraconazole, ketoconazole, terbinafine, caspofungin). The results of this study made in a non-epidemic zone revealed that despite a typical clinical presentation, the diagnosis and management were delayed because this imported disease is rare in France. The patients received new broad-spectrum triazole and caspofungin, but none were cured with antifungal therapy alone. Copyright © 2013. Published by Elsevier SAS.

  5. 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.

  6. [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.

  7. 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

  8. Determinants of severe anemia among laboring mothers in Mekelle city public hospitals, Tigray region, Ethiopia.

    Directory of Open Access Journals (Sweden)

    Yirga Ebuy

    Full Text Available Anemia is a global public health problem that has affected a significant number of pregnant mothers worldwide. The World Health Organization has estimated the prevalence of anemia in pregnant women at 18% and 56% in developed and developing countries, respectively. This study aimed to identify factors associated with severe anemia among laboring women in Mekelle city public hospitals, Tigray, Ethiopia.This unmatched case-control study involved 264 (88 = cases and 176 = controls pregnant women who were recruited when they came for delivery service in Mekelle city public hospitals. The data was collected from July to August, 2016. In this study, a systematic sampling technique was used inselecting controls, but the cases were enrolled until the required sample size was reached. Bivariate and multivariate analyses were conducted to find predictors of severe anemia. Statistically significant predictors of severe anemia were identified at P-value <0.05 and 95% confidence interval.A total of 264 pregnant women who came for delivery services were enrolled in this study. The major predicting variables for the occurrence of severe anemia among laboring women were residency (AOR = 3.28, 95% CI: 1.26-8.48, number of pregnancies (AOR = 2.46, 95% CI: 1.14-5.29, iron folate supplementation (AOR = 3.29, 95% CI: 1.27-8.49, dietary diversification score (AOR = 3.23, 95% CI: 1.19-8.71 and duration of menstrual cycle (AOR = 2.37, 95% CI: 1.10-5.10. The variable 'blood loss during pregnancy' (AOR = 6.63 95% CI: 2.96-14.86 was identified as a strong predictor of the outcome variable, severe anemia.This study identified determinants of severe anemia among laboring women in Mekelle city public hospitals, Northern Ethiopia. To reduce anemia, strengthening health education provision related to the importance of birth spacing and consuming diversified and iron-enriched food should be considered. Moreover, screening of pregnant women for state of anemia during their

  9. Energy statistics. France; Statistiques energetiques. France

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2002-10-01

    This document summarizes in a series of tables the energy statistical data for France: consumption since 1973; energy supplies (production, imports, exports, stocks) and uses (refining, power production, internal uses, sectoral consumption) for coal, petroleum, gas, electricity, and renewable energy sources; national production and consumption of primary energy; final consumption per sector and per energy source; general indicators (energy bill, US$ change rate, prices, energy independence, internal gross product); projections. Details (resources, uses, prices, imports, internal consumption) are given separately for petroleum, natural gas, electric power and solid mineral fuels. (J.S.)

  10. Paludismo grave y complicado en niños. Hospital regional de Bata. Guinea Ecuatorial. 2003 Severe and complicated malaria in children at “Bata” Regional Hospital- Equatorial Guinea

    Directory of Open Access Journals (Sweden)

    Sandra Hernández García

    2005-09-01

    Full Text Available El paludismo grave es el causado por el Plasmodium falciparum, que cada año cobra millones de vidas en los países del tercer mundo, siendo los niños los más afectados, por este motivo se realizó estudio prospectivo, descriptivo transversal de los pacientes pediátricos que ingresaron con gota gruesa positiva a plasmodium falciparum, del mes de enero a julio del año 2003 en el hospital regional de Bata en Guinea Ecuatorial. Se encontró que el 49% de los ingresos correspondieron a los niños de 1-4 años, siguiendoles los menores de un año con 34,5% de casos. Se encontró que el 24% de los niños solo permanecieron un día en el hospital y el 67% de 2-5 días. Presentaron complicaciones 35,5% de los ingresados, la anemia severa fue la complicación que más se presentó (17,3%, los trastornos hidroelectrolíticos le siguieron con un 10%. Fallecieron 16 niños, de ellos con anemia severa 10 para (62,5%, con estadía de menos de un día fallecieron 7 pacientes y de 2-5 días otros 7 niños y entre los 6-13 días hubo 2 muertes. La principal recomendación fue que los niños con sospecha de paludismo deben ser atendidos inmediatamente para evitar las graves complicaciones de ésta enfermedad.Severe malaria is caused by Plasmodium falciparum taken millions of lives in Third World countries every year and being children the most affected. A descriptive, prospective, cross "sectional and correlational-casual study was carried out with pediatric patients who were admitted at Bata Regional Hospital in Equatorial Guinea after practicing a thick" film method test with positive results of plasmodium falciparum from January to July 2003, aimed at establishing clinical features of children affected by plasmodium falciparum determining the number of admissions, stay in hospital, complications and mortality, scientific methods used were empiric; analyzing documents and verbal interviews, statistic methods were: parametric samples and percentage

  11. 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

    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...... in 46 (74%) of the 62 cases reviewed. During the same time period MDA identified substandard care in 18 cases. Staff perceived poor organization of work and lack of training as important causes for substandard care. Local MDA was considered useful although time-consuming and sometimes threatening......, and staff dedication to the process was questioned. CONCLUSION: Quality assurance of emergency obstetric care might be strengthened by supplementing internal MDA with external CE....

  12. 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.

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

    Science.gov (United States)

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

    2016-01-01

    BACKGROUND 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. STUDY DESIGN AND METHODS 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. RESULTS 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 blood transfusions but only 41% (106) of these had a positive blood film. CONCLUSION In this setting, clinicians often order blood based on the clinical impression of “severe anemia.” This has implications for laboratory workload and the blood supply itself. However, the majority of children with severe anemia were appropriately transfused. The use of antimalarials with blood transfusions irrespective of blood film results is common practice. PMID:27611471

  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. 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 blood transfusions but only 41% (106) of these had a positive blood film. In this setting, clinicians often order blood based on the clinical impression of "severe anemia." This has implications for laboratory workload and the blood supply itself. However, the majority of children with severe anemia were appropriately transfused. The use of antimalarials with blood transfusions irrespective of blood film results is common practice. © 2016 The Authors. Transfusion published by Wiley Periodicals, Inc. on behalf of AABB.

  16. PATIENT SAFETY IN SURGERY: THE QUALITY OF IMPLEMENTATION OF PATIENT SAFETY CHECKLISTS IN A REGIONAL HOSPITAL

    Directory of Open Access Journals (Sweden)

    V. Karyadinata

    2012-09-01

    Full Text Available Introduction. Patient safety and the avoidance of inhospital adverse events is a key focus of clinical practice and medical audit. A large of proportion of medical errors affect surgical patients in the peri-operative setting. Safety checklists have been adopted by the medical profession from the aviation industry as a cheap and reliable method of avoiding errors which arise from complex or stressful situations. Current evidence suggests that the use of periooperative checklists has led to a decrease in surgical morbidity and hospital costs. Aim. To assess the quality of implementation of a modified patient safety checklist in a UK district general hospital. Methods. An observational tool was designed to assess in real time the peri-operative performance of the surgical safety checklist in patients undergoing general surgical, urological or orthopaedic procedures. Initiation of the checklist, duration of performance and staff participation were audited in real time. Results. 338 cases were monitored. Nurses were most active in initiating the safety checklist. The checklist was performed successfully in less than a minute in most cases. 11-24% of staff (according to professional group present in the operating room did not participate in the checklist. Critical safety checks (patient identity and procedure name were performed in all cases across all specialties. Variations were noted in checking other categories, such as deep vein thrombosis (DVT prophylaxis or patient warming. Conclusions. There is still a potential for improving the practice and culture of surgical patient safety activities. Staff training and designation of patient safety leadership roles is needed in increasing compliance and implementation of patient safety mechanism, such as peri-operative checklists. There is significant data to advocate the need to implement patient safety surgical checklists internationally

  17. 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

  18. 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.

  19. [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

  20. Electrical energy statistics for France

    International Nuclear Information System (INIS)

    2009-07-01

    ). Sales of energy between actors of the power system made of sales of the Balance Responsible Entities, sales of generation capacity auctions and sales on Powernext Day-Ahead Market reached 385.1 TWh, an increase of 1.0 % compared with 2007 (381.4 TWh). The statistics concerning the quality of supply are marked in 2008 by an increase of the long outages mainly due to the incident happened in Provence-Alpes-Cote d'Azur after a violent storm on November 3, 2008. Contents: 1 - Electrical energy balances: Monthly balance of the electrical energy flows on the RTE network and in France 2 - Capacity and energy: Daily capacity curves, National consumption and temperature, Daily high and low energy and capacity figures for 2008; 3 - Networks: Lines and cables in operation, Substations, Transformers owned by RTE, Cross-border lines at HVB voltage excluding Corsica; 4 - Physical exchanges: Trend in the balance of physical exchanges - France, Monotone of export balance - France excluding Corsica, Monthly monitoring of physical exchanges on the borders of the RTE network; 5 - Market mechanism: Contractual electricity exchanges with foreign countries, Daily market coupling between Netherlands (NL), Belgium (BE) and France (FR), Balance Responsible Entities (BR), Use of the VPP, Energy sales on Powernext, Balancing mechanism; 6 - Consumption of electricity: Trend of national consumption of electricity in France, Annual breakdown of end customers connected to the RTE network, Consumption of Large-scale industry and SME/SMIs: annual breakdown per activity, Monotone of capacity values called by national consumption in 2008; 7 - Generation of electricity: Developments in generating facilities in France, Injections on the RTE network by connection voltage, Injections on the RTE network by installation type; 8 - Technical performance of RTE: Quality of supply, Safety of the electric system; 9 - Regional data: Administrative limits, Description of the RTE network and technical performance

  1. [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

  2. 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.

  3. Musculoskeletal Problems Among Greek Perioperative Nurses in Regional Hospitals in Southern Peloponnese : Musculoskeletal Problems in Perioperative Nurses.

    Science.gov (United States)

    Bakola, Helen; Zyga, Sofia; Stergioulas, Apostolos; Kipreos, George; Panoutsopoulos, George

    2017-01-01

    The surgery unit is a particularly labor-intensive environment in the hospital. Studies reflect the correlation of labor risk factors for musculoskeletal injuries among nurses but few have investigated the relationship to perioperative nurses. The purpose of this study is the identification and definition of ergonomic risk factors in the operating room and their connection with musculoskeletal disorders in perioperative nurses in regional hospitals in Greece. Forty four Greek perioperative nurses working in regional hospitals in southern Peloponnese participated. Anonymous self-administered questionnaire was used to collect the data, which consisted of three parts (investigating musculoskeletal symptoms, description of work, psychometric evaluation). The analysis was done with the statistical program SPSS.19. Symptoms of musculoskeletal problems emerged. Specifically, 54.4% in the lumbar, 47.7% in the neck, 45.5% in the shoulder, followed by smaller percentages of the hip, knee, elbow and ankle. 6.8% of participants indicated no musculoskeletal symptoms in the last year while 74.9% of those who had symptoms presented them in two or more areas. Activities rated as a major problem among others were the manual handling, tools with weight and vibration etc. 100% of respondents agreed that the work in the surgery unit is demanding and has anxiety. The lack of support from the government (81.8%), combined with the low perioperative nurses (6.8%) having the opportunity to participate in administrative decisions concerning them were related to problems in the organization and management of work. Apart from engineers target factors, a main aim should be the organization of work within the framework of a national policy based on European directives on the protection and promotion of the health and safety of workers.

  4. Upgrading France's emergency plans

    International Nuclear Information System (INIS)

    Moures, Y.

    1991-01-01

    In France as elsewhere, the Chernobyl accident spurred a new stage in the development of nuclear safety. In the months following the accident, France's Minister of Industry launched a campaign to strengthen research and safety measures to: prevent reactor accidents; reinforce the concept of quality in operations; train staff, in areas such as crisis management; systematically review plans, installations and techniques related to crisis management; study accident containment procedures. There was also a systematic review of communication links with authorities and outside emergency organizations during the critical phase of an accident. On the operational level regulatory monitoring procedures were reorganized and reinforced. France has not opted for the permanent presence of on-site inspectors, but rather for the total, continuous responsibility of the power plant operator, with the safety authority intervening at frequent intervals. A major programme was also established to increase capabilities for investigation and intervention in a radioactive environment in nuclear installations. (author)

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

    OpenAIRE

    Delgado, M. Kit; Meng, Lesley J.; Mercer, Mary P.; Pines, Jesse M.; Owens, Douglas K.; Zaric, Gregory S.

    2013-01-01

    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 st...

  6. Characteristic of low vision patients attending an eye hospital in eastern region of Nepal.

    Science.gov (United States)

    Labh, R K; Adhikari, P R; Karki, P; Singh, S K; Sitoula, R P

    2015-01-01

    Low vision is an important public health problem. To study the profile of low vision patients in a hospital of Nepal. Information related to the patients' profile, visual status, ocular disease and, low vision devices prescribed were obtained retrospectively from the records of 1,860 visually- impaired patients, regardless of the cause, presenting to the low vision department of the Biratnagar Eye Hospital, Biratnagar, Nepal, over a period of four years. These patients, after a comprehensive ocular examination, underwent low vision examination by an ophthalmologist and a low vision specialist. Of 1,860 patients, males comprised 1298 (70 %), while 562 (30 %) patients were female. Six hundred and one (32.3%) patients were of less than 20 years while 398(21.4%) were more than 60 years of age. Agriculture (500, 27 %), household work (341, 18 %) and students (308, 17 %) were the common occupations. Retinal diseases were the commonest cause of low vision. They were: macular disorders 408 (22 %), retinitis pigmentosa 226 (12.1 %) and other retinal causes 361 (19.4 %) (diabetic retinopathy, choroidal coloboma, post laser for retinal vasculitis and central retinal/branch retinal vein occlusion, healed macular chorioretinal scar secondary to retinochroiditis and choroiditis). Refractive error 215 (11.5 %), amblyopia 49 (2.6 %), optic atrophy 144 (7.8 %) and microphthalmos 105 (5.6 %) were the other causes. Uncorrected distance visual acuity was between 6/24 and 6/60 in 509 (27.4 %) and between 5/60 and PL in 1,327 (71.3 %) patients. Similarly, near visual acuity with vision better than 2.50 M (N 20) and worse than 2.50 M (N20) was present in 643(34.5%) and 1,217(65.5%) patients. About 67% and 54.5% of the patients had some improvement in their distance and near visual acuity with glasses and low vision aids. Distance spectacles 909 (49 %), near spectacles 106 (5.7 %), hand held magnifiers 78 (4 %) and telescopes 18 (1 %) were the optical devices prescribed. The prevalence of

  7. Psychiatric consultations and the management of associated comorbid medical conditions in a regional referral hospital

    Directory of Open Access Journals (Sweden)

    Nkokone S Z Tema

    2015-05-01

    Full Text Available Background. Psychiatrists are often called upon to evaluate patients with a medical condition and psychiatric symptoms, either as a complication thereof or initial presenting symptoms. There are often grey areas with regard to neuropsychiatric disorders in which psychiatrists and specialists from other clinical disciplines would need to co-manage or share ideas on the comprehensive treatment of a presenting patient. Objectives. This study was undertaken to provide a demographic and clinical profile of all patients consulted by the consultation-liaison psychiatry (CLP service at the Helen Joseph Hospital (HJH in Johannesburg, and to describe the clinical management of patients admitted with a diagnosis of a mental disorder associated with a comorbid medical condition, including delirium, dementia and a mood or psychotic disorder due to a general medical condition. Methods. A retrospective record review of all patients referred to the HJH CLP team over a 6-month period. Results. A total of 884 routine and emergency consultations were done for 662 patients (males n=305; females n=357 between the ages of 13 and 90 years who were referred from various other clinical departments. The most common documented reason for referral was a request for assessment (n=182; 27.5%, which consisted of mental state assessment, reconsultation and assessing capacity. A total of 63 patients (10.0% of cases consulted were admitted to either the medical or psychiatric wards with a confirmed diagnosis of delirium, dementia and/or a mood or psychotic disorder due to a general medical condition (although admission wards were identified in 55 files only. The medical wards admitted the majority (n=37; 67.3% mostly for delirium (n=28; 50.9%. HIV was identified as the most common systemic aetiological factor (n=23; 67.7%. Conclusion. In this study, a female patient between 31 and 45 years of age was slightly more likely to be referred to the HJH CLP service for assessment, and

  8. Association between in-hospital mortality and renal dysfunction in 186,219 patients hospitalized for acute stroke in the Emilia-Romagna region of Italy.

    Science.gov (United States)

    Fabbian, Fabio; Gallerani, Massimo; Pala, Marco; De Giorgi, Alfredo; Salmi, Raffaella; Dentali, Francesco; Ageno, Walter; Manfredini, Roberto

    2014-11-01

    Using a regional Italian database, we evaluated the relationship between renal dysfunction and in-hospital mortality (IHM) in patients with acute stroke (ischemic/hemorrhagic). Patients were classified on the basis of renal damage: without renal dysfunction, with chronic kidney disease (CKD), and with end-stage renal disease (ESRD). Of a total of 186,219 patients with a first episode of stroke, 1626 (0.9%) had CKD and 819 (0.4%) had ESRD. Stroke-related IHM (total cases) was independently associated with CKD, ESRD, atrial fibrillation (AF), age, and Charlson comorbidity index (CCI). In patients with ischemic stroke (n=154,026), IHM remained independently associated with CKD, ESRD, AF, and CCI. In patients with hemorrhagic stroke (n=32,189), variables that were independently associated with IHM were CKD, ESRD, and AF. Renal dysfunction is associated with IHM related to stroke, both ischemic and hemorrhagic, with even higher odds ratios than those of other established risk factors, such as age, comorbidities, and AF. © The Author(s) 2013.

  9. Energy in France

    International Nuclear Information System (INIS)

    Lucas, N.J.D.

    1979-01-01

    The subject is dealt with in chapters, entitled: purpose and context (includes information about France's energy supplies, use and responsible organizations); evolution of relationships among institutions; review of prevailing preoccupations of sectors (separate headings for oil, gas, electricity, coal, nuclear, and unconventional energy sources: under the nuclear heading information is given about the organization of the nuclear industry in France, mining, enrichment, reprocessing, reactor construction); nature and operation of government control; energy in the plans; formulation of policy; opposition to the nuclear policy. (U.K.)

  10. Tumors and tumor - like lesions of the oro - facial region at Mayo hospital, Lahore - a five year study

    International Nuclear Information System (INIS)

    Riaz, N.; Warriach, R.A.

    2011-01-01

    The oro-facial region including the oral cavity, the maxilla and mandible and related tissues can be the site of a multitude of neoplastic conditions. These tumours have a predilection for the entire facial region; however, odontogenic tumours tend to affect the mandible more than the maxilla. We report results from a retrospective study spanning five years on the frequency, clinical presentation, sites and character of orofacial tumors seen in the main referral hospital of Pakistan. Patients and Methods: Records of consecutive patients of all age and sex seen by the author's team at the Department of Oral and Maxillofacial Surgery, Mayo Hospital with tumours affecting the oro-facial region from January 2005 to December 2009 were retrieved, coded and entered into a database. The data were then analyzed by age, sex, presenting signs and symptoms, site of lesion, and their histology. Results: A total of 237 patients with oro-facial swellings were retrieved from the registry. The complete data set was obtained for 189 patients, comprising 108 (57.9%) males and 81 (42%) females. The most common clinical presenting features were mandibular facial swelling (63%), intra-oral swelling (55%), and ulceration (29%). The tumors were found in the mandible 67 (35%), buccal mucosa 33 (17%), floor of the mouth 22 (11%) and tongue 29 (15%). The remainder making up almost 20% was found in the palate, submandibular region, pre auricular region and lips. Ninety three (49.2%) of the patients presented with lesions that were classified as malignant of which 64 (69%) were diagnosed as squamous cell carcinoma (SCC). seventy (37.0%) had benign odontogenic tumors and twenty six (13.7%) had non-odontogenic tumor - like lesions. Sixty - four (69%) of malignant tumors were squamous cell carcinoma; sixty four (86.4%) of the benign odontogenic tumors were classified as ameloblastoma. The mean age at presentation of all lesions was 40.4 years with over 50% of benign lesions in patients aged

  11. 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 < 0.001), but similar in other regards. Severe vivax malaria monoinfection with critical illness is more common than previously thought. © The American Society of Tropical Medicine and Hygiene.

  12. 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.

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

    Directory of Open Access Journals (Sweden)

    Siyem C. Nkwawir

    2014-11-01

    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.

  14. A self-supporting library service in a rural region: a new look at hospital consortia.

    Science.gov (United States)

    Gillikin, P; Price, L; Lee, S; Sprinkle, M D; Leist, J C

    1982-04-01

    To meet the informational needs of health care practitioners and trainees in a four-county rural area of northwestern North Carolina, the eleven-member UNIFOUR Consortium was founded as a two-year experimental project from 1978 to 1980. The consortium has several unique features: (1) it is an organization of institutions, not libraries; (2) it employs its own professional librarian who manages a central library, coordinates consortium programs, and makes regular circuit visits to all affiliated institutions; (3) the central library, where the circuit is based, is a developing community hospital library, not an established academic medical center library; and (4) it is ultimately tied to the Northwest Area Health Education Center and that organization's emerging learning resources network, which includes the Bowman Gray School of Medicine, Library, two other subregional libraries, and the libraries of all member institutions. At the end of the experimental period in 1980, member institutions voted unanimously to continue the program and assume their share of the costs.

  15. Regional supply of outreach service and length of stay in psychiatric hospital among patients with schizophrenia: National case mix data analysis in Japan.

    Science.gov (United States)

    Niimura, Junko; Nakanishi, Miharu; Yamasaki, Syudo; Nishida, Atsushi

    2017-12-01

    Several clinical trials have demonstrated that linkage to an outreach service can prevent prolonged length of stay of patients at psychiatric hospitals. However, there has been no investigation of the association between length of stay in psychiatric hospital and regional supply of outreach services using national case mix data. The aim of this study was to clarify the relationship between length of stay in psychiatric hospital and regional supply of outreach services. We used data from the National Patient Survey in Japan, a nationally representative cross-sectional survey of inpatient care conducted every three years from 1996 to 2014. Data from 42,268 patients with schizophrenia who had been admitted to psychiatric hospitals were analyzed. After controlling for patient and regional characteristics, patients in regions with fewer number of visits for psychiatric nursing care at home had significantly longer length of stay in psychiatric hospitals. This finding implies that enhancement of the regional supply of outreach services would prevent prolonged length of stay in psychiatric hospitals. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Optic neuritis: Observation and experience at a tertiary care hospital in Qassim region, Saudi Arabia.

    Science.gov (United States)

    Alamgir, Mohammad Jawad; Ali, Syed Abrar; Hamdy, Nermin Aly; Khan, Moin Zafar; Mohammad, Elgamri E

    2017-01-01

    Optic neuritis (ON) can occur in isolation or association with multiple sclerosis (MS) or neuromyelitis optica. ON, is seen more commonly in Caucasians and interaction is found to exist between ethnic origin and the latitude at which the patient grows up. At present limited information is available about the profile of ON in Saudi patients. We aimed to analyze the records of ON patients, in regard to their presentation, natural history, treatment outcome, and risk and association with MS. Whether, ON in Saudi patients behaves differently from the Western and Asian patients? In this retrospective observational study; we retrieved the data from the medical records of the patients with ON, who attended the ophthalmology and neurology services of King Fahad Specialist Hospital Buraidah, Al Qassim, Saudi Arabia, from period 2006 to 2012. We recorded data of 60 patients of ON; 38 females (63.3%) and 22 males (36.7%). Color vision was affected in 66.7% of cases. Vision in the affected eye was 20/200 or worse in 74.97 % of our cases. Magnetic resonance imaging (MRI) brain revealed multiple lesions in 55% of cases; most of them developed MS on follow-up. Only 48.3% of patients had received systemic steroids. Vision improved in 85% of our cases. Most of our patients had idiopathic ON, and almost 85% had good visual recovery, in this regard our study is comparable with such studies done in other Asian countries. On the other hand, 55% of our patients had multiple MRI brain lesions, a high risk and association of MS, almost similar to the Western Europe and North American ON patients.

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

    Science.gov (United States)

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

    2017-01-01

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

  18. 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

  19. The production of photovoltaic electricity in France

    International Nuclear Information System (INIS)

    Livet, Frederic

    2014-01-01

    The author presents, comments and discusses various data related to photovoltaic energy production in France: evolution of installed power until 2013, installed power, production, hours per year and load factor for different countries (France, Spain, Germany and Italy) and for the different French regions. He highlights and comments the intermittency of photovoltaic production in France. This intermittency is related to the difference between day and night, to the difference between seasons, and to weather conditions. He discusses the possible solutions to this intermittency. In this respect, he outlines that the expansion of the photovoltaic production and the use of interconnection do not solve the problem, and discusses the possibility of massive storage and the possible interest of local consumption

  20. Electricite de France`s ALARA policy

    Energy Technology Data Exchange (ETDEWEB)

    Stricker, L. [EDF - DEPT, Paris la Defense (France); Rollin, P. [EDF Radioprotection Committee, Paris (France)

    1995-03-01

    In 1992, Electricite de France - EDF decided to improve the degree to which radiological protection is incorporated in overall management of the utility and set itself the objective of ensuring the same level of protection for workers from contractors as for those from EDF. This decision was taken in a context marked by a deterioration in exposure figures for French plants and by the new recommendations issued by the ICRP. This document describes the policy adopted by EDF at both corporate and plant level to meet these objectives, by: (1) setting up management systems which were responsive but not cumbersome; (2) a broad policy of motivation; (3) the development and use of suitable tools. The document then describes some quite positive results of EDF`s ALARA policy, giving concrete examples and analyzing the changes in global indicators.

  1. France - energy situation 1986

    International Nuclear Information System (INIS)

    1988-01-01

    The energy situation of France is reviewed on the basis of relevant data. Data on the country's national and international energy policy are followed by an outline of trends in energy sources and electric power generation. Key figures are presented on the country's external trade and balance of payments. (UA) [de

  2. 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...

  3. The action of France

    International Nuclear Information System (INIS)

    2003-01-01

    After a favorable period for the weapons mastership, the disarmament and the non-proliferation, the conditions of international safety and the strategical context revealed recently worrying developments. The France is decided to continue its action in favor of the disarmament and the non-proliferation in the continuity of its political engagements. (A.L.B.)

  4. Energy in France

    International Nuclear Information System (INIS)

    2002-01-01

    This document provides a selection of energy statistics in France on, the energy in the economy, all energies, oil, gas, coal, electricity, renewable energies, district heating systems, rational use of energy, prices, energy and the environment and some useful addresses. (A.L.B.)

  5. France energy situation

    International Nuclear Information System (INIS)

    1991-01-01

    The monthly (May 1991) energy situation analysis in France is presented: the energy consumption rise is lowered and especially, oil imports have fallen from -3.1 pc; natural gas imports and domestic electric power production have risen. The energy import dependence rate have very slightly risen, around 50 pc. Diagrams for 1989, 1990, 1991 are presented [fr

  6. 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

    2017-02-01

    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.

  7. [Assessment of the announcement procedure in 29 cancer-accredited hospitals in the Aquitaine region: the EVADA project].

    Science.gov (United States)

    Rongère-Casteigt, Julie; Pinon, Elodie; Domecq, Sandrine; Hoppe, Stéphanie; Bousser, Véronique; Vimard, Edwige; Saillour-Glenisson, Florence

    2015-01-01

    An announcement procedure is mandatory to obtain accreditation to treat cancer patients. Health care professionals in the Aquitaine region evaluated the organization of this announcement procedure in their institutions and the patients' perception, in order to initiate actions to improve the structure and traceability of this procedure. Self-assessment approach based on a retrospective study plan comprising three concomitant steps: organizational audit, medical records audit and patient experience survey. 29 institutions participated in the study. Heterogeneous organizations were observed, although progress had been made in the deployment of the announcement procedure in terms of personnel training,formal organization and the resources devoted to this procedure, but there remains considerable room for improvement in terms of traceability, coordination between doctors and nursing staff, and referral of patients to supportive care. This evaluation triggered active mobilization of hospital teams concerning the announcement procedure in the Aquitaine region and a better awareness of the patient's perception. The regional dynamic allowed exchanges between institutions, facilitating the implementation of improvement actions.

  8. 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\

  9. Can you see me? Experiences of nurses working night shift in Australian regional hospitals: a qualitative case study.

    Science.gov (United States)

    Powell, Idona

    2013-10-01

    To report a study that explored the experiences of night-shift nurses, focusing on employee interrelationships and work satisfaction. Night-shift nurses are a critical component in hospital care making it essential to understand the experiences that give meaning to their work and understand how these nurses and the organization can benefit from their contribution to hospital care. A literature review revealed minimal research in this area. Qualitative case study. A qualitative case study using semi-structured interviews and self-completed diaries was conducted in 2010 in regional public hospitals in Australia. Participants were 14 nurses working nights half or more of their shifts in medical or surgical wards. Thematic analysis identified four major areas of concern: work relationships, work environment, work practices and lifestyle impact. Notably, work relationships were most meaningful for nurses on the same shift; night-shift nurses experienced working conditions inferior to their daytime counterparts including a perception of minimal leadership. Despite limited education opportunities, night shift provided opportunity for professional growth for some nurses with a slippage in skills for others; night shift provided flexibility for family and social activities, yet impeded these same activities, primarily due to pervasive fatigue. Night-shift nurses considered their role critical, yet believed that they were poorly regarded. The strong interpersonal relationships developed between night-shift workers need to be capitalized on whilst developing a more effective leadership model, improved work environment, more equitable professional development, and genuine recognition of the critical role of night nurses. © 2013 Blackwell Publishing Ltd.

  10. Lung cancer risk and pollution in an industrial region of Northern Spain: a hospital-based case-control study.

    Science.gov (United States)

    López-Cima, María Felicitas; García-Pérez, Javier; Pérez-Gómez, Beatriz; Aragonés, Nuria; López-Abente, Gonzalo; Tardón, Adonina; Pollán, Marina

    2011-01-25

    Asturias, an Autonomous Region in Northern Spain with a large industrial area, registers high lung cancer incidence and mortality. While this excess risk of lung cancer might be partially attributable to smoking habit and occupational exposure, the role of industrial and urban pollution also needs to be assessed. The objective was to ascertain the possible effect of air pollution, both urban and industrial, on lung cancer risk in Asturias. This was a hospital-based case-control study covering 626 lung cancer patients and 626 controls recruited in Asturias and matched by ethnicity, hospital, age, and sex. Distances from the respective participants' residential locations to industrial facilities and city centers were computed. Using logistic regression, odds ratios (ORs) and 95% confidence intervals (95%CIs) for categories of distance to urban and industrial pollution sources were calculated, with adjustment for sex, age, hospital area, tobacco consumption, family history of cancer, and occupation. Whereas individuals living near industries displayed an excess risk of lung cancer (OR = 1.49; 95%CI = 0.93-2.39), which attained statistical significance for small cell carcinomas (OR = 2.23; 95%CI = 1.01-4.92), residents in urban areas showed a statistically significant increased risk for adenocarcinoma (OR = 1.92; 95%CI = 1.09-3.38). In the Gijon health area, residents in the urban area registered a statistically significant increased risk of lung cancer (OR = 2.17; 95%CI = 1.25-3.76), whereas in the Aviles health area, no differences in risk were found by area of exposure. This study provides further evidence that air pollution is a moderate risk factor for lung cancer.

  11. 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.

  12. [Motivation perception measurement of intermediate directors in three complex hospitals of the Region of the Maule, Chile].

    Science.gov (United States)

    Bustamante-Ubilla, Miguel Alejandro; del Río-Rivero, María Carolina; Lobos-Andrade, Germán Enrique; Villarreal-Navarrete, Patricia Isabel

    2009-01-01

    In this work, a questionnaire was designed and perceptions of motivation and demotivation of middle managers in three hospitals in the Region del Maule, Chile were measured. The fieldwork was carried out between September and October, 2006. A questionnaire that included 57 statements to measure attitude was administered and qualified according to a five-point Likert-type scale. The population studied included l25 professionals that supervise roughly 3 800 employees. Ten variables were identified, 5 motivational and 5 demotivational. Notable among the motivational variables are vocation and service-oriented spirit; among the demotivational variables are lack of recognition and commitment. It is affirmed that both motivational variables as well as demotivational variables are essentially qualitative and that economic and salary variables are less relevant and less hierarchical.

  13. 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

    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...... conducted between July and November 2008, the management and outcomes of 558 deliveries before and 550 after the training were observed. RESULTS: There was no significant difference in the rate of cesarean deliveries owing to prolonged labor, and vacuum delivery was not practiced after the intervention...... 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...

  14. [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.

  15. Long-term evaluation of a hospital-based violence intervention program using a regional health information exchange.

    Science.gov (United States)

    Bell, Teresa M; Gilyan, Dannielle; Moore, Brian A; Martin, Joel; Ogbemudia, Blessing; McLaughlin, Briana E; Moore, Reilin; Simons, Clark J; Zarzaur, Ben L

    2018-01-01

    Hospital-based violence intervention programs (HVIP) aim to reduce violent-injury recidivism by providing intensive case management services to high-risk patients who were violently injured. Although HVIP have been found effective at reducing recidivism, few studies have sought to identity how long their effects last. Additionally, prior studies have been limited by the fact that HVIP typically rely on self-report or data within their own healthcare system to identify new injuries. Our aim was to quantify the long-term recidivism rate of participants in an HVIP program using more objective and comprehensive data from a regional health information exchange. The study included 328 patients enrolled in Prescription for Hope (RxH), an HVIP, between January 2009 and August 2016. We obtained RxH participants' emergency department (ED) encounter data from a regional health information exchange database from the date of hospital discharge to February 2017. Our primary outcome was violent-injury recidivism rate of the RxH program. We also examined reasons for ED visits that were unrelated to violent injury. We calculated a 4.4% recidivism rate based on 8 years of statewide data, containing 1,575 unique encounters. More than 96% of participants were matched in the state database. Of the 15 patients who recidivated, only five were admitted for their injury. More than half of new violence-related injuries were treated outside of the HVIP-affiliated trauma center. The most common reasons for ED visits were pain (718 encounters), followed by suspected complications or needing additional postoperative care (181 encounters). Substance abuse, unintentional injuries, and suicidal ideation were also frequent reasons for ED visits. The low, long-term recidivism rate for RxH indicates that HVIPs have enduring positive effects on the majority of participants. Our results suggest that HVIP may further benefit patients by partnering with organizations that work to prevent suicide

  16. Rotavirus gastroenteritis in children in 4 regions in Brazil: a hospital-based surveillance study.

    Science.gov (United States)

    Munford, Veridiana; Gilio, Alfredo Elias; de Souza, Eloisa Correa; Cardoso, Debora Morais; Cardoso, Divina das Dores de Paula; Borges, Ana Maria Tavares; Costa, Paulo Sergio Sucasas da; Melgaço, Irene Angela Melo; Rosa, Humberto; Carvalho, Paulo Roberto Antonacci; Goldani, Marcelo Zubaran; Moreira, Edson Duarte; Santana, Ciria; El Khoury, Antoine; Ikedo, Fabio; Rácz, Maria Lucia

    2009-11-01

    Rotavirus is a major cause of gastroenteritis in children. Knowledge of rotavirus genotypes is important for vaccination strategies. During 2005-2006, rotavirus surveillance studies were conducted in São Paulo, Salvador, Goiânia, and Porto Alegre, Brazil. Stool samples were collected from children <5 years of age who had diarrhea and were screened by the Rotaclone Enzyme Immunoassay for the presence of rotavirus. Confirmed rotavirus-positive samples were characterized for P and G genotypes by reverse-transcriptase polymerase chain reaction. A total of 510 stool samples were collected. Of these, 221 (43.3%) were positive for rotavirus. Overall, G9 was the predominant G type, followed by G2, and G1; P[4] and P[8] were the predominant P types. The most frequent G/P genotype combination detected was G2P[4], followed by G9P[8], G9P[4], and G1P[8]. G2P[4] was the predominant type in Goiânia and Salvador; G9P[8] and G1P[8] were predominant in São Paulo and Porto Alegre, respectively. The prevalence, seasonality, and genotype distribution of rotavirus infection varied in different regions in Brazil. With immunization programs, continuous monitoring of rotavirus types is important to detect novel and emerging strains.

  17. Final report of the study on heat networks in Ile-de-France, contributing to the elaboration of the climate-air-energy regional scheme + Judicial aspect + Economic aspect + Assessment of development potential of urban heating in Ile-de-France - Analysis document based on the study on heat networks contributing to the elaboration of the climate-air-energy regional plan

    International Nuclear Information System (INIS)

    2012-10-01

    A first report is a contribution to the elaboration of a plan aiming at the substitution of fossil energies, at the development of heat deliveries, while maintaining network economic profitability. Such a plan is based on the connection of buildings, the renovation, extension and interconnection of existing networks, and the creation of new heat networks. The study addressed technical, urban, financial, judicial and cartographic aspects. Public statistical data have been used and interviews of actors (network funders, representatives of delegating authorities, social landlords, administrations, and technical professions) have been performed. A guide of good practices is proposed regarding contract reviewing conditions, possibilities of revision of subscribed power. Prospective issues are discussed: strategic stakes and deposits, actions paths and tools, strategy and action plan. Appendices address methodologies, organisation of the geographical information system, judicial aspect with the circular of 1982, financial data and aspects. Then, a set of reports more precisely presents various aspects addressed as a contribution for the study of heat networks in Ile-de-France: the judicial aspect (present status, guide of good judicial practices), the economic aspect (present status of sale prices and costs, analysis of financing, of revision formula), and an assessment of urban heating development (context, technical aspect, analysis of the geographical information system)

  18. Prevalent infant feeding practices among the mothers presenting at a tertiary care hospital in Garhwal Himalayan region, Uttarakhand, India

    Directory of Open Access Journals (Sweden)

    Vyas Kumar Rathaur

    2018-01-01

    Full Text Available Introduction: There is paucity of studies on infant feeding practices from the rural areas of garhwal Himalayas of the state of uttarakhand. The present study was designed to assess the infant feeding practices in Garhwal region. Infant feeding practices have significant implications on a child's health. Early nutritional status especially during the first year of life has been shown to have a significant effect on child health and development. Optimal infant feeding practices are crucial for nutritional status, growth, development, health, and ultimately the survival of infants and young children. The study of infant feeding practices is essential before formulation of any interventional programme. Settings and Design: A study was conducted in HNB Base Hospital and Teaching Institute with the aim to assess the infant feeding practices and the prevalence of malnutrition in the study population reporting at the hospital in garhwal region of uttarakhand. Methods and Material: This is an observational cross sectional study. 275 infants were included in the study. After taking informed consent, case study forms were filled by interviewing the infants' mothers. Weight, length and head circumference of each infant was also measured. The information thus obtained was compiled, tabulated and analysed statistically. Results: The study findings revealed that 46.4% infants in the age group 0-5 months were breastfed within 1 hour of birth. 52.8% infants aged 0-5 months of were exclusively breastfed. 33.6% infants in age group 0-5 months received prelacteal feeds. 53.12% infants in age group 6-8 months received solid, semi-solid or soft food, in addition to breast milk. 53.33% infants were partially or fully bottle fed. Age appropriate feeding was found in 56% infants. The percentage of wasting, stunting and underweight in 0-5 months was 33.6%,30.4% and 36.8% respectively . The percentage of wasting, stunting and underweight in 6-11 months was 28%, 26.5% and

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

    International Nuclear Information System (INIS)

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

    2004-01-01

    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

  20. 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).

  1. 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

  2. Tidal energy in France

    International Nuclear Information System (INIS)

    Lemperiere, F.

    2010-01-01

    The author first discusses the potential theoretical production of tidal energy in the world and more particularly in France, and compares this potential production with that of hydroelectric energy. He discusses the existence of potentially interesting sites in France in terms of sizing and exploitation modes. He describes the main associated works for turbines and sea walls, impacts on the environment, on the economy and on employment. He discusses the production possibilities and their cost, and the issue of energy storage. He indicates sites which could be built before 2025: Saint-Brieuc, Portbail-Coutainville or Granville, Mers or Cayeux, Penly or Saint-Valery en Caux. For each of this site, the author describes the project implantation, gives an gross assessment of the construction cost, and therefore of the kWh cost

  3. La titrisation en France.

    OpenAIRE

    BIROUK, O.; CASSAN, L.

    2012-01-01

    La crise financière a justifié une surveillance accrue de la titrisation dans le refinancement de l’économie. Les créances titrisées en France sont en grande majorité représentatives de crédits octroyés par les banques aux ménages et aux sociétés non financières résidents.

  4. France in Black Africa,

    Science.gov (United States)

    1989-01-01

    Difficulties with this romantic concept developed, however, when General Faidherbe began to expand French control into the Senegalese hinterland. He was...and his German 45 France in Black Africa friends to gain greater control of the AOF.6 The tragi- comedy ended with the 1942 Allied landings in North...service]). Trinquier’s own stay in Africa was short-lived. Belgian resistance to a French invasion of their turf was fierce. Trinquier’s romantic

  5. Nuclear Education in France

    International Nuclear Information System (INIS)

    Guet, C.

    2013-01-01

    This series of slides draws a picture of nuclear engineering training in France. The nuclear sector is very active and developed in France and covers all the aspects of the fuel cycle which implies a strong demand for highly skilled and trained staff. There are both an active involvement of industry in the education process through the design of adequate curricula and a strong support of the State. There are 5 masters dedicated to Science Nuclear Energy (Paris), Nuclear Waste Management (Nantes), Separation Chemistry (Montpellier), Materials for Nuclear Engineering (Grenoble), and 1 engineer degree in nuclear engineering (Saclay). In 2010-2011 there were about 1000 students completing a nuclear energy curriculum (nuclear engineering or specialized nuclear domains) at the master-engineer level throughout France. The detailed curriculum of the Master of Science Nuclear Energy is given. The National Institute of Nuclear Sciences and Techniques (INSTN) plays an important role, it has trained a large fraction of the French leading nuclear practitioners through its 50 years old 'Genie Atomique' curriculum. INSTN proposes also high level courses in nuclear disciplines including training of nuclear physicians, radio-pharmacists and medical physicists and is a major player for continuing education in nuclear sciences. (A.C.)

  6. Energy options in France

    International Nuclear Information System (INIS)

    Carle, R.

    1980-01-01

    The rapid rise of oil price and the future shortage of oil are the problems, to which those in charge of energy must face. The method of maintaining and increasing energy consumption without destroying financial balance must be found. As the common points in Japan and France, domestic energy resources are scarce, coal reserves are small and the cost is high, the room for expanding water power generation hardly remains, and the atomic energy projects of large scale seem to be the only solution, but actually, they encountered many difficulties. In France, Energy Conservation Agency was established in 1974. The energy consumption per man was 4500 kWh in 1979, and it is not high level, accordingly it is difficult to reduce the present consumption further. The growth of electricity consumption in 1979 slowed down remarkably. The present crisis is oil crisis instead of energy crisis. Therefore electric power is the most suitable medium to get rid of the bondage of oil. The breakdown of heat production is as follows: coal 41%, oil 32%, gas 4%, and uranium 23%. Since 1976, 15 power plants of 3.5 million kW were converted to coal burning, but more staffs are required for the operation and maintenance. Water power generation is valuable to supplement nuclear power generation which lacks flexibility. As the nucleus of energy projects in France, PWR development project is in progress. Six 900 MW PWR plants are in operation. (Kako, I.)

  7. Taxation in France

    CERN Document Server

    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&...

  8. 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.

  9. Where are the radioactive wastes in France? Brochure no 1

    International Nuclear Information System (INIS)

    2004-01-01

    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.)

  10. Factors associated with unintentional injury among the paediatric age population in the hospitals of Amhara National Regional State, Ethiopia

    Directory of Open Access Journals (Sweden)

    Bewket Tadesse Tiruneh

    Full Text Available Background: Childhood unintentional injuries cause nearly 875,000 deaths each year. The aim of this study was to assess the prevalence and factors associated with unintentional injury of children presenting to the hospitals of Amhara Regional State, Ethiopia. Methods: In a hospital-based, cross-sectional study undertaken in one month, from April 1 to 30th 2016, 893 children less than 18 years of age were included. Data were collected using an interviewer-administered questionnaire. Training was given to all data collectors and supervisors. Data was entered into EPI info version 7 and then exported to SPSS version 20, for further analysis. Results: Unintentional injury caused 62% (554 of all injuries in attending children. Several factors affected the likelihood of injuries, namely the age of the child, age of the parents or guardians, sex of the child, and whether the child lived with the parents. Modifiable factors were the child’s behaviour, awareness of danger, the child’s level of educational, if the child’s parent had received adequate injury counselling, and whether a child was left in the care of another child. The source of light in the house, and house floor material were also significant factors at p < 0.05. Conclusion: The prevalence of unintentional injury was high. Many of the factors associated with injuries are modifiable and safety issues for children need urgent attention. Keywords: Unintentional injury, Paediatric, Ethiopia, Low resource

  11. Bordetella pertussis diagnosis in children under five years of age in the Regional Hospital of Cajamarca, Northern Peru.

    Science.gov (United States)

    Del Valle-Mendoza, Juana; Casabona-Oré, Veronica; Petrozzi-Helasvuo, Veronica; Cornejo-Tapia, Angela; Weilg, Pablo; Pons, Maria J; Cieza-Mora, Erico; Bazán-Mayra, Jorge; Cornejo-Pacherres, Hernan; Ruiz, Joaquin

    2015-11-30

    Bordetella pertussis is an important human pathogen that causes whooping cough (pertussis), an endemic illness responsible of significant morbidity and mortality, especially in infants and children. Worldwide, there are an estimated of 16 million cases of pertussis, resulting in about 195,000 child deaths per year. In Peru, pertussis is a major health problem that has been on the increase despite immunization efforts. The objective of this study was to determine the prevalence of B. pertussis among children under five years of age suspected to have whopping cough in Cajamarca, Peru. Children diagnosed with whooping cough admitted to the Hospital Regional de Cajamarca from August 2010 to July 2013 were included. Nasopharyngeal samples were obtained for B. pertussis culture and polymerase chain reaction (PCR) detection. In 133 children, the pertussis toxin and IS481 gene were detected in 38.35% (51/133) of the cases by PCR, while only 9.02% (12/133) of the Bordetella cultures were positive. The most frequent symptoms in patients with positive B. pertussis were paroxysm of coughing 68.63% (35/51), cyanosis 56.86% (29/51), respiratory distress 43.14% (22/51), and fever 39.22% (20/51). Pneumonia and acute bronchial obstructive syndrome were present in 17.65% (9/51) and 13.72% (7/51) of the cases, respectively. B. pertussis is responsible for an important proportion of whooping cough in hospitalized children in Cajamarca. Epidemiologic surveillance programs for B. pertussis are essential in Peru, especially in children who could most benefit from the vaccine.

  12. NIVEL DE SATISFACCIÓN DEL PACIENTE ADULTO POSTOPERADO RESPECTO AL CUIDADO DE ENFERMERÍA EN SERVICIO DE CIRUGÌA DEL HOSPITAL REGIONAL DE LAMBAYEQUE

    OpenAIRE

    Oliva Ramos, Pamela; Universidad Señor de Sipán

    2014-01-01

     El presente estudio Nivel de Satisfacción del Paciente Adulto Postoperado Respecto al Cuidado de Enfermería en Servicio de Cirugía del Hospital Regional de Lambayeque Chiclayo 2013, tuvo como objetivo: Determinar el nivel de satisfacción en el paciente adulto postoperado respecto al cuidado de enfermería en servicio de cirugía del Hospital Regional de Lambayeque Chiclayo 2013. El diseño metodológico fue de tipo cuantitativo descriptivo simple, se utilizó como instrumento el cuestionario tipo...

  13. 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.)

  14. 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

  15. 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.

  16. [A pilot study of the professional autonomy, job satisfaction, and related factors of nurses at a regional hospital].

    Science.gov (United States)

    Wu, Lin-Chu; Maa, Suh-Hwa; Chung, Tieh-Chi; Huang, Kuei-Hsiang; Hsieh, Ming-Chu; Chen, Chiung-Hua

    2014-10-01

    Professional autonomy often causes confusion in nursing staffs that limit their ability to perform to the best of their professional capabilities. Moreover, heavy and busy workloads reduce the energy available for work resulting in lower working efficiency and lower job satisfaction. This study explores the status and factors related to professional autonomy and job satisfaction in nurses. A cross-sectional design was used to target the nurses employed at a regional hospital in southern Taiwan. Data on locus of control, professional autonomy, and job satisfaction were collected for analysis. Data were collected from 207 nurses, with 196 valid responses (response rate: 94.69%). One hundred and forty-six subjects (74.5%) were found to have an internal locus of control personality type. Scores for both professional autonomy and job satisfaction were above the "moderate" level (averages: 3.37 and 3.32, respectively, on a maximum scale of 5). Social demographic differences contributed to the variance in professional autonomy and job satisfaction among participants. Professional autonomy was found to be positively associated with job satisfaction. The findings of this study indicate that nurses with an internal locus of control personality exhibit higher professional autonomy and job satisfaction and that higher professional autonomy is associated with higher job satisfaction.

  17. Adherence to Canadian C-Spine Rule in a regional hospital: a retrospective study of 406 cases.

    Science.gov (United States)

    Paxton, Mark; Heal, Clare F; Drobetz, Herwig

    2012-10-01

    Cervical spine radiography may be over-utilised in an emergency department setting. The Canadian C-Spine Rule has been developed to reduce unnecessary radiography. Our aim was to retrospectively determine the proportion of cervical spine radiographs requested through the emergency department for trauma patients that were clinically indicated, according to the Canadian C-Spine Rule. This was a cross-sectional survey conducted at a regional centre in Northern Queensland, Australia. All cervical spine radiographs for trauma, performed at the Mackay Base Hospital from 1 January 2009 to the 31 December 2009, were reviewed. The relevant patient charts were audited for evidence of indications for radiography. Of 406 patients in the study, 155 patients (38%) (95% confidence interval 33.3%, 42.7%) had cervical spine imaging performed that was not indicated according to the Canadian C-Spine Rule. None of these patients had a significant cervical spine injury on radiography. Applying the Canadian C-Spine Rule would have safely reduced the incidence of cervical spine radiography by 38%. This would also reduce costs, patient morbidity and radiation exposure. © 2012 The Authors. Journal of Medical Imaging and Radiation Oncology © 2012 The Royal Australian and New Zealand College of Radiologists.

  18. Association between oral candidiasis and low CD4+ count among HIV positive patients in Hoima Regional Referral Hospital.

    Science.gov (United States)

    Nanteza, Martina; Tusiime, Jayne B; Kalyango, Joan; Kasangaki, Arabat

    2014-11-28

    The aim of this study was to determine the prevalence of Human Immune Virus (HIV) related oral lesions and their association with Cluster of Differentiation 4 (CD4+) count among treatment naïve HIV positive patients. This was a descriptive and analytical cross sectional study. Participants were 346 treatment naïve HIV positive adult patients. These were consecutively recruited from Hoima Regional Referral hospital between March and April 2012. Data collection involved interviews, oral examinations and laboratory analysis. A total of 168(48.6%) participants had oral lesions. The four commonest lesions were oral candidiasis (24.9%, CI = 20.6-29.7%), melanotic hyperpigmentation (17.3%, CI = 13.7-21.7%), kaposi sarcoma (9.3%, CI = 6.6-12.8%) and Oral Hairy Leukoplakia (OHL) (5.5%, CI = 3.5-8.4%). There was significant association between oral candidiasis and immunosuppression measured as CD4+ less than 350 cells/mm3 (OR = 2.69, CI = 1.608-4.502, p Oral candidiasis was the only oral lesion significantly predictive of immunosuppression (OR = 2.56, CI = 1.52-4.30, p Oral candidiasis can be considered as a marker for immunesuppression, making routine oral examinations essential in the management of HIV positive patients.

  19. 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

  20. High prevalence of missed opportunities for secondary fracture prevention in a regional general hospital setting in Singapore.

    Science.gov (United States)

    Gani, Linsey; Reddy, Saripalli K; Alsuwaigh, Rayan; Khoo, Joan; King, Thomas F J

    2017-12-01

    This study aims at assessing the gap in secondary fracture prevention at a regional general hospital setting in Singapore. Male patients have significantly lower rate of being investigated and treated for osteoporosis than their female counterparts. Vitamin D deficiency is prevalent in our population. Secondary fracture prevention services are not routine in Singapore; we seek to assess the treatment gap that exists in the lack of diagnosis and treatment of osteoporosis in fragility fracture patients. We performed a retrospective analysis of all admissions for fragility fractures between December 2013 and December 2014. Demographic data, rates of BMD performance, serum vitamin D investigation and calcium and vitamin D supplementation as well as antiresorptive initiation 1 year post admission were analysed. There were 125 fragility fractures in patients below 65 and 615 fractures in older patients. There was a slightly higher proportion of males in the younger population, whereas females predominated in the older population. Median vitamin D levels were low in both younger (19.1 μg/L) and older (22.0 μg/L) groups, but supplementation was lower in younger patients (4.8 versus 16.6%, p = 0.003). Rate of BMD performance was lower in younger patients (34.4 versus 64.6%, p Singapore. Male osteoporosis remains inadequately investigated and treated in both age groups.

  1. Working hours of surgical residence: perspective of a group of surgeons in a regional hospital in Hong Kong.

    Science.gov (United States)

    Lo, Siu-Fai; Spurgeon, Peter

    2007-01-01

    The Accreditation Council for Graduate Medical Education and European working time directive have restricted residents' workweek to 80 and 48 hours, respectively. Impacts on resident's training and health services are under evaluation in western countries. However, relevant studies are deficient in Hong Kong. Surgeons in a regional hospital of Hong Kong were recruited. Opinions were collected by semi-structured questionnaire. Response rate was 82%. Most respondents agreed that residents' work hours should be limited. Seventy-two percent thought that the addition of physician assistants, nurse practitioners and ancillary staff could help decrease the workload of residents. More than 60% thought that residents should have post-call afternoon off. Seventy-two percent worried that the number of operations residents performed would decrease. Only half agreed that long work hours was part of resident training and 56.3% agreed that the training period should be lengthened because of limiting work hours. Ninety-four percent agreed that sleep-deprived residents would create more medical errors; 72% thought that long work hours would impair quality of care. Surprisingly, only 28% thought that limiting work hours would compromise continued patient care. Most respondents opine that resident work hours should be regulated and welcome minor rescheduling of residents' workflow. The impacts on residents' training and patient care require further evaluation.

  2. Radiotherapy and Nuclear Medicine Project for an Integral Oncology Center at the Oaxaca High Specialization Regional Hospital

    International Nuclear Information System (INIS)

    De Jesus, M.; Trujillo-Zamudio, F. E.

    2010-01-01

    A building project of Radiotherapy and Nuclear Medicine services (diagnostic and therapy), within an Integral Oncology Center (IOC), requires interdisciplinary participation of architects, biomedical engineers, radiation oncologists and medical physicists. This report focus on the medical physicist role in designing, building and commissioning stages, for the final clinical use of an IOC at the Oaxaca High Specialization Regional Hospital (HRAEO). As a first step, during design stage, the medical physicist participates in discussions about radiation safety and regulatory requirements for the National Regulatory Agency (called CNSNS in Mexico). Medical physicists propose solutions to clinical needs and take decisions about installing medical equipment, in order to fulfill technical and medical requirements. As a second step, during the construction stage, medical physicists keep an eye on building materials and structural specifications. Meanwhile, regulatory documentation must be sent to CNSNS. This documentation compiles information about medical equipment, radioactivity facility, radiation workers and nuclear material data, in order to obtain the license for the linear accelerator, brachytherapy and nuclear medicine facilities. As a final step, after equipment installation, the commissioning stage takes place. As the conclusion, we show that medical physicists are essentials in order to fulfill with Mexican regulatory requirements in medical facilities.

  3. Self-reported "communication technology" usage in patients attending a cardiology outpatient clinic in a remote regional hospital.

    Science.gov (United States)

    Gandiya, Tariro; Dua, Anahita; King, Gerry; Mazzocco, Thomas; Hussain, Amir; Leslie, Stephen J

    2012-04-01

    This study assessed the perceived usage of, and attitudes toward, communication technologies (mobile phone and texting, e-mail, and the World Wide Web) in patients attending a cardiology clinic with a view to guiding future health service redesign. This was performed in a remote regional hospital serving both urban and rural populations. A self-completion questionnaire was completed by a convenience sample of 221 patients attending a general cardiology clinic. The questions asked about patients' access to and use of technology at home. Data collected also included age, gender, travel time to the clinic, mode of travel, and whether the respondent was accompanied to the clinic. Appropriate statistical tests were used with significance taken at the 0.05 level. Age was the strongest predictor of use of communication technologies, with younger patients more likely to use e-mail, Web, mobile phone, and texting. However, frequency of use of e-mail was not related to age. It is encouraging that over 99% of patients used at least one communication technology. This study has highlighted that there may be several potential barriers to the widespread implementation of communication technologies in general cardiology patients. Cognizance should be taken of these findings when attempting service redesign.

  4. New introductions of enterovirus 71 subgenogroup C4 strains, France, 2012.

    Science.gov (United States)

    Schuffenecker, Isabelle; Henquell, Cécile; Mirand, Audrey; Coste-Burel, Marianne; Marque-Juillet, Stéphanie; Desbois, Delphine; Lagathu, Gisèle; Bornebusch, Laure; Bailly, Jean-Luc; Lina, Bruno

    2014-08-01

    In France during 2012, human enterovirus 71 (EV-A71) subgenogroup C4 strains were detected in 4 children hospitalized for neonatal fever or meningitis. Phylogenetic analysis showed novel and independent EV-A71 introductions, presumably from China, and suggested circulation of C4 strains throughout France. This observation emphasizes the need for monitoring EV-A71 infections in Europe.

  5. 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.

  6. France country report

    Energy Technology Data Exchange (ETDEWEB)

    Mouillot, Dominique [Onet Technologies, 36, Bd des Oceans 13009 Marseille (France)

    2008-07-01

    Nuclear in France - Electricity share: 78%. Electricity production by Electricite de France: 419 TWh, 63,260 GWe installed. Number of Reactors: 58 NPPs type PWR (Pressurized Water Reactor) in operation; One under construction: EPR (European Pressurized Reactor) Flamanville 3, on time. Others nuclear installations: The AREVA NC La Hague fuel treatment and recycling plant - Capacity: 1700 tons (Facilities UP2 and UP3). COMURHEX is number one worldwide in the conversion of uranium mine concentrates into UF{sub 6} and has a processing capacity of 14,000 tonnes of uranium per year. EURODIF Production site, with the construction of the Georges Besse II plant, Centrifugation is the highest performance technology today. Others nuclear installations: MELOX production site - Mox fuel production; FBFC:fuel rods manufacturing; Waste Storage in Surface and Subsurface: The Aube department storage center in Soulaines, which houses short-lived low- to medium-level waste; the VLL storage centre in Morvilliers (Aube), which houses very low-level waste. Public acceptance: An opinion poll published in June 2007, commissioned by the OE (Observatoire de l'Energie) shows that a majority of French people support nuclear. The respondents were asked whether nuclear energy, which produces 78% of total electricity, is an asset: 51% of them backed the idea, 39% a disadvantage, 10% did not have an opinion. Energy policy: The new President Nicolas Sarkozy said that Nuclear energy is necessary for France. (Organisation of so called 'Grenelle of environment'). Projects: EPR Flamanville 3: Due to be commissioned in 2012, Commercial FBR (Fast Breeders reactor) in 2040, EURODIF will ended in 2012 and Georges Besse 2 (centrifugation) should be operational in 2012, Decommissioning of 6 UNGG reactors, Superphenix and Brennillis within 25 years. (estimated at 3 billion Euros). Nuclear waste management policy: The French National Radioactive Waste Management Agency (ANDRA) is responsible

  7. Energy statistics. France

    International Nuclear Information System (INIS)

    2002-10-01

    This document summarizes in a series of tables the energy statistical data for France: consumption since 1973; energy supplies (production, imports, exports, stocks) and uses (refining, power production, internal uses, sectoral consumption) for coal, petroleum, gas, electricity, and renewable energy sources; national production and consumption of primary energy; final consumption per sector and per energy source; general indicators (energy bill, US$ change rate, prices, energy independence, internal gross product); projections. Details (resources, uses, prices, imports, internal consumption) are given separately for petroleum, natural gas, electric power and solid mineral fuels. (J.S.)

  8. Literatures of Medieval France

    OpenAIRE

    Zink, Michel

    2017-01-01

    Dear Mr Administrator,Dear colleagues, Deep forests, enchanted castles, monsters, damsels in distress, stout-hearted heroes and boundless love. The literature of the Middle Ages has everything it takes to appeal to the imagination of children and teenagers. However, can it do more than that? And does it even still have this appeal? Anatole France claims that, to the loves of Abeille des Clarides and Georges de Blanchelande and to the magnanimity of the King of the Dwarves, his pretty little n...

  9. Planeteria: news from France

    Science.gov (United States)

    Lilensten, J.; Acker, A.; Delfosse, X.

    2011-10-01

    France has a good network of planetaria. They are linked through a network called Association of the French Speaking Planetaria. In this talk, I will present this organization and its different activities. I will also report on the making of a Art and Science museum in Grenoble which will include a planetarium. The grand opening is foreseen in 2014. Finally, I will present an astronomical show which has been adapted for planetaria and demonstrate how this benefits both to the show and the planetarium.

  10. Gas de France international strategy

    International Nuclear Information System (INIS)

    Deyirmendjian, J.

    1993-01-01

    This paper presents the main international objectives of Gaz de France, and actions taken to achieve them. The safety and the reliability of natural gas supplies is the priority-holder axis of the international strategy of Gaz de France. The second axis is to obtain a consolidated position in Europe on natural gas markets and valorize the know-how of Gaz de France in foreign countries

  11. Estrés Laboral en Médicos Residentes del Hospital Nacional Carlos Alberto Seguín Escobedo y del Hospital Regional Honorio Delgado Espinosa. Arequipa, 2015

    OpenAIRE

    Mazeyra Guillén, Alvaro Augusto

    2017-01-01

    El presente estudio tuvo como objetivos determinar el estrés laboral en los médicos residentes del Hospital “Carlos Alberto Seguín Escobedo” de EsSalud (HNCASE). y del Hospital Regional “Honorio Delgado Espinosa” (HRHDE) y establecer las semejanzas y diferencias del estrés laboral de los médicos residentes de ambos hospitales. La población estuvo conformada por 220 médicos residentes de primero, segundo y tercer año de residencia. Se aplicó el muestreo al azar estratifica...

  12. Energies in Ile de France - state of the art

    International Nuclear Information System (INIS)

    2003-01-01

    Because of the area of Ile de France, depends for 94% of outside for its energy needs, a local energy policy is a priority for the region. This document provides recommendations for the next SDRIF (Directory Scheme for the Ile De France Region) publication. After a recall of some definitions, it presents the main characteristics of the regional energy production and of the consumption. In the next chapters it analyses the final regional energy consumption per energy types and per economic activities sector and presents the organization of the energy supply of the region. Five domains of thought complete this analysis by an evaluation of the next energy policy approach: the tomorrow energy needs, the energy supply security, the place of the renewable energies in Ile de France, the transports problem, the minimization of the natural, industrial and social risks. (A.L.B.)

  13. 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...

  14. France without nuclear power

    International Nuclear Information System (INIS)

    Charmant, A.; Devezeaux, J.G.; Ladoux, N.; Vielle, M.

    1991-01-01

    As coal production declined and France found herself in a condition of energy dependency, the country decided to turn to nuclear power and a major construction program was undertaken in 1970. The consequences of this step are examined in this article, by imagining where France would be without its nuclear power. At the end of the sixties, fuel-oil incontestably offered the cheapest way of producing electricity; but the first petroleum crisis was to upset the order of economic performance, and coal then became the more attractive fuel. The first part of this article therefore presents coal as an alternative to nuclear power, describing the coal scenario first and then comparing the relative costs of nuclear and coal investment strategies and operating costs (the item that differs most is the price of the fuel). The second part of the article analyzes the consequences this would have on the electrical power market, from the supply and demand point of view, and in terms of prices. The third part of the article discusses the macro-economic consequences of such a step: the drop in the level of energy dependency, increased costs and the disappearance of electricity exports. The article ends with an analysis of the environmental consequences, which are of greater and greater concern today. The advantage here falls very much in favor of nuclear power, if we judge by the lesser emissions of sulfur dioxide, nitrogen oxides and especially carbon dioxide. 22 refs.; 13 figs.; 10 tabs

  15. 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)

  16. [Increase of Hantavirus infections in France, 2003].

    Science.gov (United States)

    Mailles, A; Vaillant, V; Haeghebaert, S; Fradet, M R; Capek, I; Zeller, H

    2005-02-01

    Hantaviral infections causing hemorrhagic fever with renal syndrome are endemic in North Eastern France. Humans are contaminated by the inhalation of aerosols contaminated by rodent faeces. In February 2003, the National reference centre (NRC) for hemorrhagic fevers detected an increased number of cases. An investigation was carried out to confirm the outbreak and take appropriate control measures. Cases were collected by the NRC. A case was defined as a person living in France with symptoms compatible with hantaviral infection and a positive blood test both for specific Puumala IgM, and IgG. Clinical information and at-risk exposures during the 2 weeks before onset were recorded. In 2003, 128 cases were diagnosed (61 in 2002). The median age of patients was 38, 77% were men and 82% were hospitalized. Patients were living in North-Eastern France. Clusters were detected in the Ardennes and Oise districts. Occupation (35%) (in agriculture, forestry, and construction work), manipulation of firewood (35%), gardening (29%), and outdoors leisure (14%) were identified as at-risk exposures in these cases. An increased number of positive diagnoses of hantaviral infections was confirmed. The location and at-risk exposures of the cases were identical in previous investigations. Exclusion and prevention of rodents' access to houses and avoiding the inhalation of contaminated dust are the only possible prevention measures of hantaviral infections. Information about the disease and its prevention needs to be made widely available to both healthcare professionals and the general population living in endemic areas.

  17. 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.)

  18. [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.

  19. 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.

  20. Post-mining in France

    International Nuclear Information System (INIS)

    2007-01-01

    This plentifully illustrated book aims at showing how new equilibria are building up during the transition between mining activity and post-mining, and at stressing on the necessity to keep up the cultural elements, the competencies and knowledge of mining works. The first chapter - mine and men - shows the importance of mineral substances in the objects of the everyday life, illustrates the importance of the mining tradition in France and describes the technical and administrative organisation of the end of the mining activity (works, rehabilitation, regulation, monitoring..). Chapter two - exploitation methods - presents the surface and underground facilities and their impact on the environment (extraction machines, workshops, ore processing plants, decantation ponds..). The third chapter deals with the rehabilitation and monitoring aspects: impact of mining activity stoppage on underground and surface waters, land stability, soils cleansing.. The last chapter summarizes the history of French mining region by region: Nord-Pas-de-Calais, Lorraine-Alsace, Massif central, Bretagne-Normandie, Provence-Alpes-Cote d'Azur and Pyrenees

  1. 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.)

  2. David Ziziemsky y el ingreso del psicoanálisis francés en el hospital de niños Sor María Ludovica de la ciudad de La Plata

    OpenAIRE

    Freston, Emilia; Iveninato, Silvina; Vallejo, Emiliano; Riva, Alicia

    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....

  3. 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.

  4. Knowledge translation lessons from an audit of Aboriginal Australians with acute coronary syndrome presenting to a regional hospital.

    Science.gov (United States)

    Haynes, Emma; Hohnen, Harry; Katzenellenbogen, Judith M; Scalley, Benjamin D; Thompson, Sandra C

    2016-01-01

    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. 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. 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. 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 individual attributes, experiences and relationships and systemic factors

  5. Yeasts of the genital region of patients attending the dermatology service at Hospital São Paulo, Brazil.

    Science.gov (United States)

    Bentubo, Henri Donnarumma Levy; Mantovani, Ariane; Yamashita, Jane Tomimori; Gambale, Walderez; Fischman, Olga

    2015-01-01

    The knowledge of the diversity of yeasts that make up the skin microbiota of human beings is essential for the efficient monitoring of infections to which a person may be predisposed. This study identified yeasts comprising the genital skin microbiota of patients attending the Dermatology Service at the Hospital São Paulo-UNIFESP, Brazil. Samples were collected from the genital region of each patient and cultured on Sabouraud dextrose agar. Individual colonies were carefully transferred to tubes daily. Yeasts were identified based on classical methodologies and confirmed using a commercial kit. Eighty-three patients were included in the study. Approximately 80% were women and 20% were men. The average age was 55 years. Hypertension, diabetes, kidney transplant and AIDS were the main underlying diseases reported by the patients. The most prevalent yeasts were Candida parapsilosis (36.1%), Rhodotorula mucilaginosa (9.2%), Rhodotorula glutinis (8.3%), Candida tropicalis (5.5%) and Trichosporon inkin (1.8%). Approximately 78% of the isolates were obtained in pure cultures. Trichosporon inkin was isolated only from women, in contrast to literature describing a high prevalence in males. Our results suggest that Candida albicans is not the main yeast found on genital skin as previously thought, and opportunistic pathogens such as C. parapsilosis, C. tropicalis, Rhodotorula spp. and T. inkin make up the genital skin microbiota, representing a risk for infection in immunocompromised subjects. These results also indicate that women are carriers of T. inkin, the etiological agent of white piedra and trichosporonosis. Copyright © 2013 Revista Iberoamericana de Micología. Published by Elsevier Espana. All rights reserved.

  6. 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.

  7. 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

  8. The introduction of a midwife-led obstetric triage system into a regional referral hospital in Ghana.

    Science.gov (United States)

    Floyd, Liz; Bryce, Fiona; Ramaswamy, Rohit; Olufolabi, Adeyemi; Srofenyoh, Emmanuel; Goodman, David; Pearson, Nancy; Morgan, Kerry; Tetteh, Cecilia; Ahwireng, Victoria; Owen, Medge

    2018-06-01

    to introduce and embed a midwife-led obstetric triage system in a busy labour ward in Accra, Ghana to improve the quality of care and to reduce delay. the study utilized a participatory action research design. Local staff participated in baseline data collection, the triage training course design and delivery, and post-training monitoring and evaluation. a regional referral hospital in Accra, Ghana undertaking 11,032 deliveries in 2012. all midwives and medical staff. measurements included maternal health outcomes, observations of labour ward activity, structured assessments of midwife actions during admission, waiting times, focus group discussions, and learning needs assessments which informed the course content. During training, two quality improvement tools were developed; coloured risk acuity wristbands and a one page triage assessment form. Participants measured compliance and accuracy in the use of these tools following course completion. initially, no formal triage system was in place. The environment was chaotic with poor compliance to existing protocols. Sixty-two midwives received triage training between 2013 and 2014. Two Triage Champions became responsible for triage implementation, monitoring and further training. Following training, the 'in-charge' midwives recorded a cumulative average of 83.4% of women wearing coloured wristbands. A separate audit by the Triage Champions found that 495/535 (93%) of the wristbands were correctly applied based on the diagnosis. Quarterly monitoring of the triage assessment forms by Kybele trainers, showed that 92% recorded the risk acuity colour, 85% a 'working diagnosis' and 82% a 'plan.' Median (interquartile range) waiting times were reduced from 40 (15-100) to 29 (11-60) minutes (p = 007). Twenty of 25 of the staff reported that the wristbands were helpful. an interactive triage training course led to the development of a triage assessment form and the use of coloured patient wristbands which resulted in delay

  9. 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.

  10. 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

  11. No apparent transmission of livestock-associated methicillin-resistant Staphylococcus aureus CC398 in a survey of staff at a regional Danish hospital

    Directory of Open Access Journals (Sweden)

    Else Toft Würtz

    2017-12-01

    Full Text Available Abstract Background In recent years, livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA multi locus sequence type CC398 has spread widely in the livestock production in Europe. The rates of LA-MRSA in hospitals have been found to be largely determined by contact to and density of livestock in the area. Methods This is a cross sectional study of the prevalence of LA-MRSA among hospital staff in a Danish hospital situated in a livestock production region. We analysed nasal swabs, air and dust samples for the presence of MRSA using PCR and mass spectrometry. Results Of 1745 employees, 545 (31% contributed nasal swabs. MRSA was not detected in any participant, nor was it detected in air or dust at the hospital or in houses of employees living on farms. Four percent of the participants had contact to pigs either directly or through household members. LA-MRSA was detected in two of 26 samples from animal sheds, both of them from pig farms. The participation rate was relatively low, but participants were representative for the source population with regards to animal contact and job titles. Conclusions The study suggests a low point prevalence of LA-MRSA carriage in Danish hospital staff even in regions where livestock production is dense. Should more studies confirm our findings we see no need for additional hospital precautions towards LA-MRSA in Denmark at the moment. We think that our data might reduce potential stigmatization of hospital workers with contact to LA-MRSA positive farms at their work places and in their communities.

  12. Death of Dementia Patients in Psychiatric Hospitals and Regional Supply of Psychiatric Services: Study of the National Data from 1996 to 2014 in Japan.

    Science.gov (United States)

    Nakanishi, Miharu; Niimura, Junko; Yamasaki, Syudo; Nishida, Atsushi

    2017-01-01

    Japan designates psychiatric inpatient care for behavior management of individuals with dementia and for helping dementia patients discharge to home. However, there has been no examination of the effectiveness of this strategy. The present study investigated the association between dementia and the discharge destination of patients in psychiatric hospitals. Data from the National Patient Survey, which is a nationally representative cross-sectional survey of inpatient care, were used. The 96,420 patients with dementia or other mental illness who were discharged from psychiatric hospitals in September of every 3 years from 1996 to 2014 were included in analyses. Of the 96,420 discharged patients, 13,823 had dementia as the primary disease. Of the 13,823 dementia patients, 3,865 (28.0%) were discharged to home, 3,870 (28.0%) were admitted to a facility or other care settings, 3,574 (25.9%) were admitted to another hospital, and 2,514 (18.2%) died. Patients were more likely to die in psychiatric hospital if their primary disease was dementia, and they had resided in a region that provided fewer home visits for psychiatric nursing care or had available a larger number of psychiatric hospital beds per capita. Psychiatric inpatient care may be ineffective as a treatment for the challenging behaviors of dementia. A community mental health system for behavior management should be constructed in parallel with a reduction in the number of hospital beds allotted for psychiatric care.

  13. France acts on electronic cigarettes.

    Science.gov (United States)

    Cahn, Zachary

    2013-11-01

    France is deciding how to regulate electronic cigarettes. I first consider the French approach and how it contrasts with other attempts at electronic cigarette regulation globally. Next, I critique the individual elements of the French proposal. The overall approach taken by France is a positive development, but banning indoor use appears unnecessary and banning advertising may be counterproductive.

  14. Women in physics in France

    Energy Technology Data Exchange (ETDEWEB)

    Pierron-Bohnes, Véronique [CNRS-University of Strasbourg, Strasbourg (France)

    2015-12-31

    We present six associations and entities working in France on issues of women in physics: the Women and Physics Commission, French Physical Society; Women in Nuclear (WiN) France; Women and Science Association; Mission for the Place of Women at CNRS; Parity, Diversity, and Women Network, CEA; and the Network of University Equality-Diversity Representatives.

  15. Women in physics in France

    International Nuclear Information System (INIS)

    Pierron-Bohnes, Véronique

    2015-01-01

    We present six associations and entities working in France on issues of women in physics: the Women and Physics Commission, French Physical Society; Women in Nuclear (WiN) France; Women and Science Association; Mission for the Place of Women at CNRS; Parity, Diversity, and Women Network, CEA; and the Network of University Equality-Diversity Representatives

  16. 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...

  17. 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...

  18. 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 &...

  19. 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...

  20. 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...

  1. 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...

  2. 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...

  3. Energy in France. References

    International Nuclear Information System (INIS)

    2000-01-01

    This small booklet is a compilation of key data about the energy in France: energy and economy (energy industries and gross internal product, employment, investments), overall energies (primary energy production and consumption, sectoral consumption, energy bill, price of imported crude oil), petroleum (primary production, sectoral consumption of refined petroleum products, automotive fuels demand, import and export of petroleum products), natural gas (production, sectoral consumption, imports per country of origin), coal (production, sectoral consumption, imports), electric power (production per origin, classical thermal production per type of fuel, sectoral consumption), renewable energies (overall production, heat networks supplied with non-conventional energy sources, wood consumption, wind power production, solar thermal and photovoltaic production), rational use of energy (primary energy intensity, cumulated energy saving), energy prices (in industries and households, automotive fuel prices, energy consumptions in households), energy and environment (CO 2 emissions). A synthesis of the main energy tariffs and prices is given in a separate folder. (J.S.)

  4. Nuclear prospects in France

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1972-07-01

    At the present time, then, we are on the threshold of the second phase of nuclear development, in the. course of which nuclear activities will play a more telling role in the economic cycle. We must therefore consider the development of nuclear energy during its first two decades in the light of the above conclusions and in the realization that for some time to come we shall find ourselves in a delicate transitional stage, during which various influences from the period behind us and the period ahead will make themselves felt. This train of events is not restricted to France, where in 1970 the CEA undertook a complete restructuring of its departments. It is also taking place in other countries, where the various atomic energy commissions are feeling the need to reorganize in order to fit themselves for essential changes. We must therefore be prepared to act in the most effective way possible during this nuclear industrial period. To this end we must establish structures and adopt ways of thinking that art in keeping with the objectives of the period, which will be accompanied by a large growth of investment in the peaceful uses of nuclear energy. Success will depend to a large extent on timely joint efforts in the public and private sectors. Taken together, these requirements imply that we must follow a long-term policy covering at least the next 20 years. As our remarks are to concern the peaceful applications of nuclear energy in France, leaving aside questions of fundamental research and military applications, we shall concentrate ori the fuel cycle and the production of nuclear power, enlarging the subject at each step to encompass the necessary and increasing international co-operation.

  5. Shielding research in France

    Energy Technology Data Exchange (ETDEWEB)

    Lafore, P

    1964-10-01

    Shielding research as an independent subject in France dates from 1956. The importance of these studies has been reflected in the contribution which they have made to power reactor design and in the resultant savings in expenditure for civil engineering and machinery for the removal of mobile shields. The Reactor Shielding Research Division numbers approximately 60 persons and uses several experimental facilities. These include: NAIADE I, installed near the ZOE reactor and operating with a natural uranium slab 2 cm thick (an effective diameter of 60 cm is the one most commonly used); the TRITON pool-type reactor, mainly used in shielding studies, includes an active-water loop, by means of which the secondary shields required for light-water reactors can be studied; core, NEREIDE, which is situated near a 2 m x 2 m aluminium window enables a large neutron source to be placed in a compartment without water in which large-scale mock-ups can be mounted for the study, in particular, of neutron diffusion in large cavities, and of reactor shielding of greater thickness than that in NAIADE I; SAMES 600 keV accelerator is used for monoenergetic neutron studies. Instrumentation studies are an important part of the work, mainly in the measurement of fast neutrons and their spectra by activation detectors. Of late, attention has been directed towards the use of (n, n') (rhodium) reactions and of heavy detectors for low-flux measurements. The simultaneous use of a large number of detectors poses automation problems. With our installation we can count 16 detectors simultaneously. Neutron spectrum studies are conducted with nuclear emulsions and a lithium-6 semiconductor spectrometer. As to the materials used, the research carried out in France involves chiefly graphite, iron and concrete at various temperatures up to 800 deg C. Different compounds, borated and non-borated and of densities up to between 1 and 9 are under consideration. Problems connected with applications are

  6. Care route of attention to chronicity in the high field and basin of Barbera. Results of the deployment of alternatives to conventional hospitalization in a regional hospital

    OpenAIRE

    Clols, Merce; Cartanya, Anton; Domenech, Miquel; Tell, Francesca; Escoda, Montserrat; Olle, Anna; Benet, Anton; Pelleja, Joaquim

    2016-01-01

    Introduction: Pius Hospital of Valls serves a reference population of about 65,000 inhabitants with a rate higher than the Catalan average superannuation. The largest population is the most frequently used health services. In 2010: the 39'6% of the highest in the center corresponded to patients older than 70 years and 21'38% in patients older than 80 years, representing 35'8% of total stays.The existence of frail elderly and pluripatológicos patients admitted to different services, both medic...

  7. Characteristics of Hospitalized Cases of Pertussis in Catalonia and Navarra, Two Regions in the North of Spain.

    Directory of Open Access Journals (Sweden)

    Inma Crespo

    Full Text Available Pertussis causes a large number of cases and hospitalizations in Catalonia and Navarra. We made a study of household cases of pertussis during 2012 and 2013 in order to identify risk factors for hospitalization in pertussis cases. Each primary case reported triggered the study of their contacts. Close contacts at home and people who were in contact for >2 hours during the transmission period of cases were included. The adjusted OR and 95% confidence intervals (CI was calculated using logistic regression. A total of 1124 pertussis cases were detected, of which 14.9% were hospitalized. Inspiratory whoop (aOR: 1.64; CI: 1.02-2.65, apnoea (aOR: 2.47; CI: 1.51-4.03 and cyanosis (aOR: 15.51; CI: 1.87-128.09 were more common in hospitalized than in outpatient cases. Hospitalization occurred in 8.7% of correctly-vaccinated cases, 41.1% of non-vaccinated cases and 9.4% of partially-vaccinated cases. In conclusion, inspiratory whoop, apnoea and cyanosis were associated factors to hospitalization while vaccination reduced hospitalizations due to pertussis.

  8. Characteristics of Hospitalized Cases of Pertussis in Catalonia and Navarra, Two Regions in the North of Spain.

    Science.gov (United States)

    Crespo, Inma; Toledo, Diana; Soldevila, Núria; Jordán, Iolanda; Solano, Rubén; Castilla, Jesús; Caylà, Joan A; Godoy, Pere; Muñoz-Almagro, Carmen; Domínguez, Ángela

    2015-01-01

    Pertussis causes a large number of cases and hospitalizations in Catalonia and Navarra. We made a study of household cases of pertussis during 2012 and 2013 in order to identify risk factors for hospitalization in pertussis cases. Each primary case reported triggered the study of their contacts. Close contacts at home and people who were in contact for >2 hours during the transmission period of cases were included. The adjusted OR and 95% confidence intervals (CI) was calculated using logistic regression. A total of 1124 pertussis cases were detected, of which 14.9% were hospitalized. Inspiratory whoop (aOR: 1.64; CI: 1.02-2.65), apnoea (aOR: 2.47; CI: 1.51-4.03) and cyanosis (aOR: 15.51; CI: 1.87-128.09) were more common in hospitalized than in outpatient cases. Hospitalization occurred in 8.7% of correctly-vaccinated cases, 41.1% of non-vaccinated cases and 9.4% of partially-vaccinated cases. In conclusion, inspiratory whoop, apnoea and cyanosis were associated factors to hospitalization while vaccination reduced hospitalizations due to pertussis.

  9. Analysis of airborne fungi in a hospital in the town of Ariquemes, Rondônia, Western Amazon region, Brazil

    Directory of Open Access Journals (Sweden)

    Jéssica Guimarães Pereira

    2014-01-01

    Full Text Available Backgound and Objectives: The hospital internal air environment is strongly associated with nosocomial fungal infections. In order to investigate the presence of hospital airborne fungi in one of the hospitals in the town of Ariquemes, Rondônia, air samples were collected in open Petri dishes between 15 to 30 minutes, containing the universal culture medium for fungi and yeasts: Saboraund agar, in the morning and afternoon, during October 2012 in the Surgical Center, Materials Center, Minor Surgery Room, Nursing Station and Hospital Admission Room. The isolated colonies underwent macroscopic analysis and subsequently the microculture technique to demonstrate the presence of airborne pathogens. Fifty colonies were isolated and 12 fungal genera were identified. All sectors showed the presence of fungi, which emphasizes the need for microbiological monitoring, especially in rooms with infection prophylaxis priority.

  10. Poppers regulation for public sale: No measure in France yet.

    Science.gov (United States)

    Victorri-Vigneau, Caroline; Trewick, David; Dejoie, Thomas; Masson, Damien; Bulteau, Samuel; Rousselet, Morgane; Sauvaget, Anne; Grall-Bronnec, Marie; Jolliet, Pascale

    2017-10-23

    Poppers have become legal in France since June 2013. Is their liberalisation associated with an increase of severe side effects observed? To identify elevated methaemoglobinaemia related to poppers abuse, we reviewed all methaemoglobin concentrations measured in Nantes university hospital, during 12 months. Methaemoglobin concentrations were superior to 25% in three cases of poppers consumption that occurred after the legalisation. Evaluating the prevalence of elevated methaemoglobinaemia could help to monitor severe complications of poppers use in France. Copyright © 2017 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.

  11. Hydroelectricity: an asset for a successful energy transition in France

    International Nuclear Information System (INIS)

    Galland, J.C.; Vincent, E.

    2013-01-01

    France's national debate on energy transition has served as a reminder that hydroelectric power plays a significant role in French electricity production. With installed power totalling 25400 MW at end 2012 (the second largest in Europe), France's hydroelectric plants produced 63.8 TWh last year (the third largest in Europe), almost 12% of total output. It is France's second largest means of producing electricity and it represents more than 80% of production of renewable energy. A source of energy developed a long time ago, thus benefiting from technological maturity, hydroelectricity can be produced in large quantity at the heart of France's regions, while also rendering indispensable service for the equilibrium of the French electricity system by compensating the intermittency of other renewable energy sources. The production costs of hydroelectric power are the lowest among all power generation technologies. (authors)

  12. 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.

  13. 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.

  14. Prevalence and Factors Associated with Hydatidiform Mole among Patients Undergoing Uterine Evacuation at Mbarara Regional Referral Hospital

    Directory of Open Access Journals (Sweden)

    Olivier Mulisya

    2018-01-01

    Full Text Available Objective. We sought to determine the prevalence of and factors associated with hydatidiform molar gestations amongst patients undergoing uterine evacuation at Mbarara Regional Referral Hospital (MRRH, Mbarara, Uganda. Methods. This was a cross-sectional study carried out from November 2016 to February 2017. All patients admitted for uterine evacuation for nonviable pregnancy were included. The study registered 181 patients. Data were collected on sociodemographics, medical conditions, obstetrics, and gynecological factors. The evacuated tissue received a full gross and histopathologic examination. Cases of pathologically suspected complete hydatidiform mole were confirmed by p57 immunohistochemistry. Data were analyzed using STATA 13. Results. The prevalence of hydatidiform mole was 6.1% (11/181. All detected moles were complete hydatidiform moles, and there were no diagnosed partial hydatidiform moles. Clinical diagnosis of molar pregnancy was suspected in 13 patients, but only 69.2% (9/13 were confirmed as molar pregnancies histologically. Two cases were clinically unsuspected. Factors that had a significant relationship with complete hydatidiform mole included maternal age of 35 years and above (aOR 13.5; CI: 1.46–125.31; p=0.00, gestational age beyond the first trimester at the time of uterine evacuation (aOR 6.2; CI: 1.07–36.14; p=0.04, and history of previous abortion (aOR 4.3; CI: 1.00–18.57; p=0.05. Conclusion. The prevalence of complete hydatidiform mole was high at 6.1%. Associated risk factors included advanced maternal age (35 years and above, history of previous abortions, and gestational age beyond the first trimester at the time of evacuations. Recommendations. We recommend putting in place capacity to do routine histopathological examination of all products of conception especially those at high risk for a molar gestation either by clinical suspicion or by risk factors including advanced maternal age, advanced gestational

  15. The Influence of Quality Assurance and Supportive Supervision on the Quality of Medical Care in Children’s Hospitals of the Municipal Level of the Rostov Region

    Directory of Open Access Journals (Sweden)

    Tatiana V. Kulichenko

    2017-01-01

    Full Text Available Background. Improving the quality of medical care is the absolute priority of the World Health Organization and all socially-oriented ministries and departments around the world.Objective. Our aim was to evaluate the effectiveness of quality  assurance and supportive supervision in municipal hospitals to improve the quality of medical care for children (by the example of the Rostov region.Methods. The open observational study included 10 second-level hospitals in the Rostov Region. At the start of the project, the quality of inpatient care for children in the region was audited based on recommendations and tools of the World Health Organization, and training of medical personnel was organized. Monitoring visits to hospitals were carried out by experts every 3 months (supportive supervision. Reaudit of the quality of care was conducted a year later.Results. As a result of regular quality assurance and supportive supervision of hospitals during the first year of operation, such indicators of the quality of medical care as the availability of medical equipment for emergency care for children, the infrastructure of children’s departments, the triage and provision of emergency care in children’s departments, managing patients with various acute conditions (fever, diarrhea, respiratory diseases, supporting care, internal quality assurance, accessibility to standards of care and clinical guidelines for the diagnosis and treatment of various diseases, respect for children’s rights were significantly (p < 0.05 improved.Conclusion. Supportive supervision and regular external quality assurances of hospitals contribute to a rapid increase in the quality of medical care for children.

  16. 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

  17. Gaz de France. Operation note

    International Nuclear Information System (INIS)

    2003-01-01

    This note was published for the public at the occasion of the admission to Euronext's Eurolist of the existing shares that make the capital of Gaz de France company, the French gas utility. The note gives some informations about Gaz de France activity, and about its strategy of development in the European gas market. Then it describes the offer relative to the opening of Gaz de France capital. Some selected financial data and some precision about the risk factors and the management of the company complete the document. (J.S.)

  18. 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.)

  19. Cholecystectomy and Diagnosis-Related Groups (DRGs): Patient Classification and Hospital Reimbursement in 11 European Countries

    OpenAIRE

    Gerli Paat-Ahi; Ain Aaviksoo; Maria Świderek

    2014-01-01

    Background As part of the EuroDRG project, researchers from eleven countries (i.e. Austria, England, Estonia, Finland, France, Germany, Ireland, Netherlands, Poland, Sweden, and Spain) compared how their Diagnosis-Related Groups (DRG) systems deal with cholecystectomy patients. The study aims to assist surgeons and national authorities to optimize their DRG systems. Methods National or regional databases were used to identify hospital cases with a procedure of cholecystectom...

  20. Appendectomy and diagnosis-related groups (DRGs): patient classification and hospital reimbursement in 11 European countries

    OpenAIRE

    Quentin, Wilm; Scheller-Kreinsen, David; Geissler, Alexander; Busse, Reinhard

    2012-01-01

    Background As part of the EuroDRG project, researchers from 11 countries (i.e., Austria, England, Estonia, Finland, France, Germany, Ireland, Netherlands, Poland, Sweden, and Spain) compared how their diagnosis-related groups (DRG) systems deal with appendectomy patients. The study aims to assist surgeons and national authorities to optimize their DRG systems. Methods National or regional databases were used to identify hospital cases with a diagnosis of appendicitis treated with a procedure ...

  1. 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

  2. Nuclear electricity from France?

    International Nuclear Information System (INIS)

    Harms, W.

    1987-01-01

    This second volume of the Berlin series presents the papers and discussion of the eleventh discussion meeting on energy law, for the first time held in Berlin, on May 12-13, 1987. The leading subject of the first conference day, namely electricity imports from France, has since then widely been discussed in the media or at other meetings, although the legal problems or obstacles revealed at this Berlin meeting are far from being solved. There is EdF's wish to export electricity to West Germany on the other hand, and there is the West German coal industry's scepticism on the other hand. Much is at stake for West Germany's national concept of enhanced use of coal for electricity generation, and the related system of subventions. Supply concepts and franchise charges, a standing topic of the power sector for quite a time now, have been discussed on the second conference day. The papers read there gave an account of the situation and also presented some new aspects. (orig./UA) [de

  3. Nuclear safety in France

    International Nuclear Information System (INIS)

    Laverie, M.

    1981-02-01

    The principles and rules governing the safety of nuclear installations are defined as from three fundamental principles and three practical rules as follows: First principle: the operator is responsible and of the highest order. Second principle: the public authorities exercise their control responsibility with respect to the design, construction and running of the installations. Third principle: nuclear safety, this is to accept that man and his technique are not infallible and that one must be prepared to control the unpredictable. First rule: the installations must include several 'lines of defence' in succession and to the extent where this is possible these must be independent of each other. Second rule: procedures are required and supervised by the Government Departments. Third rule: nuclear safety requires that any incident or anomaly must undergo an analysis in depth and is also based on a standing 'clinical' examination of the installations. The definition is given as to how the public authorities exercise their intervention: terms and conditions of the intervention by the safety authorities, authorization procedures, surveillance of the installations, general technical regulations. Two specific subjects are presented in the addendum, (a) the choice of nuclear power station sites in France and (b) the storage of radioactive wastes [fr

  4. 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...

  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. Accident response in France

    International Nuclear Information System (INIS)

    Duco, J.; L'Homme, A.; Queniart, D.

    1988-07-01

    French PWR power plant design relies basically on a deterministic approach. A probabilistic approach was introduced in France in the early seventies to define safety provisions against external impacts. In 1977 an overall safety objective was issued by the safety authority in terms of an upper probability limit for having unacceptable consequences. Additional measures were taken (the ''H'' operating procedures) to complement the automatic systems normally provided by the initial design, so as to safisfy the safety objective. The TMI-2 accident enhanced the interest in confused situations in which possible multiple equipment failure and/or unappropriate previous actions of the operators impede the implementation of any of the existing event-oriented procedures. In such situations, the objective becomes to avoid core-melt by any means available: this is the goal of the Ul symptom-oriented procedure. Whenever a core-melt occurs, the radioactive releases into the environment must be compatible with the feasibility of the off-site emergency plans; that means that for some hypothetical, but still conceivable scenarios, provisions have to be made to delay and limit the consequences of the loss of the containment: the U2, U4 and U5 ultimate procedures have been elaborated for that purpose. For the case of an emergency, a nationwide organization has been set up to provide the plant operator with a redundant technical expertise, to help him save his plant or mitigate the radiological consequences of a core-melt

  7. A filmless radiology department in a full digital regional hospital: quantitative evaluation of the increased quality and efficiency.

    Science.gov (United States)

    Nitrosi, Andrea; Borasi, Giovanni; Nicoli, Franco; Modigliani, Gino; Botti, Andrea; Bertolini, Marco; Notari, Pietro

    2007-06-01

    Reggio Emilia hospital installed Picture Archiving and Communications Systems (PACS) as the final step towards a completely digital clinical environment completing the HIS/EMR and 1,400 web/terminals for patient information access. Financial benefits throughout the hospital were assessed upfront and measured periodically. Key indicators (radiology exam turnaround time, number of radiology procedures performed, inpatients length of stay before and after the PACS implementation, etc.) were analyzed and values were statistically tested to assess workflow and productivity improvements. The hospital went "filmless" in 28 weeks. Between the half of 2004 and the respective period in 2003, overall Radiology Department productivity increased by 12%, TAT improved by more than 60%. Timelier patient care resulted in decreased lengths of stay. Neurology alone experienced a 12% improvement in average patient stay. To quantify the impact of PACS on the average hospital stays and the expected productivity benefits to inpatient productivity were used a "high level" and a "detailed" business model. Annual financial upsides have exceeded $1.9 millions/year. A well-planned PACS deployment simplifies imaging workflow and improves patient care throughout the hospital while delivering substantial financial benefits. Staff buy-in was the key in this process and on-going training and process monitoring are a must.

  8. Association between Ambient Temperatures and Mental Disorder Hospitalizations in a Subtropical City: A Time-Series Study of Hong Kong Special Administrative Region.

    Science.gov (United States)

    Chan, Emily Y Y; Lam, Holly C Y; So, Suzanne H W; Goggins, William B; Ho, Janice Y; Liu, Sida; Chung, Phoebe P W

    2018-04-14

    Background : Mental disorders have been found to be positively associated with temperature in cool to cold climatic regions but the association in warmer regions is unclear. This study presented the short-term association between temperatures and mental disorder hospitalizations in a subtropical city with a mean annual temperature over 21 °C. Methods : Using Poisson-generalized additive models and distributed-lagged nonlinear models, daily mental disorder hospitalizations between 2002 and 2011 in Hong Kong were regressed on daily mean temperature, relative humidity, and air pollutants, adjusted for seasonal trend, long-term trend, day-of-week, and holiday. Analyses were stratified by disease class, gender and age-group. Results : 44,600 admissions were included in the analysis. Temperature was positively associated with overall mental-disorder hospitalizations (cumulative relative risk at 28 °C vs. 19.4 °C (interquartile range, lag 0-2 days) = 1.09 (95% confidence interval 1.03, 1.15)), with the strongest effect among the elderly (≥75 years old). Transient mental disorders due to conditions classified elsewhere and episodic mood disorders also showed strong positive associations with temperature. Conclusion : This study found a positive temperature-mental-disorder admissions association in a warm subtropical region and the association was most prominent among older people. With the dual effect of global warming and an aging population, targeted strategies should be designed to lower the disease burden.

  9. Gaz de France 2006 sustainable development report

    International Nuclear Information System (INIS)

    2006-01-01

    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. 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.

  11. The nuclear energy in France

    International Nuclear Information System (INIS)

    Pedroso, L.J.

    1983-01-01

    An overview of the nuclear energy in France is done. The great centers and the great research lines of the French nuclear program, as well as its present status and prospects for the future are presented. (EG) [pt

  12. Electricite de France in 1992

    International Nuclear Information System (INIS)

    Menage, G.; Bergougnoux, J.

    1993-01-01

    This paper describes financial results of a french electric utility (Electricite de France) in 1992. Statistical data on investments, tariffs, and prices of electric power in Europe are also given. 7 figs., 2 tabs

  13. Gaz de France. Source document

    International Nuclear Information System (INIS)

    2005-01-01

    This document was issued by Gaz de France, the French gas utility, at the occasion of the opening of the capital of the company. It is intended to shareholders and presents some informations relative to the stocks admitted to Euronext's Eurolist, some general informations about the company and its capital, some informations about the activities of Gaz de France group, about its financial situation and results, about its management, and about its recent evolution and future perspectives. (J.S.)

  14. 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.

  15. France without nuclear power

    International Nuclear Information System (INIS)

    Barre, B.; Charmant, A.; Devezeaux, J.G.; Ladoux, N.; Vielle, M.

    1995-01-01

    As environmental issues (particularly questions associated with the greenhouse effect) become a matter of increasing current concern, the French nuclear power programme can, in retrospect, be seen to have had a highly positive impact upon emissions of atmospheric pollutants. The most spectacular effect of this programme was the reduction of carbon dioxide emissions from 530 million tonnes per annum in 1973 to 387 million tonnes per annum today. Obviously, this result cannot be considered in isolation from the economic consequences of the nuclear power programme, which have been highly significant.The most obvious consequence of nuclear power has been the production of cheap electricity, while a further consequence has been the stability of electricity prices resulting from the increasing self-sufficiency of France in energy supplies (from 22% in 1973 to 49.% in 1992). Moreover, French nuclear industry exports. In 1993, 61.7 TW·h from nuclear production were exported, which contributed F.Fr. 14.2 billion to the credit side of the balance of payment. For the same year, Framatome exports are assessed at about F.Fr. 2 billion, corresponding to manufacturing and erection of heavy components, and maintenance services. Cogema, the French nuclear fuel operator, sold nuclear materials and services for F.Fr. 9.3 billion. Thus, nuclear activities contributed more than F.Fr. 25 billion to the balance of payment. Therefore, a numerical assessment of the macroeconomic impact of the nuclear power programme is essential for any accurate evaluation of the environmental consequences of that programme. For this assessment, which is presented in the paper, the Micro-Melodie macroeconomic and energy supply model developed by the Commissariat a l'energie atomique has been used. (author). 6 refs, 4 figs, 1 tab

  16. 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

  17. Risk factors associated with in-hospital mortality in elderly patients admitted to a regional trauma center after sustaining a fall.

    Science.gov (United States)

    Cartagena, L J; Kang, A; Munnangi, S; Jordan, A; Nweze, I C; Sasthakonar, V; Boutin, A; George Angus, L D

    2017-06-01

    Falls are a significant cause of mortality in the elderly patients. Despite this, the literature on in-hospital mortality related to elderly falls remains sparse. Our study aims to determine the risk factors associated with in-hospital mortality in elderly patients admitted to a regional trauma center after sustaining a fall. All elderly case records with fall-related injuries between 2003 and 2013 were retrospectively analyzed for demographic characteristics, injury severities, comorbidity factors and clinical outcomes. Logistic regression analysis was used to examine the risk factors associated with in-hospital mortality. In total, 1026 elderly patients with fall-related injuries were included in the study. The average age of patients was 80.94 ± 8.16 years. Seventy seven percent of the patients had at least one comorbid condition. Majority of the falls occurred at home. More than half of the patients fell from ground level. Overall, the in-hospital mortality rate was 16 %. Head injury constituted the most common injury sustained in patients who died (77 %). In addition to age, ISS, GCS, ICU admission and anemia were significantly (P fall patients. Ground-level falls in the elderly can be devastating and carry a significant mortality rate. Elderly patients with anemia were two times more likely to die in the hospital after sustaining a fall in our study population. Increased focus on anemia which is often underappreciated in elderly fall patients can be beneficial in improving outcomes and reducing in-hospital mortality.

  18. [Estimation of economic costs for the care of patients with nosocomial pneumonia in a regional peruvian hospital, 2009-2011].

    Science.gov (United States)

    Dámaso-Mata, Bernardo; Chirinos-Cáceres, Jesús; Menacho-Villafuerte, Luz

    2016-06-01

    To estimate and compare the economic costs for the care of patients with and without nosocomial pneumonia at Hospital II Huánuco EsSalud during 2009-2011, in Peru. This was a partial economic evaluation of paired cases and controls. A collection sheet was used. nosocomial pneumonia. direct health costs, direct non-health costs, indirect costs, occupation, age, comorbidities, sex, origin, and education level. A bivariate analysis was performed. Forty pairs of cases and controls were identified. These patients were hospitalized for >2 weeks and prescribed more than two antibiotics. The associated direct health costs included those for hospitalization, antibiotics, auxiliary examinations, specialized assessments, and other medications. The direct non-health costs and associated indirect costs included those for transportation, food, housing, foregone payroll revenue, foregone professional fee revenue, extra-institutional expenses, and payment to caregivers during hospitalization and by telephone. The direct health costs for nosocomial pneumonia patients were more than three times and the indirect costs were more than two times higher than those for the controls. Variables with the greatest impact on costs were identified.

  19. Prevalence of Legionella pneumophila in water distribution systems in hospitals and public buildings of the Lublin region of eastern Poland

    Directory of Open Access Journals (Sweden)

    Agnieszka Sikora

    2015-05-01

    The water samples collected form the hot water supply system of hospitals and public buildings showed exceeded counts of L. pneumophila, 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.

  20. Emergencies and emergency planning in France

    International Nuclear Information System (INIS)

    Jammet, H.

    1986-01-01

    The organization for dealing with radiation emergencies in France is complex and centralized. It consists of the Radiation Security Council with participants from the Premier Ministre and the Ministers of Interior, Industry, Health, and Defense. A permanent general secretary for radiation security coordinates the work of the various departments. Planning for nuclear power emergencies is divided between on-site, in which organization and intervention are the responsibilities of the manager of the plant, and off-site, in which organization and intervention are the responsibility of the regional governor. Both on-site and off-site planning have models integrated into a special code of practice called the radiation emergency organization

  1. Revival of coal. [France and USA

    Energy Technology Data Exchange (ETDEWEB)

    1981-05-01

    This edition is devoted to the production and consumption of coal in France. It presents a study of the main topics involved, discusses the position of coal in France - under what form should it beused, and deals with coal consumption in cement works role of coal for urban district heating, future of coal gasification in France, France's coal policy, coal industry in the USA, underground gasification of coal, France's coal reserves, etc.. (In French)

  2. 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)

    Xiaosong, Chang [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); Xiaoyun, Liu [Center for Disease Prevention and Control, Lanzhou Military Region, Lanzhou 730020 (China); Qing, Zhao; Hao, Chen; Jian, Chen; Zhiqun, Qiu; Lan, Yang [Department of Environmental Hygiene, School of Military Preventive Medicine, Third Military Medical University, Chongqing 400038 (China); Jia, Cao [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

  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

    International Nuclear Information System (INIS)

    Chang Xiaosong; Meyer, Michael T.; Liu Xiaoyun; Zhao Qing; Chen Hao; Chen Jian; Qiu Zhiqun; Yang Lan; Cao Jia; Shu Weiqun

    2010-01-01

    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 μg/L to 4.240 μg/L and norfloxacin (NOR, 0.136-1.620 μg/L), ciproflaxacin (CIP, ranged from 0.011 μg/L to 0.136 μg/L), trimethoprim (TMP, 0.061-0.174 μg/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 2 O (ERY-H 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. The determinants of patient waiting time in the general outpatient department of Debre Markos and Felege Hiwot hospitals in Amhara regional state, North West, Ethiopia

    Directory of Open Access Journals (Sweden)

    Melesse Belayneh

    2017-01-01

    Full Text Available Background Patient waiting time is defined as the total time from registration until consultation with a doctor. Experiences of waiting in general are perceived as complex, subjective, and culturally influenced. Registration time, payment process/cash billing, recording classification/triaged time, few human resources and work process are the determinants of patient waiting time in the general outpatient departments. However, the complexity of wait time is poorly understood and has been explored only to a limited extent. The main objective of this study to assess patient waiting time and its determinants in Debre Markos and Felge Hiwot Referral hospitals of Amhara Regional State in North West, Ethiopia. Methods A hospital based comparative cross sectional study design was employed from October 20‐ November 20, 2014. The study population was patients presenting to general outpatient departments, from which 464 patients was selected using systematic random sampling technique. Quantitative Data was collected using structured questionnaire and A check list adopted from studies. Quantitative data was coded, entered, cleaned and analyzed using SPSS Software for windows version 20.0. Linear regression and bivariate logistic regression was applied to identify the determinants of each explanatory variable on outcome (patient waiting time. Finally data was interpreted by referring to the pertinent findings from the relevant literature reviewed. Ethical approval and clearance was obtained from ethical clearance committee of the Jimma University College of Public Health & Medical Sciences Result The measured waiting time in Felge Hiwot referral hospital mean waiting time was and its standard deviation 149.2±72.1 minutes whereas 94.2±58.3 minutes in debere markos referral hospital. The major causes of the long patient waiting time was large numbers of patient with a few doctors 94(40.5%,67(28.9% ,long searching of the cards 67(28.9%,73(31.5,and long

  5. France's 2010 energy situation

    International Nuclear Information System (INIS)

    2011-01-01

    2010 in Europe was marked by a moderate economic upturn after the crisis year of 2009, when consumption dropped. At the global level, the energy demand from emerging countries continued to push up prices. In France, 2010 was a year in which the winter months were particularly cold, causing additional consumption for heating of more than 10 per cent, estimated at 4.6 millions tonnes of oil equivalent (Mtoe). National primary energy production was 138.6 Mtoe, 0.2 Mtoe higher than the previous record year 2008. Nearly all forms of energy contributed to the increase. Nuclear power increased its output by 4.6 per cent and was only 5 per cent below its maximum, reached in 2005. Hydro production returned to a regime almost in line with the average. Wind power once again increased significantly (+19%) and photovoltaic electricity tripled, although it still only accounts for 0.6 Mtoe. Extraction of conventional fossil fuels was stable at 2.5 Mtoe. Thermal renewable energy and energy recovered from waste also increased markedly, by 10.7 per cent (+1.7 Mtoe). Total primary energy consumption increased by 3.8 per cent. Once corrected for climatic variations, it increased slightly (+1.7%) but remained well below its pre-crisis level. With 266 Mtoe it was even below its 2000 level. It progressed by 4 Mtoe per year on average in the 1990's, then by only 2 Mtoe in 2001 and 2002. Since then, despite a rebound in 2004, it had remained stable until the clear drop in 2009. Aggregated renewable thermal energy and energy recovered from waste continued their progression (+5.1%). The pace dipped slightly, but progress has been permanent since 2006 (+37% in 4 years). However, this group of sources still only accounts for 6.4 per cent of primary consumption. Stimulated by the rigours of the climate, gas beat all its records. However, after correction, its level was close to that around which it was fluctuating before the crisis, between 2002 and 2008. Primary electricity consumption (+2

  6. Regional transport and dilution during high-pollution episodes in southern France: Summary of findings from the Field Experiment to Constraint Models of Atmospheric Pollution and Emissions Transport (ESCOMPTE)

    Science.gov (United States)

    Drobinski, P.; SaïD, F.; Ancellet, G.; Arteta, J.; Augustin, P.; Bastin, S.; Brut, A.; Caccia, J. L.; Campistron, B.; Cautenet, S.; Colette, A.; Coll, I.; Corsmeier, U.; Cros, B.; Dabas, A.; Delbarre, H.; Dufour, A.; Durand, P.; GuéNard, V.; Hasel, M.; Kalthoff, N.; Kottmeier, C.; Lasry, F.; Lemonsu, A.; Lohou, F.; Masson, V.; Menut, L.; Moppert, C.; Peuch, V. H.; Puygrenier, V.; Reitebuch, O.; Vautard, R.

    2007-07-01

    In the French Mediterranean basin the large city of Marseille and its industrialized suburbs (oil plants in the Fos-Berre area) are major pollutant sources that cause frequent and hazardous pollution episodes, especially in summer when intense solar heating enhances the photochemical activity and when the sea breeze circulation redistributes pollutants farther north in the countryside. This paper summarizes the findings of 5 years of research on the sea breeze in southern France and related mesoscale transport and dilution of pollutants within the Field Experiment to Constraint Models of Atmospheric Pollution and Emissions Transport (ESCOMPTE) program held in June and July 2001. This paper provides an overview of the experimental and numerical challenges identified before the ESCOMPTE field experiment and summarizes the key findings made in observation, simulation, and theory. We specifically address the role of large-scale atmospheric circulation to local ozone vertical distribution and the mesoscale processes driving horizontal advection of pollutants and vertical transport and mixing via entrainment at the top of the sea breeze or at the front and venting along the sloped terrain. The crucial importance of the interactions between processes of various spatial and temporal scales is thus highlighted. The advances in numerical modeling and forecasting of sea breeze events and ozone pollution episodes in southern France are also underlined. Finally, we conclude and point out some open research questions needing further investigation.

  7. Regional transport and dilution during high-pollution episodes in southern France: Summary of findings from the Field Experiment to Constraint Models of Atmospheric Pollution and Emissions Transport (ESCOMPTE)

    International Nuclear Information System (INIS)

    Drobinski, P.; Menut, L.; Ancellet, G.; Bastin, S.; Colette, A.; Said, F.; Brut, A.; Campistron, B.; Cros, B.; Durand, P.; Lohou, F.; Moppert, C.; Puygrenier, V.; Arteta, J.; Cautenet, S.; Augustin, P.; Delbarre, H.; Caccia, J.L.; Guenard, V.; Coll, I.; Lasry, F.; Corsmeier, U.; Hasel, M.; Kalthoff, N.; Kottmeier, C.; Dabas, A.; Dufour, A.; Lemonsu, A.; Masson, V.; Peuch, V.H.; Reitebuch, O.; Vautard, R.

    2007-01-01

    In the French Mediterranean basin the large city of Marseille and its industrialized suburbs (oil plants in the Fos-Berre area) are major pollutant sources that cause frequent and hazardous pollution episodes, especially in summer when intense solar heating enhances the photochemical activity and when the sea breeze circulation redistributes pollutants farther north in the countryside. This paper summarizes the findings of 5 years of research on the sea breeze in southern France and related mesoscale transport and dilution of pollutants within the Field Experiment to Constraint Models of Atmospheric Pollution and Emissions Transport (ESCOMPTE) program held in June and July 2001. This paper provides an overview of the experimental and numerical challenges identified before the ESCOMPTE field experiment and summarizes the key findings made in observation, simulation, and theory. We specifically address the role of large-scale atmospheric circulation to local ozone vertical distribution and the mesoscale processes driving horizontal advection of pollutants and vertical transport and mixing via entrainment at the top of the sea breeze or at the front and venting along the sloped terrain. The crucial importance of the interactions between processes of various spatial and temporal scales is thus highlighted. The advances in numerical modeling and forecasting of sea breeze events and ozone pollution episodes in southern France are also underlined. Finally, we conclude and point out some open research questions needing further investigation. (authors)

  8. Regional transport and dilution during high-pollution episodes in southern France: Summary of findings from the Field Experiment to Constraint Models of Atmospheric Pollution and Emissions Transport (ESCOMPTE)

    Energy Technology Data Exchange (ETDEWEB)

    Drobinski, P.; Menut, L. [Ecole Polytechnique, Inst Pierre Simon Laplace, Laboratoire de Meteorologie Dynamique, F-91128 Palaiseau (France); Ancellet, G.; Bastin, S.; Colette, A. [Universite Pierre et Marie Curie, Institut Pierre Simon Laplace, Service d' aeronomie, 4 place Jussieu, F-75252 Paris, (France); Said, F.; Brut, A.; Campistron, B.; Cros, B.; Durand, P.; Lohou, F.; Moppert, C.; Puygrenier, V. [Univ Toulouse, Lab Aerol, F-31400 Toulouse, (France); Arteta, J.; Cautenet, S. [Univ Clermont Ferrand, Lab Meteorol Phys, F-63174 Aubiere, (France); Augustin, P.; Delbarre, H. [Univ Littoral Cote d' Opale, Lab Physicochim Atmosphere, F-59140 Dunkerque, (France); Caccia, J.L.; Guenard, V. [Univ Toulon and Var, Lab Sondages Electromagnet Environm Terr, F-83957 La Garde, (France); Coll, I.; Lasry, F. [Fac Sci and Technol, Lab Interuniv Syst Atmospher, F-94010 Creteil, (France); Corsmeier, U.; Hasel, M.; Kalthoff, N.; Kottmeier, C. [Univ Karlsruhe, Inst Meteorol and Klimaforsch, Forschungszentrum, D-76133 Karlsruhe, (Germany); Dabas, A.; Dufour, A.; Lemonsu, A.; Masson, V.; Peuch, V.H. [Ctr Natl Rech Meteorol, F-31057 Toulouse, (France); Reitebuch, O. [Deutsch Zentrum Luft and Raumfahrt, Inst Atmospher Phys, D-82234 Wessling, (Germany); Vautard, R. [Inst Pierre Simon Laplace, CEA Saclay, Lab Sci Climat and Environm, F-91191 Gif Sur Yvette, (France)

    2007-07-01

    In the French Mediterranean basin the large city of Marseille and its industrialized suburbs (oil plants in the Fos-Berre area) are major pollutant sources that cause frequent and hazardous pollution episodes, especially in summer when intense solar heating enhances the photochemical activity and when the sea breeze circulation redistributes pollutants farther north in the countryside. This paper summarizes the findings of 5 years of research on the sea breeze in southern France and related mesoscale transport and dilution of pollutants within the Field Experiment to Constraint Models of Atmospheric Pollution and Emissions Transport (ESCOMPTE) program held in June and July 2001. This paper provides an overview of the experimental and numerical challenges identified before the ESCOMPTE field experiment and summarizes the key findings made in observation, simulation, and theory. We specifically address the role of large-scale atmospheric circulation to local ozone vertical distribution and the mesoscale processes driving horizontal advection of pollutants and vertical transport and mixing via entrainment at the top of the sea breeze or at the front and venting along the sloped terrain. The crucial importance of the interactions between processes of various spatial and temporal scales is thus highlighted. The advances in numerical modeling and forecasting of sea breeze events and ozone pollution episodes in southern France are also underlined. Finally, we conclude and point out some open research questions needing further investigation. (authors)

  9. Paediatric in-patient care in a conflict-torn region of Somalia: are hospital outcomes of acceptable quality?

    Science.gov (United States)

    Zachariah, R.; Hinderaker, S. G.; Khogali, M.; Manzi, M.; van Griensven, J.; Ayada, L.; Jemmy, J. P.; Maalim, A.; Amin, H.

    2013-01-01

    Setting: A district hospital in conflict-torn Somalia. Objective: To report on in-patient paediatric morbidity, case fatality and exit outcomes as indicators of quality of care. Design: Cross-sectional study. Results: Of 6211 children, lower respiratory tract infections (48%) and severe acute malnutrition (16%) were the leading reasons for admission. The highest case-fatality rate was for meningitis (20%). Adverse outcomes occurred in 378 (6%) children, including 205 (3.3%) deaths; 173 (2.8%) absconded. Conclusion: Hospital exit outcomes are good even in conflict-torn Somalia, and should boost efforts to ensure that such populations are not left out in the quest to achieve universal health coverage. PMID:26393014

  10. Pattern of Occurrence of Leukemia at a Teaching Hospital in Eastern Region of Nepal - A Six Year Study

    Directory of Open Access Journals (Sweden)

    Ritu Kulshrestha

    2009-01-01

    The data published in this study reflects the leukemia pattern in the eastern region of Nepal. The pattern and distribution of AML, CML, ALL was similar to that in the developed western countries while the lesser frequency of CLL was similar to that in Southeast Asian region Key Words:leukemia, pattern, eastern Nepal, seasonality.

  11. 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.)

  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. Infection Prevention Strategy in Hospitals in the Era of Community-Associated Methicillin-Resistant Staphylococcus aureus in the Asia-Pacific Region: A Review.

    Science.gov (United States)

    Cho, Sun Young; Chung, Doo Ryeon

    2017-05-15

    Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has emerged as an important cause of healthcare-associated infection. CA-MRSA clones have replaced classic hospital MRSA clones in many countries and have shown higher potential in transmission and virulence than hospital MRSA clones. In particular, the emergence of CA-MRSA in the Asia-Pacific region is concerning owing to insufficient infection control measures in the region. The old strategies for infection prevention and control of MRSA comprised adherence to standard precaution and policy of active screening of MRSA carriers and decolonization, and it has been controversial which strategy is better in terms of outcome and cost-effectiveness. Epidemiological changes in MRSA has made the development of infection prevention strategy more complicated. Based on the literature review and the questionnaire survey, we considered infection prevention strategies for healthcare settings in the Asia-Pacific region in the era of CA-MRSA. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

  14. Does adoption of electronic health records improve the quality of care management in France? Results from the French e-SI (PREPS-SIPS) study.

    Science.gov (United States)

    Plantier, Morgane; Havet, Nathalie; Durand, Thierry; Caquot, Nicolas; Amaz, Camille; Biron, Pierre; Philip, Irène; Perrier, Lionel

    2017-06-01

    Electronic health records (EHR) are increasingly being adopted by healthcare systems worldwide. In France, the "Hôpital numérique 2012-2017" program was implemented as part of a strategic plan to modernize health information technology (HIT), including the promotion of widespread EHR use. With significant upfront investment costs as well as ongoing operational expenses, it is important to assess this system in terms of its ability to result in improvements in hospital performances. The aim of this study was to evaluate the impact of EHR use on the quality of care management in acute care hospitals throughout France. This retrospective study was based on data derived from three national databases for the year 2011: IPAQSS (indicators of improvement in the quality and the management of healthcare, "IPAQSS"), Hospi-Diag (French hospital performance indicators), and the national accreditation database. Several multivariate models were used to examine the association between the use of EHRs and specific EHR features with four quality indicators: the quality of patient record, the delay in sending information at hospital discharge, the pain status evaluation, and the nutritional status evaluation, while also adjusting for hospital characteristics. The models revealed a significant positive impact of EHR use on the four quality indicators. Additionally, they showed a differential impact according to the functionality of the element of the health record that was computerized. All four quality indicators were also impacted by the type of hospital, the geographical region, and the severity of the pathology. These results suggest that, to improve the quality of care management in hospitals, EHR adoption represents an important lever. They complete previous work dealing with EHR and the organizational performance of hospital surgical units. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. [Kidney transplantation epidemiology in France].

    Science.gov (United States)

    Hiesse, Christian

    2013-11-01

    Kidney transplantation activity in France is among the most important worldwide: in 2011, 2976 transplants have been performed (47.5 per million population), and the number of patients living with a functional graft is estimated around 30,000, representing 44.7% of all patients (n = 67,270) treated for end-stage renal failure. However, the rate of preemptive kidney transplants remains very low, only 3.3% of incident patients starting renal replacement therapy. The analysis of demand showed a progressive increase in recent years, as demonstrated by the registration rate on the kidney transplantation waiting list, increasing by 5% yearly between 2006 and 2010, but with huge differences according to age categories and regional registration areas, reflecting discrepant appreciations in indications for kidney transplantation. The median waiting time between registration and transplantation increased progressively in recent years, reaching 22.3 months with considerable variations according to regional areas and transplantation teams. Kidney transplantation activity, while increasing continuously, is far to cover the rising demand, and inexorably patients accumulate on the waiting list (around 9000 patients were registered by January 2012). This situation is the consequence of insufficient organ procurement activity. The deceased organ procurement rate remained high: 1572 harvested donors in 2011 (24.1 per million population), but the proportion of older donors rose in recent years, to reach the rate of 26% of donors older than 65 years in 2011. The procurement activity of donors after cardiac arrest was reintroduced in 2006, but increased slowly: 65 transplants were performed in 2011 using kidney procured in non heart-beating donors. The living donor kidney transplantation activity has markedly increased recently: 302 living donor transplantations were performed in 2011, representing 10.1% of the kidney transplantations. Facing the predictable increase in the number of

  16. Improving access to health care in a rural regional hospital in South Africa: Why do patients miss their appointments?

    Science.gov (United States)

    Frost, Lucy; Jenkins, Louis S; Emmink, Benjamin

    2017-03-30

    Access to health services is one of the Batho Pele ('people first') values and principles of the South African government since 1997. This necessitated some changes around public service systems, procedures, attitudes and behaviour. The challenges of providing health care to rural geographically spread populations include variations in socio-economic status, transport opportunities, access to appointment information and patient perceptions of costs and benefits of seeking health care. George hospital, situated in a rural area, serves 5000 outpatient visits monthly, with non-attendance rates of up to 40%. The aim of this research was to gain a greater understanding of the reasons behind non-attendance of outpatient department clinics to allow locally driven, targeted interventions. This was a descriptive study. We attempted to phone all patients who missed appointments over a 1-month period (n = 574). Only 20% were contactable with one person declining consent. Twenty-nine percent had no telephone number on hospital systems, 7% had incorrect numbers, 2% had died and 42% did not respond to three attempts. The main reasons for non-attendance included unaware of appointment date (16%), out of area (11%), confusion over date (11%), sick or admitted to hospital (10%), family member sick or died (7%), appointment should have been cancelled by clerical staff (6%) and transport (6%). Only 9% chose to miss their appointment. The other 24% had various reasons. Improved patient awareness of appointments, adjustments in referral systems and enabling appointment cancellation if indicated would directly improve over two-thirds of reasons for non-attendance. Understanding the underlying causes will help appointment planning, reduce wasted costs and have a significant impact on patient care.

  17. 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.

  18. Champagne for France's second low level [radioactive] waste disposal facility

    International Nuclear Information System (INIS)

    Chevrier, G.P.

    1992-01-01

    Located in the southern Champagne region, France's new million m 3 low level radioactive waste near surface repository, the Centre de l'Aube, will by 1995 completely take over from the country's first repository, Centre de la Manche (capacity 500 000 m 3 ), which has been operating since 1969. The design of the repository is described. (Author)

  19. Champagne for France's second low level [radioactive] waste disposal facility

    Energy Technology Data Exchange (ETDEWEB)

    Chevrier, G P [ANDRA, Fontenay aux Roses (France)

    1992-10-01

    Located in the southern Champagne region, France's new million m[sup 3] low level radioactive waste near surface repository, the Centre de l'Aube, will by 1995 completely take over from the country's first repository, Centre de la Manche (capacity 500 000 m[sup 3]), which has been operating since 1969. The design of the repository is described. (Author).

  20. 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.

  1. Factores predisponentes a labio leporino y/o paladar hendido en pacientes atendidos en el Hospital Regional de Loreto periodo 2008 - 2014.

    OpenAIRE

    Ferreira Díaz, Frederick; Rodríguez Vásquez, Jean Frank

    2015-01-01

    El propósito del presente trabajo de investigación fue determinar los factores predisponentes relacionados a labio leporino y/o paladar hendido en pacientes atendidos en el Hospital Regional de Loreto período 2008 - 2014. La investigación fue cuantitativa, el diseño no experimental, descriptivo simple, transversal. Los resultados fueron: El género masculino fue el más prevalente con el 52,5%. El tipo de lesión más prevalente fue fisura del paladar con el 55%, seguido de labio leporino unilate...

  2. Epidemiological profile of Road Traffic Accidents reporting at a Tertiary Care Hospital in Garhwal Region of Uttarakhand

    Directory of Open Access Journals (Sweden)

    S D Kandpal

    2015-06-01

    Full Text Available Introduction: Accidents occur not only due to ignorance but also due to carelessness, thoughtlessness and over confidence. Human, vehicle and environmental factors play roles before, during and after a trauma event. Accidents, therefore, can best studied in terms of agent, host and environmental factors and epidemiologically classified into time, place and person distribution. Objective:  To know the epidemiology of Road Traffic Injuries as seen in a Tertiary Care Hospital, Himalayan Hospital.  Methodology: A cross-sectional study was done among patients of RTA admitted at a Tertiary Care Centre. A pretested semi-structured interview schedule was used to collect necessary information regarding the time, place and the person involved in the accident. Descriptive statistics for continuous variables and frequency, percentage for categorical variables were determined. Results: There was a marked male preponderance (83.24% with maximum involvement of younger age groups. Most of the accidents had taken place in the evening hours (6 pm -12 midnight. Accidents were equally distributed throughout the year. Conclusion: Majority of the patients of RTI belonged to 21 to 30 years age group. Males out-numbered females victims.

  3. Outbreak of imipenem-resistant Acinetobacter baumannii in different wards at a regional hospital related to untrained bedside caregivers.

    Science.gov (United States)

    Wang, Ching-Hsun; Li, Jin-Feng; Huang, Li-Yueh; Lin, Fu-Mei; Yang, Ya-Sung; Siu, L Kristopher; Chang, Feng-Yee; Lin, Jung-Chung

    2017-10-01

    This study describes an outbreak caused by imipenem-resistant Acinetobacter baumannii (IRAB) involving 2 general wards at the Penghu branch of Tri-Service General Hospital. Clinical data obtained from the patients with IRAB during an outbreak from May 2014-October 2014 were reviewed. Microbiologic sampling from the environment and the hands of health care workers (HCWs) was performed. Clinical isolates from case patients were genotyped using pulsed-field gel electrophoresis (PFGE). During the outbreak period, 12 patients were colonized or infected with IRAB. The hospital room environments of the case patients were contaminated with IRAB. Hands of nurses and physicians were not colonized with IRAB, but the hands of 2 bedside caregivers of case patients were colonized with IRAB. The PFGE analysis revealed that at least 2 major genetically distinct strains disseminated between 2 different wards. After implementation of infection control measures with a cohort of nursing patients, hand hygiene education for caregivers who had not received instructions before the outbreak, and a critical value alert system to notify case patients, the outbreak was controlled successfully. This outbreak study highlights the importance of adherence to hand hygiene by all HCWs to prevent the dissemination of multidrug-resistant organisms. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  4. Approach and institutions in France

    International Nuclear Information System (INIS)

    Chanteur, J.

    1989-01-01

    In France, safety training for workers is compulsory under general legislation, supplemented in some cases by specific regulations on certain individual hazards. The radiation protection training for exposed workers is largely left to the initiative of the qualified officers, and there are regulations governing the training of the officers themselves. Qualified officers play a fundamental part in France in disseminating the radiation protection training and information which the regulations require them to have. It should be pointed out that qualification for the purposes of these regulations, implies having a clear grasp of the mechanisms involved rather than the acquisition of theoretical knowledge and requires a thorough understanding of the relevant legislation

  5. 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.)

  6. New Introductions of Enterovirus 71 Subgenogroup C4 Strains, France, 2012

    Science.gov (United States)

    Henquell, Cécile; Mirand, Audrey; Coste-Burel, Marianne; Marque-Juillet, Stéphanie; Desbois, Delphine; Lagathu, Gisèle; Bornebusch, Laure; Bailly, Jean-Luc; Lina, Bruno

    2014-01-01

    In France during 2012, human enterovirus 71 (EV-A71) subgenogroup C4 strains were detected in 4 children hospitalized for neonatal fever or meningitis. Phylogenetic analysis showed novel and independent EV-A71 introductions, presumably from China, and suggested circulation of C4 strains throughout France. This observation emphasizes the need for monitoring EV-A71 infections in Europe. PMID:25061698

  7. [Care pathway of patients with hepatocellular carcinoma in France: State of play in 2017].

    Science.gov (United States)

    Costentin, Charlotte; Ganne-Carrié, Nathalie; Rousseau, Benoit; Gérolami, René; Barbare, Jean-Claude

    2017-09-01

    Hepatocellular carcinoma is a major public health problem with one of the highest overall mortality compared to other cancers. The median overall survival in France in a hospital population with hepatocellular carcinoma is 9.4 months. Several publications reported a positive impact of hepatocellular carcinoma screening on diagnosis at an early-stage, eligibility for curative treatment and overall survival. However, the identification of patients to be included in a hepatocellular carcinoma screening program and the application of screening recommendations are not optimal. Other studies suggest a potentially negative impact of delayed diagnosis or treatment initiation on the patient's prognosis. Finally, marked variations between French regions and departments have been described in terms of access to curative treatment and overall survival. In this review article, we propose a state of play of the hepatocellular carcinoma patient's care pathway in France with the aim of identifying potential breaking points with negative impact on prognosis and of developing proposals for improvement. Copyright © 2017 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

  8. A New Approach to Identify High Burnout Medical Staffs by Kernel K-Means Cluster Analysis in a Regional Teaching Hospital in Taiwan.

    Science.gov (United States)

    Lee, Yii-Ching; Huang, Shian-Chang; Huang, Chih-Hsuan; Wu, Hsin-Hung

    2016-01-01

    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. © The Author(s) 2016.

  9. 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.

  10. 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

  11. Quality of care at ART clinic in Shashamanne referral hospital, West Arsi zone, Oromina National Regional State, South Ethiopia

    Directory of Open Access Journals (Sweden)

    Melese Belayneh

    2017-01-01

    Full Text Available Background Low income nations like Ethiopia, which are heavily affected by HIV pandemic, health system needs to provide comprehensive services for escalating numbers of HIV positive patients. While demand is increasing, resources are not expanding at desirable rates to meet these demands. This leads to the risk of running poor quality antiretroviral therapy in resource limited health facilities. However, there is paucity of research based evidences on the quality of health services in the country in general, and on anti retroviral therapy in particular. Objective To assess quality of care at antiretroviral therapy clinic in Shashamanne Referral Hospital. Method A cross‐sectional study was conducted in Shashamanne Referral hospital from May 30 to June 30,2017.The study population were selected people living with HIV, antiretroviral therapy clinics and health care workers in antiretroviral therapy clinics during the study period. Stratified sampling method was used to identify study population. Interviewer administered questionnaire was employed among 204 patients to assess their satisfaction. Medical records review check list was used to get vital information from documents of 354 patients. Interview guide was also used to assess providers’ view on services. Data were entered by using SPSS version 20 and analyzed using descriptive, bivariate and multivariate techniques. Ethical clearance was obtained from Jimma University College of Public Health and Medical Sciences. Results Resources required for implementation of antiretroviral therapy wee available as per recommendation by the national Guideline. However, scarcity of some OIs and ARV drugs and absence of a few laboratory services seen in the hospital. HIV/AIDS care given in line with national guidelines but study revealed that only 42.7% of clients eligible for isoniazid preventive therapy actually taken it. Average mean satisfaction score of patients was 2.51 and significant

  12. Social capital in a regional inter-hospital network among trauma centers (trauma network): results of a qualitative study in Germany.

    Science.gov (United States)

    Loss, Julika; Weigl, Johannes; Ernstberger, Antonio; Nerlich, Michael; Koller, Michael; Curbach, Janina

    2018-02-26

    As inter-hospital alliances have become increasingly popular in the healthcare sector, it is important to understand the challenges and benefits that the interaction between representatives of different hospitals entail. A prominent example of inter-hospital alliances are certified 'trauma networks', which consist of 5-30 trauma departments in a given region. Trauma networks are designed to improve trauma care by providing a coordinated response to injury, and have developed across the USA and multiple European countries since the 1960s. Their members need to interact regularly, e.g. develop joint protocols for patient transfer, or discuss patient safety. Social capital is a concept focusing on the development and benefits of relations and interactions within a network. The aim of our study was to explore how social capital is generated and used in a regional German trauma network. In this qualitative study, we performed semi-standardized face-to-face interviews with 23 senior trauma surgeons (2013-14). They were the official representatives of 23 out of 26 member hospitals of the Trauma Network Eastern Bavaria. The interviews covered the structure and functioning of the network, climate and reciprocity within the network, the development of social identity, and different resources and benefits derived from the network (e.g. facilitation of interactions, advocacy, work satisfaction). Transcripts were coded using thematic content analysis. According to the interviews, the studied trauma network became a group of surgeons with substantial bonding social capital. The surgeons perceived that the network's culture of interaction was flat, and they identified with the network due to a climate of mutual respect. They felt that the inclusive leadership helped establish a norm of reciprocity. Among the interviewed surgeons, the gain of technical information was seen as less important than the exchange of information on political aspects. The perceived resources derived from

  13. Implementation of integration strategies between primary care units and a regional general hospital in Brazil to update and connect health care professionals: a quasi-experimental study protocol.

    Science.gov (United States)

    Bracco, Mario Maia; Mafra, Ana Carolina Cintra Nunes; Abdo, Alexandre Hannud; Colugnati, Fernando Antonio Basile; Dalla, Marcello Dala Bernardina; Demarzo, Marcelo Marcos Piva; Abrahamsohn, Ises; Rodrigues, Aline Pacífico; Delgado, Ana Violeta Ferreira de Almeida; Dos Prazeres, Glauber Alves; Teixeira, José Carlos; Possa, Silvio

    2016-08-12

    Better communication among field health care teams and points of care, together with investments focused on improving teamwork, individual management, and clinical skills, are strategies for achieving better outcomes in patient-oriented care. This research aims to implement and evaluate interventions focused on improving communication and knowledge among health teams based on points of care in a regional public health outreach network, assessing the following hypotheses: 1) A better-working communication process between hospitals and primary health care providers can improve the sharing of information on patients as well as patients' outcomes. 2) A skill-upgrading education tool offered to health providers at their work sites can improve patients' care and outcomes. A quasi-experimental study protocol with a mixed-methods approach (quantitative and qualitative) was developed to evaluate communication tools for health care professionals based in primary care units and in a general hospital in the southern region of São Paulo City, Brazil. The usefulness and implementation processes of the integration strategies will be evaluated, considering: 1) An Internet-based communication platform that facilitates continuity and integrality of care to patients, and 2) A tailored updating distance-learning course on ambulatory care sensitive conditions for clinical skills improvements. The observational study will evaluate a non-randomized cohort of adult patients, with historical controls. Hospitalized patients diagnosed with an ambulatory care sensitive condition will be selected and followed for 1 year after hospital discharge. Data will be collected using validated questionnaires and from patients' medical records. Health care professionals will be evaluated related to their use of education and communication tools and their demographic and psychological profiles. The primary outcome measured will be the patients' 30-day hospital readmission rates. A sample size of 560

  14. [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.

  15. Electrical Energy Statistics for France 2002

    International Nuclear Information System (INIS)

    2003-11-01

    Detailed statistics on electricity flows in France and on facilities. Regional data / Consumption per sector of activity / Records over last 10 years (definitive results). In 2002, national electrical consumption reached 449.9 TWh, an increase of 0.3% compared with 2001 (448.6 TWh). Adjusted for winter and summer climate contingencies, its growth rate was 0.9% compared with 2001. Consumption by customers connected at high or medium voltage levels came to 254.2 TWh, an increase of 0.8% compared with 2001 (252.3 TWh); consumption by customers connected at low voltage levels came to 165 TWh, a decrease of 0.8% compared with 2001 (166.4 TWh). Generation in France reached 534.3 TWh, an increase of 11.5 TWh or 2.2% compared with 2001 (522.8 TWh). This increase broke down between nuclear generation and conventional thermal generation. Net nuclear generation injected, as measured by RTE, came to 415.5 TWh in 2002, an increase of 4.0% compared with 2001 (399.6 TWh). Conventional thermal generation came to 51.1 TWh, an increase of 15.4 % compared with 2001 (44.3 TWh). Hydro-electric generation amounted to 65.5 TWh, a fall of 15.3% compared with 2001 (77.3 TWh). In terms of physical exchanges with foreign countries, France exported a net total of 77 TWh, an increase of 12.6% compared with 2001 (68.4 TWh). Contractual exchanges with foreign countries, recorded by RTE, fell by 9.9 % to reach a cumulative value for exports and imports of 107.8 TWh (compared with 120 TWh in 2001)

  16. Air quality impact of the shut-down of a hospital waste incinerator in the Oporto region

    Energy Technology Data Exchange (ETDEWEB)

    Coutinho, M.; Pereira, M.; Borrego, C. [IDAD - Inst. do Ambiente e Desenvolvimento (Portugal)

    2004-09-15

    Polychlorinated dibenzo-p-dioxins (PCDDs) and dibenzofurans (PCDFs) are injected into the atmosphere by various combustion processes and dispersed throughout the environment by atmospheric transport. These combustion processes include the incineration of municipal solid wastes (MSW). The construction of a MSW incinerator in the Portuguese region of Oporto in 1998 led to the development of an external air quality monitoring program. Since that year, the collection of a total of 89 samples has provided a characterization of PCDD/PCDF levels in the Oporto region. To trace any source of contamination, a comparison of the PCDD/PCDF homologue profiles in environmental samples is made by a simple direct comparison and by cluster analysis. The determination of characteristic homologue profiles in representative environmental samples is essential to evaluate the relationship between sources and impacted areas. This information helps to understand the impact of the surrounding industries on the environment and public health, having in mind that the Oporto region is one of the major industrial and densely inhabited areas of Portugal. The present paper focuses on PCDD/PCDF ambient air data obtained in this region since June 1998 until February 2004.

  17. Newborn follow-up after discharge from a tertiary care hospital in the Western Cape region of South Africa: a prospective observational cohort study.

    Science.gov (United States)

    Milambo, Jean Paul Muambangu; Cho, KaWing; Okwundu, Charles; Olowoyeye, Abiola; Ndayisaba, Leonidas; Chand, Sanjay; Corden, Mark H

    2018-01-01

    Current practice in the Western Cape region of South Africa is to discharge newborns born in-hospital within 24 h following uncomplicated vaginal delivery and two days after caesarean section. Mothers are instructed to bring their newborn to a clinic after discharge for a health assessment. We sought to determine the rate of newborn follow-up visits and the potential barriers to timely follow-up. Mother-newborn dyads at Tygerberg Hospital in Cape Town, South Africa were enrolled from November 2014 to April 2015. Demographic data were obtained via questionnaire and medical records. Mothers were contacted one week after discharge to determine if they had brought their newborns for a follow-up visit, and if not, the barriers to follow-up. Factors associated with follow-up were analyzed using logistic regression. Of 972 newborns, 794 (82%) were seen at a clinic for a follow-up visit within one week of discharge. Mothers with a higher education level or whose newborns were less than 37 weeks were more likely to follow up. The follow-up rate did not differ based on hospital length of stay. Main reported barriers to follow-up included maternal illness, lack of money for transportation, and mother felt follow-up was unnecessary because newborn was healthy. Nearly 4 in 5 newborns were seen at a clinic within one week after hospital discharge, in keeping with local practice guidelines. Further research on the outcomes of this population and those who fail to follow up is needed to determine the impact of postnatal healthcare policy.

  18. France: Health System Review.

    Science.gov (United States)

    Chevreul, Karine; Berg Brigham, Karen; Durand-Zaleski, Isabelle; Hernandez-Quevedo, Cristina

    2015-01-01

    This analysis of the French health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. The French population has a good level of health, with the second highest life expectancy in the world for women. It has a high level of choice of providers, and a high level of satisfaction with the health system. However, unhealthy habits such as smoking and harmful alcohol consumption remain significant causes of avoidable mortality. Combined with the significant burden of chronic diseases, this has underscored the need for prevention and integration of services, although these have not historically been strengths of the French system. Although the French health care system is a social insurance system, it has historically had a stronger role for the state than other Bismarckian social insurance systems. Public financing of health care expenditure is among the highest in Europe and out-of-pocket spending among the lowest. Public insurance is compulsory and covers the resident population; it is financed by employee and employer contributions as well as increasingly through taxation. Complementary insurance plays a significant role in ensuring equity in access. Provision is mixed; providers of outpatient care are largely private, and hospital beds are predominantly public or private non-profit-making. Despite health outcomes being among the best in the European Union, social and geographical health inequities remain. Inequality in the distribution of health care professionals is a considerable barrier to equity. The rising cost of health care and the increasing demand for long-term care are also of concern. Reforms are ongoing to address these issues, while striving for equity in financial access; a long-term care reform including public coverage of long-term care is still pending. World Health Organization 2015 (acting as the host organization for, and secretariat of, the

  19. Hospitalizations for ambulatory care sensitive conditions and quality of primary care: their relation with socioeconomic and health care variables in the Madrid regional health service (Spain).

    Science.gov (United States)

    Magán, Purificación; Alberquilla, Angel; Otero, Angel; Ribera, José Manuel

    2011-01-01

    Hospitalizations for ambulatory care sensitive conditions (ACSH) have been proposed as an indirect indicator of the effectiveness and quality of care provided by primary health care. To investigate the association of ACSH rates with population socioeconomic factors and with characteristics of primary health care. Cross-sectional, ecologic study. Using hospital discharge data, ACSH were selected from the list of conditions validated for Spain. All 34 health districts in the Region of Madrid, Spain. Individuals aged 65 years or older residing in the region of Madrid between 2001 and 2003, inclusive. Age- and gender-adjusted ACSH rates in each health district. The adjusted ACSH rate per 1000 population was 35.37 in men and 20.45 in women. In the Poisson regression analysis, an inverse relation was seen between ACSH rates and the socioeconomic variables. Physician workload was the only health care variable with a statistically significant relation (rate ratio of 1.066 [95% CI; 1.041-1.091]). These results were similar in the analyses disaggregated by gender. In the multivariate analyses that included health care variables, none of the health care variables were statistically significant. ACSH may be more closely related with socioeconomic variables than with characteristics of primary care activity. Therefore, other factors outside the health system must be considered to improve health outcomes in the population.

  20. Treatment of non-Hodgkin lymphoma and mature В-cell acute leukemia in children and adolescents: data of Russian regional hospitals

    Directory of Open Access Journals (Sweden)

    Ye. V. Samochatova

    2014-07-01

    Full Text Available The article presents treatment results of 233 patients (children and adolescents under 19 years old; median — 8.76 years with CD20-positive non-Hodgkin lymphomas and B-cell acute leukemia (B-NHL/B-AL received chemotherapy (BFM B-NHL 90–95 protocols or combined chemo-immunotherapy with rituximab (B-NHL-2004mab protocol. Combined chemo-immunotherapy was used for patients with Burkitt lymphoma, diffuse large cells lymphomas stage III–IV and B-AL, and included cytoreductive phase, 6 polychemotherapy (PCT courses and rituximab. PCT courses are similar to those of original BFM B-NHL90 protocol, except for the first 2 courses, where daily methotrexate dose was reduced from 5 to 1 g/m2/24 h. Rituximab infused IV 12 hours before the start of first 4 chemotherapy courses at a dose of 375 mg/m2. The data in the questionnaires form have been submitted from 28 pediatric specialized hospitals from 27 Russia regions over the past 5 years (2005–2009. Protocol with rituximab has proved to be more effective than chemotherapy alone. The authors discuss the possibility of using combined chemo-immunotherapy for the treatment of B-NHL/B-AL at regional hospitals and the prospects for further treatment results improvement in this group of tumors.

  1. Treatment of non-Hodgkin lymphoma and mature В-cell acute leukemia in children and adolescents: data of Russian regional hospitals

    Directory of Open Access Journals (Sweden)

    Ye. V. Samochatova

    2011-01-01

    Full Text Available The article presents treatment results of 233 patients (children and adolescents under 19 years old; median — 8.76 years with CD20-positive non-Hodgkin lymphomas and B-cell acute leukemia (B-NHL/B-AL received chemotherapy (BFM B-NHL 90–95 protocols or combined chemo-immunotherapy with rituximab (B-NHL-2004mab protocol. Combined chemo-immunotherapy was used for patients with Burkitt lymphoma, diffuse large cells lymphomas stage III–IV and B-AL, and included cytoreductive phase, 6 polychemotherapy (PCT courses and rituximab. PCT courses are similar to those of original BFM B-NHL90 protocol, except for the first 2 courses, where daily methotrexate dose was reduced from 5 to 1 g/m2/24 h. Rituximab infused IV 12 hours before the start of first 4 chemotherapy courses at a dose of 375 mg/m2. The data in the questionnaires form have been submitted from 28 pediatric specialized hospitals from 27 Russia regions over the past 5 years (2005–2009. Protocol with rituximab has proved to be more effective than chemotherapy alone. The authors discuss the possibility of using combined chemo-immunotherapy for the treatment of B-NHL/B-AL at regional hospitals and the prospects for further treatment results improvement in this group of tumors.

  2. Hydrogen and fuel cell activity report - France 2010

    International Nuclear Information System (INIS)

    2010-01-01

    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 pr