Sample records for german hospital doctors

  1. Facility management in German hospitals.

    Gudat, H


    Facility management and optimum building management offer for hospitals a chance to reduce costs and to increase quality, process sequences, employee motivation and customer satisfaction. Some years ago simple services such as cleaning, catering or laundry were outsourced. Now, German hospitals progress to more complex fields such as building and medical technology, clinical support processes such as pharmacy, central laboratory and sterilization, goods and logistics services.

  2. Impact of New Shift Models for Doctors Working at a German University Hospital for Gynaecology and Obstetrics Four Years After Implementation. Can They Meet the European Working Time Directive Without Increasing Costs?

    Maschmann, J; Holderried, M; Blumenstock, G; Bamberg, M; Rieger, M A; Wallwiener, D; Brucker, S


    Background: The impact of the European Working Time Directive and subsequent collective wage agreements for doctors from 2006 onwards were substantial. So far, no systematic evaluation of their application in Germany has been performed. We evaluated the impact four years after implementation of new shift models in a University Hospital for Gynaecology and Obstetrics (UHGO). Methods: A new shift model was created together with doctors of Tübingen UHOG in 2007 and implemented in 2008. Documentation of working hours has hence been done electronically. Adherence to the average weekly working time limit (AWTL) and the maximum of 10 h daily working time (10 h-dwt) was evaluated, as well as staffing costs in relation to case-weight points gathered within the German DRG (diagnosis related groups) System. Results: Staff increased from a mean of 44.7 full time equivalent (FTE) doctors in 2007 to 52.5 FTE in 2009, 50.8 in 2010, and 54.5 in 2011. There was no statistically significant difference of the monthly staff expenditures per case-weight between the years 2009 or 2010 vs. 2007. 2011, however, was significantly more expensive than 2007 (p = 0.02). The internal control group (five other departments of the university hospital) did not show an increase during the same period. AWTL were respected by 90, 96, and 98 % in 2009, 2010, and 2011, respectively. Of all shifts 10 h-dwt was exceeded by 7.4 % in 2009, 1.3 % in 2010, and 2.6 % in 2011, with significant differences between 2009 and both, 2010 and 2011 (p implementation of the new shift model without increasing the cost/earnings ratio for the first two years. However, in 2011 the ratio increased significantly (p = 0.02).

  3. Job satisfaction among hospital doctors in Norway and Germany. A comparative study on national samples.

    Rosta, Judith; Nylenna, Magne; Aasland, Olaf G


    To compare German and Norwegian hospital doctors on 10 different aspects of job satisfaction and general life satisfaction. The study population consisted of a representative sample of 1,448 German and 484 Norwegian hospital doctors aged 33-65 years (n = 1,932), selected from nationwide postal surveys in 2006. The questionnaires contained items on subjective life satisfaction and the validated 10-item Job Satisfaction Scale. Each item was scored on a seven-point Likert scale from 1 (very dissatisfied) to 7 (very satisfied). A mean sum score was calculated, ranging from 1 to 7. Regression analyses and generalized-linear-model-estimated means controlled for age and gender with 95% confidence intervals were used for comparison. Norwegian hospital doctors had significantly higher life satisfaction (mean 5.31 vs. 5.15) and job satisfaction (mean 5.09 vs. 4.55) than their German colleagues. Item by item, doctors in Norway were significantly more content with seven aspects of their work: "Freedom to choose your own methods of working'' (mean 5.00 vs. 4.72), "opportunities to use your skills'' (mean 5.49 vs. 5.01), "physical working conditions'' (mean 4.62 vs. 4.08), "recognition you get for good achievements'' (mean 4.83 vs. 4.26), "overall job situation'' (mean 5.57 vs. 4.64), "work hours'' (mean 4.39 vs. 3.39), "ate of pay'' (mean 4.70 vs. 3.70). General life satisfaction and age, but not gender, were positively associated with job satisfaction in both countries. Norwegian hospital doctors enjoy a higher level of life and job satisfaction than German hospital doctors. The most likely reasons for this are more acceptable work hours, salary and control over clinical work in Norway.

  4. Structural problems in the German hospital system.

    Krukemeyer, M G


    The German health care system has been based on the Hospital Financing Act, which the German government introduced in 1972. According to that, the federal states plan hospitals and make investments. The health insurance funds finance the operating costs. But now the Hospital Financing Act is obsolete, because both the health insurance funds and the federal states are in financial trouble and try to avoid the costs, which are nevertheless rising. In order to freeze costs, the legislators have introduced a new remuneration system, called DRGs (Diagnosis Related Groups), which will be mandatory from 2007 onwards. In this system, the treatment provided will be coded and remunerated on the basis of the primary diagnosis. Periods of hospitalisation and different remuneration systems will no longer be relevant. Transparency and quality will thus be promoted, and the upshot will be more competition among the hospitals. Hospitals that cannot meet quality standards will lose patients and will ultimately have to close. Other participants in the health care system, such as, for example, nursing staff, physicians, pharmacies, rehabilitaion centres and patients, will also be concerned in many ways. The consequences of the DRGs for the health care system, its future development and possible alternatives are discussed in this article.

  5. A Survey of U.S. Doctoral Degrees Related to the Teaching of German--1983.

    Benseler, David P.


    Lists titles of doctoral dissertations related to the teaching of German and completed in U.S. universities during 1982. Included are dissertations completed in German, comparative literature, linguistics, and foreign language education departments. The list is derived from the annual survey done by the Modern Language Journal. (SED)

  6. Variation in duration of hospital stay between hospitals and between doctors within hospitals

    Westert, Gert P.; Nieboer, Anna P.; Groenewegen, Peter P.


    Whether one examines the average length of hospital stay at the level of geographic areas, at the level of hospitals, or at the level of doctors, length-of-stay figures are known to vary widely. Even for hospital admissions for comparable surgical procedures among comparable groups of patients, sign

  7. Variation in duration in hospital stay between hospitals and between doctors within hospitals.

    Westert, G.P.; Nieboer, A.P.; Groenewegen, P.P.


    Whether one examines the average length of hospital stay at the level of geographic areas, at the level of hospitals, or at the level of doctors, length-of-stay figures are known to vary widely. Even for hospital admissions for comparable surgical procedures among comparable groups of patients, sign




    Whether one examines the average length of hospital stay at the level of geographic areas, at the level of hospitals, or at the level of doctors, length-of-stay figures are known to vary widely. Even for hospital admissions for comparable surgical procedures among comparable groups of patients, sign

  9. The good doctor: a qualitative study of German homeopathic physicians.

    Kliems, Harald; Witt, Claudia M


    The objective of this study was to identify the factors that make a good doctor, both from a patient and a physician perspective. Is there a connection between practicing homeopathy and being a good doctor? This was a qualitative study of homeopathically trained physicians and their patients, using observation of patient-physician interactions (n = 29) and interviews with patients (n = 20) and with physicians (n = 4). Patients identified the availability of time, both in itself and as a prerequisite for other physician characteristics, as the single most important factor. Other factors include scope of diagnosis/holistic approach, patient-centeredness/empathy, and perceived competence/therapeutic success. Patients did not link these factors to the homeopathic orientation of their physician, while physicians clearly made this connection. The findings confirm other studies of patient satisfaction and physician characteristics. The availability of time, a holistic approach, and high physician empathy lead to high patient satisfaction. Homeopathic physicians probably are more likely to exhibit these characteristics. Health care policy should create conditions that enable individual physicians to be "good doctors." For medical education, a stronger emphasis on interpersonal skills and practitioner empathy could lead to higher patient satisfaction and potentially better treatment outcomes. Homeopathy might provide a good role model for this type of education.

  10. Choosing a doctor and hospital for your cancer treatment

    ... htm Choosing a doctor and hospital for your cancer treatment To use the sharing features on this page, please enable JavaScript. When you seek cancer treatment, you want to find the best care possible. ...

  11. Through doctors' eyes: A qualitative study of hospital doctor perspectives on their working conditions.

    McGowan, Yvonne


    BACKGROUND: Hospital doctors face significant challenges in the current health care environment, working with staff shortages and cutbacks to health care expenditure, alongside increased demand for health care and increased public expectations. OBJECTIVE: This article analyses challenges faced by junior hospital doctors, providing insight into the experiences of these frontline staff in delivering health services in recessionary times. DESIGN: A qualitative methodology was chosen. METHODS: Semi-structured in-depth interviews were conducted with 20 doctors from urban Irish hospitals. Interviews were recorded via note taking. Full transcripts were analysed thematically using NVivo software. RESULTS: Dominant themes included the following: (1) unrealistic workloads: characterised by staff shortages, extended working hours, irregular and frequently interrupted breaks; (2) fatigue and its impact: the quality of care provided to patients while doctors were sleep-deprived was questioned; however, little reflection was given to any impact this may have had on junior doctors own health; (3) undervalued and disillusioned: insufficient training, intensive workloads and a perceived lack of power to influence change resulted in a sense of detachment among junior doctors. They appeared immune to their surroundings. CONCLUSION: Respondents ascribed little importance to the impact of current working conditions on their own health. They felt their roles were underappreciated and undervalued by policy makers and hospital management. Respondents were concerned with the lack of time and opportunity for training. This study highlighted several \\'red flags\\

  12. Cost and technical efficiency of German hospitals: does ownership matter?

    Herr, Annika


    This paper is the first to investigate both the technical and cost efficiency of more than 1500 German general hospitals. More specifically, it deals with the question how hospital efficiency varies with ownership, patient structure, and other exogenous factors, which are neither inputs to nor outputs of the production process. The empirical results for the years from 2001 to 2003 indicate that private and non-profit hospitals are on average less cost efficient and less technically efficient than publicly owned hospitals. The hospital rankings based on estimated efficiency scores turn out to be negatively correlated with average length of stay, which is highest in private hospitals. The results are derived by conducting a Stochastic Frontier Analysis assuming both Cobb-Douglas and translog production technologies and using a newly available and multifaceted administrative German data set.

  13. Teamwork and collaboration among doctors and nurses in two public hospitals in China

    Li, F; Xu, H.; Johnston, JM


    The Work-related Collaboration among Doctor-Nurse Scale (WCDNS) was ad-ministered to 398 doctors and nurses working in one of two hospitals in Guangzhou to assess 1) inter professional (doctor-nurse) differences in collaboration and teamwork and 2) inter hospital (general-specialist) differences in doctor nurse collaboration. Significant between profession and hospital differences were observed. Implications for future studies in doctor-nurse collaboration are discussed.

  14. Mandatory Quality Disclosure and Quality Supply : Evidence from German Hospitals

    Filistrucchi, L.; Ozbugday, F.C.


    Abstract: Using a newly constructed dataset on German hospitals, which includes 24 process and outcome indicators of clinical quality, we test whether quality has increased in various clinical areas since the introduction of mandatory quality reports and the online publication of part of the

  15. German hospital database-allocation of patients to appropriate hospitals.

    Schneider, Rita; Reiners, Christoph


    Effective response to radiological emergencies requires information about available qualified hospitals and defined methods to timely allocate patients to appropriate hospitals. In Germany, updated information about hospitals concerning their qualification and willingness to treat radiological emergency patients is not summarized. The objectives were to identify qualified hospitals, assess hospital capacities and treatment capabilities, to examine willingness to respond to various radiological emergencies and to develop a concept for matching patients to hospitals. A Germany-wide combined postal/Web survey of 99 selected hospitals conducted in 2007 covered relevant organizational characteristics, hospital resources, treatment expertise, and the willingness to accept radiological emergency patients by a self-reported written questionnaire with 57 items. Survey results were documented in a Microsoft Access database. A database-driven Web application was developed to allocate patients to hospitals. Of 99 hospitals, 69 responded and 54 indicated their willingness to accept radiological emergency patients. 17,512 total hospital beds, 2,084 intensive care, and 170 reverse isolation beds were reported. Availability of laboratory and in-patient departments ranged from 14 radiobiology to 47 laboratory medicine departments and from 13 burn care to 52 trauma surgery departments. 48 and 40 hospitals stated treatment competence for local and whole body external exposure, respectively. 34 and 29 hospitals reported treatment expertise for contamination and incorporation, respectively. In this publication baseline data of qualified hospitals concerning capacities and competence to manage radiological emergency patients are presented, and an allocation concept for radiological emergency patients is provided.

  16. [Clinical risk management in german hospitals - does size really matter?].

    Bohnet-Joschko, S; Jandeck, L M; Zippel, C; Andersen, M; Krummenauer, F


    In the last years, German hospitals have implemented different measures to increase patient safety. Special importance has been attached to near miss reporting systems (critical incident reporting system, CIRS) as instruments for risk identification in health care, instruments that promise high potential for organisational learning. To gain insight into the current status of critical incident reporting systems and other instruments for clinical risk management, a survey among 341 hospitals was carried out in 2009. Questions covered a process of six steps: from risk strategy to methods for risk identification, to risk analysis and risk assessment, to risk controlling and risk monitoring. Structured telephone interviews were conducted with 341 German hospitals, featuring in their statutory quality reports certain predefined key terms that indicated the concluded or planned implementation of clinical risk management. The main objective of those interviews was to check the relation between status/organisation of self-reported risk management and both operator (private, public, NPO) and size of hospital. The implementation of near miss reporting systems (CIRS) in German hospitals has been constantly rising since 2004: in 2009, 54 % of the interviewed hospitals reported an implemented CIRS; of these, 72 % reported the system to be hospital-wide. An association between CIRS and private, public or NPO-operator could not be detected (Fisher p = 1.000); however, the degree of CIRS implementation was significantly increasing with the size of the hospital, i.e., the number of beds (Fisher p = 0.008): only 38 % of the hospitals with less than 100 beds reported CIRS implementation against 52 % of those between 100 to 500 beds, and 67 % of those with more than 500 beds. While 62 % of the hospitals interviewed reported the maintenance of a risk management committee, only 14 % reported the implementation of risk analysing techniques. As to clinical risk

  17. Pediatric Neurosurgical Care in a German Field Hospital in Afghanistan.

    Mauer, Uwe Max; Freude, Gregor; Schulz, Chris; Kunz, Ulrich; Mathieu, Rene


    Background and Study Objectives Children are commonly found among the injured in war settings. Prognosis often depends on the presence of brain injury. Not all neurosurgery departments of German Armed Forces hospitals, however, have experience in the care of children with neurosurgical conditions. Against this background, we assessed the group of pediatric neurosurgical patients in a German (Role 3) field hospital in Mazar-e-Sharif, Afghanistan. Patients/Materials and Methods We analyzed the operative logbooks from January 1, 2008, to December 31, 2013, to assess the number of neurosurgical procedures that were performed on children (study period, 327 neurosurgical procedures were performed at the German field hospital. Of these, 29 (9%) were performed on children. The mean age of the pediatric patients (7 girls and 22 boys) was 11.7 years (median age: 12 years; range: 5-17 years). Only three procedures were performed for conditions other than trauma. Pediatric patients accounted for almost 10% of all patients who underwent neurosurgery during a recent military deployment in Mazar-e-Sharif. This percentage is similar to those reported by other nations. These findings show that a considerable number of children underwent neurosurgical treatment. Conclusions Military planners should be aware that Role 3 medical treatment facilities must provide care for pediatric emergencies and must therefore be staffed and equipped accordingly. For military hospitals at home, this means that the management of pediatric patients is an opportunity for medical personnel to receive important pediatric training that enables them to provide care to children in deployed medical facilities. Georg Thieme Verlag KG Stuttgart · New York.

  18. How do patients define "good" and "bad" doctors? - Qualitative approach to the representations of hospital patients

    Luthy, C; Cedraschi, C; Perrin, E; Allaz, AF


    Questions under study: Knowledge of hospital patients' perceptions of doctors' qualities is limited. The purpose of this study was to explore hospital patients' definitions of "good" and "bad" doctors. Methods: Semi-structured interviews conducted with 68 consecutive hospital patients. The questions

  19. A 'German world' shared among doctors: a history of the relationship between Japanese and German psychiatry before World War II.

    Hashimoto, Akira


    This article deals with the critical history of German and Japanese psychiatrists who dreamed of a 'German world' that would cross borders. It analyses their discourse, not only by looking at their biographical backgrounds, but also by examining them in a wider context linked to German academic predominance and cultural propaganda before World War II. By focusing on Wilhelm Stieda, Wilhelm Weygandt and Kure Shuzo, the article shows that the positive evaluation of Japanese psychiatry by the two Germans encouraged Kure, who was eager to modernize the treatment of and institutions for the mentally ill in Japan. Their statements on Japanese psychiatry reflect their ideological and historical framework, with reference to national/ethnic identity, academic position, and the relationship between Germany and Japan.

  20. Advanced services in hospital logistics in the German health service sector

    Kriegel, Johannes; Jehle, Franziska; Dieck, Marcel; Mallory, Patricia


    ...: What are the developmental options to expand the current capabilities of the hospital contract logistics service providers on the basis of the priorities of the decision-makers in the German hospital sector...

  1. Sinus pilonidalis in patients of German military hospitals: a review

    Kueper, Janina


    Full Text Available Pilonidal sinus disease (PSD most commonly presents in young men when hair follicles enter through damaged epithelium and cause an inflammatory reaction. This results in the formation of fistular tracts. We reviewed studies based on a shared cohort of patients who presented at German military hospitals with PSD. The effect of the morphology of the sinus, perioperative protocol, and aftercare of the surgical treatment on the recurrence of PSD were evaluated. The drainage of acute abscesses before surgery, the application of methylene blue during surgery and open wound treatment were generally found to reduce the recurrence rate. A positive family history, postoperative epilation and primary suture as the healing method were found to elevate the recurrence rate. Long-term follow up of over 15 years was found to be a vital component of patient care as only 60% of the overall recurrences recorded had taken place by year 5 postoperatively.

  2. Clinical utility and impact of autopsies on clinical practice among doctors in a large teaching hospital in Ghana

    Edem Tette


    : Strengthening the interaction between doctors and pathologists is essential in improving the autopsy process and utilization in the hospital. KBTH should create opportunities for doctors to attend autopsy demonstrations and for pathologists to attend clinicopathological meetings in the hospital.

  3. Effectiveness of mask ventilation performed by hospital doctors in an Irish tertiary referral teaching hospital.

    Walsh, K


    The objective of this study was to assess the effectiveness of mask ventilation performed by 112 doctors with clinical responsibilities at a tertiary referral teaching hospital. Participant doctors were asked to perform mask ventilation for three minutes on a Resusci Anne mannequin using a facemask and a two litre self inflating bag. The tidal volumes generated were quantified using a Laerdal skillmeter computer as grades 0-5, corresponding to 0, 334, 434, 561, 673 and > 800 ml respectively. The effectiveness of mask ventilation (i.e. the proportion of ventilation attempts which achieved a volume delivery of > 434 mls) was greater for anaesthetists [78.0 (29.5)%] than for non anaesthetists [54.6 (40.0)%] (P = 0.012). Doctors who had attended one or more resuscitation courses where no more effective at mask ventilation than their colleagues who had not undertaken such courses. It is likely that first responders to in-hospital cardiac arrests are commonly unable to perform adequate mask ventilation.

  4. Analysis of Training Mode of German Doctors%德国博士生培养模式探析

    孔锴; 姜俊和


    The distinctive training mode of doctoral students of German higher education in its long-term development is analyzed.The distinguishing training features are discussed from three main aspects: the obtaining of doctor qualification;the training mode of doctoral students;the awarding of doctor's degree.It is pointed out that learning from the helpful experience of German's training mode of doctors will do much good to our country's training mode of doctoral students.%分析了德国高等教育在长期发展中形成的具有自身特色的博士生培养模式,从博士生资格的取得、博士生培养方式、博士学位授予等几个方面探讨了德国博士生的培养特色,认为汲取德国博士生培养的有益经验对我国的博士生培养会有很大帮助。

  5. [The background of the hardships of Moabit Hospital; an aspect of German medicine under the National-Socialistic rule].

    Izumi, H


    Under the National-Socialistic (Nazi) rule, Moabit Hospital (City Hospital of Berlin at Moabit) met various hardships. In the present communication, their sufferings and backgrounds are described as an aspect of German medicine during the Nazi regime. 1. Around April 1st, 1933, the day of an anti-Jewish boycott, the Jewish doctors, co-medical and non-medical personnel were banned from the hospital. 2. At the hospital, they were forced to perform involuntary sterilization on psychiatric patients and patients with hereditary disease, by an inhuman law. 3. Dr. Georg Groscurth, a chief physician of the hospital, was executed because of his anti-Nazi activity. His act came from his patriotism and righteous indignation against the cruelty of Nazism. 4. In comparison with the inhumanity of the Nazis and in relation to the origin of the name of the area, Moabit, the author comments on "the Prussian tolerance" realized by Elector Friedlich Wilhelm of Brandenburg. The author believes this tolerance was one of the important causes of the flourishing of German medicine in the ninteenth century.

  6. Sticking with One Doctor May Help Keep Seniors Out of the Hospital

    ... a senior research associate, and Chris Salisbury, a professor of primary health care. Not only would it benefit patients, it would improve doctors' job satisfaction and likely reduce pressure on hospitals, they ...

  7. Junior doctor dementia champions in a district general hospital (innovative practice).

    Wilkinson, Iain; Coates, Anna; Merrick, Sophie; Lee, Chooi


    Dementia is a common condition in the UK with around 25% of patients in acute hospitals having dementia. In the UK, there is national guidance on the assessment of cognitive impairment in acute hospitals. This article is a qualitative study of junior doctors' experiences as part of a dementia and delirium team involved in changing the care of patients with dementia in a hospital in the UK. It draws on data from a focus group and follow-up questionnaire in two hospital trusts. We examine what drives doctors to become involved in such projects and the effects of this experience upon them. We suggest a typology for getting junior doctors involved in projects generating change when working with patients with dementia. Being more actively involved in caring for and developing services for patients with dementia may represent the crossing of an educational threshold for these junior doctors.

  8. Questionnaire survey of working relationships between nurses and doctors in University Teaching Hospitals in Southern Nigeria

    Adebamowo Clement A


    Full Text Available Abstract Background Smooth working relationships between nurses and doctors are necessary for efficient health care delivery. However, previous studies have shown that this is often absent with negative impact on the quality of health care delivery. In 2002, we studied factors that affect nurse-doctor working relationships in University Teaching Hospitals (UTH in Southern Nigeria in order to characterize it and identify managerial and training needs that might be used to improve it. Method Questionnaire survey of doctors and nurses working in four UTH in Southern Nigeria was done in 2002. The setting and subjects were selected by random sampling procedures. Information on factors in domains of work, union activities, personnel and hospital management were studied using closed and open-ended questionnaires. Results Nurse-doctor working relationships were statistically significantly affected by poor after-work social interaction, staff shortages, activist unionism, disregard for one's profession, and hospital management and government policies. In general, nurses had better opinion of doctors' work than doctors had about nurses' work. Conclusion Working relationships between doctors and nurses need to be improved through improved training and better working conditions, creation of better working environment, use of alternative methods of conflict resolution and balanced hospital management and government policies. This will improve the retention of staff, job satisfaction and efficiency of health care delivery in Nigeria.

  9. Job Satisfaction Analysis in Rural China: A Qualitative Study of Doctors in a Township Hospital

    Qiwei Chen


    Full Text Available Background. Township hospitals in China provide rural communities with basic but much needed critical health care services. The doctors working in these hospitals often feel unsatisfied when considering their work schedules and financial rewards. Method. To explore job satisfaction of health workers in a township hospital, a qualitative study was conducted of 39 doctors from five township hospitals in Guangxi Zhuang Autonomous Region. The goal was to understand the level of job satisfaction of doctors and to make recommendations for improvements. Results. About 75% (28/39 of the doctors expressed negative attitudes related to their work conditions. Slightly more than half (22/39 mentioned they should receive greater compensation for their work and more than one were seriously considering other options. Many participants (35/39 showed their satisfaction about the achievement of serving as a doctor. Conclusion. Their main concerns related to job satisfaction included working conditions, financial rewards, and the doctor’s relationships with patients. Increasing the incomes and fringe benefits of healthcare workers, improving their work conditions, and providing training and continuing education opportunities would help rural clinics retain doctors and eliminate the current unsatisfactory conditions. The findings also highlight the need for the government to increase financial support of township hospitals.

  10. Transmission of a multiresistant Pseudomonas aeruginosa strain at a German University Hospital.

    Pitten, F A; Panzig, B; Schröder, G; Tietze, K; Kramer, A


    Over 15 months, 60 patients at a German University Hospital became infected or colonized by a multiresistant Pseudomonas aeruginosa strain, which was isolated from tracheal secretions, blood, urine, venous catheters, ascites and several wounds. Most patients had undergone invasive treatment (surgery, cancer therapy). The genetic relationship of the isolates was investigated by pulsed field gel electrophoresis. The isolates were resistant to beta-lactam antibiotics, including carbapenems and aztreonam, to aminoglycosides and quinolones. The only in vitro susceptibility was to polymyxin B. Extensive sampling was carried out to identify contaminated medical devices, surfaces or media (water, food). Samples were taken from doctors and nursing staff and various treatment procedures were observed for several weeks. The handling of respirators, resuscitation tubes, urine bottles, and bedpans resulted in the contamination of the patients' environment, although most devices were cleaned and disinfected with automatic washer/disinfectors. Several wash basins on the intensive care unit were contaminated, but none of the drinking water samples showed any growth of P. aeruginosa. We recommend the strict use of gloves and strict application of alcoholic hand disinfectants immediately after discarding the gloves. The chain of infection ceased after strict cohort isolation and the subsequent introduction of the specific hygiene regime.

  11. MedlinePlus FAQ: Information on Doctors or Hospitals

    ... this page, please enable JavaScript. Answer: Many health topic pages in MedlinePlus contain a section which lists directories of doctors and services relevant to the topic. The Directories page lists many sources of information about physicians, other ...

  12. Burnout among doctors in residency training in a tertiary hospital.

    Ogundipe, O A; Olagunju, A T; Lasebikan, V O; Coker, A O


    The mental health of doctors is an issue of growing concern all over the world as it frequently interplays with their professional trainings and responsibilities. This study was done to determine the pattern and correlates of burnout among 204 doctors undergoing residency training. Eligible participants were interviewed using designed questionnaire, General Health Questionnaire (GHQ-12) and Maslach Burnout Inventory (MBI). The mean age of participants was 33.44±4.50. Ninety-three (45.6%) respondents reported burnout in the dimension of emotional exhaustion (EE), 118 (57.8%) in the dimension of depersonalization (D), and 126 (61.8%) in the dimension of reduced personal accomplishment (RPA). Factors that were significantly associated with all the dimensions of burnout were perceived heavy workload and presence of emotional distress (based on GHQ score of ≥3). The perception of call duty as being not stressful was negatively predictive of burnout in the emotional exhaustion subscale (odds ratio [OR]=0.52; 95%confidence interval [CI]=0.29-0.97; p=0.03), while emotional distress was a positive predictor (OR=6.97; 95%CI=3.28-14.81; pburnout in the depersonalization subscale (OR=0.36; 95%CI=0.17-0.76); pburnout in the reduced personal accomplishment subscale. Burnout is highly prevalent among resident doctors. Evolvement of comprehensive mental health services, training supports, conflict de-escalation/resolution mechanisms, and periodic assessment are indicated to mitigate work related distress with burn out among resident doctors, while improving their productivity.

  13. Cost awareness among doctors in an Irish university-affiliated teaching hospital

    William H.C. Tiong


    Full Text Available Previous studies in USA and Canada have found that physicians and physicians in training have a limited understanding of medical care costs. In this study, we set out to survey all grades of doctors in the surgical department, emergency department, and anaesthetic department in a university-affiliated, Irish teaching hospital. Open-ended questionnaires on cost of 25 routinely used items in the hospital were sent to each department. The aims of the study were to assess the present knowledge of cost among the various grades of doctors, and to evaluate the level of professional experience on cost awareness and their confidence in their estimates. We had an overall response rate of 56.8% with 68.5% of doctors admitted to have estimated more than 90% of their responses. Ninety three percent of doctors have no confidence in their estimates on cost of listed items. We found that the lack of cost awareness was universal among doctors of all grades (P = 0.236. The doctors in our study population showed a high level of inaccuracy on their estimates of cost of routinely used items with 84% of the items overestimated. Our results were discouraging and demonstrated that considerable educational activity will be necessary if doctors are to be more cost effective in meeting the national health care budget.

  14. Pain issues from the palliative perspective: a survey among doctors in Hospital Melaka.

    Taye, G A W C


    This survey was intended to gauge the management of pain in palliative cancer patients by the doctors in Melaka Hospital. It also sought to identify possible barriers to adequate pain management among doctors and gauge their response to the adequacy of medical school teaching on cancer pain issues. A 39 item survey was used to cover the issues involved. Overall, the doctors displayed a lack of systematic approach to cancer pain management with inadequate knowledge of analgesia handling. Medical school exposure to cancer pain issues was lacking. Formulation of accepted clinical practice guidelines and new education strategies can improve cancer pain management.

  15. Why did so many German doctors join the Nazi Party early?

    Haque, Omar S; De Freitas, Julian; Viani, Ivana; Niederschulte, Bradley; Bursztajn, Harold J


    During the Weimar Republic in the mid-twentieth century, more than half of all German physicians became early joiners of the Nazi Party, surpassing the party enrollments of all other professions. From early on, the German Medical Society played the most instrumental role in the Nazi medical program, beginning with the marginalization of Jewish physicians, proceeding to coerced "experimentation," "euthanization," and sterilization, and culminating in genocide via the medicalization of mass murder of Jews and others caricatured and demonized by Nazi ideology. Given the medical oath to "do no harm," many postwar ethical analyses have strained to make sense of these seemingly paradoxical atrocities. Why did physicians act in such a manner? Yet few have tried to explain the self-selected Nazi enrollment of such an overwhelming proportion of the German Medical Society in the first place. This article lends insight into this paradox by exploring some major vulnerabilities, motives, and rationalizations that may have predisposed German physicians to Nazi membership-professional vulnerabilities among physicians in general (valuing conformity and obedience to authority, valuing the prevention of contamination and fighting against mortality, and possessing a basic interest in biomedical knowledge and research), economic factors and motives (related to physician economic insecurity and incentives for economic advancement), and Nazi ideological and historical rationalizations (beliefs about Social Darwinism, eugenics, and the social organism as sacred). Of particular significance for future research and education is the manner in which the persecution of Jewish physician colleagues was rationalized in the name of medical ethics itself. Giving proper consideration to the forces that fueled "Nazi Medicine" is of great importance, as it can highlight the conditions and motivations that make physicians susceptible to misapplications of medicine, and guide us toward prevention of

  16. [The German academic degree "Dr. med." is better than its reputation. Results of a questionnaire of doctoral students].

    Pabst, R; Park, D-H; Paulmann, V


    Recently there were mostly emotional debates about the scientific background and relevance of the German academic title "Dr. med.", while objective data are scarce. When submitting their doctoral thesis at the Medical School of Hannover students were asked anonymously about the type, topic, duration, quality of supervision as well as frequency and type of publication of the results. 180 doctoral candidates (62% women) participated in the study. The supervision was graded as good by the majority of students. The duration working on the thesis was equivalent to 47 weeks of a full time employment. There was some negative influence in participating in lectures and courses. Nearly all participants (98%) would recommend younger students to work on a dissertation as they had done themselves in parallel to the curriculum. The ability of how to interprete scientific data was assumed to be positively influenced. About two thirds stated that the results had been published in original articles at the time of submitting the thesis. More data from other medical faculties are needed to document the relevance of the medical dissertation to replace the emotional by a more rational debate. © Georg Thieme Verlag KG Stuttgart · New York.

  17. Submerged discontent and patterns of accommodation: a case study of doctors' pay in two public hospitals in China.

    Cao, Xuebing


    The article evaluates submerged discontent among Chinese public hospital doctors (Note1) regarding their pay and patterns of accommodation, including doctors' responses through formal and informal actions in the context of health service marketization. On the basis of a case study of two public hospitals, the article illustrates the dynamical impact of marketization on Chinese doctors' pay-related dissatisfaction and health service employment relationship. Because of the authoritarian management and compliant trade unions, the conflict between doctors and hospitals is unable to be accommodated through collective methods. Instead, doctors' discontent is often channelled through informal, individual and subtle activities. Meanwhile, doctors' professional society is gradually influential, showing its potential of developing doctors' group identity and protecting members' interests in future.

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

    Nimptsch, Ulrike; Wengler, Annelene; Mansky, Thomas


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

  19. A Failure to Communicate? Doctors and Nurses in American Hospitals.

    Michel, Lucie


    This article showcases the realities and challenges of teamwork in American hospitals based on the in situ comparison with France. Drawing on observation of nurse-physician interactions in hospitals in the two nations, this article highlights a troubling conflict between teamwork rhetoric and realities on the ward. Although the use of informatics systems such as electronic health records is supposed to increase cooperation, the observations presented here show that on the contrary, it inhibits communication that is becoming mainly virtual. While the nursing profession is more developed and provides stronger education in the United States, this story highlights the challenges in creating a shared environment of work and suggests the importance of balancing professional autonomy and effective teamwork. Copyright © 2017 by Duke University Press.

  20. A study of needle stick injuries among non-consultant hospital doctors in Ireland.

    O'Connor, M B


    NCHDs are exposed to a great number of blood-borne infections. Needle stick injuries are possibly the main route of acquiring such infections from a non-consultant hospital doctors (NCHDs) perspective. This study examines NCHDs experiences surrounding needle stick injuries.

  1. Factors influencing performance of cardiopulmonary resuscitation (CPR) by Foundation Year 1 hospital doctors.

    Sayee, Nicole; McCluskey, David


    Foundation Year One (FY1) doctors are often the first medical staff responders at in-hospital cardiac arrests. The study objectives were to assess the cardiopulmonary resuscitation (CPR) skills of FY1 doctors at a Belfast teaching hospital and to highlight factors that influence their performance. A group of FY1 doctors working in a Belfast teaching hospital were asked to participate in this study. These junior doctors were regularly on-call for acute medical emergencies including cardiac arrest. Participants were instructed to perform two, 3 minute sessions of CPR on a skills reporter manikin. Each session was separated by a 5 minute rest period, one session using a compression-to-ventilation ratio of 15:2 and the other using a ratio of 30:2. Performance was gauged both objectively, by measuring the depth of chest compressions, and subjectively by a panel of 5 Advanced Life Support (ALS) instructors who reviewed the tracings of each CPR session. Overall, 85% of medical FY1's working in the hospital participated in the study. Objective results determined that males performed significantly better than their female counterparts using both the 15:2 and 30:2 ratios. The male FY1 doctors performed equally well using both 15:2 and 30:2 ratios, in comparison to female doctors who were noted to be better using the 15:2 ratio. Individuals with a Body mass index (BMI) greater than the mean for the group, performed significantly better than those with a lower BMI when using the 30:2 ratio. BMI was an important factor and correlated with chest compression depth. Females with a low BMI performed less well when using a ratio of 30:2. Overall, expert opinion significantly favoured the 15:2 ratio for the FY1 doctor group. CPR performance can be influenced by factors such as gender and BMI, as such the individual rescuer should take these into account when determining which compression to ventilation ration to perform in order to maximise patient outcome. This study showed that

  2. Does type of hospital ownership influence physicians' daily work schedules? An observational real-time study in German hospital departments

    Schöffel Norman


    Full Text Available Abstract Background During the last two decades the German hospital sector has been engaged in a constant process of transformation. One obvious sign of this is the growing amount of hospital privatization. To date, most research studies have focused on the effects of privatization regarding financial outcomes and quality of care, leaving important organizational issues unexplored. Yet little attention has been devoted to the effects of privatization on physicians' working routines. The aim of this observational real-time study is to deliver exact data about physicians' work at hospitals of different ownership. By analysing working hours, further impacts of hospital privatization can be assessed and areas of improvement identified. Methods Observations were made by shadowing 100 physicians working in private, for-profit or non-profit as well as public hospital departments individually during whole weekday shifts in urban German settings. A total of 300 days of observations were conducted. All working activities were recorded, accurate to the second, by using a mobile personal computer. Results Results have shown significant differences in physicians' working activities, depending on hospital ownership, concerning working hours and time spent on direct and indirect patient care. Conclusion This is the first real-time analysis on differences in work activities depending on hospital ownership. The study provides an objective insight into physicians' daily work routines at hospitals of different ownership, with additional information on effects of hospital privatization.

  3. Does type of hospital ownership influence physicians' daily work schedules? An observational real-time study in German hospital departments

    Mache, Stefanie; Scutaru, Cristian; Vitzthum, Karin; Quarcoo, David; Schöffel, Norman; Welte, Tobias; Klapp, Burghard F; Groneberg, David A


    Background During the last two decades the German hospital sector has been engaged in a constant process of transformation. One obvious sign of this is the growing amount of hospital privatization. To date, most research studies have focused on the effects of privatization regarding financial outcomes and quality of care, leaving important organizational issues unexplored. Yet little attention has been devoted to the effects of privatization on physicians' working routines. The aim of this observational real-time study is to deliver exact data about physicians' work at hospitals of different ownership. By analysing working hours, further impacts of hospital privatization can be assessed and areas of improvement identified. Methods Observations were made by shadowing 100 physicians working in private, for-profit or non-profit as well as public hospital departments individually during whole weekday shifts in urban German settings. A total of 300 days of observations were conducted. All working activities were recorded, accurate to the second, by using a mobile personal computer. Results Results have shown significant differences in physicians' working activities, depending on hospital ownership, concerning working hours and time spent on direct and indirect patient care. Conclusion This is the first real-time analysis on differences in work activities depending on hospital ownership. The study provides an objective insight into physicians' daily work routines at hospitals of different ownership, with additional information on effects of hospital privatization. PMID:19473487

  4. [On the comprehensibility of German hospital quality reports: systematic evaluation and need for action].

    Friedemann, J; Schubert, H-J; Schwappach, D


    This paper focuses on the current resolutions for quality reports of German hospitals as released in 2007 as well as on comprehensibility of these reports for patients. It is meant to analyse the textual information given by these quality reports. Its main objective was to attain a reliable assessment of their comprehensibility for patients on the basis of objective measuring methods. A further goal was to qualify eventual differences between large and small or private and public hospital operators. On the basis of the attained results conclusions on the appropriateness of the current legal situation and the existing criteria for quality reports were to be drawn. The textual system part of 200 German hospital reports was analysed as published in the Internet (latest download 28th May, 2007). The selection took place by means of a controlled sample. The sample structure essentially corresponds to the German hospital system structure in terms of bed numbers and its ratio of public and private operators. The analysis measured all formal text patterns as well as technical terms by means of a computer-aided device. The readability index for each text was calculated according to all known readability formulas for the German language. German hospital quality reports are readable only for those patients who dispose of above-average communicative skills. The analysed reports contain more than 10% technical terms while 17% of the chosen words and 60% of all sentences are too long. 10% of all sentences are too complex and 25% comprise more than three technical terms. To understand these texts at least an entrance qualification for higher education is required in accordance to readability indices. The texts' degree of complexity is comparable to that of philosophical papers. Most textual information given by German hospital quality reports is proven to be unreadable and incomprehensible for most patients. There are no fundamental differences concerning hospital size and


    Fastenemeier Heribert


    Full Text Available The demographic evolution and its consequences – population ageing - have been the topic of multiple research studies and analyses in many countries, industries or political regimes. Health care systems have been faced with questions regarding future financing, organization and resource allocation under the impact of the demographic evolution. This time is the hospital sector in focus. Analyzing the situation in German hospitals on the basis of recent, detailed statistical data and studies, this paper provides information, data and figures on elderly hospitalized patients with regard to costs, diagnoses and operations and presents briefly implications of the demographic evolution and of an ageing population for hospitals.


    Amit A.


    Full Text Available BACKGROUND: Monitoring and evaluation of adverse drug reactions (ADRs through a well - organized pharmacovigilance system is vital for safe use of medicines. ADR reporting by healthcare professionals forms the backbone of pharmacovigilance system. AIM: To assess the awareness of pharmacovigilance among resident doctors in a tertiary care hospital. MATERIAL AND METHODS: This is a cross sectional descriptive study, carried out in a total 160 resident doctors from various specialities in a government run tertiary care teaching hospital were administered a questionnaire to evaluate knowledge, attitude and practice of pharmacovigilance. The questionnaire consisted of open and closed ended questions. The study was conducted in January/ February 2012. RESULTS: Most of the residents had heard the term ‘pharmacovigilance’ but only 25% knew the actual meaning of it. About 84% of the residents did not know about Pharmacovigilance Programme of India ( PvPI, 68% did not know about existence of any ADR reporting centers in the country. Most of them (75% agreed that ADR reporting is responsibility of the doctors. So far none of the residents have reported an ADR under PvPI. CONCLUSION: The awareness of pharmacovigilance among resident doctors in teaching hospitals is very low. There is an urgent need to train health professionals in pharmacovigilance to improve the current sorry state.

  7. New drug prescribing by hospital doctors: the nature and meaning of knowledge.

    Prosser, Helen; Walley, Tom


    In the UK the high cost of new drugs is partly accountable for the growth in spending on prescription drugs. Most prescribing takes place in general practice and the influence of secondary care prescribing on primary care prescribing is well recognized; yet the factors that influence hospital prescribing have been little researched. Drawing on accounts of actual prescribing events from hospital doctors from a range of specialties, we investigated the processes by which new drugs come into practice, from hospital doctors' awareness of new drugs to the assimilation and interpretation of evidential sources. The determinants of new drug prescribing were interconnected within four forms of knowledge: scientific knowledge, social knowledge, patient knowledge and experiential knowledge. Furthermore, the nature of knowledge could only be understood within its situated context. The revelation of multiple and contingent forms of knowledge highlights the problematic nature of knowledge construction within the approaches of evidence-based medicine.

  8. Discrimination in waiting times by insurance type and financial soundness of German acute care hospitals.

    Schwierz, Christoph; Wübker, Achim; Wübker, Ansgar; Kuchinke, Björn A


    This paper shows that patients with private health insurance (PHI) are being offered significantly shorter waiting times than patients with statutory health insurance (SHI) in German acute hospital care. This behavior may be driven by the higher expected profitability of PHI relative to SHI holders. Further, we find that hospitals offering private insurees shorter waiting times when compared with SHI holders have a significantly better financial performance than those abstaining from or with less discrimination.

  9. The relationship between transformational leadership and social capital in hospitals--a survey of medical directors of all German hospitals.

    Hammer, Antje; Ommen, Oliver; Röttger, Julia; Pfaff, Holger


    The German hospital market has been undergoing major changes in recent years. Success in this new market is determined by a multitude of factors. One is the quality of the social relationships between staff and the presence of shared values and rules. This factor can be considered an organization's "social capital." This study investigates the relationship between social capital and leadership style in German hospitals using a written survey of medical directors. In 2008, a cross-sectional representative study was conducted with 1224 medical directors from every hospital in Germany with at least 1 internal medicine unit and 1 surgery unit. Among the scales included in the standardized questionnaire were scales used to assess the medical directors' evaluation of social capital and transformational leadership in the hospital. We used a multiple linear regression model to examine the relationship between social capital and internal coordination. We controlled for hospital ownership, teaching status, and number of beds. In total, we received questionnaires from 551 medical directors, resulting in a response rate of 45.2%. The participating hospitals had an average of 345 beds. The sample included public (41.3%), not-for-profit (46.9%), and for-profit (11.7%) hospitals. The data, which exclusively represent the perceptions of the medical directors, indicate a significant correlation between a transformational leadership style of the executive management and the social capital as perceived by medical directors. A transformational leadership style of the executive management accounted for 36% of variance of the perceived social capital. The perceived social capital in German hospitals is closely related to the leadership style of the executive management. A transformational leadership style of the executive management appears to successfully strengthen the hospital's social capital.

  10. [Overcoming language barriers with telephone interpreters: first experiences at a German children's hospital].

    Langer, Thorsten; Wirth, Stefan


    Language barriers in the care for patients with limited German language proficiency contribute to impaired quality of care, more frequent medical errors and decreased patient satisfaction. However, professional interpreters are not systematically used in Germany. We conducted a pilot study in a German paediatric hospital to explore the demand for an interpreter by conducting a survey among parents and to test the use of telephone interpreters. Eight percent of the respondents said they were interested in interpreter support. All physicians and parents using a telephone interpreter were very satisfied with the quality and the organisation of the service.

  11. [Instruments of management accounting in german hospitals - potentials for competitive advantage and status quo].

    Berens, W; Lachmann, M; Wömpener, A


    The aim of this study is to provide an analysis of the status quo for the usage of instruments of management accounting in German hospitals. 600 managing directors of German hospitals were asked to answer a questionnaire about the usage of management accounting instruments in their hospitals. We obtained 121 usable datasets, which are evaluated in this study. A significant increase in the usage of management accounting instruments can be observed over time. The respondents have an overall positive perception of the usage of these instruments. Cost accounting and information systems are among the most widely used instruments, while widely discussed concepts like the balanced scorecard or clinical pathways show surprisingly low usage rates. © Georg Thieme Verlag KG Stuttgart · New York.

  12. Continuing professional development and Irish hospital doctors: a survey of current use and future needs.

    Maher, Bridget; Faruqui, Adnan; Horgan, Mary; Bergin, Colm; Tuathaigh, Colm O; Bennett, Deirdre


    Doctors rate clinical relevance and applicability as the most important determinants of continuing professional development (CPD) course selection. This study examined patterns of current CPD practice and perceived CPD needs among hospital doctors in Ireland across various clinical specialties. A cross-sectional survey was administered to doctors, focusing on the areas of training needs analysis, CPD course content and preferred course format. In total, 547 doctors identified doctor-patient communication as the skill ranked highest for importance and level of current performance. Workload/time organisation and stress management were areas where a skills deficiency was identified. Non-clinical CPD topics, including resilience training, management and communication skills, were preferred areas for future CPD offerings. All respondents favoured interactive, hands-on sessions. CPD course completion and preference patterns differed significantly across clinical specialties. These results highlight the importance of considering the individual needs and preferences of clinicians across clinical specialties to facilitate more effective CPD programmes. © Royal College of Physicians 2017. All rights reserved.

  13. Intergroup communication between hospital doctors: implications for quality of patient care.

    Hewett, David G; Watson, Bernadette M; Gallois, Cindy; Ward, Michael; Leggett, Barbara A


    Hospitals involve a complex socio-technical health system, where communication failures influence the quality of patient care. Research indicates the importance of social identity and intergroup relationships articulated through power, control, status and competition. This study focused on interspecialty communication among doctors for patients requiring the involvement of multiple specialist departments. The paper reports on an interview study in Australia, framed by social identity and communication accommodation theories of doctors' experiences of managing such patients, to explore the impact of communication. Interviews were undertaken with 45 doctors working in a large metropolitan hospital, and were analysed using Leximancer (text mining software) and interpretation of major themes. Findings indicated that intergroup conflict is a central influence on communication. Contested responsibilities emerged from a model of care driven by single-specialty ownership of the patient, with doctors allowed to evade responsibility for patients over whom they had no sense of ownership. Counter-accommodative communication, particularly involving interpersonal control, appeared as important for reinforcing social identity and winning conflicts. Strategies to resolve intergroup conflict must address structural issues generating an intergroup climate and evoke interpersonal salience to moderate their effect.

  14. [Strategic planning: an important economic action for German hospitals].

    Wiese, Christoph H R; Zink, Wolfgang; Russo, Sebastian G


    In medical systems, economic issues and means of action are in the course of dwindling human (physicians and nurses) and financial resources are more important. For this reason, physicians must understand basic economic principles. Only in this way, there may be medical autonomy from social systems and hospital administrators. The current work is an approach to present a model for strategic planning of an anesthesia department. For this, a "strengths", "weaknesses", "opportunities", and "threats" (SWOT) analysis is used. This display is an example of an exemplary anaesthetic department.

  15. An Overview of the Opportunities the Presence of Specialist Doctors Resident in Hospitals

    Reza Moradi


    Full Text Available Attention to the functions and pattern organized staff are important to achieve organizational goals, especially for hospitals that are one of the important components into account a element in improving the health system and providing a fair field of utilization of health intervention. So this study was to review the opportunities of presence resident doctors in hospitals based on the instructions of the health system reform plan. This is a narrative review that returning to the site of the Persian (Magiran, Irandoc, Google Scholar, Iranmedex, SID and English (PubMed, Scopus, EMBASE and Sciencedirect and also library studies with keywords (physicians, resident physicians, health equity, project development, opportunity specialist and human resources and the English word for them in this area and the 30 related articles was extracted. Given the evidence may not be fully implemented in all government hospitals because of problems such as the lack of doctors in public hospitals or other administrative problems, but it can be said that is one of the best model to achieve better clinical outcomes in hospitals. In order to solve problems, there is the need to design and create the appropriate environment for the successful implementation plan, or create an ideal environment for the implementation of evidence-based medicine moved.

  16. Business intelligence and information systems in hospitals--distribution and usage of BI and HIS in German hospitals.

    Bartsch, Patrick; Lux, Thomas; Wagner, Alexander; Gabriel, Roland


    This paper shows the results of a short survey taken place in February 2013 within German Hospitals. The present studies view is bottom-up and the interviews are done directly with the hospitals CIOs. There are some effects like the G-DRG implementation in Germany that are evident in the results. The survey indicates also the different methods of adapting the solutions, either by having an all-in-one solution by a single provider or by using a modular solution from multiple providers.

  17. A Study of Power Relations in Doctor-Patient Interactions in Selected Hospitals in Lagos State, Nigeria

    Adam, Qasim


    This paper explores power relations in clinical interactions in Nigeria. It seeks to investigate the use of power between doctors and patients during consultations on patient-centred approach to medicine in selected public and private hospitals in Lagos State, Nigeria. The objective is to establish how doctors' projection of power, using the…

  18. [Characteristics of bacteria isolated from body surface of German cockroaches caught in hospitals].

    Czajka, Ewa; Pancer, Katarzyna; Kochman, Maria; Gliniewicz, Aleksandra; Sawicka, Bozena; Rabczenko, Daniel; Stypułkowska-Misiurewicz, Hanna


    The objective of the study was to identify bacterial flora from external parts of German cockroaches caught in hospitals. The susceptibility of the bacteria to the most important groups of antimicrobial agents was also examined. 80 strains of bacteria were isolated, among them 34 strains of Gram-positive cocci and 31 strains of Gram-negative rods. One of isolated strains of Citrobacter freundii and two strains of Serratia liquefaciens showed ESBL mechanism of resistance and extended level of AmpC--type beta-lactamases. Two Staphylococcus strains (S. epidermidis and S. equorum) were resistant to erythromycin and clindamycin (MLSB mechanism of resistance). Such strains, resistant to antibiotics and chemiotherapeutics may be reservoirs of resistance genes which can be transmitted into other bacteria. Presence of such pathogens on the body surface of German cockroaches, very mobile insects, might create conditions for easy dissemination of them in hospital environment.

  19. Why are hospital doctors not referring to Consultation-Liaison Psychiatry? - a systemic review.

    Chen, Kai Yang; Evans, Rebecca; Larkins, Sarah


    Consultation-Liaison Psychiatry (CLP) is a subspecialty of psychiatry that provides care to inpatients under non-psychiatric care. Despite evidence of benefits of CLP for inpatients with psychiatric comorbidities, referral rates from hospital doctors remain low. This review aims to understand barriers to CLP inpatient referral as described in the literature. We searched on Medline, PsychINFO, CINAHL and SCOPUS, using MESH and the following keywords: 1) Consultation-Liaison Psychiatry, Consultation Liaison Psychiatry, Consultation Psychiatry, Liaison Psychiatry, Hospital Psychiatry, Psychosomatic Medicine, the 2) Referral, Consultation, Consultancy and 3) Inpatient, Hospitalized patient, Hospitalized patient. We considered papers published between 1 Jan 1965 and 30 Sep 2015 and all articles written in English that contribute to understanding of barriers to CLP referral were included. Thirty-five eligible articles were found and they were grouped thematically into three categories: (1) Systemic factors; (2) Referrer factors; (3) Patient factors. Systemic factors that improves referrals include a dedicated CLP service, active CLP consultant and collaborative screening of patients. Referrer factors that increases referrals include doctors of internal medicine specialty and comfortable with CLP. Patients more likely to be referred tend to be young, has psychiatric history, live in an urban setting or has functional psychosis. This is the first systematic review that examines factors that influence CLP inpatient referrals. Although there is research in this area, it is of limited quality. Education could be provided to hospital doctors to better recognise mental illness. Collaborative screening of vulnerable groups could prevent inpatients from missing out on psychiatric care. CLP clinicians should use the knowledge gained in this review to provide quality engagement with referrers.

  20. Awareness and attitude of doctors and nurses at a teaching hospital to skin donation and banking.

    Michael, A I; Ademola, S A; Olawoye, O A; Iyun, A O; Oluwatosin, O M


    This study sought to determine the awareness and attitude of doctors and nurses in a teaching hospital to skin donation and banking, and to identify needs for personnel educational programmes. A cross sectional survey on doctors and nurses was carried out using a 44-item questionnaire that included a Likert scale on attitudes. Predictors of favourable attitudes were determined. Eighty (49.7%) doctors and 81 (50.3%) nurses participated in the study. Many participants, 126 (78.3%), knew that skin could be donated, but only 96 (59.6%) participants were aware of skin banking. The main source of information was during professional training (17.4%). Only 41 (25.5%) participants were willing to donate skin after death. Body disfigurement was the major reason (20.5%) against skin donation. Participants who were doctors, were aware of skin banking, and who were previous blood donors had higher attitudes scores (pbanking were predictors of favourable attitudes to skin donation and banking. Knowledge transfer during health professional training on the usefulness of banked skin in patients with major burns may lead to improved attitude of health professionals and acceptance of this modality of burn management. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

  1. Practise what you preach: health behaviours and stress among non-consultant hospital doctors.

    Feeney, Sinéad


    High rates of psychological distress, depression and suicide have been reported among doctors. Furthermore, many doctors do not access healthcare by conventional means. This study aimed to increase understanding regarding non-consultant hospital doctors\\' (NCHDs\\') response to stress and barriers to accessing supports, and identify possible solutions. Medical manpower departments in 58 hospitals distributed a 25-item questionnaire to 4,074 NCHDs; we received 707 responses (response rate, 17.4%). 60% of NCHDs were unable to take time off work when unwell; \\'letting teammates down\\' (90.8%) and \\'difficulty covering call\\' (85.9%) were the leading reasons. \\'Being too busy\\' (85%), \\'self-prescription\\' (66.6%) and \\'self-management\\' (53.1%) were ranked highest in deterring NCHDs from visiting a general practitioner (GP). 22.9% of NCHDs would not attend a GP with anxiety or depression until they began to feel hopeless, helpless or suicidal. 12.2% would not seek help at all. 55% of respondents (n = 330) had to move away from partners or dependants due to work, negatively affecting the social supports of 82.9%. Possible practical solutions were explored. NCHDS are a vulnerable population and have a particularly challenging lifestyle. Key recommendations include improved GP and counselling access for NCHDs, and addressing the culture of self-treatment and poor health behaviours through undergraduate and postgraduate education.

  2. Founding an adverse drug reaction (ADR) network: a method for improving doctors spontaneous ADR reporting in a general hospital.

    Goldstein, Lee Hilary; Berlin, Maya; Saliba, Walid; Elias, Mazen; Berkovitch, Matitiyahu


    Adverse drug reactions (ADR) are underreported by doctors despite numerous efforts. We aimed to determine if establishing an "ADR reporting doctor's network" within a hospital would increase the quantity of ADRs reported by hospital doctors. One hundred hospital doctors joined the network. Email reminders were sent to network members during the 1 year study period, conveying information about ADRs reported, amusingly and pleasantly reminding them to report ADRs in minimal detail, by phone, email, text message or mail to the Clinical Pharmacology Unit, who would further complete the report. A total of 114 ADRs were reported during the study period in comparison to 48, 26, and 17 in the previous 3 years (2008, 2009, 2010, respectively). In the 3 years prior, doctors reported 41.7% of the reported ADRs whereas in the study period, doctors reported 74.3% of ADRs (P reports. Ninety seven percent of doctors' reports were of ADR network members. Thirty-four (34%) network members reported an ADR during the study period and 31 of the 34 reporters had never reported ADRs before becoming network members. Establishing an ADR network of doctors substantially increases ADR reporting amongst its members.

  3. Temporal and spatial organization of doctors' computer usage in a UK hospital department.

    Martins, H M G; Nightingale, P; Jones, M R


    This paper describes the use of an application accessible via distributed desktop computing and wireless mobile devices in a specialist department of a UK acute hospital. Data (application logs, in-depth interviews, and ethnographic observation) were simultaneously collected to study doctors' work via this application, when and where they accessed different areas of it, and from what computing devices. These show that the application is widely used, but in significantly different ways over time and space. For example, physicians and surgeons differ in how they use the application and in their choice of mobile or desktop computing. Consultants and junior doctors in the same teams also seem to access different sources of patient information, at different times, and from different locations. Mobile technology was used almost exclusively during the morning by groups of clinicians, predominantly for ward rounds.

  4. Creativity in Medical Learning: A direction-finding study of junior hospital doctors

    Martin Talbot


    Full Text Available In a questionnaire study of creativity, the author has assessed the teaching and clinical practice of medical teachers, as observed by their students. The study has taken some preliminary steps to assess the place of creativity in postgraduate medical learning in the United Kingdom. Junior doctors were asked to compare their ‘best’ teacher with their ‘worst’ utilising a semantic differential scale and questions derived from Torrance’s definitions of creativity. The response rate was 81 (56.25% of 144 junior hospital doctors, in whose view, ‘best’ teachers showed greater creative behaviour as evidenced by significantly higher creativity scores on the majority of parameters (p<0.0001.

  5. Doctors' perspectives on the barriers to appropriate prescribing in older hospitalized patients: A qualitative study.

    Cullinan, S


    Older patients commonly suffer from multimorbidites and take multiple medications. As a result, these patients are more vulnerable to potentially inappropriate prescribing (PIP). PIP in older patients may result in adverse drug events and hospitalisations. However, little has been done to identify why PIP occurs. The objectives of this study were; (1) to identify hospital doctors\\' perceptions as to why PIP occurs, (2) to identify the barriers to addressing the issues identified, and (3) to determine which intervention types would be best suited to improving prescribing.

  6. Supervisory needs of research doctoral students in a university teaching hospital setting.

    Caldwell, Patrina Hy; Oldmeadow, Wendy; Jones, Cheryl A


    Teaching hospitals affiliated with universities are now common sites for research higher degree supervision. We hypothesised that the hospital environment poses unique challenges to supervision compared with the traditional university research institute setting. This study aimed to identify and rank important supervision issues in a clinical setting from the students' perspective. Using the Delphi method to explore issues and facilitate consensus, small group discussions were conducted with 10 research doctoral students from a tertiary teaching hospital. We identified supervision issues that are unique to the hospital-based context. These include the demands placed on supervisors combining clinical and supervisory roles, the challenges of academic medical/scientific writing and career issues for students who are already established in their professions. Other issues identified, common to all doctoral students, include differing expectations between students and supervisors (with students wanting support for their career plans, training in research skills and increasing autonomy and responsibility), supervisor access, quality and frequency of meetings, lack of training in writing and dealing with conflicts. Our research identified that postgraduate students of supervisors who combine clinical and supervisory roles report significant issues with supervision, some of which are unique to the clinical setting. Clinician researchers who supervise postgraduate students need to balance clinical and supervisory responsibilities, identify and negotiate student expectations early in candidature and provide career counselling to students who are already highly experienced. Furthermore, clinician supervisors should undertake postgraduate supervisor training programme tailored to the hospital setting to better support their students. © 2012 The Authors. Journal of Paediatrics and Child Health © 2012 Paediatrics and Child Health Division (Royal Australasian College of

  7. Improving computer-mediated synchronous communication of doctors in rural communities through cloud computing: A case study of rural hospitals in South Africa

    Coleman, A


    Full Text Available This paper investigated how doctors in remote rural hospitals in South Africa use computer-mediated tool to communicate with experienced and specialist doctors for professional advice to improve on their clinical practices. A case study approach...

  8. Extending Miles & Snow's strategy choice typology to the German hospital sector.

    Helmig, Bernd; Hinz, Vera; Ingerfurth, Stefan


    Hospitals' strategy choices represent highly relevant factors that affect organizational performance and survival. This study assesses the differences among hospitals' strategic choices. This strategy definition and assessment reflects the typology proposed by Miles and Snow, who distinguish four strategy types: defender, analyzer, prospector, and reactor. Synthesis of empirical evidence from previous studies that have applied Miles and Snow's typology in the hospital sector using various methodological approaches and measures provides hints for industry-specific patterns and avenues for further research. Taking an extended view of strategic choice, the authors conduct an empirical survey of a sample of 178 German hospitals. The authors apply a multi-item measure of the Miles and Snow strategy types in the hospital sector and identify hybrid strategy types that deviate from the four strategy types defined by Miles and Snow. Overall, seven distinct strategy types emerge from this analysis. There exist three distinct hybrid types in particular. Strategy choice is systematically related to hospital size and teaching status but not to ownership and location. The significant variance in performance for the seven different strategy types justifies the distinction between them. The results support the idea of industry-specific strategy choices. Policy makers should analyze the structural context in which hospitals operate and intervene through political and regulatory means.

  9. [A paradigm change in German academic medicine. Merger and privatization as exemplified with the university hospitals in Marburg and Giessen].

    Maisch, Bernhard


    1. The intended fusion of the university hospitals Marburg and Giessen in the state of Hessia is "a marriage under pressure with uncalculated risk" (Spiegel 2005). In the present political and financial situation it hardly appears to be avoidable. From the point of the view of the faculty of medicine in Marburg it is difficult to understand, that the profits of this well guided university hospital with a positive yearly budget should go to the neighboring university hospital which still had a fair amount of deficit spending in the last years.2. Both medical faculties suffer from a very low budget from the state of Hessia for research and teaching. Giessen much more than Marburg, have a substantial need for investments in buildings and infrastructure. Both institutions have a similar need for investments in costly medical apparatuses. This is a problem, which many university hospitals face nowadays.3. The intended privatisation of one or both university hospitals will need sound answers to several fundamental questions and problems:a) A privatisation potentially endangers the freedom of research and teaching garanteed by the German constitution. A private company will undoubtedly influence by active or missing additional support the direction of research in the respective academic institution. An example is the priorisation of clinical in contrast to basic research.b) With the privatisation practical absurdities in the separation of research and teaching on one side and hospital care on the other will become obvious with respect to the status of the academic employees, the obligatory taxation (16%) when a transfer of labor from one institution to the other is taken into account. The use of rooms for seminars, lectures and bedside with a double function for both teaching, research and hospital care has to be clarified with a convincing solution in everyday practice.c) The potential additional acquisition of patients, which has been advocated by the Hessian state

  10. How do hospital doctors manage patients with medically unexplained symptoms: a qualitative study of physicians.

    Warner, Alex; Walters, Kate; Lamahewa, Kethakie; Buszewicz, Marta


    Objective Medically unexplained symptoms are a common presentation in medical practice and are associated with significant morbidity and high levels of service use. Most research exploring the attitudes and training of doctors in treating patients with unexplained symptoms has been conducted in primary care. This study aims to explore the ways in which doctors working in secondary care approach and manage patients with medically unexplained symptoms. Design A qualitative study using in-depth interviews and thematic analysis. Setting Three hospitals in the North Thames area. Participants Twenty consultant and training-grade physicians working in cardiology, gastroenterology, rheumatology and neurology. Main outcome measure Physicians' approach to patients with medically unexplained symptoms and their views on managing these patients. Results There was considerable variation in how the physicians approached patients who presented with medically unexplained symptoms. Investigations were often ordered without a clear rationale and the explanations given to patients when results of investigations were normal were highly variable, both within and across specialties. The doctor's level of experience appeared to be a more important factor in their investigation and management strategies than their medical specialty. Physicians reported little or no formal training in how to manage such presentations, with no apparent consistency in how they had developed their approach. Doctors described learning from their own experience and from senior role models. Organisational barriers were identified to the effective management of these patients, particularly in terms of continuity of care. Conclusions Given the importance of this topic, there is a need for serious consideration as to how the management of patients with medically unexplained symptoms is included in medical training and in the planning and delivery of services.

  11. Mobile and fixed computer use by doctors and nurses on hospital wards

    Andersen, Pia; Lindgaard, Anne-Mette; Prgomet, M.


    , computers on wheels (COWs) and tablet PCs-was made. Two types of COWs were available on the wards: generic COWs (laptops mounted on trolleys) and ergonomic COWs (an integrated computer and cart device). Heuristic evaluation of the user interfaces was also carried out. RESULTS: The majority (93......BACKGROUND: Selecting the right mix of stationary and mobile computing devices is a significant challenge for system planners and implementers. There is very limited research evidence upon which to base such decisions. OBJECTIVE: We aimed to investigate the relationships between clinician role......, clinical task, and selection of a computer hardware device in hospital wards. METHODS: Twenty-seven nurses and eight doctors were observed for a total of 80 hours as they used a range of computing devices to access a computerized provider order entry system on two wards at a major Sydney teaching hospital...

  12. A study of needle stick injuries among non-consultant hospital doctors in Ireland.

    O'Connor, M B


    INTRODUCTION: NCHDs are exposed to a great number of blood-borne infections. Needle stick injuries are possibly the main route of acquiring such infections from a non-consultant hospital doctors (NCHDs) perspective. This study examines NCHDs experiences surrounding needle stick injuries. METHODS: A cross-sectional self-administered anonymous questionnaire survey was conducted on 185 NCHDs working in a clinical setting among seven teaching hospitals in Ireland. Implied consent was obtained. The data was analysed using Excel spreadsheets. Ethical approval was received. RESULTS: A response rate of 85.4% (158\\/185) was achieved. Findings of the study are shown in the manuscript table. CONCLUSIONS: A needle stick injury (NI) history is greater among surgical NCHDs than medical NCHDs. The level of disposable glove usage is worryingly poor. Training in sharps handling and dealing with a NI needs to be addressed. HIV is the blood-borne infection most fear of being contracting as a consequence of a NI.

  13. The effect of performance-related pay of hospital doctors on hospital behaviour: a case study from Shandong, China

    Mills Anne


    Full Text Available Abstract Background With the recognition that public hospitals are often productively inefficient, reforms have taken place worldwide to increase their administrative autonomy and financial responsibility. Reforms in China have been some of the most radical: the government budget for public hospitals was fixed, and hospitals had to rely on charges to fill their financing gap. Accompanying these changes was the widespread introduction of performance-related pay for hospital doctors – termed the "bonus" system. While the policy objective was to improve productivity and cost recovery, it is likely that the incentive to increase the quantity of care provided would operate regardless of whether the care was medically necessary. Methods The primary concerns of this study were to assess the effects of the bonus system on hospital revenue, cost recovery and productivity, and to explore whether various forms of bonus pay were associated with the provision of unnecessary care. The study drew on longitudinal data on revenue and productivity from six panel hospitals, and a detailed record review of 2303 tracer disease patients (1161 appendicitis patients and 1142 pneumonia patients was used to identify unnecessary care. Results The study found that bonus system change over time contributed significantly to the increase in hospital service revenue and hospital cost recovery. There was an increase in unnecessary care and in the probability of admission when the bonus system switched from one with a weaker incentive to increase services to one with a stronger incentive, suggesting that improvement in the financial health of public hospitals was achieved at least in part through the provision of more unnecessary care and drugs and through admitting more patients. Conclusion There was little evidence that the performance-related pay system as designed by the sample of Chinese public hospitals was socially desirable. Hospitals should be monitored more closely

  14. Doctors' knowledge of patients' rights at King Fahd Hospital of the University.

    Al-Muammar, Sarah A; Gari, Danya M K


    To assess the level of physicians' knowledge about the contents of patients' bill of rights (PBR) and its implementation. This cross-sectional study was carried out at a university hospital in the Eastern Province of Saudi Arabia. All physicians working in the hospital received a self-administered questionnaire to measure their level of knowledge of PBR. Scoring was done to determine the knowledge of the details. The study was approved by the Institutional Review Board of the University Hospital and permission sought from the administration. Data analysis performed with SPSS; descriptive analyses included frequency and percentages for categorical variables, and mean and standard deviations for continuous variables. Bivariate analyses were carried out to determine association between sociodemographic variables and the level of knowledge (adequate/inadequate). Logistic regression analysis were performed to calculate adjusted odds ratio at 0.05 significance level. Most (52.7%) of the physicians were females, were aged between 25 and 30 years (58.5%), and Saudi (80.2%). The majority of the physicians belonged to the residency program (44.9%) and had work experience of 1-5 years (45.4%). About 44% physicians had adequate knowledge about PBR and 55.56% had inadequate knowledge. Regarding physician's response to each item of PBR, the majority (98.1%) gave correct answer to Item 2: "Patients should know the identity and professional status of the healthcare providers responsible for their treatment" (98.1%). Item 25: "Doctors are entitled to withhold any procedures related to a patient's condition if the patient refuses their choice of treatment" was the item with the least correct response (15.5%). Reinforcement and strict implementation of PBR are necessary. The institution should provide training and motivate physicians, especially younger doctors regarding PBR to ensure good health for all and safeguard the integrity of both the physician and the hospital.

  15. Nursing practice in the prevention of pressure ulcers: an observational study of German Hospitals.

    Hoviattalab, Khadijeh; Hashemizadeh, Haydeh; D'Cruz, Gibson; Halfens, Ruud J G; Dassen, Theo


    The study aimed to establish the range and extent of preventive interventions undertaken by nurses for patients who are at high risk of developing or currently have a pressure ulcer. Since 2000, the German National Expert Standard for the prevention of pressure ulcers has provided evidence-based recommendations, but limited studies have been published on its adherence in hospitals. There are also limited observational studies that investigated whether patients who are at risk of or have pressure ulcers are provided with appropriate preventative measures. A nonparticipant observational descriptive design was used. A sample of 32 adult patients who were at high risk of developing or currently had a pressure ulcer were observed during all shifts in medical and surgical wards in two general hospitals in Germany. A range of preventive interventions that were in line with the German National Expert Standard was observed. The most frequent preventive measures were 'cleaning the patients' skin' and 'minimizing exposure to moisture' that were undertaken in more than 90% of all patients. The least frequent measures were 'patient and relative education', 'assessment and recording of nutritional status'. This study demonstrates that the pressure ulcers preventive interventions as set out in the German National Expert Standard were not fully implemented. The study highlights the need for further studies on the barriers that impede the undertaking of the interventions that may prevent the development or deterioration of pressure ulcers and the delivery of evidence-based preventative care. This study provides an insight into the extent of pressure ulcers preventive practices used by nurses. The results may serve as a basis for developing an effective strategy to improve nursing practice in this area and the promotion of evidence-based practice. However, our results refer to two general hospitals and for a broader population, further studies with larger data samples are needed.

  16. Nationwide evaluation of day-to-day clinical pharmacists' interventions in German hospitals.

    Langebrake, Claudia; Ihbe-Heffinger, Angela; Leichenberg, Katja; Kaden, Sandra; Kunkel, Mareike; Lueb, Michael; Hilgarth, Heike; Hohmann, Carina


    To describe and evaluate the extent and diversity of nationwide data from clinical pharmacists' interventions (PIs) in German hospitals. Retrospective analysis. The ADKA-DokuPIK German database, a national anonymous self-reported Internet-based documentation system for routine PIs as well as for medication errors reported by German hospital pharmacists. Data sets from ADKA-DokuPIK entered between January 2009 and December 2012 were analyzed descriptively. A total of 27,610 PIs were entered, mainly by ward-based clinical pharmacists (82.5%). Most of the PIs were performed on surgical wards (37.8%), followed by anesthesiology/intensive care unit/intermediate care unit and internal medicine. The most prevalent therapeutic subgroup that was the trigger for the PIs was antibacterials for systemic use (13.9%), followed by antithrombotic agents, analgesics, drugs for acid-related disorders, and agents acting on the renin-angiotensin system. About a quarter of interventions (23.4%) were performed due to inappropriate use of drugs, followed by use of a wrong dose or administration interval (22.1%), resulting in the most frequently taken actions of change of dose, change of drug, and drug stopped/paused (withheld). Altogether, the implementation rate of the PIs was 85.5%. Underlying medication errors were predominantly classified as "error, no harm" according to the National Coordinating Council for Medication Error Reporting and Prevention. For the first time in a European country, our findings show the scope of clinical pharmacist involvement in patient care in daily clinical practice and demonstrate the usefulness and importance of their proactive interventions in the prevention of hazards and risks for hospital inpatients. © 2015 Pharmacotherapy Publications, Inc.

  17. [Oral anticoagulation after major hip or knee replacement surgery: a process-driven managerial pharmacoeconomic analysis in German hospitals].

    Wilke, T; Neumann, K; Klapper, U; Messer, I; Werner, A; Seidel, U; Röleke, D


    The thrombin inhibitor dabigatranetexilat is used for prophylaxis of venous thromboembolism after total hip or knee replacement surgery (THR/TKR). Patients can take it orally in hospitals. In a managerial pharmacoeconomic analysis of six German acute-care hospitals and six German rehabilitation hospitals, the use of dabigatranetexilat was compared with the use of low-molecular-weight heparins. The analysis showed that the new drug led to an economic advantage for an acute-care hospital of 2.43 euro per patient per day. In a rehabilitation hospital, the use of dabigatranetexilat led to an economic advantage of 1.40 euro per patient per day. These results have direct implications for drug decisions in hospitals. To demonstrate that fact, the price difference between dabigatranetexilat and low-molecular-weight heparins was derived to lead exactly to their"economic neutrality" from the hospital's point of view.

  18. Doctors as street-level bureaucrats in a rural hospital in South Africa.

    Gaede, Bernhard M


    In the perspectives of implementation of policy, the top-down and bottom-up perspectives of policy-making dominate the discourse. However, service delivery and therefore the experience of the policy by the citizen ultimately depend on the civil servant at the front line to implement the policy. Lipsky named this street-level bureaucracy, which has been used to understand professionals working in the public sector throughout the world. The public sector in South Africa has undergone a number of changes in the transition to a democratic state, post 1994. This needs to be understood in public administration developments throughout the world. At the time of the study, the public sector was characterized by considerable inefficiencies and system failures as well as inequitable distribution of resources. The context of the study was a rural hospital serving a population of approximately 150 000. An insider-ethnography over a period of 13 months explored the challenges of being a professional within the public sector in a rural hospital in South Africa. Data collection included participant observation, field notes of events and meetings, and documentation review supplemented with in-depth interviews of doctors working at a rural hospital. Street-level bureaucracy was used as a framework to understand the challenges of being a professional and civil servant in the public sector. The context of a resource-constrained setting was seen as a major limitation to delivering a quality service. Yet considerable evidence pointed to doctors (both individually and collectively) being active in managing the services in the context and aiming to achieve optimal health service coverage for the population. In the daily routine of the work, doctors often advocated for patients and went beyond the narrow definitions of the guidelines. They compensated for failing systems, beyond a local interpretation of policy. However, doctors also at times used their discretion negatively, to avoid work

  19. Board characteristics, governance objectives, and hospital performance: An empirical analysis of German hospitals.

    Thiel, Andrea; Winter, Vera; Büchner, Vera Antonia


    There is a growing need for hospital supervisory boards to support hospital management in different areas, including (financial) monitoring, resource provision, stakeholder relationships, and strategic decision-making. Little is currently known about how boards' emphases on these various governance objectives contribute to performance. Using a dominant logics perspective, this article aims to detect the governance logics that hospital boards emphasize, to determine whether there are distinct clusters of hospitals with the same sets of emphases, and to show how cluster membership relates to board characteristics and financial performance. Using factor analysis, we identify latent classes of governance objectives and use hierarchical cluster analysis to detect distinct clusters with varying emphasis on the classes. We then use multinomial regression to explore the associations between cluster membership and board characteristics (size, gender diversity, and occupational diversity) and examine the associations between clusters and financial performance using OLS regression. Classes of objectives reflecting three governance theories-agency theory, stewardship theory, and stakeholder theory-can be distinguished, and hospitals can be divided into four clusters based on their board's relative emphasis on the classes. Cluster membership is significantly associated with board characteristics. There is also a significant association between cluster membership and hospital financial performance, with two of three groups performing significantly better than the reference group. High performance in hospitals can be the result of governance logics, which, compared to simple board characteristics, are associated with better financial outcomes. Hospitals can influence the emphasis placed on different governance objectives and enhance organizational success by creating boards that are small enough to be effective yet diverse enough to profit from a wide variety of expertise and

  20. Bacterial load of German cockroach (Blattella germanica) found in hospital environment

    Menasria, Taha; Moussa, Fatima; El-Hamza, Souad; Tine, Samir; Megri, Rochdi; Chenchouni, Haroun


    Background Cockroaches are among the most common pests in public dwellings and health facilities. Their presence can raise safety concerns, especially as they maybe carriers of pathogenic organisms. Methods This study was carried out to isolate and identify the bacterial flora from German cockroaches (Blattella germanica). Cockroaches collected by hand catches from two public hospital environments in Tebessa city (northeast Algeria) were screened for microbial load from their external surfaces and alimentary tract using standard bacterial protocols. Results A total of 174 bacterial isolates were isolated from 39 German cockroach specimens. The most common and abundant bacterial species belonged to the Pseudomonas group (23.5%) and Serratia (13.2%). Pathogens like Staphylococcus aureus were also isolated, as well as opportunistic pathogens like Klebsiella species and food spoilage bacteria such as Enterobacter and Citrobacter species were isolated from both external surface and digestive tract of the insect. Generalized linear models (GLM) were performed to analyze the variation of abundances and occurrences of bacterial isolates harboured by B. germanica. The GLMs revealed that the main factors affecting variation of bacterial diversity and abundance were sex and hospital (P cockroach acts as reservoir and potential vector of some bacterial pathogens. PMID:24766338

  1. Working conditions and Work-Family Conflict in German hospital physicians: psychosocial and organisational predictors and consequences

    Schwappach David


    Full Text Available Abstract Background Germany currently experiences a situation of major physician attrition. The incompatibility between work and family has been discussed as one of the major reasons for the increasing departure of German physicians for non-clinical occupations or abroad. This study investigates predictors for one particular direction of Work-Family Conflict – namely work interfering with family conflict (WIF – which are located within the psychosocial work environment or work organisation of hospital physicians. Furthermore, effects of WIF on the individual physicians' physical and mental health were examined. Analyses were performed with an emphasis on gender differences. Comparisons with the general German population were made. Methods Data were collected by questionnaires as part of a study on Psychosocial work hazards and strains of German hospital physicians during April–July 2005. Two hundred and ninety-six hospital physicians (response rate 38.9% participated in the survey. The Copenhagen Psychosocial Questionnaire (COPSOQ, work interfering with family conflict scale (WIF, and hospital-specific single items on work organisation were used to assess WIF, its predictors, and consequences. Results German hospital physicians reported elevated levels of WIF (mean = 74 compared to the general German population (mean = 45, p p Conclusion In our study, work interfering with family conflict (WIF as part of Work-Family Conflict (WFC was highly prevalent among German hospital physicians. Factors of work organisation as well as factors of interpersonal relations at work were identified as significant predictors for WIF. Some of these predictors are accessible to alteration by improving work organisation in hospitals.

  2. [German qualified doctors license to continue practice in south Jutland after the reunion. (Application of danish jus practicandi, process and result)].

    Johannsen, Andreas


    At the reunion of the southern part of Jutland with Denmark 1920 danish legislation had to be introduced in the new incorporated region. According to a special law doctors educated in Germany could obtain danish medical authorization, if they were born or established in the region before 1.1.1918, under certain circumstances it was possible to dispense from this date. The law meant that all doctors, in the region had to ask for danish authorization. Matrimonial relationship and personal connections were strong arguments for a dispensation, but not always sufficient. In more cases a refusal was given because of a german attitude at the applicant in spite of matrimonial relationship, with the result that the applicant had to leave an established practice and Denmark. 53 doctors were given danish authorization immediately. 8 got an authorization by dispensation and 10 got a refusal. A survey of the applications and the corrected archives shows, that the cases mostly were handled without problems. But the cases, where dispensation and especially refusal were given, were often very complicated and followed by heavy local national reactions. This paper describes the background of the special law and the course of the cases with particular weight on the cases where dispensation or refusal were given.

  3. [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"].

    Itoh, Tsunetoshi


    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.

  4. Doctor-Patient Communication In An Out-Patient Clinic Of A Teaching Hospital

    Amir Ali


    Full Text Available Research question: What is the degree of satisfaction of patient with doctor-patient communication? Objective: To study the degree of satisfaction with doctor-patient communication. Study design: Cross-sectional Setting & participants: Patient attending department of Medicine, J.N.M.C. Hospital, A.M.U., Aligarh. Study period: April 1977 to March 1998. Sample size: 4460 urban male patients aged 18 years and above. Study variables: Age, no of clinic visits. Statistical analysis: Chi-Square test. Results: 38.34% patients received satisfactory answers to their questions. The proportion of dissatisfaction was (70.31% among elderly patients. The patients who visited clinic on more than 4 occasions were relatively more satisfied (43.83%. Majority of the patients received information on nature of investigation (30.71% and about treatment (26.63% but only 6.07% received information on prognosis and 18.92% about nature of the disease. Majority of the patients (82.62% preferred verbal information.

  5. Medical Aid, Repression, and International Relations: The East German Hospital at Metema.

    Borowy, Iris


    Between 1984 and 1988, the German Democratic Republic (GDR) built a hospital in a remote part of Ethiopia, close to the Sudanese border. The project evolved in a complex combination of contexts, including the general foreign policy goals of the GDR, its specific alliance with Ethiopia, the famine of 1984-85, civil war in Ethiopia, and a controversial resettlement program by the government of Mengistu Haile Mariam. Though almost unknown today, it was a high-profile project at the time, which received the personal support both by Erich Honecker in the GDR and Mengistu Haile Mariam in Ethiopia. However, their interest was directed more at the political goals the project was expected to serve than at the hospital itself. Both the preparation and the implementation of the project were extremely difficult and almost failed due to problems of transportation, of red tape, and of security. The operation of the hospital was also not ideal, involving frustrated personnel and less than complete acceptance by the local population. Ironically, for all its practical difficulties, the hospital has outlived both governments and their political goals, surviving as a medical institution.

  6. Effort-reward imbalance and burnout among German nurses in medical compared with psychiatric hospital settings.

    Schulz, M; Damkröger, A; Heins, C; Wehlitz, L; Löhr, M; Driessen, M; Behrens, J; Wingenfeld, K


    The aim of this study was to investigate whether nurses' efforts and rewards, as well as the effort-reward imbalance (ERI) and burnout, differ between subjects working in psychiatric vs. medical hospitals and between nurses under education and examined nurses respectively. Furthermore, the relationship between ERI and burnout was evaluated. Nursing is associated with high levels of emotional strain and heavy workloads. Burnout and a negative ERI can result in high absenteeism and turnover and have been identified as reasons why nurses leave their profession. In the last decade, working conditions of the nursing profession have changed in Germany, but somatic and psychiatric hospitals developed in different ways. This development may lead to different profiles. A sample of 389 nurses (78.8% female) in four German hospitals was investigated. A total of 147 nurses worked in psychiatric hospitals and 236 nurses worked in medical (somatic) hospitals. Fifty participants were still under education. The Effort-Reward Imbalance Inventory measures effort, reward and overcommitment at job and provides an imbalance score between effort and reward. The Maslach Burnout Inventory with the subscales, emotional exhaustion, lack of accomplishment and depersonalization, was also used. Nurses working in medical hospitals reported more burnout and had higher ERI scores. Subjects under education were comparable to examined nurses in terms of burnout but had lower ERI scores. Multiple regression analyses showed all ERI scales to be significant predictors for emotional exhaustion, while age, field of work and educational status further predict effort or ERI respectively. At present, the working situation of nurses in different settings appears to be characterized by a perceived imbalance of effort and reward and is associated with a high risk of developing burnout symptoms.

  7. The CLAS App A mobile training tool to improve handover procedures between hospital interface and family doctors

    Maher, Bridget; Drachsler, Hendrik; Kalz, Marco; Specht, Marcus


    Maher, B., Drachsler, H., Kalz, M., & Specht, M. (2012). The CLAS App - A mobile training tool to improve handover procedures between hospital interface and family doctors. In M. Specht, J. Multisilta, & M. Sharples (Eds.), Proceedings of the 11th World Conference on Mobile and Contextual Learning 2

  8. Hospital doctors' self-rated skills in and use of evidence-based medicine - a questionnaire survey

    Oliveri, Roberto S; Gluud, Christian; Wille-Jørgensen, Peer A


    Problems in understanding basic aspects of evidence-based medicine (EBM) may form barriers to its implementation into clinical practice. We examined hospital doctors' skills in EBM terms and related these skills to their use of information sources, critical appraisal, and implementation of EBM...

  9. Strategies to enhance rational use of antibiotics in hospital : a guideline by the German Society for Infectious Diseases

    de With, K.; Allerberger, F.; Amann, S.; Apfalter, P.; Brodt, H. -R.; Eckmanns, T.; Fellhauer, M.; Geiss, H. K.; Janata, O.; Krause, R.; Lemmen, S.; Meyer, E.; Mittermayer, H.; Porsche, U.; Presterl, E.; Reuter, S.; Sinha, B.; Strauss, R.; Wechsler-Foerdoes, A.; Wenisch, C.; Kern, W. V.


    In the time of increasing resistance and paucity of new drug development there is a growing need for strategies to enhance rational use of antibiotics in German and Austrian hospitals. An evidence-based guideline on recommendations for implementation of antibiotic stewardship (ABS) programmes was de

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

    Völk, M; Danz, B


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

  11. The Impact of Private versus Social Health Insurance on Offered Waiting Times in German Acute Care Hospitals

    Schwierz, Christoph; Wübker, Ansgar; Kuchinke, Björn A.


    This paper shows that patients with private health insurance (PHI) are being offered significantly shorter waiting times than patients with statutory health insurance (SHI) in German acute hospital care. This behavior may be driven by the higher expected profitability of PHI relative to SHI holders. Further,we find that hospitals offering private insurees shorter waiting times as compared to SHI holders have a significantly better financial performance than those abstaining from or with less ...

  12. Assessing the functional performance of post-call hospital doctors using a Nintendo Wii.

    Clancy, K


    Sleep deprivation is an established part of the working life for Non-Consultant Hospital Doctors (NCHDs) in Ireland. Concern exists about the effect of extended NCHD work hours. We utilised a Nintendo Wii to evaluate motor function of NCHDs both prior to their on-call shift and the day afterwards. Data was exported to SPSS ver. 15 for statistical analysis with p < 0.05 considered significant. A total of 72 NCHDs were invited to participate in this study. There was a 62.5% (45) rate of follow-up. Overall 27 (60%) NCHDs were on medical call, with 18 (40%) on surgical call. There was no statistically significant difference between NCHDs pre-and post-call motor assessment scores. The majority of study participants (75.5%, n = 34) had four or more hours sleep. On-call duty allows for a greater than anticipated amount of sleep per on-call shift and therefore has a negligible effect on the motor skills of medical staff.

  13. Effect of Organ Scandal on Corneal Donation Rate and Organ Donors at a German University Hospital.

    Röck, Daniel; Petersen, Peter; Yoeruek, Efdal; Thaler, Sebastian; Bartz-Schmidt, Karl Ulrich; Röck, Tobias


    BACKGROUND The purpose of this study was to assess the effect of an organ transplantation scandal on the rate of corneal donations and organ donors at the University Hospital Tübingen. MATERIAL AND METHODS Data from all hospital deaths from January 2012 to December 2013 were analyzed retrospectively. Each deceased patient was considered as a potential corneal donor. The corneal donor procurement was handled by an ophthalmic resident on a full-time basis with standard used unchanged set of procedures. Each patient who died due to cerebral complications was considered as a potential organ donor. During the two-year period, a German transplantation scandal occurred at the end of 2012 and received worldwide attention. The rates of corneal donation and organ donation in 2012 and 2013 were examined and evaluated. RESULTS Among the 1685 deceased patients, approval for corneal donation was received in 220 cases (13.1%): 124 cases (15.0%) in 2012 and 96 cases (11.2%) in 2013. This corresponds to a decline of 23%. The leading causes of nonfulfillment of corneal donations were refusal to donation: 401 cases (48.4%) in 2012 and 445 cases (52.0%) in 2013; and medical contraindications: 201 cases (24.2%) in 2012 and 212 cases (24.8%) in 2013. During the two-year period, consent for organ donation was obtained in 25 cases (1.5%): 15 cases (1.8%) in 2012 and 10 cases (1.2%) in 2013. The number of realized organ donors was 20 cases (1.2%): 12 cases (1.4%) in 2012 and 8 cases (0.9%) in 2013. This corresponds to a decline of 33%. CONCLUSIONS After a transplantation scandal, the number of realized corneal donors and realized organ donors decreased significantly. It seems that increasing professional performance is very important to gaining trust inside and outside the hospital and improving corneal and organ donation rate.

  14. Smoking behaviour among young doctors of a tertiary care hospital in North India

    Muneer A. Bhat


    Full Text Available Background: Tobacco use is one of the biggest public health threats the world has ever faced. There are more than one billion smokers in the world. Almost half of the worlds children breathe air polluted by tobacco. Aim of current study was to study the smoking trends among young doctors in a tertiary care institute in north India. Methods: A descriptive observational cross-sectional epidemiological study was conducted among 250 doctors of a tertiary care Hospital in Jammu and Kashmir (Sheri Kashmir Institute of Medical Sciences, SKIMS during the two months of February-March, 2014. The predesigned tool adopted during data collection was a questionnaire that was developed at the institute with the assistance from the faculty members and other experts. Results: Among 250 participants, (20% were smokers; among smokers, (76% were regular smokers and (24% were occasional smokers. Majority of smokers were in the age group of 21-30 years (80% and started smoking between 11-20 years (70%. All of them were male (100%. No significant difference was observed among urban and rural students. Among smokers, majority (60% was in the practice of smoking for last 6 months to 1 year and 26% smoked for <6 months; and (14% smoked for more than 5 years .It was found more than half of the responding (60% students used to smoke 5-9 cigarettes per day; 14% is <5 and 26% consumed 10 or more per day .Among smokers, peer pressure was found in 80% cases. ( and #967;2 = 107, P <0.001. Among smokers, almost 20% had other addiction and among non-smokers only 5% had .Effect of parental smoking was significantly higher in smokers than non-smoker ( and #967;2 = 66.2, P <0.001 .It was seen that peer pressure was the most important risk factor (60% of initiation of smoking habit followed by parental influence (20%. Majority (78.4% had no intention to quit in the next 6 months. Lack of Incentive (36.36% and Addiction (27.27% were the main reasons for not quitting. Conclusion: We

  15. A Survey of Knowledge and Practices of Transfusion Medicine Among Post Intern Doctors in Specialized Hospital in Sri Lanka.

    Kumarage, Samantha; Fernando, Rahal; Gunasekara, Lanka


    Knowledge of transfusion medicine is the key element of better transfusion practices. This deficit observed at the blood bank end on daily basis exposing the patients for redundant risk. We assessed the knowledge of transfusion medicine among post intern doctors. To assess the knowledge of transfusion medicine among post intern doctors in working in our hospital. Self administrated questionnaire was used. 45 questions of transfusion medicine included in the questioner. A total 57 post internship doctors participated in the survey. Statistical analysis was done using SPSS. In overall survey average score was 41.45%. Lowest score 19.8% was for the area of lab result interpretation. Highest score 56.63% obtained for the administration of blood component. Differences among the medical officers of various specialties were not statistically significant. Transfusion medicine knowledge among post internship doctors in our hospital need to be upgraded. © American Society for Clinical Pathology, 2016. All rights reserved. For permissions, please e-mail:

  16. The involvement of medical doctors in hospital governance and implications for quality management: a quick scan in 19 and an in depth study in 7 OECD countries.

    Rotar, A M; Botje, D; Klazinga, N S; Lombarts, K M; Groene, O; Sunol, R; Plochg, T


    Hospital governance is broadening its orientation from cost and production controls towards 'improving performance on clinical outcomes'. Given this new focus one might assume that doctors are drawn into hospital management across OECD countries. Hospital performance in terms of patient health, quality of care and efficiency outcomes is supposed to benefit from their involvement. However, international comparative evidence supporting this idea is limited. Just a few studies indicate that there may be a positive relationship between medical doctors being part of hospital boards, and overall hospital performance. More importantly, the assumed relationship between these so-called doctor managers and hospital performance has remained a 'black-box' thus far. However, there is an increasing literature on the implementation of quality management systems in hospitals and their relation with improved performance. It seems therefore fair to assume that the relation between the involvement of doctors in hospital management and improved hospital performance is partly mediated via quality management systems. The threefold aim of this paper is to 1) perform a quick scan of the current situation with regard to doctor managers in hospital management in 19 OECD countries, 2) explore the phenomenon of doctor managers in depth in 7 OECD countries, and 3) investigate whether doctor involvement in hospital management is associated with more advanced implementation of quality management systems. This study draws both on a quick scan amongst country coordinators in OECD's Health Care Quality Indicator program, and on the DUQuE project which focused on the implementation of quality management systems in European hospitals. This paper reports two main findings. First, medical doctors fulfil a broad scope of managerial roles at departmental and hospital level but only partly accompanied by formal decision making responsibilities. Second, doctor managers having more formal decision making

  17. Medical leadership, a systematic narrative review: do hospitals and healthcare organisations perform better when led by doctors?

    Clay-Williams, Robyn; Ludlow, Kristiana; Testa, Luke; Li, Zhicheng; Braithwaite, Jeffrey


    Despite common assumptions that doctors are well placed to lead hospitals and healthcare organisations, the peer-reviewed literature contains little evidence on the performance of doctors in leadership roles in comparison with that of non-medical managers. To determine whether there is an association between the leader's medical background and management performance in terms of organisational performance or patient outcomes. We searched for peer-reviewed, English language studies using Medline, Embase and Emerald Management between 2005 and 2017. We included quantitative, qualitative and mixed method empirical studies on the performance of senior healthcare managers where participants were described as doctors or leaders and where comparative performance data were provided on non-medical leaders. Studies without full text available, or no organisational, leadership behaviour or patient measures, were excluded. The search, conducted in Medline (n=3395), Embase (n=1913) and Emerald Management (n=454) databases, yielded 3926 entries. After the application of inclusion and exclusion criteria, 16 studies remained. Twelve studies found that there were positive differences between medical and non-medical leaders, and eight studies correlated those findings with hospital performance or patient outcomes. Six studies examined the composition of boards of directors; otherwise, there were few common areas of investigation. Five inter-related themes emerged from a narrative analysis: the impact of medical leadership on outcomes; doctors on boards; contribution of qualifications and experience; the medical leader as an individual or part of a team and doctors transitioning into the medical leadership role. A modest body of evidence supports the importance of including doctors on organisational governing boards. Despite many published articles on the topic of whether hospitals and healthcare organisations perform better when led by doctors, there were few empirical studies that

  18. Knowledge, awareness and practice of ethics among doctors in tertiary care hospital.

    Singh, Surjit; Sharma, Pramod Kumar; Bhandari, Bharti; Kaur, Rimplejeet


    With the advancement of healthcare and medical research, doctors need to be aware of the basic ethical principles. This cross-sectional study is an attempt to assess the knowledge, awareness, and practice of health-care ethics among health-care professionals. After taking written informed consent, a standard questionnaire was administered to 117 doctors. No personal information was recorded on the questionnaire so as to ensure the confidentiality and anonymity of participants. Data analysis was done using SPSS version 21 (IBM Corp., Armonk, NY, USA). Statistically significant difference observed between the opinions of consultant and senior resident (SRs) on issues like, adherence to confidentiality; paternalistic attitude of doctors (doctors should do their best for the patient irrespective of patient's opinion); doctor's decision should be final in case of disagreement and interest in learning ethics (P ethics. Surprisingly, the response of clinical and nonclinical faculty did not differ as far as awareness and practice of ethics were concerned. The significant difference is observed in the knowledge, awareness, and practice of ethics among consultants and SRs. Conferences, symposium, and workshops, on health-care ethics, may act as a means of sensitizing doctors and thus will help to bridge this gap and protect the well-being and confidentiality of the patients. Such an effort may bring about harmonious change in the doctor-patient relationship.

  19. Effects of coaching supervision, mentoring supervision and abusive supervision on talent development among trainee doctors in public hospitals: moderating role of clinical learning environment.

    Subramaniam, Anusuiya; Silong, Abu Daud; Uli, Jegak; Ismail, Ismi Arif


    Effective talent development requires robust supervision. However, the effects of supervisory styles (coaching, mentoring and abusive supervision) on talent development and the moderating effects of clinical learning environment in the relationship between supervisory styles and talent development among public hospital trainee doctors have not been thoroughly researched. In this study, we aim to achieve the following, (1) identify the extent to which supervisory styles (coaching, mentoring and abusive supervision) can facilitate talent development among trainee doctors in public hospital and (2) examine whether coaching, mentoring and abusive supervision are moderated by clinical learning environment in predicting talent development among trainee doctors in public hospital. A questionnaire-based critical survey was conducted among trainee doctors undergoing housemanship at six public hospitals in the Klang Valley, Malaysia. Prior permission was obtained from the Ministry of Health Malaysia to conduct the research in the identified public hospitals. The survey yielded 355 responses. The results were analysed using SPSS 20.0 and SEM with AMOS 20.0. The findings of this research indicate that coaching and mentoring supervision are positively associated with talent development, and that there is no significant relationship between abusive supervision and talent development. The findings also support the moderating role of clinical learning environment on the relationships between coaching supervision-talent development, mentoring supervision-talent development and abusive supervision-talent development among public hospital trainee doctors. Overall, the proposed model indicates a 26 % variance in talent development. This study provides an improved understanding on the role of the supervisory styles (coaching and mentoring supervision) on facilitating talent development among public hospital trainee doctors. Furthermore, this study extends the literature to better

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

    Wilson Sue


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

  1. Mobile and fixed computer use by doctors and nurses on hospital wards

    Andersen, Pia; Lindgaard, Anne-Mette; Prgomet, M.


    and doctors were observed performing workarounds, such as transcribing medication orders from the computer to paper. CONCLUSIONS: The choice of device was related to clinical role, nature of the clinical task, degree of mobility required, including where task completion occurs, and device design. Nurses' work......, and clinical tasks performed by doctors during ward rounds, require highly mobile computer devices. Nurses and doctors on ward rounds showed a strong preference for generic COWs over all other devices. Tablet PCs were selected by doctors for only a small proportion of clinical tasks. Even when using mobile......BACKGROUND: Selecting the right mix of stationary and mobile computing devices is a significant challenge for system planners and implementers. There is very limited research evidence upon which to base such decisions. OBJECTIVE: We aimed to investigate the relationships between clinician role...

  2. Cutaneous larva migrans in Hospital Kuala Lumpur, Malaysia: rate of correct diagnosis made by the referring primary care doctors.

    Yap, Felix Boon-Bin


    A retrospective study was undertaken to determine the clinical features of cutaneous larva migrans (CLM) seen in the Department of Dermatology, Hospital Kuala Lumpur (Kuala Lumpur, Malaysia) and to assess the rate of correct diagnosis made by the referring primary care doctors. Clinical records of all 31 patients with CLM seen between January 2006 and June 2010 were retrieved. The majority of patients were male. The mean age was 32.2 years. Pruritus was reported in 83.9% of cases and serpiginous tracts in 100%. The mean lesion count was 4.4 and the mean duration of disease before presentation was 3.1 weeks. The majority of skin lesions were on the buttock and lower extremities. Only 45.2% of patients had the correct diagnosis made by the referring primary care doctors. Older age of patients and lower number of lesions were associated with a higher rate of correct diagnosis. The low rate of correct diagnosis made by the referring primary care doctors to the dermatologists in this study warrants the need for education of not only primary care doctors but also future primary care providers, consisting of medical students, house officers and junior medical officers.

  3. Do you agree with the doctor's decision to continue treatment?: A scenario-based study of hospital nurses in Italy

    Francesca Ingravallo


    Full Text Available INTRODUCTION: A lack of social consensus on the duty to comply with a patient's request to forgo treatment was reported in Italy, but little is known about the nurses' attitudes regarding this issue. MATERIALS AND METHODS: Questionnaire including two clinical scenarios regarding doctor's decision to not comply with a competent patient's request to forgo treatment was administered to all nurses (n = 487 of an Italian medium-sized hospital. RESULTS: Eighty-five percent of nurses completed the study. Although 83% of participants supported a general right to self-determination, around 40% of them agreed with the doctor's decision in both scenarios. The multivariate analyses adjusted for gender, age, length of professional experience, and care setting showed that the agreement with the doctor's decision was significantly associated with nurses' personal background beliefs about self-determination and quality of life. DISCUSSION AND CONCLUSIONS: Many nurses have difficulty in accepting a patient's request to forgo treatment. Increasing ethical reflection and discussion at both educational and professional level, and introducing ethical consultation services would be essential to develop a consistent approach to end-of-life decisions in Italian hospitals.

  4. Assessment of the knowledge and attitudes of intern doctors to medication prescribing errors in a Nigeria tertiary hospital.

    Ajemigbitse, Adetutu A; Omole, Moses Kayode; Ezike, Nnamdi Chika; Erhun, Wilson O


    Junior doctors are reported to make most of the prescribing errors in the hospital setting. The aim of the following study is to determine the knowledge intern doctors have about prescribing errors and circumstances contributing to making them. A structured questionnaire was distributed to intern doctors in National Hospital Abuja Nigeria. Respondents gave information about their experience with prescribing medicines, the extent to which they agreed with the definition of a clinically meaningful prescribing error and events that constituted such. Their experience with prescribing certain categories of medicines was also sought. Data was analyzed with Statistical Package for the Social Sciences (SPSS) software version 17 (SPSS Inc Chicago, Ill, USA). Chi-squared analysis contrasted differences in proportions; P Interns were least confident prescribing antibiotics (12, 25.5%), opioid analgesics (12, 25.5%) cytotoxics (10, 21.3%) and antipsychotics (9, 19.1%) unsupervised. Respondents seemed to have a low awareness of making prescribing errors. Principles of rational prescribing and events that constitute prescribing errors should be taught in the practice setting.

  5. Explaining medical disputes in Chinese public hospitals: the doctor-patient relationship and its implications for health policy reforms.

    He, Alex Jingwei; Qian, Jiwei


    In recent years China has witnessed a surge in medical disputes, including many widely reported violent riots, attacks, and protests in hospitals. This is the result of a confluence of inappropriate incentives in the health system, the consequent distorted behaviors of physicians, mounting social distrust of the medical profession, and institutional failures of the legal framework. The detrimental effects of the damaged doctor-patient relationship have begun to emerge, calling for rigorous study and serious policy intervention. Using a sequential exploratory design, this article seeks to explain medical disputes in Chinese public hospitals with primary data collected from Shenzhen City. The analysis finds that medical disputes of various forms are disturbingly widespread and reveals that inappropriate internal incentives in hospitals and the heavy workload of physicians undermine the quality of clinical encounters, which easily triggers disputes. Empirically, a heavy workload is associated with a larger number of disputes. A greater number of disputes are associated with higher-level hospitals, which can afford larger financial settlements. The resolution of disputes via the legal channel appears to be unpopular. This article argues that restoring a healthy doctor-patient relationship is no less important than other institutional aspects of health care reform.

  6. [The new treatment procedure of the German statutory accident insurance: From the perspective of a community hospital].

    Bonnaire, F; Goepel, M; Bula, P


    The requirements of the German statutory accident insurance (DGUV) for the new treatment procedure were presented on 1 January 2013 in a new catalogue. The implementation of the certification of hospitals for the very severe injury procedure (SAV) by the DGUV should have been completed by 2014. These requirements placed high demands on trauma-oriented hospitals because of the high structural and personnel prerequisites. The background to the new organization was the wish of the DGUV for quality improvement in patient treatment in hospitals for patients with very severe occupational and occupation-related trauma by placement in qualified centers with high case numbers. No increase in income was planned for the hospitals to cope with the necessary improvements in quality. After 2 years of experience with the SAV we can confirm for a community hospital that the structural requirements could be improved (e.g. establishment of departments of neurosurgery, plastic surgery and thoracic surgery) but the high requirements for qualification and attendance of physicians on duty are a continuous problem and are also costly. The numbers of severely injured trauma patients have greatly increased, particularly in 2015. The charges for the complex treatment are not adequately reflected in the German diagnosis-related groups system and no extra flat rate funding per case is explicitly planned in the DRG remuneration catalogue. The invoicing of a center surcharge in addition to the DRG charges has not been introduced.

  7. A Retrospective Perinatal Data Analysis of Immigrant and German Women from Representative Birth Cohorts at the Virchow Hospital, Berlin.

    Armbrust, R; von Rennenberg, R; David, M


    Introduction: The aim of this study was to define and characterise differences in the level of obstetric care provided to immigrant and German women. Materials and Methods: An analysis of the Virchow Hospital's birth registers was conducted for the years 1974, 1984 and 1994. The study population of 5445 patients was grouped according to ancestry/family origin on the basis of a name analysis, and subsequently also according to parity (primiparous or multiparous). On name analysis 2741 women were defined as German, 1598 were grouped as women of Turkish origin and 810 as immigrants of other origin. χ(2) tests and Fisher's exact test were used for significance testing (significance level p German primipara and multipara from 1984 onwards. Discussion: This retrospective analysis of three historical birth cohorts showed significant differences in perinatal care between German and immigrant women, presumably reflecting deficits in care. It seems remarkable that this trend has not changed over a time span of three decades despite a continuous increase in immigration and acculturation. A "research paradox", however, remains: Despite these increasing rates, there are no current or older, prospective or systematic studies of obstetric care in immigrants.

  8. Knowledge and attitudes of doctors on medical ethics in a teaching hospital, Manipur.

    Brogen, Akoijam S; Rajkumari, Bishwalata; Laishram, Jalina; Joy, Akoijam


    This study aimed to assess the knowledge of and attitudes to, medical ethics among doctors in the Regional Institute of Medical Sciences (RIMS), Imphal, Manipur. It also looked at the association between levels of knowledge and selected variables. A self-administered structured questionnaire was distributed to all doctors working in RIMS, Imphal between September and October 2007. 315 of 440 (71.6%) doctors contacted, responded. 62.2% of respondents (196) were below 35 years of age. 22.5% (71) were faculty members. 98.7% (311) had heard of the Code of Medical Ethics but only 188 (59.7%) had read it, even in part. 69.2% (218) felt that the undergraduate curriculum on medical ethics was not adequate. 10.5% (33) could describe what medical professionalism meant. Knowledge of medical ethics was higher among those who were over 35 years of age, those who graduated before 1999 and those having higher educational qualifications. The doctors in this survey lacked adequate and detailed knowledge on the code of ethics, though most of them had read it once. There is a need to sensitise doctors on medical ethics and professionalism.

  9. Quality care, public perception and quick-fix service management: a Delphi study on stressors of hospital doctors in Ireland

    Hayes, Blanaid; Fitzgerald, Deirdre; Doherty, Sally; Walsh, Gillian


    Objectives To identify and rank the most significant workplace stressors to which consultants and trainees are exposed within the publicly funded health sector in Ireland. Design Following a preliminary semistructured telephone interview, a Delphi technique with 3 rounds of reiterative questionnaires was used to obtain consensus. Conducted in Spring 2014, doctors were purposively selected by their college faculty or specialty training body. Setting Consultants and higher specialist trainees who were engaged at a collegiate level with their faculty or professional training body. All were employed in the Irish publicly funded health sector by the Health Services Executive. Participants 49 doctors: 30 consultants (13 male, 17 female) and 19 trainees (7 male, 12 female). Consultants and trainees were from a wide range of hospital specialties including anaesthetics, radiology and psychiatry. Results Consultants are most concerned with the quality of healthcare management and its impact on service. They are also concerned about the quality of care they provide. They feel undervalued within the negative sociocultural environment that they work. Trainees also feel undervalued with an uncertain future and they also perceive their sociocultural environment as negative. They echo concerns regarding the quality of care they provide. They struggle with the interface between career demands and personal life. Conclusions This Delphi study sought to explore the working life of doctors in Irish hospitals at a time when resources are scarce. It identified both common and distinct concerns regarding sources of stress for 2 groups of doctors. Its identification of key stressors should guide managers and clinicians towards solutions for improving the quality of patient care and the health of care providers. PMID:26700286

  10. The effectiveness of a 'train the trainer' model of resuscitation education for rural peripheral hospital doctors in Sri Lanka.

    Bishan N Rajapakse

    Full Text Available BACKGROUND: Sri Lankan rural doctors based in isolated peripheral hospitals routinely resuscitate critically ill patients but have difficulty accessing training. We tested a train-the-trainer model that could be utilised in isolated rural hospitals. METHODS: Eight selected rural hospital non-specialist doctors attended a 2-day instructor course. These "trained trainers" educated their colleagues in advanced cardiac life support at peripheral hospital workshops and we tested their students in resuscitation knowledge and skills pre and post training, and at 6- and 12-weeks. Knowledge was assessed through 30 multiple choice questions (MCQ, and resuscitation skills were assessed by performance in a video recorded simulated scenario of a cardiac arrest using a Resuci Anne Skill Trainer mannequin. RESULTS/DISCUSSION/CONCLUSION: Fifty seven doctors were trained. Pre and post training assessment was possible in 51 participants, and 6-week and 12-week follow up was possible for 43, and 38 participants respectively. Mean MCQ scores significantly improved over time (p<0.001, and a significant improvement was noted in "average ventilation volume", "compression count", and "compressions with no error", "adequate depth", "average depth", and "compression rate" (p<0.01. The proportion of participants with compression depth ≥40mm increased post intervention (p<0.05 and at 12-week follow up (p<0.05, and proportion of ventilation volumes between 400-1000mls increased post intervention (p<0.001. A significant increase in the proportion of participants who "checked for responsiveness", "opened the airway", "performed a breathing check", who used the "correct compression ratio", and who used an "appropriate facemask technique" was also noted (p<0.001. A train-the-trainer model of resuscitation education was effective in improving resuscitation knowledge and skills in Sri Lankan rural peripheral hospital doctors. Improvement was sustained to 12 weeks for most

  11. Perceptions of doctors and nurses at a Ugandan hospital regarding the introduction and use of the South African Triage Scale

    Francis Mulindwa


    Full Text Available Background: International Hospital Kampala (IHK experienced a challenge with how to standardise the triaging and sorting of patients. There was no triage tool to help to prioritise which patients to attend to first, with very sick patient often being missed.Aim and setting: To explore whether the introduction of the South African Triage Scale (SATS was seen as valuable and sustainable by the IHK’s outpatient department and emergency unit (OPD and EU staff.Methods: The study used qualitative methods to introduce SATS in the OPD and EU at IHK and to obtain the perceptions of doctors and nurses who had used it for 3–6 months on its applicability and sustainability. Specific questions about challenges faced prior to its introduction, strengths and weaknesses of the triage tool, the impact it had on staff practices, and their recommendations on the continued use of the tool were asked. In-depth interviews were conducted with 4 doctors and 12 nurses.Results: SATS was found to be necessary, applicable and recommended for use in the IHK setting. It improved the sorting of patients, as well as nurse-patient and nurse-doctor communication.The IHK OPD & EU staff attained new skills, with nurses becoming more involved in-patient care. It is possibly also useful in telephone triaging and planning of hospital staffing.Conclusion: Adequate nurse staffing, a computer application for automated coding of patients, and regular training would encourage consistent use and sustainability of SATS. Setting up a hospital committee to review signs and symptoms would increase acceptability and sustainability. SATS is valuable in the IHK setting because it improved overall efficiency of triaging and care, with significantly more strengths than weaknesses.Keywords: South African Triage Scale; Perceptions

  12. A study on the interactions of doctors with medical representatives of pharmaceutical companies in a Tertiary Care Teaching Hospital of South India

    Sandeep Kumar Gupta


    Full Text Available Background: The promotional activities by medical representatives (MRs of the pharmaceutical companies can impact the prescribing pattern of doctors. Hence, the interaction between doctors and the pharmaceutical industry is coming under increasing scrutiny. Objective: The primary objective was to assess the attitude of the doctors toward the interaction with the MRs of the pharmaceutical company. The secondary objective was to assess the awareness of the doctors about regulations governing their interaction with the pharmaceutical company. Materials and Methods: This was a cross-sectional study. This study was carried out using a pretested questionnaire containing 10 questions between June and September 2014. The doctors working in the Dhanalakshmi Srinivasan Medical College and Hospital, Perambalur (Tamil Nadu during the study period was included. Results: A total of 100 pretested questionnaires were distributed, and 81 doctors responded (response rate 81%. 37% doctors responded that they interacted with MR once a week whereas 25.9% told that they interact with MRs twice a month. About 69.1% doctors think that MR exaggerate the benefits of medicines and downplays the risks and contraindications of medicine(P = 0.000. 61.7% doctors think that MR has an impact on their prescribing (P = 0.000. 63% doctors stated that they had received promotional tools such as stationery items, drug sample, textbooks or journal reprints from MR in last 12 months (P = 0.0012. Unfortunately, 70.4% doctors have not read the guidelines about interacting with the pharmaceutical industry or its representative (P = 0.000. Conclusion: Rather than forbidding any connection between doctors and industry, it is better to establish ethical guidelines. The Medical Council of India code is a step in the right direction, but the majority of doctors in this study have not read the guidelines about interacting with the pharmaceutical industry or its representative.

  13. Is social capital as perceived by the medical director associated with coordination among hospital staff? A nationwide survey in German hospitals.

    Gloede, Tristan D; Hammer, Antje; Ommen, Oliver; Ernstmann, Nicole; Pfaff, Holger


    Effective coordination among all members of hospital staff has been shown to be associated with better quality of care. The literature indicates that social capital, a form of organizational resource, may facilitate the task of coordination. However, to the best of our knowledge, no study has yet examined this link within a healthcare setting. Thus, the objective of this study was to analyze the relationship between social capital and coordination among hospital staff, as perceived by the medical director being a key informant of the hospital. In 2008, we surveyed the medical directors of 1224 German hospitals by the use of a standardized questionnaire. We conducted stepwise multivariate linear regression and controlled for hospital size, ownership and teaching status. In total, 551 medical directors (45%) responded to the survey. We found social capital to be a significant predictor of coordination (β = 0.444, p social capital can be associated with better coordination among members of hospital staff, as perceived by the medical director. Therefore, investment in social capital may facilitate better organization of work processes in hospitals and may therefore help to improve patient outcomes. However, longitudinal studies are needed in order to explain the causal relationship between social capital and coordination among hospital staff.

  14. A Study Of Power Relations In Doctor-Patient Interactions In Selected Hospitals In Lagos State, Nigeria

    Qasim Adam


    Full Text Available This paper explores power relations in clinical interactions in Nigeria. It seeks to investigate the use of power between doctors and patients during consultations on patient-centred approach to medicine in selected public and private hospitals in Lagos State, Nigeria. The objective is to establish how doctors' projection of power, using the discourse resources of transitivity, affects positively or negatively their relationship with patients. This study employs triangulation as its methodology. A judicious mix of quantitative and qualitative methods has been utilized to give the  study a scientific shape. Proportionate stratified random sampling and purposive sampling procedures were employed. The study employs the theoretical and analytical paradigms of Systemic Functional Linguistics and Critical Discourse Analysis. The findings revealed that doctors predominantly use this process to the benefit of the patients. Minimal level of intrusive and cooperative interruptions was also observed. It is expected that this study will give more visibility on the best way patients can be empowered by lessening doctors’ use of polar interrogatives and completely avoiding interruptive discourse in clinical interactions

  15. General self-efficacy and the effect of hospital workplace violence on doctors' stress and job satisfaction in China.

    Yao, Yongcheng; Wang, Wei; Wang, Faxuan; Yao, Wu


    This study aims at exploring associations of general self-efficacy (GSE), workplace violence and doctors' work-related attitudes. In this study a cross-sectional survey design was applied. Questionnaires were administrated to 758 doctors working in 9 hospitals of Zhengzhou, Henan province, China, between June and October 2010. General information on age, gender, and years of working was collected, and the doctors' experience and witnessing workplace violence, job satisfaction, job initiative, occupational stress as well as GSE were measured. General linear regression analysis was performed in association analyses. Both experiencing and witnessing workplace violence were significantly positively correlated with the level of occupational stress but significantly negatively correlated with job satisfaction, job initiative, and GSE. General self-efficacy significantly modified relationships between both experiencing and witnessing workplace violence with occupational stress (β = 0.49 for experiencing violence; β = 0.43 for witnessing violence; p 0.05). The levels of occupational stress declined significantly with the increase of GSE, while job satisfaction increased significantly along with its increase. The effects of GSE on occupational stress and job satisfaction weakened as the frequency of violence increased. The findings suggest that GSE can modify effects of workplace violence on health care workers' stress and job satisfaction. Enhancing GSE in combination with stress reduction may lead to facilitating health care workers' recovery from workplace violence, and thereby improving their work-related attitudes.

  16. Sources of drug information and their influence on the prescribing behaviour of doctors in a teaching hospital in Ibadan, Nigeria.

    Oshikoya, Kazeem Adeola; Oreagba, Ibrahim; Adeyemi, Olayinka


    Pharmaceutical drug promotion is a means of informing health professionals about new drugs. The approach is often times unethical and inappropriate and may promote irrational prescribing. Dearth of information on impact of pharmaceutical drug promotion on prescribing behaviour of doctors in developing African countries has necessitated this study. We therefore aimed to determine the sources of drug information for doctors working in a teaching hospital in Nigeria and to assess the self-reported impact of the sources on their prescribing behaviour. A total of 163 doctors working at the University College Hospital (UCH), Ibadan in Nigeria were evaluated with a questionnaire for their demographics and sources of drug information. For doctors who relied on drug promotion, they were asked to self-report and self-rate their opinion on extent of interactions with pharmaceutical companies as well as how such interactions had impacted on their prescribing behaviour. Apart from the demographics, each question was evaluated with a typical five-level Likert item. Data analyses were with simple descriptive statistics. Of the 400 doctors working at UCH, only 40.8% participated in the study. Drug information was sourced from colleagues (161, 98.8%), reference books (158, 96.9%), pharmaceutical sales representatives-PSRs (152, 93.2%), promotion materials (151, 92.6%), scientific papers/journals/internet (149, 91.4%), and drug promotion forum/product launches (144, 88.3%). Each source was highly utilized but there was no wide variation in their pattern of use. According to the self-report of over a half of the respondents, PSRs was an accurate and reliable drug information resource; PSRs increased their awareness of the promoted drugs; and their prescribing behaviours were influenced by information from PSRs. Respondents tend to rely on a broad range of drug information resources which include potentially inappropriate resources such as PSRs. Since this study was based on self

  17. Knowledge gaps about smoking cessation in hospitalized patients and their doctors.

    Raupach, Tobias; Merker, Jacqueline; Hasenfuß, Gerd; Andreas, Stefan; Pipe, Andrew


    BACKGROUND: Hospitalization is an opportune time for smoking cessation support; cessation interventions delivered by hospital physicians are effective. While general practitioners' and outpatients' knowledge and attitudes towards smoking cessation have been studied in great detail, in-patient cessation programmes have received less attention. DESIGN: Questionnaire-based survey of a convenience sample of hospital physicians and in-patients at Göttingen University Hospital, Germany. M...

  18. [The use of benzodiazepines and Z-drugs for patients with sleeping problems - A survey among hospital doctors and nurses].

    Weiß, V; Heinemann, S; Himmel, W; Nau, R; Hummers-Pradier, E


    Aim | Benzodiazepines and Z-drugs are frequently prescribed sleep medications in spite of their poor risk-benefit ratio when used over a longer period of time. The aim of the study was to find out how the medical and nursing staff in a general hospital estimated the frequency of use for these drugs, and the risk-benefit ratio for elderly patients as well as the factors which positively influence the perceived use of these drugs. Methods | All members of the medical and nursing staff of a hospital received a questionnaire about their use of, and attitudes towards, benzodiazepines and Z-drugs. Absolute and relative frequencies were calculated to estimate the perceived frequency of use and the risk-benefit ratio. Multiple logistic regressions were used to analyze which factors are associated with a perceived high use of benzodiazepines or Z-drugs for insomnia. Results | More nurses than hospital doctors believed that they dispensed benzodiazepines often or always (57 % vs. 29 %) to patients with insomnia; this was also the case for Z-drugs (66 % vs. 29 %). Nearly half of the hospital doctors and 29 % of the nurses perceived more harms than benefits for benzodiazepines in the elderly. The following factors were associated with a high perceived usage of Z-drugs: working as a nurse (OR: 13,95; 95%-CI: 3,87-50,28), working in a non-surgical department (5,41; 2,00-14,61), having benzodiazepines, only the perceived positive risk-benefit ratio had an influence on the perceived use (3,35; 1,28-8.79). Conclusion | The medical and nursing staff perceived the frequency of prescription of benzodiazepines and Z-drugs and the risk-benefit ratio in different ways. Other aspects, such as working in a non-surgical department or having a smaller amount of working experience may also influence the decision to use Z-drugs.

  19. [Frequency and assessment of symptoms in hospitalized patient with advanced chronic diseases: is there concordance among patients and doctors?].

    Palma, Alejandra; Del Río, Ignacia; Bonati, Pilar; Tupper, Laura; Villarroel, Luis; Olivares, Patricia; Nervi, Flavio


    Physicians tend to over or underestimate symptoms reported by patients. Therefore standardized symptom scoring systems have been proposed to overcome this drawback. To estimate the prevalence and the diagnostic accuracy of physical and psychological symptoms and delirium in patients admitted to an internal medicine service at a university hospital. We studied 58 patients, 45 with metastasic cancer and 13 with other advanced chronic diseases. The following scales were used: the Confusion Assessment Method for the diagnosis of delirium; the Edmonton Symptom Assessment Scale (ESAS) for pain and other physical symptoms; the Hospital Anxiety and Depression Scale to assess anxiety and depression. The ESAS was simultaneously applied to patients without delirium and their doctors to assess the level of diagnostic concordance. Twenty two percent of patients had delirium. Among the 45 patients without delirium, 11 (25%) had at least eight symptoms and 39 (88.6%) had four symptoms. The prevalence of symptoms was very high, ranging from 22 to 78%. Pain, restlessness, anorexia and sleep disorders were the most common. The concordance between symptoms reported by patients and those recorded by doctor was very low, with a Kappa index between 0.001 and 0.334. In our sample of chronic patients, there is a very high frequency of psychological and physical symptoms that are insufficiently recorded by the medical team.

  20. The role of the hospital in the health policy of the German Social Democratic movement before World War I.

    Labisch, A


    In this article, the author aims to contrast the traditional architecture-oriented history of hospitals with an empirical sociohistorical approach. The main topic discussed is the hospital's role in health policy as seen by German Social Democrats in the late 19th and early 20th centuries. Social democratic hospital policy developed as a compromise between two extreme positions: the party theoretician's abstract ideals on the one side and the rank and file's pragmatic view on the other. Thus, the social history of the hospital can illustrate how, around the turn of the century, the political labor movement in Germany shifted from radical revolutionary aims to pragmatic social reform in everyday political practice. At the same time, the hospital underwent a fundamental social change from a charity institution to a municipal center of modern medical care. This implies that any static or one-sided interpretation of the hospital's history and sociology is inadequate: its social role constantly changes according to broader social change and different interests of social groups and organizations. As for the social history of medicine in general, modern medicine's development can not be adequately understood from the narrow perspective of medical institutions themselves. It has to be seen in the broader context of socioeconomic and sociocultural development.

  1. A Retrospective Perinatal Data Analysis of Immigrant and German Women from Representative Birth Cohorts at the Virchow Hospital, Berlin

    Armbrust, R.; von Rennenberg, R.; David, M.


    Introduction: The aim of this study was to define and characterise differences in the level of obstetric care provided to immigrant and German women. Materials and Methods: An analysis of the Virchow Hospitalʼs birth registers was conducted for the years 1974, 1984 and 1994. The study population of 5445 patients was grouped according to ancestry/family origin on the basis of a name analysis, and subsequently also according to parity (primiparous or multiparous). On name analysis 2741 women were defined as German, 1598 were grouped as women of Turkish origin and 810 as immigrants of other origin. χ2 tests and Fisherʼs exact test were used for significance testing (significance level p episiotomy, higher grade perineal tears and severe postpartum haemorrhage did not differ between the groups. There were however significant differences in the use of uterine stimulants, analgesics in labour and both local and regional anaesthesia, with women of Turkish origin and other immigrants receiving anaesthesia less, but oxytocin more often. Rooming-in was more common among German primipara and multipara from 1984 onwards. Discussion: This retrospective analysis of three historical birth cohorts showed significant differences in perinatal care between German and immigrant women, presumably reflecting deficits in care. It seems remarkable that this trend has not changed over a time span of three decades despite a continuous increase in immigration and acculturation. A “research paradox”, however, remains: Despite these increasing rates, there are no current or older, prospective or systematic studies of obstetric care in immigrants. PMID:27904165

  2. Improving Computer-Mediated Synchronous Communication of Doctors in Rural Communities Through Cloud Computing: A Case Study of Rural Hospitals in South Africa

    Alfred Coleman


    Full Text Available This paper investigated how doctors in remote rural hospitals in South Africa use computer-mediated toolto communicate with experienced and specialist doctors for professional advice to improve on their clinicalpractices. A case study approach was used. Ten doctors were purposively selected from ten hospitals in theNorth West Province. Data was collected using semi-structured open ended interview questions. Theinterviewees were asked to tell in their own words the average number of patients served per week,processes used in consultation with other doctors, communication practices using computer-mediated tool,transmission speed of the computer-mediated tool and satisfaction in using the computer-mediatedcommunication tool. The findings revealed that an average of 15 consultations per doctor to a specialistdoctor per week was done through face to face or through telephone conversation instead of using acomputer-mediated tool. Participants cited reasons for not using computer-mediated tool forcommunication due to slow transmission speed of the Internet and regular down turn of the Internetconnectivity, constant electricity power outages and lack of e-health application software to support realtime computer-mediated communication. The results led to the recommendation of a hybrid cloudcomputing architecture for improving communication between doctors in hospitals.

  3. Determining the agent factors related with time management of responsible doctors and nurses in clinics at Ankara University hospitals.

    Acuner, Ahmet Munir; Nilgun, Sarp; Cifteli, F Gulay


    This research has been planned and conducted as a descriptive scanning model field study in order to determine the agent factors related with time management of doctors and nurses in positions of responsibility at Ankara University hospitals. As data collection instruments; the "Personal Information Form" which has been developed to determine the socio-demographical characteristics of the research group, the questionnaire of "Determining the Time Management Attitudes and Behaviour of Managers, Time Management Opportunities of the Managers, Prodcutive Working Times of the Managers and the Factors Causing Them to Lose Time", developed by Erdem has been used. It has been determined that the time management attitudes and behaviour of doctors, nurses and nurse assistants responsible for clinics are all different. It was found that nurse assistants graduated from pre-undergraduate or high schools are the least conscious of time management. In particular, nurse assistants of 36 years old and over with 21 years of work experience and 11 years of management experience show little awareness of time management. The time losing factors of the research group were found to be unnecessary visitors, lack of materials and the excessive amount of time spent on obtaining the necessary equipment.

  4. Procedural confidence in hospital based practitioners: implications for the training and practice of doctors at all grades

    Tsagkaraki Petroula A


    Full Text Available Abstract Background Medical doctors routinely undertake a number of practical procedures and these should be performed competently. The UK Postgraduate Medical Education and Training Board (PMETB curriculum lists the procedures trainees should be competent in. We aimed to describe medical practitioner's confidence in their procedural skills, and to define which practical procedures are important in current medical practice. Methods A cross sectional observational study was performed measuring procedural confidence in 181 hospital practitioners at all grades from 2 centres in East Anglia, England. Results Both trainees and consultants provide significant service provision. SpR level doctors perform the widest range and the highest median number of procedures per year. Most consultants perform few if any procedures, however some perform a narrow range at high volume. Cumulative confidence for the procedures tested peaks in the SpR grade. Five key procedures (central line insertion, lumbar puncture, pleural aspiration, ascitic aspiration, and intercostal drain insertion are the most commonly performed, are seen as important generic skills, and correspond to the total number of procedures for which confidence can be maintained. Key determinants of confidence are gender, number of procedures performed in the previous year and total number of procedures performed. Conclusion The highest volume of service requirement is for six procedures. The procedural confidence is dependent upon gender, number of procedures performed in the previous year and total number of procedures performed. This has implications for those designing the training curriculum and with regards the move to shorten the duration of training.

  5. Attitudes Toward Euthanasia Among Doctors in a Tertiary Care Hospital in South India: A Cross Sectional study.

    Kamath, Sneha; Bhate, Priya; Mathew, Ginu; Sashidharan, Srijith; Daniel, Anjali B


    Advances in expertise and equipment have enabled the medical profession to exercise more control over the processes of life and death, creating a number of moral and ethical dilemmas. People may live for extended periods with chronic painful or debilitating conditions that may be incurable. This study attempts to study the attitudes of doctors toward euthanasia and the possible factors responsible for these attitudes. A cross-sectional survey of 213 doctors working at a tertiary care hospital was conducted to determine their attitudes toward euthanasia. A self-administered questionnaire was used to assess attitudes and personal perceptions about euthanasia. The Chi square test was used to assess factors influencing attitudes toward euthanasia. A majority of the respondents (69.3%) supported the concept of euthanasia. Relief from unbearable pain and suffering was the most commonly (80.3%) cited reason for being willing to consider the option of euthanasia. Majority of those who were against euthanasia (66.2%) felt that the freedom to perform euthanasia could easily be misused. Disapproval of euthanasia was associated with religious affiliation (Peuthanasia for the relief of unbearable pain and suffering. Religion and speciality appear to be significant in determining attitudes toward euthanasia.

  6. [Successful patient-activated help call for a doctor during in-hospital stay].

    Hansen, Mette Mejlby; Hasselkvist, Birgith; Thordal, Sofie; Riiskjær, Erik; Kelsen, Jens


    Department of Medicine, Randers Regional Hospital, conducted a study of patient-activated help call, involving 1,050 patients with nearly 3,700 days in-hospital stay. Patients were encou-raged to bypass traditional clinical hierarchy of communication when they felt, that their concern was not met by the staff. Three help calls were related to the management of pain. In two cases it resulted in a surgical procedure. A survey including 104 patients revealed that one third reported that patient safety was improved by the initiative and nearly three quarters re-ported that they would be willing to activate the call.

  7. Hospital doctors behave differently, and only by respecting the fundamentals of professional organizations will managers be able to create common goals with professionals.

    Van Dijck, H


    Hospital doctors behave differently from other hospital workers. The general and specific characteristics of the doctors' behavior are described. As professionals, doctors want to make autonomous decisions and more specifically, they negotiate differently. The best description of their negotiation style is one that features multi-actor, multi-issue characteristics. They behave as actors in a network in never-ending rounds of negotiations with variable issues up for discussion: one time you lose, the next you win. A doctor's career starts with a long residency period in which he or she absorbs professional habits. His or her knowledge and way of organizing are implicit. It is hard for him or her to explicitly describe what he or she is doing. This makes it difficult for managers to discuss quality issues with doctors. Dealing with disruptive behavior is not easy either. The difficult tasks of the chief medical officer, who acts as a go-between, are highlighted. Only when managers respect the fundamentals of the professional organization will they be able to create common goals with the professionals. Common goals bring about better care in hospitals.

  8. 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

    Jurke, A; Kock, R; Becker, K; Thole, S; Hendrix, R; Rossen, J; Daniels-Haardt, I; Friedrich, AW


    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

  9. 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

    Jurke, A; Kock, R; Becker, K; Thole, S; Hendrix, R; Rossen, J; Daniels-Haardt, I; Friedrich, AW


    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

  10. [Patients with schizophrenia in forensic-psychiatric hospitals (section 63 German Penal Code) in North Rhine-Westphalia].

    Kutscher, S; Schiffer, B; Seifert, D


    The aim of our study was to determine the development of the number of patients with schizophrenia in detention (section 63 German Penal Code) in North Rhine-Westphalia and the characterization of these patients. Patients with schizophrenia are examined, by using a standardized questionnaire answered by the attending psychiatrist or psychologist (n = 531). During the last 12 years the number of patients with schizophrenia in forensic-psychiatric hospitals has increased three times, whereas the number of patients with other diagnoses heightened only twofold. The patients with schizophrenia showed high rates of psychiatric comorbidities (substance disorders 73.9 %, personality disorders 17.2 %), previous inpatient treatments (78.3 % with a mean of 7.5 stays) and previous convictions (63.4 %). Almost half of these convictions (46.6 %) were violent offences (e. g. assault, homicide). Possible explanations for this development are discussed.

  11. [Hospital Doctors Should Receive Lecture for Sedation According to Joint Commission International].

    Ueshima, Hironobu; Komasawa, Nobuyasu; Kitamura, Akira


    At our hospital, intending to obtaining an approval from the Joint Commission International (JCI), we conducted a workshop on sedation for all staff physicians. A sedation instructor authorized by the Japanese Association for Medical Simulation gave a lecture using the "practice guidelines for sedation and administration of analgesics for non-anesthesiologists", revised in 2002 by the American Society of Anesthesiologists, following which, a test using 10 true-false questions was conducted, while before and after the lecture a questionnaire survey on the sedation lecture was carried out Among 191 physicians attending the lecture, except for one person, 7 or more questions were answered correctly. From the questionnaires, the sedation lectures were also generally accepted favourably. In the test of understanding, the mistakes were mostly in the sections on "sedation evaluation" "intraoperative monitoring" "pharmaceutical knowledge" and "airway management methods". The sedation lecture in the hospital was effective.

  12. Doctors as managers: moving towards general management? The case of unitary management reform in Norwegian hospitals.

    Mo, Tone Opdahl


    The paper seeks to explore whether the development in department management in Norwegian hospitals after the unitary management reform in 2001 constitutes a development in the direction of general management. Interviews were conducted with ten managers from different levels in a large Norwegian university hospital in 2001-2002, as a unitary management model was implemented. There is an emerging change of practice among the physician managers according to this study. The manager function is more explicit and takes a more general responsibility for the department and the professions. However, the managerial function is substantiated by conditions related to the professional field of knowledge, which gives legitimacy within a medical logic. Contact with the clinic is stressed as important, but it is possible to adjust both amount and content of a clinical engagement to the demands of the new manager position. This has both a symbolic and a practical significance, as it involves both legitimacy and identity issues. The paper shows that the institutionalised medical understanding of management has a bearing on managerial reforms. Managerial changes need to relate to this if they are to have consequences for the managerial roles and structures on department level in hospitals. The paper suggests that the future development of this role will depend on the way the collectivist and individualist aspects of responsibility are handled, as well as on the further development of managerial knowledge of physicians.

  13. 基于医方访谈的乡镇卫生院医患信任研究%Study of Doctor-patient Trust in Township Hospitals Based on Doctors' Interview

    刘一; 王晓燕; 于鲁明; 彭迎春; 周慧姊


    Objective To describe the trust status of doctor-patient relationship in township hospitals as well as the influencing factors,then put forward to relevant countermeasures. Methods Purpose sampling method was used to select three towns B,Q and C from a distant outskirt in Beijing as the observation places,according to geographical positions of the township hospitals,town population and cultural level,where the township hospitals were subjected to 3 d spot research by not participato-ry observation method. Besides 12 doctors chosen by purpose sampling method received personal interview. Results The mean score of the doctor-patient relationship evaluation by township doctors was ( 3. 83 ± 0. 58 ) with 5 as the full mark. 9 doctors thought the trust type largely belonged to operational relationship. In terms of trust degree of the patients,6 in 12 doctors thought" so-so",5 doctors thought" high"and 1 was not clear about it. The doctors in township hospitals thought the trust was mainly built on competence(10 persons),on medical ethics(10 persons),on service attitude(4 persons),on genetic relationship (2 persons),on geo-relationship(1 person),on responsibility(1 person). Conclusion Doctors in township hospitals con-clude that patient trust township hospitals more than county doctors,but less than big city hospitals. The trust type toward town-ship hospitals belongs to relationship trust and doctor's competence,moral and attitude are the influencing factors for doctor-pa-tient relationship. Therefore the doctor-patient relationship can be improved by advancing medical technology,increasing public health personnel,strengthening the doctor-patient communication,escalating equipment levels and adding drug types etc.%目的:了解乡镇卫生院医患信任现状及存在的问题,并提出相关对策建议。方法选取北京市北部某远郊区作为研究现场,采用目的抽样法,在综合考虑乡镇卫生院地理位置、乡镇人口及文化发展水

  14. Shopping in Hospitality: Situational Constructions of Customer-Vendor Relationships among Shopping Tourists at a Bazaar on the German-Polish Border

    Busch, Dominic


    This article presents an analysis of a short customer-vendor dialogue between a German couple and a Polish vendor at a food bazaar on the Polish border with Germany. In this situation, interactants have to negotiate and construct framings of hospitality abroad, customer-vendor relations, as well as intercultural relations. It is assumed that…

  15. Shopping in Hospitality: Situational Constructions of Customer-Vendor Relationships among Shopping Tourists at a Bazaar on the German-Polish Border

    Busch, Dominic


    This article presents an analysis of a short customer-vendor dialogue between a German couple and a Polish vendor at a food bazaar on the Polish border with Germany. In this situation, interactants have to negotiate and construct framings of hospitality abroad, customer-vendor relations, as well as intercultural relations. It is assumed that…

  16. All in a day's work: an observational study to quantify how and with whom doctors on hospital wards spend their time.

    Westbrook, Johanna I; Ampt, Amanda; Kearney, Leanne; Rob, Marilyn I


    To quantify time doctors in hospital wards spend on specific work tasks, and with health professionals and patients. Observational time and motion study. 400-bed teaching hospital in Sydney. 19 doctors (seven registrars, five residents, seven interns) in four wards were observed between 08:30 and 19:00 for a total of 151 hours between July and December 2006. Proportions of time in categories of work; proportions of tasks performed with health professionals and patients; proportions of tasks using specific information tools; rates of multitasking and interruptions. The greatest proportions of doctors' time were in professional communication (33%; 95% CI, 29%-38%); social activities, such as non-work communication and meal breaks (17%; 95% CI, 13%-21%), and indirect care, such as planning care (17%; 95% CI, 15%-19%). Multitasking involved 20% of time, and on average, doctors were interrupted every 21 minutes. Most tasks were completed with another doctor (56%; 95% CI, 55%-57%), while 24% (95% CI, 23%-25%) were undertaken alone and 15% (95% CI, 15%-16%) with a patient. Interns spent more time completing documentation and administrative tasks, and less time in direct care than residents and registrars. The time interns spent documenting (22%) was almost double the time they were engaged in direct patient care. Two-thirds of doctors' time was consumed by three work categories: professional communication, social activities and indirect care. Doctors on wards are interrupted at considerably lower rates than those in emergency and intensive care units. The results confirm interns' previously reported dissatisfaction with their level of administrative work and documentation.

  17. The well-being and mental health of male and female hospital doctors in Germany.

    Mache, Stefanie; Klapp, Burghard F; Groneberg, David A


    This study focuses on the associations between subjective well-being and mental health. In addition, gender differences are evaluated. The research was conducted as a cross-sectional online survey using a standardized questionnaire to assess physicians' mental health and well-being. Results have shown moderate scores for mental health and well-being in physicians. In general, male physicians perceive a better well-being and higher mental health score than female physicians. Well-being and mental health should be improved to increase physicians' work ability and subsequently, the quality of treatment and patient satisfaction. Mental health prevention should be more widely implemented in hospitals, and its awareness and early treatment should be encouraged. Mental health interventions might include modifying physicians' daily work schedules, providing curricula on mental health and offering training on the awareness of distress and well-being.

  18. Leveraging on information technology to enhance patient care: a doctor's perspective of implementation in a Singapore academic hospital.

    Ong, B K C


    Information technology (IT) can improve the safety of patient care by minimising prescribing errors and organising patient-specific information from diverse databases. Apart from legibility, prescribing safety is enhanced as online access to databases carrying patient drug history, scientific drug information and guideline reference, and patient-specific information is available to the physician. Such specific information includes discharge summaries, surgical procedure summaries, laboratory data and investigation reports. In addition, decision support and prompts can be built in to catch errant orders. For such system implementations to work, the IT backbone must be fast, reliable and simple to use. End-user involvement and ownership of all aspects of development are key to a usable system. However, the hospital leadership must also have the will to mandate and support these development efforts. With such support, the design and implementation team can then map out a strategy where the greatest impact is achieved in both safety and enhanced information flow. The system should not be considered a finished work, but a continual work in progress. The National University Hospital's continuously updated Computerised Patient Support System (CPSS) is an example of an IT system designed to manage information and facilitate prescribing. It is a client-server based, one-point ordering and information access portal for doctors that has widespread adoption for drug prescription at outpatient and discharge medication usage areas. This system has built in safety prompts and rudimentary decision support. It has also become the choice means of accessing patient-related databases that impact on diagnoses and management.

  19. A survey of the attitude and practice of research among doctors in Riyadh Military Hospital primary care centers, Saudi Arabia

    Saad H Al-Abdullateef


    Full Text Available Objectives: To assess the attitude and practice of doctors in the Military Hospital Primary Care Centers in Riyadh (RMH toward research and to identify the main barriers to conduct research. Materials and Methods: A cross-sectional study was conducted from March to April, 2010, at RMH primary care centers. The sample included all general practitioners (GPs working in primary healthcare centers. A self-administered questionnaire was formulated from different sources and used as a tool for data collection. Results: The response rate was 75%. Among the respondents 96.9% agreed that research in primary care was important for different reasons. Most of the GPs had a positive attitude toward research: 68% had been influenced by research in their clinical practice and 66% had an interest in conducting research, and74.2% of the respondents had plans to do research in the future. Insufficient time was the most frequently cited barrier (83.5% for participating in research, followed by the lack of support (58.8%. Conclusions: Many of the GPs had a positive attitude toward research, but had no publications or plan for new research. Lack of time, support, and money were the main constraints for carrying out research.

  20. A mixed methods pilot study to investigate the impact of a hospital-specific iPhone application (iTreat) within a British junior doctor cohort.

    Payne, Karl Fb; Weeks, Lucy; Dunning, Paul


    We present a pilot study to investigate the impact of introducing a hospital-specific smartphone application into a cohort of British junior doctors. We created the iPhone application 'iTreat' that contained disease management and antibiotic dosing guidelines specific to our hospital, together with a postgraduate education department really simple syndication feed, a contact number phonebook and a favourites section. This intervention was trialled in a group of 39 foundation grade junior doctors, in a UK hospital, for a time period of 4 months. Mixed methods data capture, utilising survey and semi-structured interviews, was used to evaluate application usage patterns and potential barriers to endorsement of smartphone technology in the hospital setting. Sixty eight per cent of participants felt the application saved them time during clinical activities, with a decrease in the frequency of participants not referring to hospital clinical guidelines. The findings from this pilot study point towards the internal hospital environment as having a major impact upon smartphone usage. Participants viewed smartphone use as unprofessional in the ward-based setting, with a perceived negative attitude from other healthcare staff. An understanding of how healthcare staff choose to utilise smartphones in the clinical environment is crucial to enable the successful assimilation of smartphone technology into the hospital setting. This pilot study provides experience and parameters for future substantive studies being carried out by this group.

  1. Implementing clinical ethics in German hospitals: content, didactics and evaluation of a nationwide postgraduate training programme.

    Dörries, Andrea; Simon, Alfred; Neitzke, Gerald; Vollmann, Jochen


    The Hannover qualifying programme 'ethics consultation in hospitals', conducted by a four-institution cooperation partnership, is an interdisciplinary, scientifically based programme for healthcare professionals interested in ethics consultation services and is widely acknowledged by hospital managements and healthcare professionals. It is unique concerning its content, scope and teaching format. With its basic and advanced modules it has provided training and education for 367 healthcare professionals with 570 participations since 2003 (until February 2010). One characteristic feature is its attractiveness for health professionals from different backgrounds. Internationally, the Hannover programme is one of the few schedules with both academics and non-academics as target groups and a high participation rate of physicians. The concept of the Hannover programme is in great demand, and its schedule is continuously optimised through evaluation. The goals of enabling healthcare professionals from different professional backgrounds to define and reflect ethical problems, to facilitate and support the process of decision-making and to work out structures for their own institutions seem to have been achieved. However, in order to obtain effective and sustainable results, participation in the programme should be supplemented regularly by in-house training sessions or individual expert consultations. Future challenges include new thematic courses and providing a network for former participants, especially when they come from non-academic hospitals. The network is a reasonable platform to discuss participants' experiences, successes and pitfalls. A further task will be research on how the programme's concept can support the sustainability of ethics structures in the various institutions.

  2. A Survey on The Knowledge, Attitude and Confidence Level of Adult Cardiopulmonary Resuscitation Among Junior Doctors in Hospital Universiti Sains Malaysia and Hospital Raja Perempuan Zainab II, Kota Bharu, Kelantan, Malaysia.

    Chew F Z A W M N, K S; Mohd Hashairi, F; Ida Zarina, Z; Shaik Farid, A W; Abu Yazid, M N; Nik Hisamuddin, N A R


    Junior doctors are often the "first line" doctors called to attend to patients in cardiac arrest. We performed an anonymous questionnaire study from October 2008 to December 2008 to assess the knowledge, attitude and skill of cardiopulmonary resuscitation among junior doctors in Hospital Universiti Sains Malaysia and Hospital Raja Perempuan Zainab II. Out of the 100 questionnaire forms sent out, 70 were returned completed. The majority (85.8%) stated that they were not confident of managing a resuscitation case. There was a statistically significant (p<0.001) association between duration of clinical practice and confidence level. Up to 77.1% said that BLS should be re-certified every two years.

  3. IT adoption of clinical information systems in Austrian and German hospitals: results of a comparative survey with a focus on nursing

    Schaubmayr Christine


    Full Text Available Abstract Background IT adoption is a process that is influenced by different external and internal factors. This study aimed 1. to identify similarities and differences in the prevalence of medical and nursing IT systems in Austrian and German hospitals, and 2. to match these findings with characteristics of the two countries, in particular their healthcare system, and with features of the hospitals. Methods In 2007, all acute care hospitals in both countries received questionnaires with identical questions. 12.4% in Germany and 34.6% in Austria responded. Results The surveys revealed a consistent higher usage of nearly all clinical IT systems, especially nursing systems, but also PACS and electronic archiving systems, in Austrian than in German hospitals. These findings correspond with a significantly wider use of standardised nursing terminologies and a higher number of PC workstations on the wards (average 2.1 PCs in Germany, 3.2 PCs in Austria. Despite these differences, Austrian and German hospitals both reported a similar IT budget of 2.6% in Austria and 2.0% in Germany (median. Conclusions Despite the many similarities of the Austrian and German healthcare system there are distinct differences which may have led to a wider use of IT systems in Austrian hospitals. In nursing, the specific legal requirement to document nursing diagnoses in Austria may have stimulated the use of standardised terminologies for nursing diagnoses and the implementation of electronic nursing documentation systems. Other factors which correspond with the wider use of clinical IT systems in Austria are: good infrastructure of medical-technical devices, rigorous organisational changes which had led to leaner processes and to a lower length of stay, and finally a more IT friendly climate. As country size is the most pronounced difference between Germany and Austria it could be that smaller countries, such as Austria, are more ready to translate innovation into

  4. Creating opportunities for interdisciplinary collaboration and patient-centred care: how nurses, doctors, pharmacists and patients use communication strategies when managing medications in an acute hospital setting.

    Liu, Wei; Gerdtz, Marie; Manias, Elizabeth


    This paper examines the communication strategies that nurses, doctors, pharmacists and patients use when managing medications. Patient-centred medication management is best accomplished through interdisciplinary practice. Effective communication about managing medications between clinicians and patients has a direct influence on patient outcomes. There is a lack of research that adopts a multidisciplinary approach and involves critical in-depth analysis of medication interactions among nurses, doctors, pharmacists and patients. A critical ethnographic approach with video reflexivity was adopted to capture communication strategies during medication activities in two general medical wards of an acute care hospital in Melbourne, Australia. A mixed ethnographic approach combining participant observations, field interviews, video recordings and video reflexive focus groups and interviews was employed. Seventy-six nurses, 31 doctors, 1 pharmacist and 27 patients gave written consent to participate in the study. Data analysis was informed by Fairclough's critical discourse analytic framework. Clinicians' use of communication strategies was demonstrated in their interpersonal, authoritative and instructive talk with patients. Doctors adopted the language discourse of normalisation to standardise patients' illness experiences. Nurses and pharmacists employed the language discourses of preparedness and scrutiny to ensure that patient safety was maintained. Patients took up the discourse of politeness to raise medication concerns and question treatment decisions made by doctors, in their attempts to challenge decision-making about their health care treatment. In addition, the video method revealed clinicians' extensive use of body language in communication processes for medication management. The use of communication strategies by nurses, doctors, pharmacists and patients created opportunities for improved interdisciplinary collaboration and patient-centred medication

  5. Awareness of HIV testing guidelines is low among Swiss emergency doctors: a survey of five teaching hospitals in French-speaking Switzerland.

    Katharine E A Darling

    Full Text Available BACKGROUND: In Switzerland, 30% of HIV-infected individuals are diagnosed late. To optimize HIV testing, the Swiss Federal Office of Public Health (FOPH updated 'Provider Induced Counseling and Testing' (PICT recommendations in 2010. These permit doctors to test patients if HIV infection is suspected, without explicit consent or pre-test counseling; patients should nonetheless be informed that testing will be performed. We examined awareness of these updated recommendations among emergency department (ED doctors. METHODS: We conducted a questionnaire-based survey among 167 ED doctors at five teaching hospitals in French-Speaking Switzerland between 1(st May and 31(st July 2011. For 25 clinical scenarios, participants had to state whether HIV testing was indicated or whether patient consent or pre-test counseling was required. We asked how many HIV tests participants had requested in the previous month, and whether they were aware of the FOPH testing recommendations. RESULTS: 144/167 doctors (88% returned the questionnaire. Median postgraduate experience was 6.5 years (interquartile range [IQR] 3; 12. Mean percentage of correct answers was 59 ± 11%, senior doctors scoring higher (P=0.001. Lowest-scoring questions pertained to acute HIV infection and scenarios where patient consent was not required. Median number of test requests was 1 (IQR 0-2, range 0-10. Only 26/144 (18% of participants were aware of the updated FOPH recommendations. Those aware had higher scores (P=0.001 but did not perform more HIV tests. CONCLUSIONS: Swiss ED doctors are not aware of the national HIV testing recommendations and rarely perform HIV tests. Improved recommendation dissemination and adherence is required if ED doctors are to contribute to earlier HIV diagnoses.

  6. Medical aspects of renewable energy shown by the example of German hospitals; Umweltmedizinische Gesichtspunkte der regenerativen Energieerzeugung am Beispiel deutscher Krankenhaeuser

    Waschnewski, R.


    To what extend are renewable energy sources used in German hospitals? This is the main objective, this is paper is dealing with. The energy consumption profile is very specific in hospitals. In a questionnaire based study, 79 hospitals have been questioned to elucidate the current situation in German hospitals with respect to energy consumption, and to get an idea of the proportion of alternative energy sources already in use. Our analysis reveals that 14% of the hospitals analysed are already using renewable energy sources. Main sources already utilized are photovoltaic, solar thermal devices, and to a lower extend geothermic energy as well comes into operation. Almost three quarters of the questioned institutions claim, they are aware of funding possibilities and the option of contracting with respect to providing financial support in relation to aquisition of new establishments of alternative energy systems within their institution. Roughly half of the hospital's technical supervisors are aware of the precise energy potential of their institution. The situation about information and awareness with respect to possibilities related to the usage of green energy is deficient and should be improved, but the openness with respect to the topic in general seems to be very positive and advantage of that climate should be taken. Our survey allowed to get an initial estimate on the green energy situation in German hospitals. The focus of the discussion is channeled towards the environmental aspects of the energy production. The survey data allow to conclude that the current information situation is deficient. The data further provide insight into what are the main barriers with respect to the use of renewable energy. Based on our results future analyses can not focus on specific aspects and further evaluate approaches allowing to extend the usage of alternative energy sources in hospitals. (orig.)

  7. Nursing in the information age: status quo and future of ICT use in German hospitals.

    Hübner, Ursula; Sellemann, Björn


    Hospital information systems (HIS) should give support to nurses in their clinical and managerial duties. Though there are statistical data on the current use of HIS systems we know only little about the numbers of nursing modules implemented. We therefore conducted a nationwide survey in Germany (n = 2182) on the current state and future plans of HIS modules including nursing applications (response rate of 27.6 %). The findings show that management applications (84 % accounting) are still more frequent than clinical applications, in particular clinical patient record systems (19 %). What applied for HIS modules in general held also true for nursing on a lower level. Whereas 51 % of the hospitals had rostering systems in place only 6 % used care planning software. Priorities and plans for the future reveal no change in the rank order of systems. We argue that in order for clinical documentation and planning systems to catch up they must be immediately rewarding for the clinicians in their daily need for information

  8. A time study of physicians' work in a German university eye hospital to estimate unit costs.

    Jan Wolff

    Full Text Available Technical efficiency of hospital services is debated since performance has been heterogeneous. Staff time represents the main resource in patient care and its inappropriate allocation has been identified as a key factor of inefficiency. The aim of this study was to analyse the utilisation of physicians' work time stratified by staff groups, tasks and places of work. A further aim was to use these data to estimate resource use per unit of output.A self-reporting work-sampling study was carried during 14-days at a University Eye Hospital. Staff costs of physicians per unit of output were calculated at the wards, the operating rooms and the outpatient unit.Forty per cent of total work time was spent in contact with the patient. Thirty per cent was spent with documentation tasks. Time spent with documentation tasks declined monotonically with increasing seniority of staff. Unit costs were 56 € per patient day at the wards, 77 € and 20 € per intervention at the operating rooms for inpatients and outpatients, respectively, and 33 € per contact at the outpatient unit. Substantial differences in resources directly dedicated to the patient were found between these locations.The presented data provide unprecedented units costs in inpatient Ophthalmology. Future research should focus on analysing factors that influence differences in time allocation, such as types of patients, organisation of care processes and composition of staff.

  9. Multicentre investigation of carbapenemase-producing Escherichia coli and Klebsiella pneumoniae in German hospitals.

    Kaase, Martin; Schimanski, Sven; Schiller, Reinhold; Beyreiß, Bettina; Thürmer, Alexander; Steinmann, Jörg; Kempf, Volkhard A; Hess, Christina; Sobottka, Ingo; Fenner, Ines; Ziesing, Stefan; Burckhardt, Irene; von Müller, Lutz; Hamprecht, Axel; Tammer, Ina; Wantia, Nina; Becker, Karsten; Holzmann, Thomas; Furitsch, Martina; Volmer, Gabriele; Gatermann, Sören G


    Aim of this study was to determine the incidence and molecular epidemiology of carbapenemase-producing Escherichia coli and Klebsiella pneumoniae in Germany. E. coli and K. pneumoniae isolates from clinical samples which were non-susceptible to carbapenems were collected in laboratories serving 20 hospitals throughout Germany from November 2013 to April 2014. The isolates were tested for the presence of carbapenemases by PCR and phenotypic methods and typed by multilocus sequence typing. Risk factors including a previous hospitalization abroad were analysed. Carbapenemases were detected in 24 isolates from 22 patients out of 464,514 admissions. Carbapenemases included OXA-48 (n=14), KPC-2 (n=8) and NDM-1 (n=2). Except for two K. pneumoniae isolates with ST101, all OXA-48 producing strains belonged to different clones. In contrast, half of KPC-2 producing K. pneumoniae were of ST258 and both NDM-1 producing strains were of ST11. Compared to carbapenem-susceptible controls, patients with carbapenemase-producing strains differed by a significantly higher proportion of males, a higher proportion of isolates from wound samples and a more frequent previous stay abroad in univariate analysis. This multicentre study demonstrated an incidence of carbapenemase-producing E. coli and K. pneumoniae from clinical samples in Germany of 0.047 cases per 1000 admissions. OXA-48 was more frequent than KPC-2 and NDM-1 and showed a multiclonal background.

  10. [Requirements for the prevention of nosocomial infections. German Guideline 2009 and reality. Current data from hospitals in Frankfurt am Main, Germany].

    Heudorf, U; Exner, M


    In 2009, the new directive of the German Commission for Hospital Hygiene and Infection Prevention (Kommission für Krankenhaushygiene und Infektionsprävention, KRINKO) entitled Human and Organizational Requirements for the Prevention of Nosocomial Infections was published, including detailed information on the needs of hygiene professionals in hospital settings. Compared to the needs calculated according to the above policy, the current staff hygiene health professionals (HHPs) in the hospitals of Frankfurt am Main (Frankfurt/M), Germany, was on average 27.6%: 36% in the large hospitals (>600 beds), 21.6% in medium hospitals (300-600 beds), and 19.8% in small hospitals (hospitals had a full-time hygienist. The demands of the KRINKO policy have not been met by any of the hospitals. Hospitals with lower percentages of hospital hygiene staff not only had a lower rating of hygienic quality, they also showed a lower usage of hand disinfection per patient-day. In Germany, there is currently a lack of trained HHPs and hygienists to meet the needs of the KRINKO policy. Therefore, the reactions of the hospitals in Frankfurt/M ranged from the establishment of additional jobs for HHPs to changes in structures and organization of hospital hygiene. Thus, the new KRINKO guideline in Frankfurt/M did not result in a wave of recruitment of health professionals, but at least resulted in organizational and structural improvements in hygiene.

  11. Exposure to coughed airborne pathogens in a double bed hospital patient room with overhead mixing ventilation: impact of posture of coughing patient and location of doctor

    Kierat, W.; Bolashikov, Zhecho Dimitrov; Melikov, Arsen Krikor


    The exposure of a doctor and a patient to air coughed by a second infected patient was studied in a mock-up of two-bed hospital infectious ward with mixing ventilation at 22oC (71.6 F) room air temperature. The effect of posture of the coughing patient lying sideways or on back), position...... with a cough generator. Another heated dummy was used to simulate the second patient in the second bed. The cough consisted of 100% CO2. The Peak Cough Time was 4 s, when the doctor was close to coughing patient and increased more than twice for the exposed patient. The level of exposure (Peak Concentration...... Level) depends on the positioning relative to the cough direction: lying or standing still, facing or turned sideways and changed varied 194 to 10228 ppm. Ventilation rates of 12 h-1 (recommended by present hospital standards) resulted in increased background exposure levels and may suggest risk from...

  12. A Study of Workplace Violence Experienced by Doctors and Associated Risk Factors in a Tertiary Care Hospital of South Delhi, India

    Kumar, Mukesh; Das, Timiresh; Pardeshi, Geeta; Kishore, Jugal; Padmanandan, Arun


    Introduction The increasing incidences of violence against doctors in their workplaces are an important reason for stress among these healthcare workers. Many incidences of workplace violence against doctors have been reported in the past and are also being continuously reported from different parts of the country as well as the world. Aim To determine the prevalence of workplace violence among doctors and to study the associated risk factors in a tertiary care hospital of Delhi, India. Material and Methods A cross-sectional study was conducted using a self-administered semi-structured questionnaire. The contents were: data related to the workplace, incidences at work, violence prevention policy of the institution, reporting of incidences and follow-up, education and training for violence management. A total of 151 doctors participated in the study. Results Total participants in the study were 151. The mean age of study participants was 26.73±4.24 years. Almost half (47.02%; 44.56% of males and 50.84% of females) of the doctors reported having an experience of violence during work hours in past 12 months. Among the cases, 39.4% were reported from Department of Obstetrics and Gynaecology while Surgery, Medicine and other departments reported 29.6%, 26.8% and 4.2% respectively. Patients or their relatives were perpetrators in most of the cases. Maximum (87.3%) of the reported cases were of verbal violence while 8.6% of the cases were of physical violence. Younger doctors with less work experience were more prone to physical violence. Regarding the time of violence, 35.1% of such cases occurred during afternoon while 30.1% of them took place at night. Conclusion A large number of doctors had experienced violence in past 12 months in a tertiary care hospital of South Delhi, India. Verbal violence came out to be most common form of violence experienced by the doctors. Afternoon or night hours were the timings when majority of such cases were reported. PMID:28050406

  13. A survey of blood utilization in children and adolescents in a German university hospital.

    Zimmermann, R; Handtrack, D; Zingsem, J; Weisbach, V; Neidhardt, B; Glaser, A; Eckstein, R


    There are no detailed data on blood use with regard to diagnoses of recipients during infancy, childhood and adolescence. Available information on this issue is incomplete and no longer current. We conducted a survey of blood component use in children and adolescents in an acute-care university hospital in the greater area of Nuremberg between June 1994 and September 1996. Packed red blood cells (RBCs), fresh-frozen plasmas (FFPs) and platelet (PLT) components were evaluated for the recipients discharge diagnoses. Source study files were extracted from the hospital transfusion service and the medical records department. Transfused units were listed by broad diagnostic categories and leading diagnostic groups formed from principal diagnoses of the recipients according to the International Classification of Diseases, 9th edn (ICD-9). 34.3% of 2869 RBC cell units, 35.0% of 1095 FFP units and 5.0% of 1028 PLT components were used in patients with congenital diseases, mainly cardiac defects. The disease category neoplastic diseases was next most frequently associated with blood transfusion diagnosed in recipients of 23.9% of all RBCs, 15.6% of all FFP units and in 66.4% of all PLT units. Malignant diseases and benign haematological diseases (diagnostic categories II and IV) accounted for 68.9% of all costs of blood component transfusion. These findings demonstrate the increased importance of platelet transfusion for the organization of local and regional blood donation programmes and for cost analysis exercises. The study shows that detailed information on local blood use may be obtained quickly using available data collections of transfusion services and medical record departments.

  14. Web-based Training an deutschen Universitäts-Augenkliniken – Lehre 2.0? [Web-based Training in German University Eye Hospitals – Education 2.0?

    Handzel, Daniel M.


    Full Text Available [english] Purpose: To analyse web-based training in ophthalmology offered by German university eye hospitals. Methods: In January 2010 the websites of all 36 German university hospitals were searched for information provided for visitors, students and doctors alike. We evaluated the offer in terms of quantity and quality. Results: All websites could be accessed at the time of the study. 28 pages provided information for students and doctors, one page only for students, three exclusively for doctors. Four pages didn’t offer any information for these target groups. The websites offered information on events like congresses or students curricular education, there were also material for download for these events or for other purposes. We found complex e-learning-platforms on 9 pages. These dealt with special ophthalmological topics in a didactic arrangement. In spite of the extensive possibilities offered by the technology of Web 2.0, many conceivable tools were only rarely made available. It was not always possible to determine if the information provided was up-to-date, very often the last actualization of the content was long ago. On one page the date for the last change was stated as 2004. Conclusion: Currently there are 9 functional e-learning-applications offered by German university eye hospitals. Two additional hospitals present links to a project of the German Ophthalmological Society. There was a considerable variation in quantity and quality. No website made use of crediting successful studying, e.g. with CME-points or OSCE-credits. All German university eye hospitals present themselves in the World Wide Web. However, the lack of modern, technical as well as didactical state-of-the-art learning applications is alarming as it leaves an essential medium of today’s communication unused. [german] Zielsetzung: Analyse der webbasierten ophthalmologischen Lernprogramme, welche von den Internetseiten der Universitäts-Augenkliniken in

  15. Evaluation of the Patients, Doctors and Nurses View Points about Patient Bill of Rights in Rasht Public Hospitals

    Zahra Bostani Khalesi


    Full Text Available Background & Objective: With the aim to clarify the rights of the patients on the basis of medical ethic norms, Patient Bill of Rights in five categories was developed in Iran for the first time, during 2002. The main objective of this study was to determine the views of patients, physicians and nurses about this aspect of medical ethics and its necessary to comply in Rasht public hospitals. Materials &Methods: In this cross-sectional study the data were collected by filling a reliable and validated questionnaire consisting of demographic part and 25 specific questions about the rights of patients, these questions were answered By 185 patients, 22 nurses and 14 doctors. Each of the criteria necessary to use was measured by the Likert scale from zero (completely disagree to five (fully agree. SPSS software 16 and one way ANOVA tests were used for data analysis. Result: The results showed that all groups were agreeing with the necessity to have a bill and consider the patient's rights during treatment (P<0.05. But the most controversial point were related to the rights of patient to have access to their information and the right to choose and decide (P<0.05. However, 68.2 percent of physicians, 80.05 percent of nurses, and 93 percent of patients were agreed with the Bill of Rights. Conclusion: Although all the groups were agreed with the patient's Bill of rights (P<0.05, It seems it is necessary to reconsider the issue of providing the necessary information to the patient and give attention to their choices and decisions by the medical health service providers.

  16. Measures undertaken in the German Armed Forces Field Hospital deployed in Kosovo to contain a potential outbreak of Crimean-Congo hemorrhagic fever.

    Frangoulidis, Dimitrios; Meyer, Hermann


    During May and June 2001, the World Health Organization reported an outbreak of Crimean-Congo hemorrhagic fever in Kosovo. Two of the outbreak foci were located within the German Kosovo Force's zone of responsibility and thus countermeasures were undertaken at the German field hospital in Prizren to prepare for a potential outbreak among soldiers. A risk assessment was undertaken and the following essential issues were addressed: the education of troops with emphasis given to the prevention of tick bites, the establishment of an isolation unit, including barrier nursing and technical safety measures, the establishment of procedures for the safe handling of biological specimens intended for laboratory diagnosis, protocols for the treatment and prophylaxis with ribavirin, protocols for effective disinfection and decontamination, and an "outbreak plan" should the disease spread among soldiers. Using Army Mobile Field Hospital System equipment, a plan was implemented within 72 hours. The procedures described herein are likely to be suitable for the containment of other highly contagious diseases.

  17. Involuntary medication, seclusion, and restraint in German psychiatric hospitals after the adoption of legislation in 2013

    Erich eFlammer


    Full Text Available Background: Involuntary medication in psychiatric treatment of inpatients is highly controversial. While laws regulating involuntary medication have been changed in Germany, no data has been available to date on how often involuntary medication is actually applied. Recently, our hospital group introduced specific routine documentation of legal status and application of involuntary medication in the patients’ electronic records, which allows the assessment of the frequency of involuntary medication.Method: For the year 2014, we extracted aggregated data from the electronic database on age, sex, psychiatric diagnosis, legal status during admission, kind of coercive measure (mechanical restraint, seclusion, and involuntary medication applied, and the number and duration of seclusion and restraint episodes for seven study sites.Results: A total of 1,514 (9.6% of 15,832 admissions were involuntary. At least one coercive measure was applied in 976 (6.2% admissions. Seclusion was applied in 579 (3.7% admissions, mechanical restraint was applied in 529 (3.3% admissions, and involuntary medication was applied in 78 (0.5% admissions. Two-thirds of involuntary medications were applied in cases of emergency; the remainder was applied after a formal decision by a judge. In 55 (70.5% of the admissions with involuntary medication, at least one other coercive measure (seclusion, restraint, or both was applied as well.Conclusion: Involuntary medication is rarely applied and less frequent than seclusion or mechanical restraint, possibly as a consequence of recent legal restrictions.

  18. The current state of physical activity and exercise programs in German-speaking, Swiss psychiatric hospitals: results from a brief online survey.

    Brand, Serge; Colledge, Flora; Beeler, Nadja; Pühse, Uwe; Kalak, Nadeem; Sadeghi Bahmani, Dena; Mikoteit, Thorsten; Holsboer-Trachsler, Edith; Gerber, Markus


    Physical activity and exercise programs (PAEPs) are an important factor in increasing and maintaining physical and mental health. This holds particularly true for patients with psychiatric disorders undergoing treatment in a psychiatric hospital. To understand whether the benefits reported in the literature are mirrored in current treatment modalities, the aim of the present study was to assess the current state of PAEPs in psychiatric hospitals in the German-speaking part of Switzerland. All psychiatric hospitals (N=55) in the German-speaking part of Switzerland were contacted in spring 2014. Staff responsible for PAEPs were asked to complete an online questionnaire covering questions related to PAEPs such as type, frequency, staff training, treatment rationale, importance of PAEPs within the treatment strategy, and possible avenues to increase PAEPs. Staff members of 48 different psychiatric hospitals completed the survey. Hospitals provided the following therapeutic treatments: relaxation techniques (100%), sports therapy (97%), activity-related psychotherapeutic interventions (95%), physiotherapy (85%), body therapies (59%), far-east techniques (57%), and hippotherapy (22%). Frequencies ranged from once/week to five times/week. Approximately 25% of patients participated in the PAEPs. Interventions were offered irrespective of psychiatric disorders. PAEP providers wanted and needed more vocational training. All participating psychiatric hospitals offer a broad variety of PAEPs in their treatment curricula. However, the majority of inpatients do not participate in PAEPs. Furthermore, those who do participate cannot continue to do so following discharge. PAEP providers need specific extended vocational trainings and believe that the potential of PA should be improved.

  19. Attitudes toward euthanasia among doctors in a tertiary care hospital in South India: A cross sectional study

    Sneha Kamath


    Conclusions: A majority of the doctors in this study supported euthanasia for the relief of unbearable pain and suffering. Religion and speciality appear to be significant in determining attitudes toward euthanasia.

  20. Relação entre enfermeiros e médicos em hospital escola: a perspectiva dos médicos Professional relationship between nurses and doctors at the hospital of medical school: the view of doctors

    Ana Maria de Oliveira


    determine, in the view of physicians, the existence of conflict in the relationship between them and nurses at the Hospital das Clinicas, Universidade Federal de Goiás (HC / UFG and what factors are associated with it. To this goal, 30 doctors completed a questionnaire with demographic data and questions about the variables that affect the relationship, using a Lickert scale. Among the results, the average of age is 42.7 years, 50% of participants are female and 93.3% of the respondents worked elsewhere. The average of years of working in the HC is 16.3. Concerning to the conflict, we highlighted four factors of conflict prevention (Pc, with Middle Ranking (RM greater than 3.0, and two others generators of conflict (2Gc. These factors are: Interprofessional Communication (RM=3.03; Autonomy in Team (RM=3.63; Interprofessional Relationship (RM=3.36; Working Conditions (RM=2.26, Influence of Hospital as a School (RM=2.83 and Patient Benefits (RM = 3,93. We concluded that in the analyzed reality the conflict is considered non-existent, because there is a favorable ratio of protective factors (4Pc:2Gc, but it is imminent, due to the persistence of factors that can unleash it ("Working Conditions" and "Influence of Hospital as a School ". Moreover, there is power struggle with nursing, which can unbalance the situation and create ethical problems.

  1. Does increased prehospital replacement volume lead to a poor clinical course and an increased mortality? A matched-pair analysis of 1896 patients of the Trauma Registry of the German Society for Trauma Surgery who were managed by an emergency doctor at the accident site.

    Hussmann, Bjoern; Lefering, Rolf; Waydhas, Christian; Touma, Alexander; Kauther, Max D; Ruchholtz, Steffen; Lendemans, Sven


    Severe bleeding after trauma frequently leads to a poor outcome. Prehospital fluid replacement therapy is regarded as an important primary treatment option. Our study aimed to assess the influence of prehospital fluid replacement therapy on the post-traumatic course of severely injured patients in a retrospective analysis of matched pairs. The data of 51,425 patients of the Trauma Registry of the German Society for Trauma Surgery were analysed. The following patients were included: Injury Severity Score ≥ 16 points, primary admission, age ≥ 16 years, no isolated brain injury, transfusion of at least one unit of packed red blood cells (pRBC), systolic blood pressure ≥ 60 mmHg at the accident site. The patients were divided into two groups according to the following matched-pair criteria (low-volume: 0-1500 ml prehospital volume replaced; high-volume: ≥ 1501 ml prehospital volume): intubation at the accident site (yes/no), time from injury to hospital ± 10 min., means of rescue (emergency helicopter, MICU), Abbreviated Injury Scale (body regions), injury year, systolic blood pressure and age (years). All patients were managed by an emergency doctor at the accident site. A total of 948 patients in each group met the inclusion criteria. Increasing replacement volume was associated with an increased need for transfusion (pRBCs: low-volume: 7 units, high-volume: 8.3 units; ptrauma. Copyright © 2012 Elsevier Ltd. All rights reserved.

  2. One-day point prevalence of emerging bacterial pathogens in a nationwide sample of 62 German hospitals in 2012 and comparison with the results of the one-day point prevalence of 2010

    Wegner, Christian


    Full Text Available [english] Background: Antibiotic resistance of bacterial pathogens is an emerging problem worldwide. To combat multidrug resistant organisms (MRDOs networks of care providers have been established in all states in Germany. The HICARE-network, a project to combat MRDOs, founded by the Federal Ministry of Education and Research, has published data from 2010 of a voluntary, German-wide, multicenter point-prevalence survey in 2011 conducted in collaboration with the German Society of Hospital Hygiene. The aim of the present survey was the re-evaluation of the situation in 2012.Method: The survey was conducted as a voluntary, anonymous, point-prevalence in May 2012 using routine data of microbiological diagnostics of the hospitals. As in the former survey of 2010 it was differentiated between primary, secondary and tertiary care hospitals and only data from intensive care units, surgical and medical wards were collected. Based on the survey form used in 2010, an updated version was used including more pathogens and corrected issues observed in the former survey. Methicillin-resistant (MRSA (total as well as separated in hospital-acquired (HA, community-acquired (CA and lifestock-associated (LA MRSA, vancomycin resistant (VRSA/GRSA, vancomycin resistant resp. (VR-resp. VR-, extended-spectrum-beta-lactamase-building (ESBL (ESBL-EC and (ESBL-KP, multiresistant spp. (MAB, multiresistant spp. (MRP, carbapenemase-producing Enterobacteriaceae (CRE as well as (CD infections and severe infections requiring ICU-treatment were included in the survey along with additional data on screening strategy, the equipment with infection control staff and possible confounders.Results: Out of 1,550 hospitals asked to participate, 62 returned data (4%. Data from 56 hospitals including primary (26, secondary (20 and tertiary (10 care hospitals were analyzable (3.6%. The most frequently reported organisms were MRSA 1.53% [CI95: 1.32–1.75], followed by CDAD 1.30% [CI95: 1

  3. [Acute pain therapy in German hospitals as competitive factor. Do competition, ownership and case severity influence the practice of acute pain therapy?].

    Erlenwein, J; Hinz, J; Meißner, W; Stamer, U; Bauer, M; Petzke, F


    Due to the implementation of the diagnosis-related groups (DRG) system, the competitive pressure on German hospitals increased. In this context it has been shown that acute pain management offers economic benefits for hospitals. The aim of this study was to analyze the impact of the competitive situation, the ownership and the economic resources required on structures and processes for acute pain management. A standardized questionnaire on structures and processes of acute pain management was mailed to the 885 directors of German departments of anesthesiology listed as members of the German Society of Anesthesiology and Intensive Care Medicine (DGAI, Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin). For most hospitals a strong regional competition existed; however, this parameter affected neither the implementation of structures nor the recommended treatment processes for pain therapy. In contrast, a clear preference for hospitals in private ownership to use the benchmarking tool QUIPS (quality improvement in postoperative pain therapy) was found. These hospitals also presented information on coping with the management of pain in the corporate clinic mission statement more often and published information about the quality of acute pain management in the quality reports more frequently. No differences were found between hospitals with different forms of ownership in the implementation of acute pain services, quality circles, expert standard pain management and the implementation of recommended processes. Hospitals with a higher case mix index (CMI) had a certified acute pain management more often. The corporate mission statement of these hospitals also contained information on how to cope with pain, presentation of the quality of pain management in the quality report, implementation of quality circles and the implementation of the expert standard pain management more frequently. There were no differences in the frequency of using the benchmarking

  4. Exposure to Exhaled Air from a Sick Occupant in a Two-Bed Hospital Room with Mixing Ventilation: Effect of Posture of Doctor and Air Change Rate

    Bolashikov, Zhecho Dimitrov; Melikov, Arsen Krikor; Barova, Mariya


    Full-scale measurements were performed in a climate chamber set as a two-bed hospital room, ventilated at 3, 6 and 12 ACH with overhead mixing ventilation. Air temperature was kept constant at 22 °C. Two breathing thermal manikins were used to mimic a sick patient lying on one side in one...... of the beds and a doctor. A thermal dummy mimicked an exposed patient lying in the second bed. The doctor either stood up or sat in a chair 0.55 m facing the sick patient. The ‘sick patient’ was exhaling through the mouth and inhaling from the nose. Tracer gas (R 134A) was mixed with the exhaled air to mimic...

  5. 公立医院医生心理资本特征研究%Research on characteristic psychological capital of doctors in public hospitals

    任桂芳; 尹文强; 黄冬梅; 孙葵; 李伟


    目的 了解医生心理资本现状,并分析其特点,以使医院管理更加具有针对性.方法 运用定量与定性相结合的方法,对公立医院医生进行心理资本状况的研究.结果 医生事务型心理资本得分4.25分,人际型心理资本得分4.41分;医生心理资本各维度得分最高的是“谦虚沉稳”,得分最低的是“乐观希望”;医生心理资本在性别、年龄、工作总年限、月均收入等方面存在差异,而在职称、医院级别、聘用形式等方面无差异.结论 医生具有较强的心理资本以应对压力.增强医生心理资本,对提高医疗服务质量具有重要的实践意义.%Objective To study the state of doctors' psychological capital in public hospitals,and to analyze the characteristics of such capital,so as to better leverage the capital as a hospital management tool.Methods A quantitative and qualitative research was made on the state of doctors' psychological capital.Results The doctors' task-oriented psychological capital scored 4.25,and guanxi-oriented psychological capital 4.41; “modesty and prudence”scored the highest in all dimensions of the doctors' psychological capital,“optimism and hope”lowest; the doctors with different genders,ages,seniority,and monthly average income have a difference in psychological capital.However,no significant difference was found with varying titles,hospital levels,and employment models.Conclusion The doctors were found with a strong psychological capital to cope with stress.Better psychological capital will raise quality of care in practice.

  6. 二级医院医生工作满意度研究%The study of job satisfaction of secondary hospital doctors

    孟梦; 尹文强; 李丹; 王青


    目的 了解二级医院医生工作满意度水平,研究其主要影响因素,并提出相应对策.方法 采用自制的问卷以多阶段分层随机抽样的方法调查了2066名二级医院医生,运用方差分析、相关、非条件logistic回归等方法进行分析.结果 二级医院医生总体工作满意度的平均得分为(3.44±0.95)分.其中57.6%的医生对当前的工作表示满意;工作本身满意度分量表的得分最高,为(3.91±0.79)分,工作回报满意度分量表的得分最低,仅(2.85±1.16)分;非条件Logistic回归分析表明,领导行为对医生工作满意度的决定作用最大(β=0.7,P<0.01).结论 二级医院医生总体工作满意度处于中等偏上水平,医生最不满意的方面集中在工作回报和执业环境方面.%Objective To realize job satisfaction of doctors from the secondary hospital and its influencing factors and put forward countermeasures for doctor job satisfaction.Methods 2066 doctors from the secondary hospital were investigated by self-made scale,and analyzed by analysis of variance,non-conditional logistic regression analysis and other methods.Results The average score of total job satisfaction of doctors was (3.44±0.95),in which about 57.6% of doctors expressed satisfaction with the current work.The scale of job itself satisfaction had the hisheet score,that was (3.91±0.79),while the scale of job retum satisfaction had the lowest score,that was (2.85±1.16).Leadership behavior played the most decisive role in doctors job satisfaction(sβ=0.7,P<0.01).Condusion The total job satisfaction of secondary hospital doctors is just above the average and doctors are most dissatisfied with the work concentrated in the areas of return and the practice environment.

  7. Awareness about medical research among resident doctors in a tertiary care hospital: A cross-sectional survey

    Dattatray B Pawar


    Full Text Available Context: Every medical practitioner should strive to contribute to the generation of evidence by conducting research. For carrying out research, adequate knowledge, practical skills, and development of the right attitude are crucial. A literature review shows that data regarding knowledge, attitude, and practices toward medical research, among resident doctors in India, is lacking. Aims: This study was conducted to assess research-related knowledge, attitude, and practices among resident doctors. Settings and Design: A cross-sectional survey was conducted using a pretested, structured, and pre-validated questionnaire. Materials and Methods: With approval of the Institutional Ethics Committee and a verbal consent, a cross-sectional survey among 100 resident doctors pursuing their second and third years in the MD and MS courses was conducted using a structured and pre-validated questionnaire. Statistical Analysis: Descriptive statistics were used to analyze the results. Results: The concept of research hypothesis was known to 58% of the residents. Ninety-eight percent of the residents were aware of the procedure to obtain informed consent. Seventy-six percent agreed that research training should be mandatory. Although 88% of the residents were interested in conducting research in future, 50% had participated in research other than a dissertation project, 28% had made scientific presentations, and only 4% had publications. Lack of time (74%, lack of research curriculum (42%, and inadequate facilities (38% were stated as major obstacles for pursuing research. Conclusions: Although resident doctors demonstrated a fairly good knowledge and positive attitude toward research, it did not translate into practice for most of them. There is a need to improve the existing medical education system to foster research culture among resident doctors

  8. The current state of physical activity and exercise programs in German-speaking, Swiss psychiatric hospitals: results from a brief online survey

    Brand, Serge; Colledge, Flora; Beeler, Nadja; Pühse, Uwe; Kalak, Nadeem; Sadeghi Bahmani, Dena; Mikoteit, Thorsten; Holsboer-Trachsler, Edith; Gerber, Markus


    Background Physical activity and exercise programs (PAEPs) are an important factor in increasing and maintaining physical and mental health. This holds particularly true for patients with psychiatric disorders undergoing treatment in a psychiatric hospital. To understand whether the benefits reported in the literature are mirrored in current treatment modalities, the aim of the present study was to assess the current state of PAEPs in psychiatric hospitals in the German-speaking part of Switzerland. Methods All psychiatric hospitals (N=55) in the German-speaking part of Switzerland were contacted in spring 2014. Staff responsible for PAEPs were asked to complete an online questionnaire covering questions related to PAEPs such as type, frequency, staff training, treatment rationale, importance of PAEPs within the treatment strategy, and possible avenues to increase PAEPs. Results Staff members of 48 different psychiatric hospitals completed the survey. Hospitals provided the following therapeutic treatments: relaxation techniques (100%), sports therapy (97%), activity-related psychotherapeutic interventions (95%), physiotherapy (85%), body therapies (59%), far-east techniques (57%), and hippotherapy (22%). Frequencies ranged from once/week to five times/week. Approximately 25% of patients participated in the PAEPs. Interventions were offered irrespective of psychiatric disorders. PAEP providers wanted and needed more vocational training. Conclusion All participating psychiatric hospitals offer a broad variety of PAEPs in their treatment curricula. However, the majority of inpatients do not participate in PAEPs. Furthermore, those who do participate cannot continue to do so following discharge. PAEP providers need specific extended vocational trainings and believe that the potential of PA should be improved. PMID:27350748

  9. The current state of physical activity and exercise programs in German-speaking, Swiss psychiatric hospitals: results from a brief online survey



    Full Text Available Serge Brand,1,2 Flora Colledge,2 Nadja Beeler,2 Uwe Pühse,2 Nadeem Kalak,1 Dena Sadeghi Bahmani,1 Thorsten Mikoteit,1 Edith Holsboer-Trachsler,1 Markus Gerber2 1Psychiatric Clinics of the University of Basel, Center for Affective, Stress and Sleep Disorders, 2Department of Sport, Exercise and Health, Sport Science Section, University of Basel, Basel, Switzerland Background: Physical activity and exercise programs (PAEPs are an important factor in increasing and maintaining physical and mental health. This holds particularly true for patients with psychiatric disorders undergoing treatment in a psychiatric hospital. To understand whether the benefits reported in the literature are mirrored in current treatment modalities, the aim of the present study was to assess the current state of PAEPs in psychiatric hospitals in the German-speaking part of Switzerland. Methods: All psychiatric hospitals (N=55 in the German-speaking part of Switzerland were contacted in spring 2014. Staff responsible for PAEPs were asked to complete an online questionnaire covering questions related to PAEPs such as type, frequency, staff training, treatment rationale, importance of PAEPs within the treatment strategy, and possible avenues to increase PAEPs. Results: Staff members of 48 different psychiatric hospitals completed the survey. Hospitals provided the following therapeutic treatments: relaxation techniques (100%, sports therapy (97%, activity-related psychotherapeutic interventions (95%, physiotherapy (85%, body therapies (59%, far-east techniques (57%, and hippotherapy (22%. Frequencies ranged from once/week to five times/week. Approximately 25% of patients participated in the PAEPs. Interventions were offered irrespective of psychiatric disorders. PAEP providers wanted and needed more vocational training. Conclusion: All participating psychiatric hospitals offer a broad variety of PAEPs in their treatment curricula. However, the majority of inpatients do not

  10. Attitudes Toward Euthanasia Among Doctors in a Tertiary Care Hospital in South India: A Cross Sectional study

    Sneha Kamath; Priya Bhate; Ginu Mathew; Srijith Sashidharan; Daniel, Anjali B


    Context: Advances in expertise and equipment have enabled the medical profession to exercise more control over the processes of life and death, creating a number of moral and ethical dilemmas. People may live for extended periods with chronic painful or debilitating conditions that may be incurable. Aim: This study attempts to study the attitudes of doctors toward euthanasia and the possible factors responsible for these attitudes. Settings and Design: A cross-sectional survey of 213 ...

  11. [Caught between economic pressure and work-life balance--perspectives on emigration of German health professionals to Austria].

    Schmidt, A E; Klambauer, E


    Given the increasing lack of medical doctors in Germany, this study aimed to investigate the professional situation and the push and pull factors of German medical specialists working in Austrian hospitals. This explorative study is based on semi-structured interviews with 14 specialists working in Austria, who completed their education partly or fully in Germany. The material has been interpreted using qualitative content analysis. Better work-life balance, higher quality of life and more favourable working conditions represent major reasons for German specialists to stay in Austria. Moreover, the higher density of medical doctors in Austrian hospitals can have an impact on the distribution of responsibilities among health-care personnel, and on hospital performance. In the light of recent reforms in the German health-care system, the study underlines the importance of qualitative factors for the satisfaction of German medical doctors. These factors should be further analysed in order to avoid a brain drain of high-qualified health care staff in the future. © Georg Thieme Verlag KG Stuttgart · New York.

  12. Success of commonly used operating room management tools in reducing tardiness of first case of the day starts: evidence from German hospitals.

    Ernst, Christian; Szczesny, Andrea; Soderstrom, Naomi; Siegmund, Frank; Schleppers, Alexander


    One of the declared objectives of surgical suite management in Germany is to increase operating room (OR) efficiency by reducing tardiness of first case of the day starts. We analyzed whether the introduction of OR management tools by German hospitals in response to increasing economic pressure was successful in achieving this objective. The OR management tools we considered were the appointment of an OR manager and the development and adoption of a surgical suite governance document (OR charter). We hypothesized that tardiness of first case starts was less in ORs that have adopted one or both of these tools. Using representative 2005 survey data from 107 German anesthesiology departments, we used a Tobit model to estimate the effect of the introduction of an OR manager or OR charter on tardiness of first case starts, while controlling for hospital size and surgical suite complexity. Adoption reduced tardiness of first case starts by at least 7 minutes (mean reduction 15 minutes, 95% confidence interval (CI): 7-22 minutes, P tardiness of first case starts figure prominently the objectives of surgical suite management in Germany. Our results suggest that the appointment of an OR manager or the adoption of an OR charter support this objective. For short-term decision making on the day of surgery, this reduction in tardiness may have economic implications, because it reduced overutilized OR time.

  13. Mutation analysis of BRCA1, BRCA2, PALB2 and BRD7 in a hospital-based series of German patients with triple-negative breast cancer.

    Franziska Pern

    Full Text Available Triple-negative breast cancer (TNBC is an aggressive form of breast carcinoma with a poor prognosis. Recent evidence suggests that some patients with TNBC harbour germ-line mutations in DNA repair genes which may render their tumours susceptible to novel therapies such as treatment with PARP inhibitors. In the present study, we have investigated a hospital-based series of 40 German patients with TNBC for the presence of germ-line mutations in BRCA1, BRCA2, PALB2, and BRD7 genes. Microfluidic array PCR and next-generation sequencing was used for BRCA1 and BRCA2 analysis while conventional high-resolution melting and Sanger sequencing was applied to study the coding regions of PALB2 and BRD7, respectively. Truncating mutations in BRCA1 were found in six patients, and truncating mutations in BRCA2 and PALB2 were detected in one patient each, whereas no truncating mutation was identified in BRD7. One patient was a double heterozygote for the PALB2 mutation, c.758insT, and a BRCA1 mutation, c.927delA. Our results confirm in a hospital-based setting that a substantial proportion of German TNBC patients (17.5% harbour germ-line mutations in genes involved in homology-directed DNA repair, with a preponderance of BRCA1 mutations. Triple-negative breast cancer should be considered as an additional criterion for future genetic counselling and diagnostic sequencing.

  14. Supervisors' perspective on medical thesis projects and dropout rates: survey among thesis supervisors at a large German university hospital.

    Can, Elif; Richter, Felicitas; Valchanova, Ralitsa; Dewey, Marc


    To identify underlying causes for failure of medical thesis projects and the constantly high drop-out rate in Germany from the supervisors' perspective and to compare the results with the students' perspective. Cross-sectional survey. Online questionnaire for survey of medical thesis supervisors among the staff of Charité-Universitätsmedizin Berlin, Germany. Published, earlier longitudinal survey among students for comparison. 1069 thesis supervisors participated. Data are presented using descriptive statistics, and the χ(2) test served to compare the results among supervisors with the earlier data from the longitudinal survey of doctoral students. Not applicable. This survey is an observational study. Of 3653 potential participants, 1069 (29.3%) supervising 3744 doctoral candidates participated in the study. Supervisors considered themselves to be highly motivated and to offer adequate supervision. On the other hand, 87% stated that they did not feel well prepared for thesis supervision. Supervisors gave lack of timeliness of doctoral students and personal differences (p=0.024 and p=0.001) as the main reasons for terminating thesis projects. Doctoral students predominantly mentioned methodological problems and difficult subjects as critical issues (p=0.001 and pthesis supervisors and medical students feel ill prepared for their roles in the process of a medical dissertation. Contradictory reasons for terminating medical thesis projects based on supervisors' and students' self-assessment suggest a lack of communication and true scientific collaboration between supervisors and doctoral students as the major underlying issue that requires resolution. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  15. Longer pre-hospital delay in acute myocardial infarction in women because of longer doctor decision time

    Bouma, J; Broer, J; Bleeker, J; van Sonderen, E; Meyboom-de Jong, B; DeJongste, MJL


    Study objective-To measure the prehospital delay times in patients with proven acute myocardial infarction (AMI) and to identify possibilities for reduction of treatment delay. Design-Descriptive three centre study. Setting-One university teaching hospital and two regional hospitals in Groningen, th

  16. Infection prevention during anaesthesia ventilation by the use of breathing system filters (BSF): Joint recommendation by German Society of Hospital Hygiene (DGKH) and German Society for Anaesthesiology and Intensive Care (DGAI).

    Kramer, Axel; Kranabetter, Rainer; Rathgeber, Jörg; Züchner, Klaus; Assadian, Ojan; Daeschlein, Georg; Hübner, Nils-Olaf; Dietlein, Edeltrut; Exner, Martin; Gründling, Matthias; Lehmann, Christian; Wendt, Michael; Graf, Bernhard Martin; Holst, Dietmar; Jatzwauk, Lutz; Puhlmann, Birgit; Welte, Thomas; Wilkes, Antony R


    An interdisciplinary working group from the German Society of Hospital Hygiene (DGKH) and the German Society for Anaesthesiology and Intensive Care (DGAI) worked out the following recommendations for infection prevention during anaesthesia by using breathing system filters (BSF). The BSF shall be changed after each patient. The filter retention efficiency for airborne particles is recommended to be >99% (II). The retention performance of BSF for liquids is recommended to be at pressures of at least 60 hPa (=60 mbar) or 20 hPa above the selected maximum ventilation pressure in the anaesthetic system. The anaesthesia breathing system may be used for a period of up to 7 days provided that the functional requirements of the system remain unchanged and the manufacturer states this in the instructions for use.THE BREATHING SYSTEM AND THE MANUAL VENTILATION BAG ARE CHANGED IMMEDIATELY AFTER THE RESPECTIVE ANAESTHESIA IF THE FOLLOWING SITUATION HAS OCCURRED OR IT IS SUSPECTED TO HAVE OCCURRED: Notifiable infectious disease involving the risk of transmission via the breathing system and the manual bag, e.g. tuberculosis, acute viral hepatitis, measles, influenza virus, infection and/or colonisation with a multi-resistant pathogen or upper or lower respiratory tract infections. In case of visible contamination e.g. by blood or in case of defect, it is required that the BSF and also the anaesthesia breathing system is changed and the breathing gas conducting parts of the anaesthesia ventilator are hygienically reprocessed.Observing of the appropriate hand disinfection is very important. All surfaces of the anaesthesia equipment exposed to hand contact must be disinfected after each case.

  17. A Case of Blunt Traumatic Cardiac Tamponade Successfully Treated by Out-of-hospital Pericardial Drainage in a "Doctor-helicopter" Ambulance Staffed by Skilled Emergency Physicians.

    Otsuka, Hiroyuki; Sato, Toshiki; Morita, Seiji; Nakagawa, Yoshihide; Inokuchi, Sadaki


    We report a 55-year-old man who relapsed into a state of shock in an ambulance before arriving at our critical care center after a fall injury. The diagnosis of cardiac tamponade was made by portable ultrasound, and immediate pericardiocentesis and drainage were performed at the heliport. He was then transported immediately to our hospital with continuous drainage and surgery was performed. After surgery, the patient was transferred to the intensive care unit in stable condition. After undergoing rehabilitation, he made a full recovery and was discharged. This case illustrates that such patients can be treated reliably by pericardial drainage performed by skilled emergency physicians in the field by making use of the "doctor-helicopter" ambulance transportation system, followed by emergency surgery in a critical care center.

  18. Evaluation of reprocessing medical devices in 14 German regional hospitals and at 27 medical practitioners‘ offices within the European context – consequences for European harmonization

    Thiede, Birgit


    Full Text Available [english] Safe reprocessing of medical devices through cleaning, disinfection, and sterilization is essential for the prevention of health care associated infections (HAI and to guarantee patient safety. Several studies detected residual contamination and even severe infections of patients, despite carrying out reprocessing. To develop appropriate solutions, the existing situation in Germany and selected European countries was analyzed. Additionally, in 27 medical practitioners’ offices and 14 hospitals, the true practice of reprocessing was analyzed using a questionnaire, a checklist, and inspection on site. A structured analysis of potential alternatives to the internal reprocessing was conducted within the German and European context. The results indicate that the conditions for the execution of the reprocessing process in the analyzed health facilities in southern Hesse (Germany do not satisfy legal requirements. The detected deficiencies were consistent with other reports from Germany and Europe. The analysis gave insight into several reasons for the detected deficiencies. The three main reasons were the high costs for proper implementation, the subjective value assigned to the reprocessing unit in health care facilities, and deficits in monitoring by the health authority. Throughout the European Union, a similar regulatory framework for the performance of the reprocessing process exists, while the environment, structures of the health systems and administrative supervision vary significantly. The German states as well as selected European countries are currently discussing the challenges of increased quality-assured execution of the reprocessing process. For instance, the same supervisory system for hospitals and medical practitioners should be established at an equal standard. Alternatives such as the use of single-use medical devices, outsourcing the decontamination processes, or the cooperation of health facilities may be considered

  19. 'I used to fight with them but now I have stopped!': conflict and doctor-nurse anaesthetists' motivation in maternal and neonatal care provision in a specialist referral hospital

    Aberese-Ako, M.; Agyepong, I.A.; Gerrits, T.; van Dijk, H.


    Background and Objectives: This paper analyses why and how conflicts occur and their influence on doctors and nurse-anaesthetists' motivation in the provision of maternal and neonatal health care in a specialist hospital. Methodology: The study used ethnographic methods including participant observa

  20. [The new medical treatment procedure of the German Statutory Accident Insurance: From the perspective of BG hospitals].

    Bühren, V; Perl, M


    The Hospital Group of the Statutory Accident Insurance (BG hospitals) was affected by the new requirements for severe injury procedures (SAV) in the same manner as all other maximum care hospitals. Simultaneously, the BG clinics were merged to form a centrally organized hospital group. A substantial need for adjustment existed for specialties, such as neurosurgery and visceral surgery at some sites. Needless to say, all trauma victims benefit from the high standards required by the Statutory Accident Insurance regardless of their insurance status. The provision of medical treatment with respect to its implementation into routine practice must be further optimized and additions, e.g. for the occurrence of complications are necessary.

  1. The Role of Learning in Health Technology Assessments: An Empirical Assessment of Endovascular Aneurysm Repairs in German Hospitals.

    Varabyova, Yauheniya; Blankart, Carl Rudolf; Schreyögg, Jonas


    Changes in performance due to learning may dynamically influence the results of a technology evaluation through the change in effectiveness and costs. In this study, we estimate the effect of learning using the example of two minimally invasive treatments of abdominal aortic aneurysms: endovascular aneurysm repair (EVAR) and fenestrated EVAR (fEVAR). The analysis is based on the administrative data of over 40,000 patients admitted with unruptured abdominal aortic aneurysm to more than 500 different hospitals over the years 2006 to 2013. We examine two patient outcomes, namely, in-hospital mortality and length of stay using hierarchical regression models with random effects at the hospital level. The estimated models control for patient and hospital characteristics and take learning interdependency between EVAR and fEVAR into account. In case of EVAR, we observe a significant decrease both in the in-hospital mortality and length of stay with experience accumulated at the hospital level; however, the learning curve for fEVAR in both outcomes is effectively flat. To foster the consideration of learning in health technology assessments of medical devices, a general framework for estimating learning effects is derived from the analysis. © 2017 The Authors. Health Economics published by John Wiley & Sons, Ltd.

  2. APPENDIX:A Doctor's Confession


    Not long ago, Xinhua News Agency reported on a confession by Xiao Qiwei regarding corruption in medicine purchases at a hospital in Sichuan. Excerpts follow: I have been working as a doctor for 35 years. As far as I know, corruption in medicine purchases dates from the 1990s. After 1998, all kinds of medicine salespersons surged into hospitals and talked to doctors face to face, stating clearly that they

  3. Public hospitals in China: privatisation, the demise of universal health care and the rise of patient-doctor violence.

    Zheng, Pingan; Faunce, Thomas; Johnston, Kellie


    Ensuring the safety of staff and patients has become a major problem for hospitals in China. This article examines whether one of the reasons for this violence may be the emerging injustice and inequality that have manifested in the Chinese health care system as a result of privatisation reforms since the early 1980s. It considers approaches to these issues that may assist the Chinese Government, and other nations contemplating similar policy changes, to create efficient but equity-based health care systems that minimise collateral trauma to patients and their families.

  4. On the Relationship between the Hospital and the Doctor-Patient Harmo-nious Cultural Archives%浅谈医院文化档案与医患和谐的关系

    张男; 耿志伟; 田云峰; 杨金红; 王姣云


    医院文化档案是医院行政机构中重要的组成部分,是对医院过去的历史事件等一系列发展历程的真实记录,并且文化档案也是医院精神文化的载体与传承,其肩负着医院文化特色的延续以及精神文明的传播责任。同时医院文化档案的创立以及加强对医患和谐的关系也具有重要的作用,在医患关系不断恶化,医患矛盾频繁发生的今天,加强医院文化档案的管理工作,对于改善医患关系,创建医患和谐具有重要作用。%Hospital culture archives hospital administration an important part of the hospital is a series of past historical events of the real course of development records,archives and cultural heritage is also the support and spiritual culture of the hospital, which shoulders the hospital cultural characteristics continuation and spread of spiritual responsibility.At the same time the creation of the hospital culture archives and strengthen the doctor-patient rapport also has an important role in the deteriorating relationship between doctors and patients, patient conflicts frequently occurring today,strengthening the management of the hospital culture archives,to improve doctor-patient relationship, create harmonious doctor-patient plays an important role.

  5. 精神科专科医院与综合医院医师工作倦怠及相关因素分析%Analysis on occupational burnout of psychiatrists in psychiatry hospitals and doctors in general hospitals

    杨程甲; 张胜军; 钟天平; 许明智


    Objective To investigate the characteristics of occupational burnout of psychiatrists in psychiatry hos-pitals and doctors in general hospitals, and to explore the association between work stress and somatization, as well as health-related behaviors.Methods A cross-sectional study was implemented.121 psychiatrists and 121 doctors filled out the Maslach Burnout lnventory-General Survey (MBI-GS) and Patient Health Questionnaire(PHQ-15) to explore the level of job burnout and somatic complains.Results There were 89.3%of psychiatrists and 99.2%of doctors suffer-ing from burnout.Doctors in general hospitals yielded higher scores of burnout, exhaustion and reduced personal accom-plishment ( P<0.001) .Psychiatrists more often engaged in physical exercise, smoke less, and kept a better dietary rou-tine than doctors in general hospitals (P<0.05 or P<0.001).The PHQ-15 total scores, stomach pain, back pain, pain in arms/legs/joints, chest pain, palpitation, shortness of breath, sexual problems, abnormal bowel movement, diges-tive discomfort, tiredness and sleep difficulties were notably higher in doctors in general hospital(P<0.05 or P<0.001). Engagement in physical exercise was negatively correlated with exhaustion, while overall PHQ score was positively correla-ted with exhaustion.Results from multiple linear regression showed that MBI-GS score (β=0.375, 95%CI:2.85 -3.09), exhaustion(β=0.273,95%CI:3.11-3.47) and gender (β=0.218,95%CI:1.38-1.51) were potential risk factors of somatic complains(R2 =0.102).Conclusion There are higher burnout level and more somatic complains in doctors in general hospitals.Exhaustion is a predictive factor of somatic symptoms, and a healthy lifestyle may have some effects on reducing burnout.%目的:调查精神科专科医院及综合医院医务人员工作压力状况,并探讨不同专科医师工作压力与功能性躯体不适及健康相关行为的关系。方法应用Maslach工作倦怠量表通用版( MBI-GS

  6. 三所精神病院间医护人员对精神疾病态度的比较%Comparison of Attitudes on Mental Illness among Doctors and Nurses of Three Psychiatric Hospitals

    徐东; 费立鹏; 许德广; 邵贵忠; 曾闽风


    Objective: To compare the attitudes of doctors and nurses from different psychiatric hospitals on mental illness and its stigma experienced by mentally ill patients and their family members. Methods: A questionnaire was administered to 102 doctors and 116 nurses from three psychiatric hospitals in Beijing with different mean lengths of admission and different proportions of chronic patients. Results: There was relatively little difference in the attitudes of nurses among the three hospitals, but doctors from the three centers differed significantly in their beliefs about the social worth of psychiatric patients, patients' level of violence and the need to restrict patients' social activities, as well as the effect of stigma on patients and their family members. These differences among physicians remained after adjusting for gender, age and level of education; this suggests that their attitudes were related to the types of patients they treated.Conclusion: The attitudes of doctors and to a lesser extent nurses on mental illness are affected by the duration of illness and level of social disability of the psychiatric patients they treat.

  7. Medical work Assessment in German hospitals: a Real-time Observation study (MAGRO – the study protocol

    Mache Stefanie


    Full Text Available Abstract Background The increasing economic pressure characterizes the current situation in health care and the need to justify medical decisions and organizational processes due to limited financial resources is omnipresent. Physicians tend to interpret this development as a decimation of their own medical influence. This becomes even more obvious after a change in hospital ownership i.e. from a public to a private profit oriented organization. In this case each work procedure is revised. To date, most research studies have focused mainly on differences between hospitals of different ownership regarding financial outcomes and quality of care, leaving important organizational issues unexplored. Little attention has been devoted to the effects of hospital ownership on physicians' working routines. The aim of this observational real time study is to deliver exact data about physicians' work at hospitals of different ownership. Methods The consequences of different management types on the organizational structures of the physicians' work situation and on job satisfaction in the ward situation are monitored by objective real time studies and multi-level psycho diagnostic measurements. Discussion This study is unique in its focus. To date no results have been found for computer-based real time studies on work activity in the clinical field in order to objectively evaluate a physician's work-related stress. After a complete documentation of the physicians' work processes the daily work flow can be estimated and systematically optimized. This can stimulate an overall improvement of health care services in Germany.

  8. Doctors Today

    Murphy, JFA


    Doctors’ relationship with patients and their role in society is changing. Until the 1960s doctors concentrated on the welfare of patients with less emphasis placed on patients’ rights1. Over recent decades there has been increasing empowerment of the individual across all facets of society including health care. Doctors continue to be perceived as having expertise and authority over medical science. Patients, however, now hold sway over questions of values or preferences. We all must be aware of this change in the doctor- patient interaction. We need to be more aware of the outcomes that patients view as important. The concept of shared decision-making with the patient is now widely appreciated. The process involves a change in mind set particularly for doctors who trained in an earlier era.

  9. Detection of Bendiocarb and Carbaryl Resistance Mechanisms among German Cockroach Blattella germanica (Blattaria: Blattellidae Collected from Tabriz Hospitals, East Azerbaijan Province, Iran in 2013

    Afshin Salehi


    Full Text Available Background: Insecticide resistance is one of the serious problems for German cockroach control program. This study was conducted to determine the bendiocarb and Carbaryl resistance mechanisms in German cockroaches using the piperonyl butoxide (PBO.Methods: Bioassay tests were conducted with 4 to 6 different concentrations of both insecticides with four replicates of 10 susceptible strain cockroaches per concentration to determine of discriminative concentration. After determining discriminative concentration, the result was compared to wild strain. The levels of susceptibility and resistance ratio (RR and synergism ratio (SR were calculated for each five wild strains. Moreover resistance mechanisms in wild strains were determined using PBO synergist in vivo.Results: Hospital strains showed different levels of resistance to bendiocarb and carbaryl compared to susceptible strain. The bendiocarb and carbaryl resistance ratios ranged from 2.11 to 7.97 and 1.67 to 2 at LD50 levels, respec­tively. The synergist PBO significantly enhanced the toxicity of bendiocarb and carbaryl to all strains with different degrees of synergist ratio, 1.31, 1.39, 3.61, 1.78, 1.62 and 2.1 fold for bendiocarb, 1.19, 1.18, 1.12. 1.29, 1.45 and 1.11- fold for carbaryl, suggesting monooxygenase involvement in bendiocarb and carbaryl resistance.Conclusion: The synergetic effect of PBO had the highest effect on bendiocarb and resistance level was significantly reduced, which indicates the important role of monoxidase enzyme in creating resistance to Bendiocarb. Piperonyl butoxide did not have a significant synergistic effect on carbaryl and did not significantly break the resistance.

  10. Doctor Shopping

    Sansone, Lori A.


    Doctor shopping is defined as seeing multiple treatment providers, either during a single illness episode or to procure prescription medications illicitly. According to the available literature, prevalence rates of doctor shopping vary widely, from 6.3 to 56 percent. However, this variability is partially attributable to research methodology, including the study definition of doctor shopping as well as the patient sample. The reasons for doctor shopping are varied. Some patient explanations for this phenomenon relate to clinician factors, such as inconvenient office hours or locations, long waiting times, personal characteristics or qualities of the provider, and/or insufficient communication time between the patient and clinician. Some patient explanations relate to personal factors and include both illness factors (e.g., symptom persistence, lack of understanding or nonacceptance of the diagnosis or treatment) as well as psychological factors (e.g., somatization, prescription drug-seeking). Importantly, not all doctor shopping is driven by suspect motivations. Being aware of these various patient justifications for doctor shopping is important in understanding and managing these challenging patients in the clinical setting, whether they emerge in psychiatric or primary care environments. PMID:23346518

  11. Compulsory removal to and detention in hospital in the case of notifiable disease: a survey of public health doctors.

    Kaur, B; Bingham, P


    Compulsory detention of an individual in hospital, because they have a notifiable disease, is controversial. Difficulties experienced by the authors in applying Sections 37 and 38 of the Public Health (Control of Disease) Act 1984 led them to conduct a postal survey of the experience of Consultants in Communicable Disease Control/Medical Officers of Environmental Health (CCDC/MOEH) currently in post in England. Out of 138 respondents (80% response rate), 48 respondents (34.8%) had dealt with 'non-compliant' individuals posing an infectious risk to the community. Of the 48, 13 respondents achieved compliance by threatening to use Section 37/38 and only 6 respondents resorted to using Section 37/38, equivalent to less than one use of the sections for every hundred years of CCDC/MOEH experience. In most cases the notifiable disease in question was tuberculosis. In contrast to our experience and previously reported cases, the survey suggests generally satisfactory experience of Section 37/38 amongst CCDC/MOEH currently in post. Recommended guidelines for the use of Section 37/38 are given.

  12. [The influence of quality management on job satisfaction and work load--exemplary study in a German hospital].

    Hein, Sandra; Lauterbach, Karl W; Plamper, Evelyn; Gerber, Andreas


    Surveys among employees are getting more and more relevant in hospital settings since an increase in both (1) efficiency and (2) quality in connection with (3) enhanced patient orientation will only be achieved, if at the same time the employees' health status and satisfaction are taken into account. Thus, the objective of this study was to compare the satisfaction of employees in a single hospital enquired in 2002 with that of 2005. Particular consideration was given to their view of quality management. Is there a correlation between employees' satisfaction, their degree of information on quality management, and their assessment of quality management? In the survey of 2005 employees were more satisfied with their work and their working conditions than in the previous inquiry conducted in 2002. They felt less mental stress, despite the declining length of hospitalisation combined with a higher turnover of in-hospital cases and with lower numbers of full-time staff. The employees' satisfaction, however, differed widely among the three departments with regard to the items "involvement with decisions" and "support by the superiors". The overall assessment of quality management is positive. Specific items such as the assessment of the management's commitment to quality management were strongly influenced by the employees' degree of information on quality management, which varies between departments. In the department with the lowest work satisfaction quality management was attributed a high potential for change and improvement. After quality management will have been implemented throughout the hospital, a new survey should be undertaken to evaluate whether quality management affects the employees' satisfaction with their work.

  13. Guideline on allergen-specific immunotherapy in IgE-mediated allergic diseases: S2k Guideline of the German Society for Allergology and Clinical Immunology (DGAKI), the Society for Pediatric Allergy and Environmental Medicine (GPA), the Medical Association of German Allergologists (AeDA), the Austrian Society for Allergy and Immunology (ÖGAI), the Swiss Society for Allergy and Immunology (SGAI), the German Society of Dermatology (DDG), the German Society of Oto- Rhino-Laryngology, Head and Neck Surgery (DGHNO-KHC), the German Society of Pediatrics and Adolescent Medicine (DGKJ), the Society for Pediatric Pneumology (GPP), the German Respiratory Society (DGP), the German Association of ENT Surgeons (BV-HNO), the Professional Federation of Paediatricians and Youth Doctors (BVKJ), the Federal Association of Pulmonologists (BDP) and the German Dermatologists Association (BVDD).

    Pfaar, Oliver; Bachert, Claus; Bufe, Albrecht; Buhl, Roland; Ebner, Christof; Eng, Peter; Friedrichs, Frank; Fuchs, Thomas; Hamelmann, Eckard; Hartwig-Bade, Doris; Hering, Thomas; Huttegger, Isidor; Jung, Kirsten; Klimek, Ludger; Kopp, Matthias Volkmar; Merk, Hans; Rabe, Uta; Saloga, Joachim; Schmid-Grendelmeier, Peter; Schuster, Antje; Schwerk, Nicolaus; Sitter, Helmut; Umpfenbach, Ulrich; Wedi, Bettina; Wöhrl, Stefan; Worm, Margitta; Kleine-Tebbe, Jörg; Kaul, Susanne; Schwalfenberg, Anja

    , Ebner C, Eng P, Friedrichs F, Fuchs T, Hamelmann E, Hartwig-Bade D, Hering T, Huttegger I, Jung K, Klimek L, Kopp MV, Merk H, Rabe U, Saloga J, Schmid-Grendelmeier P, Schuster A, Schwerk N, Sitter H, Umpfenbach U, Wedi B, Wöhrl S, Worm M, Kleine-Tebbe J. Guideline on allergen-specific immunotherapy in IgE-mediated allergic diseases - S2k Guideline of the German Society for Allergology and Clinical Immunology (DGAKI), the Society for Pediatric Allergy and Environmental Medicine (GPA), the Medical Association of German Allergologists (AeDA), the Austrian Society for Allergy and Immunology (ÖGAI), the Swiss Society for Allergy and Immunology (SGAI), the German Society of Dermatology (DDG), the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery (DGHNO-KHC), the German Society of Pediatrics and Adolescent Medicine (DGKJ), the Society for Pediatric Pneumology (GPP), the German Respiratory Society (DGP), the German Association of ENT Surgeons (BV-HNO), the Professional Federation of Paediatricians and Youth Doctors (BVKJ), the Federal Association of Pulmonologists (BDP) and the German Dermatologists Association (BVDD). Allergo J Int 2014;23:282-319.

  14. 北京地区三级医院医生职业幸福感现状及影响因素%Occupational well-being status and influence factors of doctors in third class hospitals in Beijing area

    马妮娜; 张曼华; 朱洁; 刘婷


    Objective To understand the current status of doctors' occupational well-being in three class general hospi-tals in Beijing, and discuss its influencing factors, then may provide a reference for the promotion strategies later. Methods Combined purpose sampling and convenience sampling method were used, and semi-structured interview method was used to do the individual in-depth interviews with 30 doctors from four three class general hospitals in Beijing area, understand the status of their occupational well-being and influencing factors. Results The average of doctors' occupational well-being was (6.03±1.43) points (out of 10 points), overall the doctors' occupational well-being was lower. Doctors believed that the maln factors influenced on their occupational well-being including excessive work pressure (27 people), disproportionate pay (23 people), poor doctor-patient relationship (18 people), hospital manage-ment issues (17 people). Conclusion Doctors' occupational well-being is lower in the three class general hospital in Beijing. The maln factors influenced on doctors' occupational well-being are workload, long working hours, dispropor-tionately individuals pay and reward and doctor-patient relationship disharmony. In order to enhance the doctors' oc-cupational well-being, improving diagnosis and treatment system, optimizing hospitals resource allocation, building de-partment subculture, communication skills tralning for doctors and other channels are better ways.%目的:了解目前北京地区三级综合医院医生的职业幸福感现状,并对其影响因素进行探讨,为后期可能的提升策略提供参考。方法采用目的抽样与便利抽样相结合、半结构化访谈的方法,对北京地区4所三级综合医院中30名医生进行个人深入访谈,了解其职业幸福感现状及影响因素。结果医生的职业幸福感平均得分为(6.03±1.43)分(满分为10分),医生总体职

  15. Analysis of Doctors' Resignation in Public Hospital and its Influential Factors%某公立医院医生离职情况分析及影响因素研究

    张冬娟; 张春芳; 王晶桐


    目的探讨某公立医院医生离职的特点及相关因素,为医院的人力资源管理提供依据。方法以我院2009至2014年间72名离职医生为研究对象,收集其基本信息进行回顾性分析,并结合深度访谈、问卷调查等明确医生离职的原因和去向,进行描述性分析。结果医生离职受个人因素、家庭因素、工作因素和外部就业机会等多种因素的影响,不同职称级别的医生离职的主要影响因素存在差异。结论医院要改进绩效工资分配制度,保证医生获得公平合理的收入,提高医生的职业安全感,加强对年轻医生的关心与培养,建立科学合理的人才梯队,保证人力资源的良性发展。%Objective To explore the characteristics and related factors of doctors' resignation in a public hospital and to provide evidences for the management of human resources in hospitals.Methods In total of 72 doctors who resigned from our hospital from 2009 to 2014 were included in our study, and there basic information was collected to conduct retrospective analysis. In-depth interview and questionnaire were adopted to find out each doctor's resignation reason and new job after resignation so as to conduct descriptive analysis.Results Doctors' resignation was influenced by many different factors including personal factors, family factors, job satisfaction, and external career opportunities. There were differences of resignation reasons among doctors at different professional ranks and levels.Conclusion It is necessary to improve the performance salary distribution system in order to ensure doctors maintain a fair and reasonable income level, to increase the job security by improving the job environment, to improve the training and welfare for young doctors, and to establish a beneficial and reasonable recruiting and promotion system to ensure the healthy career and skill development as well as fair opportunity for doctors.

  16. Going to the Doctor

    ... Happens in the Operating Room? Going to the Doctor KidsHealth > For Kids > Going to the Doctor A ... it's time to meet the doctor. continue Hello, Doctor The doctor will come in and say hello, ...


    Methods: This was a cross-sectional questionnaire based study involving medical doctors working at the .... Set up pharmacovigilance team in hospital and clinical presentation of ... of functional pharmacovigilance committee in the hospitals.

  18. [Job satisfaction among Norwegian doctors].

    Nylenna, Magne; Aasland, Olaf Gjerløw


    Doctors' job satisfaction has been discussed internationally in recent years based on reports of increasing professional dissatisfaction. We have studied Norwegian doctors' job satisfaction and their general satisfaction with life. A survey was conducted among a representative sample of practicing Norwegian doctors in 2008. The validated 10-item Job Satisfaction Scale was used to assess job satisfaction. 1,072 (65 %) doctors responded. They reported a mean job satisfaction of 5.3 on a scale from 1 (very dissatisfied) to 7 (very satisfied). Job satisfaction increased with increasing age. Private practice specialists reported the highest level of job satisfaction (5.8), and general practitioners reported higher job satisfaction (5.5) than hospital doctors (5.1). Among specialty groups, community doctors scored highest (5.6) and doctors in surgical disciplines lowest (5.0). While long working hours was negatively correlated with job satisfaction, the perception of being professionally updated and having part-time affiliation(s) in addition to a regular job were positively correlated with job satisfaction. 52.9 % of doctors reported a very high general satisfaction. Norwegian doctors have a high level of job satisfaction. Satisfaction with life in general is also high and at least in line with that in the Norwegian population.

  19. Sensitivity of clinical isolates from German hospitals to amoxicillin/clavulanic acid (Augmentin) compared with other antibiotics.

    Focht, J; Klietmann, W; Nösner, K; Rolinson, G N; Johnsen, J


    17,244 pathogens isolated from clinical specimens of 24 hospitals in the Moers area (North-Rhine Westphalia, FRG) were tested in regard to their susceptibility to Augmentin (amoxicillin and clavulanic acid). For this purpose, minimal inhibitory concentrations were determined by use of microbroth dilution technique. 80% of Gram-negative, 98% of Gram-positive and 97% of anaerobic isolates were susceptible to Augmentin (breakpoint 4 mg/l amoxicillin in the presence of 2.5 mg/l clavulanic acid). In a second part of the study the susceptibility to Augmentin of 4.137 Gram-negative and 10.958 Gram-positive pathogens was compared to their sensitivity against benzylpenicillin, flucloxacillin, mezlocillin, erythromycin, clindamycin, fusidic acid, ampicillin, cefaclor and doxycyclin.

  20. Association between hospital procedure volume and early complications after pacemaker implantation: results from a large, unselected, contemporary cohort of the German nationwide obligatory external quality assurance programme.

    Nowak, Bernd; Tasche, Karl; Barnewold, Linda; Heller, Günther; Schmidt, Boris; Bordignon, Stefano; Chun, K R Julian; Fürnkranz, Alexander; Mehta, Rajendra H


    Several studies demonstrated an inverse relationship between cardioverter-defibrillator implantation volume and complication rates, suggesting better outcomes for higher volume centres. However, the association of institutional procedural volume with patient outcomes for permanent pacemaker (PPM) implantation remains less known, especially in decentralized implantation systems. We performed retrospective examination of data on patients undergoing PPM from the German obligatory quality assurance programme (2007-12) to evaluate the relationship of hospital PPM volume (categorized into quintiles of their mean annual volume) with risk-adjusted in-hospital surgical complications (composite of pneumothorax, haemothorax, pericardial effusion, or pocket haematoma, all requiring intervention, or device infection) and pacemaker lead dislocation. Overall 430 416 PPM implantations were documented in 1226 hospitals. Systems included dual (72.8%) and single (25.8%) chamber PPM and cardiac resynchronization therapy (CRT) devices (1.1%). Complications included surgical (0.92%), and ventricular (0.99%), and atrial (1.22%) lead dislocation. Despite an increase in relatively complex procedures (dual chamber, CRT), there was a significant decrease in the procedural and fluoroscopy times and complications from lowest to highest implantation volume quintiles (P for trend <0.0001). The greatest difference was observed between the lowest (1-50 implantations/year-reference group) and the second-lowest (51-90 implantations/year) quintile: surgical complications [odds ratio (OR) 0.69; confidence interval (CI) 0.60-0.78], atrial lead dislocations (OR 0.69; CI 0.59-0.80), and ventricular lead dislocations (OR 0.73; CI 0.63-0.84). Hospital annual PPM volume was directly related to indication-based implantation of relatively more complex PPM and yet inversely with procedural times and rates of early surgical complications and lead dislocations. Thus, our data suggest better performance and lower

  1. Candida albicans bloodstream isolates in a German university hospital are genetically heterogenous and susceptible to commonly used antifungals.

    Huyke, Johanna; Martin, Ronny; Walther, Grit; Weber, Michael; Kaerger, Kerstin; Bougnoux, Marie-Elisabeth; Elias, Johannes; Kurzai, Oliver


    From an eight-year-span, 99 Candida bloodstream isolates were collected at the University Hospital Wuerzburg, Germany. In this study, all strains were analyzed using molecular and phenotypic typing methods. Confirmatory species identification revealed three isolates that were initially diagnosed as C. albicans to be actually C. dubliniensis. Two isolates contained a mixed culture of C. albicans and C. glabrata, in one of the specimens both species could be separated while it was not possible to recover C. albicans in the other sample. The remaining 95 C. albicans isolates were profiled by multilocus sequence typing (MLST). Phylogenetic analyses showed a highly heterogenous collection of strains, associated with many different clades and constituting a set of new diploid sequence types (DST). For all strains with identical DST, patient data were reviewed for potential nosocomial transmission. In addition, all isolates were tested for their susceptibility to amphotericin B, caspofungin, fluconazole, itraconazole, posaconazole and voriconazole. No clinically relevant resistance could be detected. Furthermore, these data underline that correlation between minimal inhibitory concentrations for caspofungin and anidulafungin is low.

  2. First Report of German Cockroaches (Blattella germanica) as Reservoirs of CTX-M-15 Extended-Spectrum-β-Lactamase- and OXA-48 Carbapenemase-Producing Enterobacteriaceae in Batna University Hospital, Algeria.

    Loucif, Lotfi; Gacemi-Kirane, Djamila; Cherak, Zineb; Chamlal, Naima; Grainat, Nadia; Rolain, Jean-Marc


    Here we report the isolation of extended-spectrum β-lactamase (ESBL)- and carbapenemase-producing Enterobacteriaceae from German cockroaches caught in the burn unit of Batna University Hospital in Algeria. Nine of 12 isolates harbored the blaCTX-M-15 ESBL gene. One Enterobacter cloacae isolate belonging to sequence type 528 coexpressed the blaOXA-48, blaCTX-M-15, and blaTEM genes. Our findings indicate that cockroaches may be one of the most dangerous reservoirs for ESBL and carbapenemase producers in hospitals.

  3. Research on the"Green Hospital"from the Perspective of the Doctor of Humane care Quality%“绿色医院”视角下的医生人文关怀品质研究

    兰利莹; 熊伟


    Objective To understand the factors of humanistic caring ability and its effect of doctors, to explore the humanistic care for patients in a hospital doctor significance.Methods Use the convenient sampling method,the management staf of the Jinlin Medical col ege at al levels of doctors,hospital administrators and higher medical institutions to consult the experts.Results Resident and attending the humanistic caring ability was significantly higher than that of the chief physician,and hospital management personnel of humanistic caring ability of different level were signify-cantly lower than those of physicians caring ability,the difference had statistical significance(P<0.05). Conclusion The doctor of humane care of patients,can reduce medical disputes,improve patient satisfaction.%目的:了解医生的人文关怀能力及其影响因素,探讨医生人文关怀对患者的意义。方法利用方便抽样的方法,对吉林医药学院的各级医生、医院管理人员及上级医疗机构管理人员进行专家咨询。结果住院医生及主治医师的人文关怀能力明显高于主任医生,且医院管理人员的人文关怀能力均明显低于不同等级医师的关怀能力,差异均有统计学意义(均P<0.05)。结论通过医生对患者的人文关怀,可减少医患纠纷,提高患者的满意度。

  4. Doctoral Education

    Ridder, Hanne Mette Ochsner


    Doctoral education covers the “third cycle” of degrees following the bachelor’s and the master’s degree. The education of researchers is necessary for developing music therapy as a scientific discipline and calls for a certain research culture that not only brings knowledge on research...... with an integration of science and practice. This leads to a description of the principles of problem-based learning as a social constructive approach, problematization, self-directed learning and learning community. The chapter is concluded with an example of a model of doctoral education, the Aalborg model, where...... the coursework, supervision, and curriculum is based on problem-based learning. About the book: 'International Perspectives in Music Therapy Education and Training: Adapting to a Changing World,' the first anthology of its kind, edited by Professor Karen Goodman, brings noted educators from Brazil, Canada...

  5. Doctoral Education

    Ridder, Hanne Mette Ochsner


    Doctoral education covers the “third cycle” of degrees following the bachelor’s and the master’s degree. The education of researchers is necessary for developing music therapy as a scientific discipline and calls for a certain research culture that not only brings knowledge on research...... with an integration of science and practice. This leads to a description of the principles of problem-based learning as a social constructive approach, problematization, self-directed learning and learning community. The chapter is concluded with an example of a model of doctoral education, the Aalborg model, where...... the coursework, supervision, and curriculum is based on problem-based learning. About the book: 'International Perspectives in Music Therapy Education and Training: Adapting to a Changing World,' the first anthology of its kind, edited by Professor Karen Goodman, brings noted educators from Brazil, Canada...

  6. Talking to Your Doctor

    ... Doctor Research Underway Plain Language Talking to Your Doctor Preparing for Your Medical Appointment (4:37) Understanding ... sources of information. How to Talk to your Doctor Talking With Your Doctor , NIH News in Health ...

  7. Vitamin D Deficiency in Adult Patients with Schizophreniform and Autism Spectrum Syndromes: A One-Year Cohort Study at a German Tertiary Care Hospital

    Dominique Endres


    Full Text Available Introduction: Vitamin D has many immunomodulatory, anti-inflammatory, and neuroprotective functions, and previous studies have demonstrated an association between vitamin D deficiency and neuropsychiatric disease. The aim of our study was to analyze the prevalence of vitamin D deficiency in a one-year cohort of adult inpatients with schizophreniform and autism-spectrum syndromes in a naturalistic in-patient setting in Germany. Participants and methods: Our study was comprised of 60 adult schizophreniform and 23 adult high-functioning autism spectrum patients who were hospitalized Page: 2between January and December of 2015. We compared our findings with a historical German reference cohort of 3,917 adults using Pearson’s two-sided chi-squared test. The laboratory measurements of 25-hydroxyvitamin D2/3 (25(OHvitamin D were obtained using a chemiluminescence immunoassay. Results: In the schizophreniform group, we found decreased ( 30 ng/ml were observed in only 5% of the schizophreniform patients, 8.7% of the autism spectrum patients, and 21.9% of the healthy controls. Discussion: We found very high rates of 25(OHvitamin D deficiency in both patient groups, and have discussed whether our findings might be related to alterations in the immunological mechanisms. Irrespective of the possible pathophysiological links between vitamin D deficiency and schizophrenia or autism spectrum disorders, a more frequent measurement of vitamin D levels seems to be justified in these patient groups. Further prospective, controlled, blinded, and randomized research should be conducted to analyze the effectiveness of vitamin D supplementation on the improvement of psychiatric symptoms.

  8. The Effect of Out-Patient Doctor Workstation in Improving the Level of Hospital Services%门诊医生工作站在提升医院服务水平中的作用

    孟晓阳; 宋忠良


    The clinical information system is an important guarantee to support the normal functioning of the hospital; outpatient doctor workstation is the core of the clinical information system. Through comparison of the outpatient medical services before and after the application of the outpatient doctor services, the paper discussed the effect of outpatient doctor workstation in improving the level of hospital services from five aspects; work efficiency, quality of care, treatment processes 9 medical management y and health care policy.%门诊信息系统是支撑医院正常运转的重要保障,门诊医生工作站是门诊信息系统的核心.通过对比门诊医生工作站上线前后门诊医疗业务的变化,从工作效率、医疗质量、就诊流程、医疗管理、医保政策5方面阐述了门诊医生工作站在提升医院服务水平中的重要作用.

  9. 医院管理人员与医护人员对医患关系评价的差异性分析%Analysis of Evaluation Difference between Hospital Administrator and Medical Personnel on Doctor-patient Relationship

    汉业旭; 王晓燕; 张建; 梁立智; 关丽征; 宋晓霞; 焦峰


    Objective To know about evaluation difference and the cause of it between hospital administrator and medical personnel on doctor-patient relationship. Methods Questionnaire survey was used to investigate 114 hospital administrators and 378 medical personnel, and the result was analyzed by statistical techniques. Results There are statistical significance between hospital administrator and medical personnel in terms of their evaluation difference on doctor-patient relationship, and the evaluation difference is relevant to their life satisfaction and work experience. Conclusion The difference in working principle between hospital administrator and medical personnel is the key issue in the evaluation difference on doctor-patient relationship; hospital administrator needs to strengthen the management theory of humanism, manage the hospitar scientifically , as well as pursue high medical quality, and build up a strong foundation for hospital, construct a harmonious relationship between doctors and patients.%目的 了解医院行政管理人员与医护人员对医患关系的总体评价,探究其差异产生的原因.方法 对北京市5家三级甲等医院114名医院行政管理人员和378名医护人员进行问卷调查,运用秩和检验、Logistic回归等方法对其结果进行统计学分析.结果 医院行政管理人员与医务人员对医患关系的评价存在差异,具有统计学意义;差异产生的原因与他们的生活满意度和工作总体感受相关.结论 医院行政管理人员与医护人员对医患关系评价的差异与其各自的岗位特点有直接关系;医院行政管理需加强人本管理理念,科学管理医院,同时追求更高的医疗质量,打造坚实的医院品牌,构建和谐的医患关系.

  10. Abridged version of the AWMF guideline for the medical clinical diagnostics of indoor mould exposure: S2K Guideline of the German Society of Hygiene, Environmental Medicine and Preventive Medicine (GHUP) in collaboration with the German Association of Allergists (AeDA), the German Society of Dermatology (DDG), the German Society for Allergology and Clinical Immunology (DGAKI), the German Society for Occupational and Environmental Medicine (DGAUM), the German Society for Hospital Hygiene (DGKH), the German Society for Pneumology and Respiratory Medicine (DGP), the German Mycological Society (DMykG), the Society for Pediatric Allergology and Environmental Medicine (GPA), the German Federal Association of Pediatric Pneumology (BAPP), and the Austrian Society for Medical Mycology (ÖGMM).

    Wiesmüller, Gerhard A; Heinzow, Birger; Aurbach, Ute; Bergmann, Karl-Christian; Bufe, Albrecht; Buzina, Walter; Cornely, Oliver A; Engelhart, Steffen; Fischer, Guido; Gabrio, Thomas; Heinz, Werner; Herr, Caroline E W; Kleine-Tebbe, Jörg; Klimek, Ludger; Köberle, Martin; Lichtnecker, Herbert; Lob-Corzilius, Thomas; Merget, Rolf; Mülleneisen, Norbert; Nowak, Dennis; Rabe, Uta; Raulf, Monika; Seidl, Hans Peter; Steiß, Jens-Oliver; Szewszyk, Regine; Thomas, Peter; Valtanen, Kerttu; Hurraß, Julia


    . Whether or not toxin formation occurs in individual cases is determined by environmental and growth conditions, above all the substrate. In the case of indoor moisture/mould damage, everyone can be affected by odour effects and/or mood disorders. However, this is not a health hazard. Predisposing factors for odour effects can include genetic and hormonal influences, imprinting, context and adaptation effects. Predisposing factors for mood disorders may include environmental concerns, anxiety, condition, and attribution, as well as various diseases. Risk groups to be protected particularly with regard to an infection risk are persons on immunosuppression according to the classification of the German Commission for Hospital Hygiene and Infection Prevention (Kommission für Krankenhaushygiene und Infektionsprävention, KRINKO) at the Robert Koch- Institute (RKI) and persons with cystic fibrosis (mucoviscidosis); with regard to an allergic risk, persons with cystic fibrosis (mucoviscidosis) and patients with bronchial asthma should be protected. The rational diagnostics include the medical history, physical examination, and conventional allergy diagnostics including provocation tests if necessary; sometimes cellular test systems are indicated. In the case of mould infections the reader is referred to the AWMF guideline "Diagnosis and Therapy of Invasive Aspergillus Infections". With regard to mycotoxins, there are currently no useful and validated test procedures for clinical diagnostics. From a preventive medicine standpoint it is important that indoor mould infestation in relevant dimension cannot be tolerated for precautionary reasons. With regard to evaluating the extent of damage and selecting a remedial procedure, the reader is referred to the revised version of the mould guideline issued by the German Federal Environment Agency (Umweltbundesamt, UBA).

  11. NATO mission in Kosovo: historical backgrounds and informations of working as radiologist in the German field hospital; Der Kosovoeinsatz der NATO: Geschichtliche Hintergruende und Informationen zur Arbeit im Einsatzlazarett der Bundeswehr aus Sicht eines Radiologen

    Voelk, M.; Danz, B. [Bundeswehrkrankenhaus Ulm (DE). Abt. VIII (Radiologie)


    The first part of this article describes how the NATO mission in Kosovo came into existence and focuses on the historical background and ethnical problems. The second part deals with the working conditions of a radiologist in the German field hospital in Prizren and focuses on the personnel and technical equipment in the radiological department. (orig.) [German] Der vorliegende Artikel befasst sich im 1. Teil mit den Hintergruenden, die zum Einsatz der NATO im Kosovo gefuehrt haben. Hierbei wird insbesondere auf die ethnischen und geschichtlichen Zusammenhaenge und Probleme eingegangen. Im 2. Teil wird aus der Sicht eines Radiologen im Einsatzland ueber die Arbeitsbedingungen im deutschen Einsatzlazarett in Prizren berichtet. Schwerpunkte liegen hier auf der personellen und technischen Ausstattung der radiologischen Abteilung. (orig.)

  12. Perspectives of Patients, Doctors and Medical Students at a Public University Hospital in Rio de Janeiro Regarding Tuberculosis and Therapeutic Adherence.

    Elizabeth da Trindade de Andrade

    Full Text Available The World Health Organization (WHO identifies 8.7 million new cases of tuberculosis (TB annually around the world. The unfavorable outcomes of TB treatment prevent the achievement of the WHO's cure target.To evaluate existing intersections in the conceptions relative to the knowledge of TB, the experience of the illness and the treatment.Doctors, medical students and patients were selected from a public university in Rio de Janeiro, Brazil, from 2011 to 2013. The data were obtained by semi-structured individual and focus group interviews, participant observation and a field journal. The inclusion of patients was interrupted due to saturation, and the inclusion of doctors and medical students stopped due to exhaustion. The theoretical background included symbolic Interactionism, and the analysis used rounded Theory. The analysis prioritized the actions/interactions axis.Twenty-three patients with pulmonary TB, seven doctors and 15 medical students were included. In the interviews, themes such as stigma, self-segregation, and difficulties in assistance emerged, in addition to defense mechanisms such as denial, rationalization, isolation and other mental mechanisms, including guilt, accountability and concealment of the disease. Aspects related to the assistance strategy, the social support network, bonding with the healthcare staff and the doctor-patient relationship were highlighted as adherence enablers. Doctors and students recommended an expansion of the theoretical and practical instruction on TB during medical students' education. The existence of health programs and policies was mentioned as a potential enabler of adherence.The main concepts identified were the stigma, self-segregation, guilt, responsibility, concealment and emotional repercussions. In relation to the facilitation of therapeutic adherence, the concepts identified were the bonds with healthcare staff, the doctor-patient relationship, assistance and educational health

  13. Evaluation of the knowledge, attitude and the practice of pharmacovigilance among the interns and doctors in a tertiary level care teaching hospital in Northern India

    Manreet Singh Sekhon


    Conclusions: There is a great need to create awareness and to promote the reporting of ADR amongst interns and doctors, which will lay a solid foundation for these healthcare professionals to be involved in quality pharmacovigilance. [Int J Basic Clin Pharmacol 2016; 5(3.000: 1068-1074

  14. 浅谈医院在营造良好医患关系中的作用%The Roles of Hospital in Building Harmonious Doctor-Patient Relationship

    季学磊; 葛艺东; 程结南; 姜兰兰; 朱苏月; 徐明亮; 崔人喜; 王谊雯; 何思忠


    随着卫生医疗服务水平的提高,医患矛盾却呈现日益加重的趋势。作为医患关系发生的主要场所,医院在营造良好医患关系方面有着不可替代的作用。本文将从医院管理层面来探讨如何建构良好的医患关系。%With the development of social economy and socioculture,health service in China has made great improve.However,the doctor-patient contradiction has been undergoing a severe trial. As the main venue where the doctor-patient relationship occurred,the hospital plays an impotent role in establishment of a good rapport between physicians and patients.The aim of this article is to discuss how to establish a harmonious doctor-patient relationship on a management level.

  15. Empirical analysis on the job satisfaction of doctors in public hospitals%公立医院医生工作本身满意度实证分析

    张宜民; 尹文强; 孙葵; 黄冬梅; 赵延奎; 李艳丽


    目的 了解我国公立医院医生工作本身满意度的现状和人口学特征差异,并识别其内部决定因素,为改善公立医院管理体制提供科学依据.方法 自行设计量表,按照多阶段分层抽样的方法,从全国4个省区抽取公立医院医生5 677名,对所获样本数据进行实证分析.结果 量表信度和效度良好;公立医院医生工作本身满意度的平均得分较高,表示"较满意"及以上的人群占样本总量的78.20%;在是否带教及不同级别医院、年龄、工作年限、职称、科室等变量上,差异有统计学意义;主要受专业兴趣、性格适合、医疗保险自主及工作胜任等因素的影响.结论 注意不同医生群体间的差异,积极发挥主要决定因素的内在激励作用,提高公立医院医生对工作本身的满意程度,可有效改善医疗服务质量.%Objective To understand the current status and demographic differences in job satisfaction of doctors in public hospitals and find out the internal determinants, with the aim of providing scientific basis for improving the management mechanism of public hospitals. Methods A total of 5 677 doctors in public hospitals from four provinces were enrolled by method of multi-stage stratifiedsampling, and they were tested by the self-designed scale. Empirical analysis was conducted on the acquired data. Results The reliability and validity of the self-designed scale were good. Most doctors in public hospitals were highly satisfied with their job, with the population being 78.20% of the total. The differences were significant on partial demographic variables, including whether teaching, grade of hospital, age, length of service, professional title, department, etc. The job satisfaction was mainly determined by such factors as interest on speciality, whether in suit with character, medical autonomy, job competence, etc. Conclusion The quality of medical services can be improved by attaching importance to the

  16. Hospitals

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

  17. Choosing a Family Doctor

    ... nav nav, .header-9#header-section #main-nav, #overlay-menu nav, #mobile-menu, #one-page-nav li . ... editorial staff Home Your Health Resources Doctor Visit Preparation Choosing a Family Doctor Choosing a Family Doctor ...

  18. The research of Chinese medical students′understanding current of China's doctor-patient relationship in teaching hospital%教学医院医学生对我国医患关系现状认知的研究

    蒋晓敏; 孙忠河


    As contradictions and disputes of doctor-patient relationship are increasingly intensified, Chinese medical students have faced big challenge of it. This paper recognizes the importance of solutions. With reference to some surveys of medical residents in school and hospital, the authors emphasize that strong clinical skills, patient-centered model, good communication and optimistic attitude are the keys to improving doctor-patient relationship, so that to guide the medical students in teaching hospitals to get better learning and clinical practicing.%我国医患关系日益紧张,医学生如临深渊.本文运用文献总结、学生采访等手段,通过探究医患关系现状、原因以及医学生对现状的认识,力求深化医患沟通知识及技巧,得出改善医患关系的启示,以指导教学医院医学生更好地学习和实习.

  19. 医患关系视角下的医院管理者角色期待%Expectations of the Role of Hospital Administrators to Harmonize the Doctor-Patient Relationship

    王倩云; 郑龙; 吕书革


    医院管理者在构建和谐医患关系中发挥着重要作用,是组织架构的优化者、环境变化的调适者、决策执行的督导者、和谐人际的引领者。本文通过对医院管理者角色定位、履职影响因素的分析,提出管理者应做好“五个关注”,推动医患关系趋于和谐稳定。%Hospital Administrators play an important role in building a harmonious doctor -patient rela-tionship.They will make the crucial function in the organizational structure , regulation of circumstance changes , and supervision of decision -making executive , and leading the construction of harmonious interpersonal .In this paper, the roles of the hospital administrators and influence factors to fulfill the roles were analyzed , and then five issues were put forward to promote the doctor -patient relationship .

  20. Prevalence and molecular characteristics of methicillin-resistant Staphylococcus aureus (MRSA) among pigs on German farms and import of livestock-related MRSA into hospitals

    Köck, R; Harlizius, J; Bressan, N; Laerberg, R; Wieler, L H; Witte, W; Deurenberg, R H; Voss, A; Becker, K; Friedrich, A W


    The aim of this study was to evaluate the prevalence and molecular characteristics of methicillin-resistant Staphylococcus aureus (MRSA) among pigs and estimate the impact of this animal reservoir on human healthcare. Nasal swabs were derived from 1,600 pigs at 40 German farms. The MRSA were charact

  1. Patient-Related Factors Influencing Satisfaction in the Patient-Doctor Encounters at the General Outpatient Clinic of the University of Calabar Teaching Hospital, Calabar, Nigeria

    Ndifreke E. Udonwa


    Full Text Available Medical consultation is at the centre of clinical practice. Satisfaction of a patient with this process is a major determinant of the clinical outcome. This study sought to determine the proportion of patients who were satisfied with their doctor-patient encounter and the patient-related factors that affected patients’ satisfaction with the consultation process. A clinic-based, cross-sectional study using a modified version of the General Practice Assessment Questionnaire (GPAQ, which employed a systematic sampling technique, was used. The questionnaires were administered on 430 patients within the ages of 18 years and 65 years. Among the 430 subjects within the ages of 18 years and 65 years studied, 200 (46.5% were males and 230 (53.5% were females. Only 59.3% were satisfied with their patient-doctor encounter. The patient’s perception of time spent in the consultation, illness understanding after the visit, ability to cope with the illness after the visit, and ability to maintain health after visit were the only factors that affected patient’s satisfaction with the consultation. In our environment, nonsatisfaction with the patient-doctor encounter is high. Only few factors considered to encourage a patients satisfaction at primary care consultation contributed to end-of-consultation satisfaction. This calls for refocusing so as to improve the overall patient care in our cultural context and meet the patient needs in our environment.

  2. German Guidelines.

    Kruis, Wolfgang; Nguyen, Gia P; Leifeld, Ludger


    Because of its frequency, diverticular disease is a burden on health care systems. Only few formal guidelines covering all aspects of the disease exist. Here, some selected statements from the German guidelines are given. The guidelines include significant recommendations for the diagnosis and management of diverticular disease. Both diagnosis and management depend definitely on clear definitions of the situation of an individual patient. Therefore, a new classification is proposed that is based on earlier suggestions. An internationally established classification would not only enable better patient care but could also lead to studies with comparable results.

  3. Positioning doctors for convenience medicine.

    Haley, M


    Faced with an increasingly competitive environment, physicians must learn to organize themselves into group practices positioned to perform as the customer expects. To be successful, these new group practices must recruit the kind of physician who will meet the consumer's demands for quality care: convenience, continuity of care, and confidence in the doctor's competence. This article describes how doctors can become more competitive based on my observations as a former consultant with such healthcare companies as Cigna Healthplan, the largest for-profit HMO, and as the current vice president of Operations Planning and Development with Republic Health Corporation, a Dallas-based hospital management company. These observations should help hospital managers learn how to organize their medical staffs to better serve the patient's needs. By repositioning their physician services, hospitals should become better positioned to compete for new patients.

  4. 'I Used to Fight with Them but Now I Have Stopped!': Conflict and Doctor-Nurse-Anaesthetists' Motivation in Maternal and Neonatal Care Provision in a Specialist Referral Hospital.

    Matilda Aberese-Ako

    Full Text Available This paper analyses why and how conflicts occur and their influence on doctors and nurse-anaesthetists' motivation in the provision of maternal and neonatal health care in a specialist hospital.The study used ethnographic methods including participant observation, conversation and in-depth interviews over eleven months in a specialist referral hospital in Ghana. Qualitative analysis software Nvivo 8 was used for coding and analysis of data. Main themes identified in the analysis form the basis for interpreting and reporting study findings.Ethical clearance was obtained from the Ghana Health Service Ethics Review board (approval number GHS-ERC:06/01/12 and from the University of Wageningen. Written consent was obtained from interview participants, while verbal consent was obtained for conversations. To protect the identity of the hospital and research participants pseudonyms are used in the article and the part of Ghana in which the study was conducted is not mentioned.Individual characteristics, interpersonal and organisational factors contributed to conflicts. Unequal power relations and distrust relations among doctors and nurse-anaesthetists affected how they responded to conflicts. Responses to conflicts including forcing, avoiding, accommodating and compromising contributed to persistent conflicts, which frustrated and demotivated doctors and nurse-anaesthetists. Demotivated workers exhibited poor attitudes in collaborating with co-workers in the provision of maternal and neonatal care, which sometimes led to poor health worker response to client care, consequently compromising the hospital's goal of providing quality health care to clients.To improve health care delivery in health facilities in Ghana, health managers and supervisors need to identify conflicts as an important phenomenon that should be addressed whenever they occur. Effective mechanisms including training managers and health workers on conflict management should be put in

  5. 三甲儿童医院门诊护理细节管理对医患关系的影响%Affect Tertiary Level Children's Hospital Outpatient Care Details of the Management of the Doctor-patient Relationship



    Objective Investigate the ef ect of a large children's hospital outpatient care and management of the doctor-patient relationship details. Methods This study used self-made questionnaire on 625 cases of children or their families were anonymous survey. The questionnaire mainly related to nurses, family members and hospital three children, a total of 11 questions. Results Patient identity details of outpatient care af ect patient relationship before six were ranked poor at itude of nurses (97%), basic nursing skil s unskil ed technical operations (94.9%), lack of communication skil s (91.5%), professionalism is not high (81.9%), lack of humane care (75%), poor mental quality (60%) ,Families of children with pediatric medical knowledge of the relevant legal knowledge and understanding is not enough, hospital outpatient department of the hospital environment factors such as poor doctor-patient relationship is af ected. Conclusion Strengthen management can improve patient care details of the families of children with satisfaction, Improve the doctor-patient relationship, Reduce the occur ence of medical disputes.%目的:探讨大型儿童医院门诊护理细节管理对医患关系的影响。方法本研究采用自制调查问卷对625例患儿或家属进行无记名调查。调查问卷主要涉及护理人员、患儿家属及医院三个方面,共11个问题。结果患者认同门诊护理细节影响医患关系排名前六的分别是护理人员的服务态度恶劣(97%)、基础护理技术操作技巧不熟练(94.9%)、缺乏沟通技巧(91.5%)、专业素养不高(81.9%)、缺乏人文关怀(75%)、心理素质较差(60%),患儿家属对相关儿科医学知识和法律知识了解不够,医院门诊部的就医环境较差等也是影响医患关系因素。结论加强门诊护理细节管理可以提高患儿家属满意度,改善医患关系,减少医疗纠纷的发生。

  6. How does a doctor study other doctors being doctors?

    Risør, Torsten

    The intension of this presentation is to encourage debate on auto-ethnography in medical systems. The empirical starting point will be my present study of how young doctors learn to make decisions about diagnosis and treatment of the individual patient. The study is an ethnographic field study...... involving participant observation and individual interviews with nine newly graduated doctors for a period of 18 months. The background of the ethnographer who is also the author of the present abstract poses a few interesting challenges to the study. I am a doctor doing fieldwork in my own medical culture......, among other doctors, at departments where I have worked. My parents, my sister and my grandfather are doctors. So reflections and experiences concerning medicine and being a doctor are integrated parts of my personal history and identity. Will I be capable of critical reflection on something...

  7. Media Coping Strategy for Doctor-patient Dispute Processing in Hospital%医院在医患纠纷处理中的媒体应对策略



    阐述了医患纠纷中媒体介入的影响及媒体应对在医院医患纠纷处理中的重要性,讨论了目前医院媒体应对中存在的主要问题,并提出医院在医患纠纷中的媒体应对策略,主要有:迅速查明真相,积极配合媒体报道;发布权威消息,还原事件真相;监督媒体报道,严惩侵权行为;开通医院官方微博、微信公众平台。%This paper expounded the influences of the doctor -patient dispute media intervention and media re-sponse in the importance of the hospital medical disputes processing , discusses the media response to the main problems existing in the hospital , and put forward hospital in media strategies of medical disputes , mainly include:quickly find out the truth , actively cooperate with media;Release authoritative information , restore the truth;Su-pervision and media reports , punish infringement behavior;Opened a hospital official weibo , WeChat public plat-form.

  8. Understanding doctors' ethical challenges as role virtue conflicts.

    McDougall, Rosalind


    This paper argues that doctors' ethical challenges can be usefully conceptualised as role virtue conflicts. The hospital environment requires doctors to be simultaneously good doctors, good team members, good learners and good employees. I articulate a possible set of role virtues for each of these four roles, as a basis for a virtue ethics approach to analysing doctors' ethical challenges. Using one junior doctor's story, I argue that understanding doctors' ethical challenges as role virtue conflicts enables recognition of important moral considerations that are overlooked by other approaches to ethical analysis.

  9. Doctors' involvement in torture

    Sonntag, Jesper


    Doctors from both non-democratic and democratic countries are involved in torture. The majority of doctors involved in torture are doctors at risk. Doctors at risk might compromise their ethical duty towards patients for the following possible reasons: individual factors (such as career, economic...

  10. German Studies in America. German Studies Notes.

    Sander, Volkmar; Osterle, Heinz D.

    This volume contains two papers, "German Studies in America," by Volkmar Sander, and "Historicism, Marxism, Structuralism: Ideas for German Culture Courses," by Heinz D. Osterle. The first paper discusses the position of German studies in the United States today. The greatest challenge comes from low enrollments; therefore,…

  11. German Studies in America. German Studies Notes.

    Sander, Volkmar; Osterle, Heinz D.

    This volume contains two papers, "German Studies in America," by Volkmar Sander, and "Historicism, Marxism, Structuralism: Ideas for German Culture Courses," by Heinz D. Osterle. The first paper discusses the position of German studies in the United States today. The greatest challenge comes from low enrollments; therefore,…


    Medical Service


    IN URGENT NEED OF A DOCTOR GENEVA EMERGENCY SERVICES GENEVA AND VAUD 144 FIRE BRIGAD 118 POLICE 117 CERN FIREMEN 767-44-44 ANTI-POISONS CENTRE Open 24h/24h 01-251-51-51 Patient not fit to be moved, call family doctor, or: GP AT HOME, open 24h/24h 748-49-50 Association Of Geneva Doctors Emergency Doctors at home 07h-23h 322 20 20 Patient fit to be moved: HOPITAL CANTONAL CENTRAL 24 Micheli-du-Crest 372-33-11 ou 382-33-11 EMERGENCIES 382-33-11 ou 372-33-11 CHILDREN'S HOSPITAL 6 rue Willy-Donzé 372-33-11 MATERNITY 32 la Cluse 382-68-16 ou 382-33-11 OPHTHALMOLOGY 22 Alcide Jentzer 382-33-11 ou 372-33-11 MEDICAL CENTRE CORNAVIN 1-3 rue du Jura 345 45 50 HOPITAL DE LA TOUR Meyrin EMERGENCIES 719-61-11 URGENCES PEDIATRIQUES 719-61-00 LA TOUR MEDICAL CENTRE 719-74-00 European EmergencyCall 112 FRANCE EMERGENCY SERVICES 15 FIRE BRIGADE 18 POLICE 17 CERN FIREMEN AT HOME 00-41-22-767-44-44 ANTI-POISONS CENTRE Open 24h/24h 04-72-11-69-11 All doctors will...

  13. 湖北省部分医院创伤急救颈椎保护技能现状调查%Present status of cervical immobilization skills for trauma of some hospital doctors of Hubei Province

    杨奇盛; 赵剡; 王翔; 宋小兵; 潘正启


    Retrospective analysis was conducted for the results of first-aid competitions so as to understand the present status of how emergency doctors of Hubei Province grasp the skills and consciousnesses of cervical immobilization.From 6 out of 19 teams,38 participating doctors from grade 3A hospitals provided patient cervical immobilization while 2 teams offered no cervical protection.It is necessary to intensify the skills and consciousnesses of cervical immobilization in clinical practice.%回顾分析湖北省急救医师技能竞赛中创伤急救颈椎保护比赛结果,了解全省急救医师保护颈椎的意识、手法等基本技能掌握情况.全省19支三级甲等医院(含市州级急救中心)代表队的38人参赛,6支队实施了颈椎保护动作,2支队未对颈椎进行任何保护.提示在临床工作中要不断强化保护颈椎意识、规范保护颈椎手法和正确放置颈托的方法.

  14. Automatisierte Artikelbestellverwaltung: Doctor-Doc – ein bibliothekarisches Verwaltungswerkzeug / Automation in Interlibrary Loan: Doctor-Doc – a tool for librarians

    Fischer, Markus


    Full Text Available Interlibrary loan has always been an important service to supplement own library holdings.To organize and standardize the order process of journal articles for 6 hospitals, we did create an online tool for the Solothurner Spitäler AG. The resulting application is available for libraries free of charge under The application is maintained and will be further developed by an association founded specially for this purpose. Doctor-Doc is not a supplier of articles, but rather a platform to organize orders at existing suppliers like Subito, British Library or any other supplying libraries. Doctor-Doc is OpenURL compliant and is able to resolve identifiers like PMIDs. In combination with an existing account from the german EZB, libraries can use the application as a linkresolver.The application has become an essential tool to efficiently manage interlibrary loan for the Solothurner Spitäler AG. The tool is also used by many libraries in Germany and Switzerland.

  15. ["Smoked meat, full of rind, hardly edible"--patient's complaints and doctor's rebuttal in the first German state-run mental sanatory "Rasemühle" between 1903 and 1932].

    Fangerau, Heiner


    Around 1900 a psychiatric reform movement propagated the foundation of sanatoriums for the lower middle class in Germany. These sanatoriums were supposed to cure patients suffering from neurasthenia and associated disorders. Many private sanatoriums existed for curing neurasthenia. Visiting them was a luxury beyond most of the patients' means. Therefore, the so called "Volksnervenheilstätten"-movement aimed at providing sanatorium care for free or at very low costs. One of the first sanatoriums that arose from this movement was the "Rasemühle" close to Goettingen. It was founded in 1903. As a governmentally funded institution for the less wealthy the "Rasemühle" constantly moved between legitimation and critique. Areas of conflict included on the one hand the need to operate economically (as requested by the sponsor) and on the other hand the demands of neurasthenic patients for optimal care and cure. Patients' complaints about the sanatorium addressed to the financiers or governmental institutions and the reactions of the sanatorium's director serve as a valuable tool for reconstructing these areas of conflict. An analysis of the complaint files of the "Rasemühle" between 1903 and 1932 reveals that complaints usually included food, accommodation and the doctors' behaviour. Before the First World War the sanatorium's reaction usually aimed at pathologising patients who put forward complaints. Complaining was described as a symptom of the treated disorder. After financiers and insurance companies had reduced their engagement for neurasthenics during the late 1920s financing the sanatorium became more difficult. With the vanishing neurasthenia discourse the "Rasemühle" had to enter the market of private patients to survive. Now the reaction to complaints shifted to understanding. The responsible government agency was asked to invest into the sanatorium to make it competitive on the market. Patients were not seen anymore as unwilling petitioners but as customers

  16. hospital

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

  17. Do junior doctors take sick leave?

    Perkin, M R; Higton, A; Witcomb, M


    Nosocomial infections place a heavy burden on overstretched health services. An audit of junior doctors' sick leave behaviour was undertaken in 1993 and again in 2001. The object was to ascertain the level of common infectious illness and to investigate whether junior doctors were remaining at work inappropriately. The doctors were asked if any factors had influenced their decision to take sick leave or not. Between the two audits several initiatives have been introduced to improve the working conditions of junior doctors, including the New Deal to reduce hours of work. Eighty one junior doctors in a large teaching hospital participated in 1993 and 110 in 2001. The number reporting an infectious illness in the previous six months was similar (61.7% in 1993, 68.2% in 2001). There had been a significant increase in the percentage of infectious illness episodes for which the doctors took sick leave (15.1% in 1993, 36.8% in 2001, p work (72% in 1993, 68% in 2001). Consultant pressure was cited by 26% (1993) and 20% (2001). Use of the staff occupational health unit was minimal, with none of the ill doctors contacting the department in 1993 and only three in 2001. Overall, despite the reduction in the number of infectious doctors not taking sick leave, the majority remained at work. Fundamental changes are needed if potentially infected doctors are not to present a risk of iatrogenic infection.

  18. [Economic aspects of anesthesia. I. Health care reform in the German Republic].

    Bach, A; Bauer, M


    Implications for Hospitals and Departments of Anaesthesiology. This article outlines the new German health care laws and their impact on the statutory health care system, hospitals and anaesthesia departments. The German health care system provides coverage for all citizens, although financial support from the public sector is on the downgrade. Hence, pressure to reduce public sector health care spending is likely to continue in the near future. Hospital costs account for one-third of total health care spending in Germany, and hospitals are facing increasing economic constraints: the volume and the charges for specific medical treatments are negotiated between the hospitals and the insurance agencies (or sickness funds) in advance. Only part of hospital care is still reimbursed on the basis of a per diem rate, and an increasing number of services are based on fixed payments per case or treatment. Reducing the costs for this treatment is therefore of utmost importance for hospitals and hospital departments. The prospective payment system and the pressure to contain costs demand a controlling system that allows for cost accounting per case. However, an economic evaluation must include comparative analysis of alternative therapeutic options in terms of both costs and outcome. Economic aspects challenge the traditional relationship between physicians and patients: doctors are still the advocates of their patients, but also act as agents for their institutions. Nevertheless, not only economic issues, but also ethical priorities and the value of an anaesthetic practice must be considered in the era of cost containment. Anaesthetists must be actively involved in providing high-quality care with its obvious benefits for the patient and be able to resist efforts to cut out expensive treatment modalities regardless of their benefits.

  19. Doctoral specialization in nursing informatics.

    Gassert, C. A.; Mills, M. E.; Heller, B R


    A prototype program of doctoral study has been developed at the University of Maryland School of Nursing to prepare students with nursing expertise in the conceptualization and research of computer based information systems in hospitals, industry and other health care organizations. The graduate will be prepared to design effective nursing information systems; create innovative information technology; conduct research regarding integration of technology with nursing practice, administration, ...

  20. 三级医院医师临床能力评价方法的研究%Research on evaluation methods of doctor clinical competence in tertiary hospital

    符晓婷; 袁蕙芸


    目的适应三级医院医师临床能力科学评价、人才招聘与培养和确保医院医疗质量的需要,开展医师临床能力评价必要性、评价原则、主体、内容、方法等方面的研究,为完善医师临床能力的评价方法提供建议.方法综合运用文献检索、专家咨询、问卷调查等方式,对三级医院医师临床能力评价方法进行探讨,采用SPSS17.0统计软件包进行统计和分析.结果三级医院医师临床能力评价应注重定性定量相结合、主观客观相结合的评价原则,评价主体以上级医师为主体,多方共同参与评价,从临床工作能力、绩效与态度三方面内容进行评价,以考核评价为主、考试评价为辅,评价结果可应用于职称晋升、岗位配置、招聘等多项人力资源管理领域.结论建议从六方面优化三级医院医师临床能力评价方法.%Objectives: To meet the need of scientific evaluation of doctors' clinical competence, talents recruits and quality of medical treatment in tertiary hospital, the research on evaluation necessary, principle, evaluator, contents and methods aims to provide advice on the improvement of doctors' clinical competence evaluation. Methods: The study explored the status and trends of the evaluation method of clinical competence through documentation retrieval, questionnaire and expert interviews, and used SPSS 17.0 in data analysis. Results: The evaluation of doctors' clinical competence in tertiary hospitals should combine the qualitative method with the quantitative method and the subjective method with the objective method. Depend on participating with all parts like peers,inferiors, patients and oneself,the main body of evaluation should be superior doctors. The evaluation results should be based on the aspects of clinical capabilities, performance and attitude.The evaluation manner should be based on the performance appraisal and the subjective judgments with examination as a

  1. Cost incentives for doctors

    Schottmüller, Christoph


    If doctors take the costs of treatment into account when prescribing medication, their objectives differ from their patients' objectives because the patients are insured. This misalignment of interests hampers communication between patient and doctor. Giving cost incentives to doctors increases...... welfare if (i) the doctor's examination technology is sufficiently good or (ii) (marginal) costs of treatment are high enough. If the planner can costlessly choose the extent to which doctors take costs into account, he will opt for less than 100%. Optimal health care systems should implement different...... degrees of cost incentives depending on type of disease and/or doctor....

  2. Individual performance review in hospital practice: the development of a framework and evaluation of doctors' attitudes to its value and implementation.

    Trebble, T M; Cruickshank, L; Hockey, P M; Heyworth, N; Powell, T; Clarke, N


    Appraisal, or independent performance review (IPR) is used in human resources management in the commercial and public sectors to evaluate the performance of an employee against agreed local organisational expectations and objectives, and to identify their requirements for development and effective management. IPR for NHS consultants may provide essential information for job planning, contribute towards medical appraisal for revalidation, and facilitate productivity and quality improvement. To develop a framework for IPR for consultants, and to determine attitudes on its value, process and content. Information from commercial, public and voluntary sector models and published and other literature sources were used to develop an IPR framework. This was assessed through a three-cycle action research methodology involving qualitative interviews with 22 consultants (predominantly with medical management roles). The domains of the IPR framework included: (1) performance against objectives; (2) behaviour and leadership; (3) talent management; (4) agreed future objectives. A number of themes were identified from the consultant interviews including: ineffective current appraisal systems reflecting a lack of valid performance data and allotted time; a lack of empowerment of medical managers to address performance issues; IPR as a more explicit system, offering value in evaluating doctors performance; and the dependence of successful implementation on the engagement of the Trust executive. IPR may have value for performance evaluation of consultants, contributing toward job planning and complementing medical appraisal. Support by their employing organisation and engagement with medical managers in design and implementation is likely to be essential.

  3. Find a Cancer Doctor

    ... Home > Find a Cancer Doctor Find a Cancer Doctor Status message Locating you... The Find an Oncologist ... and caregivers. The database includes the names of physicians and other health professionals from certain ASCO membership ...

  4. Coaching doctoral students

    Godskesen, Mirjam Irene; Kobayashi, Sofie


    In this paper we focus on individual coaching carried out by an external coach as a new pedagogical element that can impact doctoral students’ sense of progress in doctoral education. The study used a mixed methods approach in that we draw on quantitative and qualitative data from the evaluation......-reported gains from coaching show that doctoral students experience coaching as an effective method to support the doctoral study process. This study also provides preliminary empirical evidence that coaching of doctoral students can facilitate the doctoral study process so that the doctoral students experience...... an enhanced feeling of progress and that they can change their study behaviour in a positive direction. The study discusses the difference between coaching and supervision, for instance power imbalances and contrary to earlier research into coaching of doctoral students this study indicates that coaching can...

  5. Strains in the nurse-doctor relationship.

    Selmanoff, E D


    Many problems and conflicts between nurses and doctors in the hospital stem from the organizational structure of the hospital rather than from the personalities of the individuals involved. Nurses often assert the latter. Understanding these conflicts requires that they be examined in terms of the organizational context within which they occur. To understand the modern American hospital it is useful to view its development. Private practitioners who at one time had cared for patients in their homes shifted the locus of care to the hospital as medical care became more complex in the latter half of the nineteenth century. Three selected aspects of hospital structure that are seen as sources of strain for nurses in their relationship with doctors are: (1) Doctors do not see themselves as full-fledged members of the hospital organization. While nurses, who do, feel bound by the operating rules of the hospital, doctors tend to operate as free agents. There is probably little that nurses can do to reduce this source of strain. (2) The hospital has two lines of authority, administrative and medical, unlike most large-scale organizations which have only one. Nurses are in the former while doctors are in the latter hierarchy. The "influence relationship" between nurses and doctors is largely unarticulated; informally "negotiated" patterns prevail. Nurses can be more aggressive in attempting to develop institutional patterns that are mutually satisfactory to themselves and to doctors and that meet the needs of the hospital as a whole. (3) In the absence of a functioning health team nurses have assumed responsibility, without the requisite authority, for the coordination of patient care. Although this action is for the immediate benefit of patients nurses should realize that it also tends to retard the development of needed organizational changes in the hospital. Nurses generally accept the possibility of changing the personality structure of an individual. They should be


    Avtar Singh


    Full Text Available BACKGROUND : Disruptive behavior in a medical setting is defined as objectionable or offensive interpersonal behavior that leads to disruption of professional activities in the workplace. 1 It has been observed that majority of doctors do not show disruptive behavior in their day today conduct and only few doctors are identified for their disruptive behavior . Special commi ttee on professional conduct and ethics defines disruptive behavior in physicians as aberrant behavior manifested through personal interaction with physicians , hospital personnel , health care professionals , patients , family members or others which interferes with patient care or could reasonably be expected to interfere with the process of delivering quality care. 2 Common forms of disruptive behaviors generally seen amongst young doctors are use of abusive language , yelling or shouting at patients , colleagues and subordinate staff , showing in disciplined behavior and at times indulging in physical abuse. 3 - 4 STUDY DESIGN : Study was conducted at a tertiary care hospital where 614 health care professionals participated which included 108 doctors 432 nurs ing staff and 74 paramedical staff METHOD : Data collection was done by semi structured pretested questionnaire and was entered in Microsoft Excel and analyzed for frequency and percentages . RESULTS : 64 % doctor , 66% nursing staff and 50% of the paramedicals answered that they have seen doctors showing disruptive behavior at one time or the other . Not all the doctors show disruptive behavior but this type of aberrant behavior is seen mainly in2 - 3 percent of doctors only. While answering to the que stion as to the type of disruptive behavior , 57% health care professionals reported that commonest form of disruptive behavior noticed by them amongst doctors was yelling or shouting on junior staff , patients and colleagues . 47% answered that doctors with disruptive behavior do not follow laid down orders or

  7. 提升医院管理水平的数字化无线医护管理系统%Digital wireless doctor-nurse management system to upgrade hospital management



    介绍了数字化医院框架的设计,并在此基础上研究开发了无线医护管理系统.阐述了无线医护管理系统的总体架构,探讨了无线医护管理系统整体建设中的关键技术:移动计算和EDA技术,无线局域网技术,中间件技术和条码和RFID技术,为医院信息化的建设提供参考.%This paper introduced the framework designs of digitalized hospitals,and developed the wireless doctor-nurse management system on such a framework.It described the overall structure of this wireless system,and probed into key technologies in overall construction of the system;mobile computing and EDA technologies,wireless LAN technology,mid-ware technology and RFID technologies.All these aimed at providing references for digitalized hospitals.Even more important,this paper has introduced the concept of overall system and key technologies.

  8. The Invention of a Medical Institution? A Discussion of Hospitals Around 1800

    Dross, Fritz


    Full Text Available The article considers the position of the hospital in the discussion on health care between self-help and formal poor relief. This is done for the late 18th and early 19th centuries when besides the famous hospital foundations e.g. in Vienna and Würzburg, a lot of hospital foundations failed. Although hospitals had been considered to be quite useful for the state by influential publicists, in the German territories neither public opinion nor doctors favoured central hospital care for the poor around 1800. A policinical model with an essential portion of curing the sick in their homes had been the modernist model of medical help in terms of late 18th / early 19th century discourse. The process of inventing the hospital as a new medical institution was based on the acceptance of family and kinship networks as requisite parts of medical help.

  9. Impact of Doctor-patient Relationship in Guangzhou on Hospital Crisis Management%广州地区医患关系状况对医院危机管理的影响分析

    林凯程; 耿仁文; 田柯; 周梅芳


    目的:对广州地区医院患者进行调查,了解患者对目前医患关系状况的评价、对医疗危机事件发生的态度及行为选择,分析医患关系状况对医院危机管理的影响.方法:采用自设问卷进行调查和访谈.结果:55.4%的患者认为目前医患关系状况好或较好;66.0%的患者认为诊疗中的医患沟通效果较好;63.9%的患者对医患沟通状况比较满意;大多数医务人员未能主动履行告知义务;72.8%的患者对医生开药或作检查有过疑问;72.8%的患者遇到医疗纠纷会首先找院方投诉;认为诊疗过失和对事件处理不够及时最易引发医疗危机事件,56.8%的患者认为危机事件会影响其选择.结论:采取多种方式加强医患沟通,预防危机事件的发生;加强医疗服务的质量管理,建立高效的危机处理机制,提高患者满意度;重视医疗危机事件的善后管理.树立新形象.%Objective To investigate patients of hospitals in Guangzhou and understand the relationship between patients on the current status of patient evaluation, medical crisis occurred choice attitudes and behavior, and to analyze crisis management of doctor-patient relationship. Methods Using self-based questionnaire and interview. Results 55.4% patients think that current state of physician-patient relationship is good or better; 66.0% patients think that communication between doctors and patients in clinics is better, and 63.9% patients is relatively satisfied with communication between doctors and patients; the majority of medical staff fail to fulfill this obligation initiatively; 72.8% patients are doubt of doctors' prescription and examination; 72.8% patients will complain to hospitals in medical disputes; 56.8% patients think that crisis events will affect their choice, because they think that the clinics on how to deal with negligence and lack of timely medicine are likely to trigger a crisis. Conclusion A variety of ways should be

  10. Talking to Your Child's Doctor

    ... to 2-Year-Old Talking to Your Child's Doctor KidsHealth > For Parents > Talking to Your Child's Doctor ... an important role in your child's health? The Doctor-Patient Relationship Today, doctors are pressured to see ...

  11. Working with doctors and nurses

    ... doctor Working with doctors and nurses Working with doctors and nurses Answering questions, filling out papers, getting ... my ability to pay? What questions will the doctor or nurse ask? top It’s a good idea ...

  12. Doctors in Balzac's work.

    Moulin, Thierry


    Balzac wrote his novels during a time of great literary and scientific change. Romanticism gave way to the school of realism, of which Balzac could be considered the founder. It was via realism, where both the positive and negative aspects of life were depicted, that doctors naturally gained a much more active role in novels. In conjunction with this was the development of science and medicine, which fascinated Balzac, also leading to the significant and prevalent role of doctors in his works. His fascination with the sciences led to him to gain many acquaintances and much knowledge in the medical domain, especially in neuropsychiatry and physiology. His fictional doctors, such as Desplein and Bianchon, thus demonstrate considerable knowledge of pathology, physiology, and neuropsychiatry. The doctors in Balzac's novels can be grouped into four categories: provincial doctors, Parisian doctors, country doctors, and military doctors. They were most often fictitious representations of real individuals (e.g. Guillaume Dupuytren), and often symbolize schools of thought which were in vogue at the time. In addition to the accurate scientific depiction of doctors, it must be noted that his doctors not only played an active role in clinically assessing their patients, but also had a sociological role in assessing society; it is through his doctors that Balzac gave his opinion of the world in which he lived.

  13. Immediately and with all available means: the Dutch Red Cross and the field hospital on behalf of the Netherlands Voluntary Legion in WWII.

    van Bergen, Leo


    Medical neutrality is one of the main principles of medical-humanitarian aid, and certainly of Red Cross aid. But how does this work in times of foreign occupation? Is it even possible then, or does it almost automatically lead to collaboration? The Dutch example of 1940-1945 gives some insight into this problem. Abandoning its post would end the aid the Dutch Red Cross (DRC) gave, so it was decided to stay in business. This, however, led to adherence to German orders, given not for humanitarian, but for military-political reasons. Amongst other things, the DRC helped to equip a field hospital for Dutch volunteers to the Waffen-SS on the eastern front, so directly strengthening the German war effort. It was clear that the doctors and nurses of this field hospital would do next to nothing to help save Russian sick or wounded, and that, if necessary, they would have to fight alongside German and Dutch soldiers.

  14. Factors associated with doctors' knowledge on antibiotic use in China.

    Bai, Yu; Wang, Sijie; Yin, Xiaoxv; Bai, Jigeng; Gong, Yanhong; Lu, Zuxun


    Misuse of antibiotics by the medical profession is a global concern. Examining doctors' knowledge about antimicrobials will be important in developing strategies to improve antibiotic use. The aim of the study was to survey Chinese doctors' knowledge on antibiotics and reveal the factors associated with their level of knowledge. A cross-sectional survey was conducted in Shanxi in central China. A total of 761 physicians were surveyed using a structured self-administered questionnaire. A generalized linear regression model was used to identify the factors associated with doctors' knowledge on antibiotic. Based on a full score of 10, the average score for doctors' knowledge on antibiotics was 6.29 (SD = 1.79). Generalized linear regression analysis indicated that doctors who either worked in the internal medicine department, who were chief doctors or who received continuing education on antibiotic, had better knowledge of antibiotics. Compared with doctors working in tertiary hospitals, doctors working in secondary hospitals or primary healthcare facilities had poorer knowledge about antibiotics. Chinese doctors have suboptimal knowledge about antimicrobials. Ongoing education is effective to enhance doctors' knowledge, but the effect remains to be further improved. More targeted interventions and education programs should improve knowledge about antimicrobials, especially for doctors working in primary healthcare institutions.

  15. Prevalence of stress in junior doctors during their internship training: a cross-sectional study of three Saudi medical colleges’ hospitals

    Abdulghani, Hamza Mohammad; Irshad, Mohammad; Al Zunitan, Mohammed A; Al Sulihem, Ali A; Al Dehaim, Muhammed A; Al Esefir, Waleed A; Al Rabiah, Abdulaziz M; Kameshki, Rashid N; Alrowais, Nourah Abdullah; Sebiany, Abdulaziz; Haque, Shafiul


    Background Medical science is perceived as a stressful educational career, and medical students experience monstrous stress during their undergraduate studies, internship, and residency training, which affects their cognitive function, practical life, and patient care. In the present study, an assessment of the prevalence of self-perceived stress among new medical graduates during their internship training has been performed, and correlations of self-perceived stress with sex, marital status, and clinical rotations have been evaluated. Patients and methods Interns of the King Khalid, King Abdulaziz, and King Fahd University hospitals in Saudi Arabia were invited to complete a stress inventory known as the Kessler 10, which is used for stress measurement. Apart from stress evaluation, the questionnaire collected personal data, such as age, sex, and marital status, in addition to information relevant to hospital training, assigned duties, and clinical training rotations. Results Our results showed that nearly 73.0% of interns were under stressed conditions. Most of the interns were affected by a severe level of stress (34.9%), followed by mild (19.3%) and moderate (18.8%) levels of stress. The stress level was significantly higher (84.0%) among female interns in comparison with male interns (66.5%) (odds ratio =2.64; confidence interval =1.59–4.39; P<0.0002). There were statistically significant differences between the percentages of male and female interns (P≤0.047) at mild, moderate, and severe stress levels. Marital status had no role in causing stress. The highest stress level was reported by interns during the clinical rotations of medicine (78.8%), followed by surgery (74.7%), pediatrics (72.4%), obstetrics and gynecology (70.1%), and emergency (58.3%). The prevalence of stress among the interns and their corresponding clinical rotations in all three hospitals had significant linear correlations (r≥0.829, P≤0.041). Conclusion We found a significantly

  16. Quality, safety, service and efifciency, the hospital survival and development-the German hospital study%质量、安全、服务和效率,医院生存和发展的根本--德国医院考察学习感悟



    本文在对德国医院进行考察学习的基础上,结合JCI认证相关知识条款提出:不论在何种体制下,医院要获得良好的生存和发展,一定是要始终坚持以病人为中心的理念,始终注重质量安全服务和效率。%In this paper, based on the study in learning German hospital, combining with the JCI certification related knowledge are proposed:no matter in what kind of systerm, the hospital needs to obtain the survival and development of needs good, must always adhwere to the concept of patient-centered, always pay attention to the quality of security service and efficiency.

  17. The German Middleway as Precursor for Single Embryo Transfer. A Retrospective Data-analysis of the Düsseldorf University Hospital's Interdisciplinary Fertility Centre - UniKiD.

    Kliebisch, T K; Bielfeld, A P; Krüssel, J S; Baston-Büst, D M


    Introduction: Patients receiving fertility treatment in Germany appear to be disadvantaged in comparison to those in other countries due to the restrictive Embryo Protection Act ("Embryonenschutzgesetz, ESchG"), which prohibits the selection of a "top" embryo. The so-called German Middleway ("Deutscher Mittelweg, DMW") now provides for a liberal interpretation of the ESchG by allowing the culture of numerous pronuclear stages (2PN stage). Materials and Methods: Retrospective cohort study of 2 assisted reproduction treatment cycles in n = 400 patients between the ages of 21 and 45 years, either treated 2× conservatively or 1× conservatively and 1× liberally according to DMW. Results: Pregnancy was achieved in 35 % of patients in the DMW group and 31 % of controls. The birth rate among controls was 28.5 % and 30.5 % in the DMW group. Most pregnancies resulted from the culture of 4 × 2PN stages. Conclusion: Patients in the DMW group had significantly higher pregnancy and birth rates compared to their previous cycles despite significantly increased age and significantly fewer transferred embryos. Key factors were the number of 2PNs generated and the quality of embryos transferred. Thus it can be assumed that particularly older patients with adequate ovarian reserves will benefit from DMW, i.e. the transfer of fewer embryos of the best possible quality.

  18. How does a doctor study other doctors being doctors?

    Risør, Torsten

    The intension of this presentation is to encourage debate on auto-ethnography in medical systems. The empirical starting point will be my present study of how young doctors learn to make decisions about diagnosis and treatment of the individual patient. The study is an ethnographic field study...... that is a part of me? How can I represent the experience and learning of my informants without simply reproducing my own experience? This makes the project both anthropology-at-home and auto-ethnography. I will present an example from the field work to illustrate the many ways in which the auto- part...... involving participant observation and individual interviews with nine newly graduated doctors for a period of 18 months. The background of the ethnographer who is also the author of the present abstract poses a few interesting challenges to the study. I am a doctor doing fieldwork in my own medical culture...

  19. Rubella (German Measles)

    ... to Be Smart About Social Media Rubella (German Measles) KidsHealth > For Parents > Rubella (German Measles) Print A A A What's in this article? ... Rubéola About Rubella Rubella — commonly known as German measles or 3-day measles — is an infection that ...

  20. Doctors and pharmaceutical industry.

    Beran, Roy G


    The pharmaceutical industry is seen as seducing doctors by providing expensive gifts, subsidising travel and underwriting practice expenses in return for those doctors prescribing products that otherwise they would not use. This paints doctors in a very negative light; suggests doctors are available to the highest bidder; implies doctors do not adequately act as independent agents; and that doctors are driven more by self-interest than by patient needs. Similar practices, in other industries, are accepted as normal business behaviour but it is automatically assumed to be improper if the pharmaceutical industry supports doctors. Should the pharmaceutical industry withdraw educational grants then there would be: fewer scientific meetings; reduced attendance at conferences; limited post graduate education; and a depreciated level of maintenance of professional standards. To suggest that doctors prescribe inappropriately in return for largesse maligns their integrity but where there is no scientific reason to choose between different treatments then there can be little argument against selecting the product manufactured by a company that has invested in the doctor and the question arises as to whether this represents bad medicine? This paper will examine what constitutes non-professional conduct in response to inducements by the pharmaceutical industry. It will review: conflict of interest; relationships between doctors and pharma and the consequences for patients; and the need for critical appraisal before automatically decrying this relationship while accepting that there remain those who do not practice ethical medicine.

  1. Prevalence of stress in junior doctors during their internship training: a cross-sectional study of three Saudi medical colleges’ hospitals

    Abdulghani HM


    Full Text Available Hamza Mohammad Abdulghani,1 Mohammad Irshad,1 Mohammed A Al Zunitan,1,2 Ali A Al Sulihem,1,2 Muhammed A Al Dehaim,1,2 Waleed A Al Esefir,1,2 Abdulaziz M Al Rabiah,1,2 Rashid N Kameshki,1,2 Nourah Abdullah Alrowais,2 Abdulaziz Sebiany,3 Shafiul Haque1 1Department of Medical Education, College of Medicine, King Saud University, Riyadh, Saudi Arabia; 2Department of Family and Community Medicine, King Saud University, Riyadh, Saudi Arabia; 3Department of Family and Community Medicine, University of  Dammam, Dammam, Saudi Arabia Background: Medical science is perceived as a stressful educational career, and medical students experience monstrous stress during their undergraduate studies, internship, and residency training, which affects their cognitive function, practical life, and patient care. In the present study, an assessment of the prevalence of self-perceived stress among new medical graduates during their internship training has been performed, and correlations of self-perceived stress with sex, marital status, and clinical rotations have been evaluated.Patients and methods: Interns of the King Khalid, King Abdulaziz, and King Fahd University hospitals in Saudi Arabia were invited to complete a stress inventory known as the Kessler 10, which is used for stress measurement. Apart from stress evaluation, the questionnaire collected personal data, such as age, sex, and marital status, in addition to information relevant to hospital training, assigned duties, and clinical training rotations.Results: Our results showed that nearly 73.0% of interns were under stressed conditions. Most of the interns were affected by a severe level of stress (34.9%, followed by mild (19.3% and moderate (18.8% levels of stress. The stress level was significantly higher (84.0% among female interns in comparison with male interns (66.5% (odds ratio =2.64; confidence interval =1.59–4.39; P<0.0002. There were statistically significant differences between the

  2. Medical restrictions to driving: the awareness of patients and doctors

    Kelly, R; Warke, T.; Steele, I.


    The study was set up to investigate the awareness of elderly patients and medical doctors of medical restrictions to driving. Separate questionnaires were completed by patients and doctors. All were interviewed face-to-face, without prior warning and their immediate answers were recorded. In total, 150 elderly patients from the acute elderly care wards, rehabilitation wards and day hospital, and 50 doctors (including all grades from consultant to junior house officer) were interviewed. The ma...

  3. 双因素理论在我院医师临床技能考核中的运用%Two-factor Theory Application in Clinical Skills Assessment for Doctors in the Hospital

    孟文娟; 王文娟; 王宝; 杜慧杰; 田秋野; 赵鹏军; 施梅


    To introduce clinical skills assessment into the assessment and appointment on professional titles as a new factor is a creative advance. A series of supporting policies according two-factor theory is introduced when managing the clinical skills assessment, which stimulated the employees to improve their professional skills while continuously guarantee their basic interest at the same time in order to improve management level, and to strengthen doctors' team building of the hospital.%将临床技能考核引入到专业技术职务评聘中是职称评聘工作的一个创新.文章介绍了运用“双因素理论”制定实施医师临床技能考核的一系列配套政策,在保障职工利益的同时激励其不断提高技术水平和职业水准,使技能考核在顺利引入的同时又达到了提高医院管理水平、加强医师队伍建设的目的.

  4. The hundredth Gentner Doctoral Student has started at CERN

    CERN Bulletin


    Almost ten years after the start of the programme in 2007, the hundredth Gentner Doctoral Student started his PhD at CERN.   The hundredth Gentner Doctoral Student, Christian Zimmer, in front of the AEgIS detector in the AD hall, where he will spend a significant portion of the next 3 years. In 2007, the German Gentner Doctoral Student Programme was established at CERN, named in honour of the celebrated nuclear physicist Wolfgang Gentner, President of the CERN Council from 1972-74. On 1 July 2016, the 100th Gentner Doctoral Student, Christian Zimmer, started his PhD at CERN, where he will work on setting up the sympathetic laser cooling of antiprotons at the AEgIS experiment. CERN’s Doctoral Student Programme has been running for many years, with 200 students currently enrolled. The Gentner programme is fully integrated into the general CERN Doctoral Student Programme, but is entirely funded by the German Federal Ministry of Education and Research (BMBF). The programme sponsors 30 to 40...

  5. Albrecht Scholz (1940-2013): German dermatologist and historian of dermatology.

    Grzybowski, Andrzej; Parish, Lawrence Charles; Plewig, Gerd


    Albrecht Scholz (Figure 1) was born in Görlitz (now Zgorzelec, a city located at the Polish-German border, covering both sides of the River Nysa) on September 6, 1940, the youngest of three children. His father was a laryngologist, specializing in voice and hearing impairment. Scholz attended school in his hometown and in 1958 passed his Matura examination, after which he studied medicine at both Humboldt University in Berlin and the “Carl Gustav Carus” Medical Academy in Dresden. Following successful completion of the state examination in 1964 and an internship at the Reichenbach Hospital the following year, he was granted the right to practice medicine. His 1964 doctoral dissertation was titled, “Evaluation of Astrand's Steps in Elderly Patients.”

  6. How Six Sigma Methodology Improved Doctors' Performance

    Zafiropoulos, George


    Six Sigma methodology was used in a District General Hospital to assess the effect of the introduction of an educational programme to limit unnecessary admissions. The performance of the doctors involved in the programme was assessed. Ishikawa Fishbone and 5 S's were initially used and Pareto analysis of their findings was performed. The results…

  7. History of German pediatric cardiology.

    Heintzen, P


    Due to the isolation of German medicine in World War II accompanied by the destruction of many hospitals, German pediatricians did not show any serious interest in the treatment of children with congenital heart diseases, nor did they take notice of the progress achieved by Helen Taussig, Alfred Blalock and other cardiologists and surgeons in the western world. This problem was even worse in East Germany. Only a few German internists and forward-looking surgeons were able and ready to take care of this group of principally operable children in places like Bonn/Düsseldorf, Marburg/Munich, Berlin, and Hamburg. However, in the early 1950s some directors of pediatrics at university hospitals--largely motivated by the cardiac surgeons--allowed or even encouraged younger colleagues to concentrate on pediatric cardiology and to begin application of heart catheterization and angiocardiography. In 1960 a group of colleagues interested in pediatric cardiology met for the first time in Frankfurt and became the nucleus of the future "working group" (1969) and finally the "German Society of Pediatric Cardiology" (1974). By 1972 pediatric cardiology had been approved as an independent (sub)specialty. Colleagues and friends from surrounding countries (Austria, Great Britain, Sweden, Switzerland, and the Netherlands) and also from the US and some eastern countries were either members or regular guests during or between the meetings. Pediatric cardiology is now represented in Germany by specialized practitioners, trainees and assistants who work in both community and university hospitals, and in specialized departments. Due to the foresightedness of the Chief of Pediatrics, Prof. G. Joppich, the first Chair of Pediatric Cardiology was founded in Göttingen in 1960 under the direction of A. Beuren. Another model of interdisciplinary cooperation between pediatric cardiologists, bioengineers, mathematicians and computer scientists was established in Kiel in 1966. In other places

  8. Countermeasures on promoting doctor in public hospitals to apply for multi-sited license in private hospitals%推动公立医院医生到民营医院多点执业的对策分析

    吴敏; 刘岩; 李晓冰


    The obstacles in the implementation of Doctor’s Multi-sited License were analyzed from three aspects including physician, administrator in public hospitals, and specific support for the policy. The government is considered to encourage private hospital and public hospitals which met certain requirements to conduct cooperation, develop multi-sited license research, issue policy to guide duty, right and benefit for multi-sited license, develop and spread medical liability insurance to share medical risk in multi-sited license, strengthen the monitoring on consultation and operation without permission.%  从医生、医院管理者、配套支持等层面梳理分析了医师多点执业实践中存在的障碍和瓶颈,提出政府应牵头鼓励和促成民营医院与有条件的公立医院建立合作,开展多点执业调查研究,制订多点执业责、权、利分配指导政策,建立和推行医疗责任保险,分担医师多点执业中的医疗风险,加强对医生私自外出会诊、手术现象的监管等促进公立医院医生到民营医院多点执业的对策建议。

  9. [Patients' rights--doctors' duties].

    Jaeger, L; Bertram, E; Grate, S; Mischkowsky, T; Paul, D; Probst, J; Scala, E; Wbllenweber, H D


    On 26 February 2013 the new "Law on Patients' Rights" (hereinafter also the "Law") became effective. This Law strengthens patients' rights vis-à-vis the insurdnce company and also regulates patients' rights regarding their relation to the doctor. This has consequences for the laws on medical liability all doctors must consider. The doctor's performance is and remains a service and such service does not hold any guarantee of success. Nevertheless, this Law primarily reads as a "law on the duties of physicians". To duly take into account these duties and to avoid mistakes and misinterpretation of the Law, the Ethics Committee of the Consortium of Osteosynthesis Trauma Germany (AOTRAUMA-D) has drafted comments on the Law. Brief summaries of its effects are to be found at the end of the respective comment under the heading "Consequences for Practice". The text of the law was influenced particularly by case law, as continuously developed by the German Federal Court of Justice ("BGH"). The implementation of the Law on Patients' Rights was effected by the newly inserted sections 630a to 630h of the German Civil Code (the "BGB"), which are analysed below. The following comments are addressed to physicians only and do not deal with the specific requirements and particularities of the other medical professions such as physiotherapy, midwifery and others so on. Special attention should be paid to the comments on the newly inserted Duty to inform, which has to be fullfilled prior to any diagnostic or therapeutic procedure (sec. 630c para 2 sentence 1 BGB). Under certain conditions the doctor also has to inform the patient about the circumstances that lead to the presumed occurance of a therapeutic or diagnostic malpractice (sec. 630c para. 2 sentence 2 BGB), based on the manifestation of an undesired event or an undesired outcome. As before, the patient's valid consent to any procedure (sec. 630d BGB) is directly linked to the comprehensive and timely provision of information

  10. [Anaesthesiology as a compulsory subject in the new German medical school curriculum. Evaluation of a curricular model at the University Hospital Aachen].

    Beckers, S K; Sopka, S; Fries, M; Skorning, M H; Kuhlen, R; Rossaint, R


    Since October 2003 new regulations for qualifications to practice medicine in Germany now require compulsory courses in anaesthesiology. Therefore, existing curricular activities had to be changed from facultative courses for a small number of interested students to compulsory activities for all students. Previous data of the department of anaesthesiology at the University Hospital Aachen (Germany) were collected and taken into consideration for the development of a new curriculum: The result was a course consisting of a tutorial with integrated "basic skill training", practical training in the operating theatre and a simulation-based session, in addition to two series of lectures. An evaluation by the students was carried out using EvaLuna as a tool for web-based on-line evaluation and faculty members had to fill out a standardized questionnaire. The different parts of the curriculum received the highest scores of all courses in the undergraduate medical school curriculum. Best results were achieved by the anaesthesia-simulation session followed by the tutorial and the practical training. The feedback of faculty members as well as the results of students' evaluation approved the developed concept of integrating anaesthesia-relevant issues into the formal medical school curriculum. Nevertheless, the on-line evaluation system EvaLuna provided additional suggestions for future improvements in the newly created curriculum.

  11. The development of online doctor reviews in China: an analysis of the largest online doctor review website in China.

    Hao, Haijing


    .366 (95% CI 1.337-1.395), respectively. Quantitatively, traditional Chinese medicine doctors (Pdoctors (Pdoctors received fewer reviews than the combined small specialty areas (Pdoctors' treatment effect measure and 91% were positive for the bedside manner measure. This was the case for the four major specialty areas, which had the most number of doctors—internal medicine, gynecology-obstetrics-pediatrics, surgery, and traditional Chinese medicine. Like consumers in the United States and Europe, Chinese consumers have started to use online doctor reviews. Similar to previous research on other countries' online doctor reviews, the online reviews in China covered almost every medical specialty, and most of the reviews were positive even though all of the reviewing procedures and the final available information were anonymous. The average number of reviews per rated doctor received in this dataset was 6, which was higher than that for doctors in the United States or Germany, probably because this dataset covered a longer time period than did the US or German dataset. But this number is still very small compared to any doctor's real patient population, and it cannot represent the reality of that population. Also, since all the data used for analysis were from one single website, the data might be biased and might not be a representative national sample of China.

  12. [German nurses during the First World War].

    Wagner, Franz


    Nurses from several German organisations participated in the First World War. For the most part, they did not work on the frontline but at the rear, in hospital trains, hospitals or refugee camps. They cared forwounded soldiers and faced epidemics of infectious diseases. The journal of the national association of nurses, which continued to be published during the war, provides a snapshot of their concerns and their questioning regarding the profession and its evolution.

  13. Maury Journals - German Vessels

    National Oceanic and Atmospheric Administration, Department of Commerce — German vessels observations, after the 1853 Brussels Conference that set International Maritime Standards, modeled after Maury Marine Standard Observations.

  14. 精神病专科医院441名医护人员职业暴露现状调查及对策%Investigation and countermeasures of occupation exposure status of 441 doctors and nurses in psychiatric hospital

    秦轶灵; 梁忠新; 梁淑敏


    目的:分析精神病专科医院医护人员发生职业暴露的常见危险因素,并提出有效防护措施。方法:对精神病医院医护人员进行职业暴露调查,并对职业暴露者相关资料进行分析。结果:441名医护人员中共有18名工作人员发生职业暴露,全部为护理人员。其中职业暴露地点全部在病房;部位有14例在手指、3例在手臂、1例在眼睛;类别有锐器伤14例(输液针10例、注射针3例、缝针1例),患者咬伤3例,血液喷溅1例;暴露环节为输液过程针刺伤8例,其中因患者兴奋不合作导致的针刺伤4例;清理用物6例;护理过程咬伤3例;输液过程血液喷溅1例。暴露源中有3例乙肝病毒阳性;无丙肝、梅毒和HIV病毒阳性。结论:加强职业暴露防护知识培训,落实标准预防措施和规范操作流程,能有效减少职业暴露的发生。%Objective:To analyze the risk factors of occupational exposure among common psychiatric hospital medical staff,and to propose effective protective measures.Methods:We investigated the occupation exposure status of doctors and nurses in psychiatric hospital,and analyzed the relevant information of occupational exposure.Results:In the 441 doctors and nurses,18 workers occurred occupational exposure,and they were all nurses.All of the occupational exposure locations were in the ward.The position of 14 cases was at the fingers,three cases were at the arm,one case was at the eye.14 patients were sharp injury(10 cases of transfusion needle,3 cases of injection needle,1 case of suture needle),3 cases were bite by the patients,1 case was blood splashes.8 cases were exposed on the infusion process with needle stick injuries,including 4 cases of needle stick injuries because of noncooperation and excitement of patients;6 cases occurred on the process of cleaning materials;3 cases with bite occurred on the nursing process;1 case with blood splashing occurred on the

  15. Dry skin and pressure ulcer risk: A multi-center cross-sectional prevalence study in German hospitals and nursing homes.

    Lechner, Anna; Lahmann, Nils; Neumann, Konrad; Blume-Peytavi, Ulrike; Kottner, Jan


    Pressure ulcers are a serious health problem in medical and nursing care. Therefore, effective prevention is crucial. Major pressure ulcer risk factors have been identified but the particular role of dry skin (xerosis cutis) is unclear. To investigate possible associations between dry skin and pressure ulcers focusing on the sacrum/trochanter and at heel/ankle skin areas. Two multicenter cross-sectional studies. In 2014 and 2015 thirty nursing homes and thirteen hospitals in Germany participated. In total 3837 participants were included. Mean age was 76.1 (SD 15.5) years. Skin assessments and data collection were performed by trained nurses based on a standardized data collection form. Descriptive comparisons and multilevel logistic regressions predicting pressure ulcers at sacrum/trochanter and ankle/heel were conducted. The prevalence of skin dryness at the trunk was significantly higher for subjects with pressure ulcers category 2+ at the sacral area compared to without (39.0% vs. 24.4%, p=0.010). Adjusted to demographic variables, mobility and type of institution dry skin at the trunk was no longer associated with pressure ulceration (OR 1.11 (95% CI 0.62-2.00)). 71.9% of patients with heel/ankle pressure ulcers category 2+ were affected by dry skin at legs or feet, compared to 42.8% of subjects without pressure ulcers (ppressure ulcer development. Skin dryness may be less important for sacral pressure ulcers. Therefore, the variable skin status should be better defined in future studies and pressure ulcer risk models. Results further support differences in pressure ulcer aetiologies between anatomical locations. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. [The happy doctor].

    van Dongen, Christel M P; van der Graaf, Yolanda


    Descriptive, questionnaire-based. To study what makes doctors and medical students happy: Descriptive, questionnaire-based. Descriptive, questionnaire-based. For the purposes of this study, doctors and medical students completed an online questionnaire in the summer of 2012. They were presented with questions enquiring into general characteristics and into happiness. We asked them to define happiness, and to describe their happiest moments. The results were interpreted with the aid of simple statistics. 401 doctors, registrars and medical students took part in the study. 41% of the respondents were male and 59% female. Average age was 40 years. Students, GPs, anaesthesiologists and internists were the best represented. On average, the participants gave their 'happiness' a score of 7.6. The younger doctors ( 48 years (7.8), which also explains the relatively low scores for students (7.1). GPs were the happiest, with an average score of 7.9, closely followed by the 'other doctors', with an average score of 7.8, and the medical specialists (7.6). Within the specialties, bearing in mind that the low numbers means that results should be interpreted with some caution, the doctors with 'minority specialties' were the happiest, followed by internists and the supporting specialties. Psychiatrists and surgical colleagues can be found at the bottom of the list. The determinants 'love and relationships' and 'family' contribute the most to feeling happy. Older doctors are happier than younger doctors and GPs are generally happier than medical specialists. The determinants 'love and relationships' and family' are the most important for doctors' happiness.


    Design. A descriptive study combining quantitative and qualitative methods: a quantitative audit of operating theatre ... type of anaesthetic, type of procedure, and whether a .... Furthermore, the issue of observer bias in qualitative research.

  18. [Quality of German medical services: a review].

    Braun, J; Robbers, J; Lakomek, H-J


    In the current draft of the law on the reform of the support structures of hospital provision (German Hospital Structure Law) the future quality of provision is highly significant. Quality assurance measures are mandatory for hospitals. The Federal General Committee was legally charged with developing the relevant quality indicators for structural, procedural and outcome quality that are designed to form the criteria and the basis for planning decisions in the federal states. This involves a paradigm shift in quality assurance measures in hospitals. In the future, subject to the verified quality, this should have an influence on hospital planning, and the funding or regulation of hospital departments should also adhere to this prescribed quality. This review reveals the course of quality or quality assurance measures in medical services in Germany. The status of the institutions responsible for the quality of care in hospitals and the significance of quality indicators are explained.

  19. Patient-doctor relationship: the practice orientation of doctors in Kano.

    Abiola, T; Udofia, O; Abdullahi, A T


    Attitude and orientation of doctors to the doctor-patient relationship has a direct influence on delivery of high quality health- care. No study to the knowledge of these researchers has so far examined the practice orientation of doctors in Nigeria to this phenomenon. The aims of this study were to determine the orientation of Kano doctors to the practice of doctor-patient relationship and physicians' related-factors. Participants were doctors working in four major hospitals (i.e., two federal-owned and two state-owned) servicing Kano State and its environs. The Patient-Practitioner Orientation Scale (PPOS) and a socio-demographic questionnaire were completed by the 214 participants. The PPOS has 18 items and measures three parameters of a total score and two dimension of "sharing" and "caring". The mean age of participants was 31.72 years (standard deviation = 0.87), with 22% being females, 40.7% have been practicing for ≥ 6 years and about two-third working in federal-owned health institution. The Cronbach's alpha of total PPOS scores was 0.733 and that of two sub-scale scores of "sharing" and "caring" were 0.659 and 0.546 respectively. Most of the doctors' orientation (92.5%) was towards doctor-centered (i.e., paternalistic) care, majority (75.2%) upheld the view of not sharing much information and control with patients, and showing little interest in psychosocial concerns of patients (i.e., 'caring'=93.0%). Respondents' characteristics that were significantly associated with high doctor 'caring' relationship orientation were being ≥ 30-year-old and practicing for ≥ 6 years. Working in State-owned hospitals was also significantly associated with high doctor "sharing" orientation. This paper demonstrated why patient-centered medical interviewing should be given top priority in medical training in Nigeria, and particularly for federal health institutions saddled with production of new doctors and further training for practicing doctors.

  20. Health Information in German (Deutsch)

    ... Tools You Are Here: Home → Multiple Languages → German (Deutsch) URL of this page: Health Information in German (Deutsch) To use the sharing features on this page, ...

  1. Doctor of osteopathic medicine

    ... and Wilkins; 2010. Gevitz N. The "doctor of osteopathy": expanding the scope of practice. J Am Osteopath ... 6):ES28-S38. Moore WJ. The eccentricities of osteopathy. BMJ . 2012;345:e5890. Stark J. A degree ...

  2. Going to the Doctor

    ... time they go to the doctor, but the truth is that kids don't need many shots ... The Nemours Foundation, iStock, Getty Images, Corbis, Veer, Science Photo Library, Science Source Images, Shutterstock, and Clipart. ...

  3. Talking to Your Doctor

    Full Text Available ... Trials and You Talking to Your Doctor Science Education Resources Community Resources Clear Health A–Z Publications ... Research & Training Medical Research Initiatives Science Highlights Science Education Research in NIH Labs & Clinics Training Opportunities Library ...

  4. Finding the Right Doctor

    ... you meet someone that doesn’t match your communication style, you should switch,” Dr. Krumholz said. Another part ... for looking around: When you feel that the communication style is not matching your own If your doctor ...

  5. Talking to Your Doctor

    Full Text Available ... your appointment. Consider bringing a close friend or family member with you. Take notes about what the doctor says, or ask a friend or family member to take notes for you. Learn how ...

  6. Talking to Your Doctor

    Full Text Available ... Simple Clear Health from NIH Cultural Respect Language Access Talking to Your Doctor Research Underway Plain Language ... to take notes for you. Learn how to access your medical records, so you can keep track ...

  7. 上海某三级医院医师膳食模式及其与慢性病的关系%Dietary patterns and risk of chronic diseases in doctors of a tertiary hospital in Shanghai

    周丽; 程蓁; 陈科


    目的 研究上海某三级医院医师的膳食模式及其与慢性病的关系.方法 对118例样本采集一般情况、食物频率、慢性病等信息,经前处理后用SPSS提供的因子分析获得膳食模式,描述膳食模式、分布及其与慢性痛的关系.调查的118例对象中男性44例,女性74例,平均年龄(38.4±10.8)岁,平均体质量(62.6±10.0)kg.结果 高血压患者20例(16.9%),血脂异常患者17例(14.4%),糖尿病患者0例.33项食物频率经前处理后转变为9大类食物频率并换算成单位体质量的食物频率,再经因子分析获得“水产果蔬”、“优质蛋白”、“传统主食”三种膳食模式,膳食模式标化因子得分以三等分(T1 ~T3)方式描述.男性更易接受水产果蔬和优质蛋白模式,年龄越小越易接受水产果蔬模式.控制性别、年龄后,传统主食模式(T3拟合度)为高血压的保护因素,优质蛋白模式(T3拟合度)为血脂异常的保护因素.结论 该三级医院男医师更易接受水产果蔬和优质蛋白的膳食模式,传统主食模式与高血之间有良性关系,优质蛋白模式与血脂异常之间有良性关系.横断面调查中可能包含的局限性有待于在进一步研究中证实与解决.%Objective To survey dietary patterns and risk of chronic diseases in doctors of a tertiary hospital in Shanghai.Methods The dietary pattern and prevalence of chronic disease were surveyed in 118 doctors including 44 males and 74 females with the average age of 38.4 ± 10.8.The distribution of dietary pattern and its correlation with chronic diseases was analyzed with SPSS software.Results The prevalence of hypertension,dyslipidemia and diabetes were 16.9%,14.4% and 0,respectively.The frequency of 33 food items of 9 types were surveyed and transformed into 3 dietary patterns:aquatic-fruit-vegetable pattern,protein pattern and traditional pattern.Patterns were described with tertiled factor scores (T1 ~ T3).Males

  8. [Carl Gillmeister: the first Doctor of veterinary medicine in Mecklenburg--and in Germany (1834)].

    Kuhlmann, W; Schäffer, J


    German schools and faculties of veterinary medicine did not receive the sovereign right to award the degree "Doctor medicinae veterinarae" until the early twentieth century. Until then, in the nineteenth century there were two possibilities for veterinarians to earn a doctoral degree, usually referred to as the title of "Doctor": 1. On the basis of an exceptionally excellent dissertation and after very stringent examination a candidate could be awarded the degree "Dr. med." by the faculty of a medical school, or, if the candidate had studied at a philosophical faculty, the degree "Dr. phil." 2. A doctoral degree specifically in veterinary medicine could be earned only at a medical faculty. The Medical Faculty of the University of Giessen awarded the degree "Doctor in arte veterinaria" for the first time in 1832. In this study we prove that Giessen was not the first German university to award a doctorate in veterinary medicine, a priority which has never been questioned in the literature. As early as 1829, veterinarians could earn the degree "Doctor artis veterinariae" at the Medical Faculty of the University of Rostock, where three such awards are documented between 1829 and 1831. The designation "medicina" was also intially avoided in Rostock. Therefore, of particular significance is the discovery of a fourth such document from the Rostock University Archives, the doctoral diploma of Carl Jacob Friedrich Gillmeister, who at the age of 22 was awarded the degree "Doctor medicinae veterinariae" in Rostock after a successful defense. This is the earliest, but also the last archival record of the German doctoral degree in veterinary medicine in the modern sense, because after Gillmeister no veterinarian could earn a doctoral degree in Rostock further more. Gillmeisters vita sheds light on the times and the difficulties of the veterinary profession in the poor agricultural area of Mecklenburg.

  9. University strategy for doctoral training: the Ghent University Doctoral Schools.

    Bracke, N; Moens, L


    The Doctoral Schools at Ghent University have a three-fold mission: (1) to provide support to doctoral students during their doctoral research, (2) to foster a quality culture in (doctoral) research, (3) to promote the international and social stature and prestige of the doctorate vis-a-vis potential researchers and the potential labour market. The Doctoral Schools offer top-level specialized courses and transferable skills training to doctoral students as part of their doctoral training programme. They establish mechanisms of quality assurance in doctoral research. The Doctoral Schools initialize and support initiatives of internationalization. They also organize information sessions, promotional events and interaction with the labour market, and as such keep a finger on the pulse of external stakeholders.

  10. The role ofprivate hospitals in South Africa

    DepartInent ofConnnunity Health, University ofthe. Witwatersrand, Johannesburg ... ing the efficiency of the private hospital sector, ... mended that a system of hospital accreditation be developed to .... in the case of academic hospitals. Doctors' ...

  11. Controle de infecção oral em pacientes internados: uma abordagem direcionada aos médicos intensivistas e cardiologistas Oral infection control in hospitalized patients: an approach to cardiologist and intensive care units doctors

    Sérgio Kahn


    Full Text Available O objetivo do presente estudo foi verificar o grau de conhecimento médico sobre medicina periodontal e verificar a existência de algum protocolo de controle de infecção da cavidade oral em pacientes internados em hospitais. Para tal, 110 médicos cardiologistas e intensivistas lotados em cinco hospitais no município do Rio de Janeiro foram entrevistados. Dentre os indivíduos, 75,4% afirmaram ter conhecimento sobre o termo medicina periodontal; entretanto, apenas 30% declararam já ter lido algo a respeito. Apenas 2,7% dos médicos possuem o hábito de coletar informações sobre a história odontológica de seus pacientes e 58,2% afirmaram que essa conduta é condicional ao quadro apresentado pelo paciente. Com base nos dados obtidos, pode-se concluir que o conhecimento sobre medicina periodontal e, consequentemente, sobre a importância do controle do biofilme oral na manutenção da saúde sistêmica, apresenta-se pouco difundido entre a classe médica. Verificou-se não haver setor ou pessoa responsável pelo controle de infecção oral dentro dos hospitais avaliados e, consequentemente, a não existência de qualquer protocolo, eficaz ou não, de controle de infecção oral nessas unidades.This paper aims to find the current level of periodontal med-care knowledge, as well as the possible existence of some oral infection control protocol regarding hospitalized patients. Our sample gathered 110 cardiologists and intensive care units doctors selected from medical teams of five Rio de Janeiro hospitals. Preliminary numbers: 75.4% said to have heard something about Periodontal Medicine, although only 30% out of this group admitted to have read something concerning such subject. On the other side, only 2.7% of the sample informed to do consistent information searching along their patients anamnese, while 58.2% out of this group admitted such procedure conditional to the patient's general state at the due moment. Through such numbers, we

  12. The effect of effort-reward imbalance at work on the professional attitude of doctors in public hospitals%工作付出—回报失衡对公立医院医生职业心态的影响

    孙葵; 尹文强; 黄冬梅; 于倩倩; 赵延奎; 陈钟鸣; 李云伟


    Objective: To explore the effects of effort-reward imbalance (ERI) at work on the occupational burnout, job satisfaction and turnover intention of doctors in public hospitals. Methods: By using self-designed questionnaires to in-vestigate job attitude, this paper adopts a stratified random sampling method to select 1910 doctors from public hospitals in Jinan, Weifang and Dezhou cities based on the level of economic development in Shandong province. The data are ana-lyzed using descriptive analysis, correlation analysis, hierarchical regression analysis, etc. Results: The effort-reward imbal-ance at work exists in the surveyed public hospitals. The job effort of doctors is 1. 39 ± 0. 37 times higher than job reward. The effort-reward imbalance at work has positive predictive effects on occupational burnout, negative predictive effects on job satis-faction, and positive predictive effects on turnover intention. Conclusions:Public hospital administrators should improve the ef-fort-reward ratio of doctors in order to stabilize doctors' professional attitude at work and enhance their morale.%目的:探讨付出—回报失衡对公立医院医生职业倦怠、工作满意度和离职意向的影响. 方法:利用课题组编制的医生工作感受量表,按照分层随机抽样原则,根据经济发展水平从山东省抽取济南、潍坊、德州3市的1 910名公立医院医生进行调查,采用描述性统计分析、相关分析、分层回归分析等分析方法. 结果:医生工作付出—回报失衡,工作付出是工作回报的1. 54 ± 0. 74倍. 工作付出—回报失衡对职业倦怠有正向预测作用,对工作满意度有负向预测作用,对离职意向有正向预测作用. 结论:管理者应从改善医生付出—回报比例入手,以稳定医生职业心态,提升其工作积极性.

  13. Medical thrillers: doctored fiction for future doctors?

    Charpy, Jean-Pierre


    Medical thrillers have been a mainstay of popular fiction since the late 1970s and still attract a wide readership today. This article examines this specialized genre and its core conventions within the context of professionally-based fiction, i.e. the class of thrillers written by professionals or former professionals. The author maps this largely unchartered territory and analyzes the fictional representations of doctors and medicine provided in such novels. He argues that medical thrillers, which are not originally aimed at specialized readers and sometimes project a flawed image of medicine, may be used as a pedagogical tool with non-native learners of medical English.


    Medical Service


    IN URGENT NEED OF A DOCTOR GENEVA EMERGENCY SERVICES GENEVA AND VAUD 144 FIRE BRIGADE 118 POLICE 117 CERN FIREMEN 767-44-44 ANTI-POISONS CENTRE Open 24h/24h 01-251-51-51 Patient not fit to be moved, call family doctor, or: GP AT HOME, open 24h/24h 748-49-50 Association Of Geneva Doctors Emergency Doctors at home 07h-23h 322 20 20 Patient fit to be moved: HOPITAL CANTONAL CENTRAL 24 Micheli-du-Crest 372-33-11 ou 382-33-11 EMERGENCIES 382-33-11 ou 372-33-11 CHILDREN'S HOSPITAL 6 rue Willy-Donzé 372-33-11 MATERNITY 32 la Cluse 382-68-16 ou 382-33-11 OPHTHALMOLOGY 22 Alcide Jentzer 382-33-11 ou 372-33-11 MEDICAL CENTRE CORNAVIN 1-3 rue du Jura 345 45 50 HOPITAL DE LA TOUR Meyrin EMERGENCIES 719-61-11 URGENCES PEDIATRIQUES 719-61-00 LA TOUR MEDICAL CENTRE 719-74-00 European Emergency Call 112 FRANCE EMERGENCY SERVICES 15 FIRE BRIGADE 18 POLICE 17 CERN FIREMEN AT HOME 00-41-22-767-44-44 ANTI-POISONS CENTRE Open 24h/24h 04-72-11-69-11 All doctors ...

  15. Learning Dynamics in Doctoral Supervision

    Kobayashi, Sofie

    This doctoral research explores doctoral supervision within life science research in a Danish university. From one angle it investigates doctoral students’ experiences with strengthening the relationship with their supervisors through a structured meeting with the supervisor, prepared as part...... of an introduction course for new doctoral students. This study showed how the course provides an effective way build supervisee agency and strengthening supervisory relationships through clarification and alignment of expectations and sharing goals about doctoral studies. From the other angle the research...

  16. Are doctors altruistic?

    Glannon, W; Ross, L F


    There is a growing belief in the US that medicine is an altruistic profession, and that physicians display altruism in their daily work. We argue that one of the most fundamental features of medical professionalism is a fiduciary responsibility to patients, which implies a duty or obligation to act in patients' best medical interests. The term that best captures this sense of obligation is "beneficence", which contrasts with "altruism" because the latter act is supererogatory and is beyond obligation. On the other hand, we offer several examples in which patients act altruistically. If it is patients and not the doctors who are altruistic, then the patients are the gift-bearers and to that extent doctors owe them gratitude and respect for their many contributions to medicine. Recognising this might help us better understand the moral significance of the doctor-patient relationship in modern medicine.

  17. German-Chinese wedding

    Iken, Joern


    German wind power technology is widely regarded as being ahead of its competitors worldwide. Combine this technology with production in China and a renowned designer and you should get a competitive product. (orig.)

  18. Should Doctors Be Allowed to Impose Operations on Patients?


    Li Liyun,a 22-year-old who was in her ninth month of pregnancy,died of serious pneumonia at Chaoyang Hospital in west Beijing on November 21,after her husband refused to let doctors perform a Caesarean sec- tion.The hospital had offered to do the operation free of charge but the husband did not believe it.

  19. Influence of different nursing models on doctor-patient relationship in the department of radiology in a hospital%某医院放射科不同护理模式对医患关系的影响

    钞俊; 邹文远; 朱新枝; 顾永丽; 李胜; 石思李


    目的 探讨放射科不同护理模式对医患关系的影响,旨在提高服务质量.方法 对某医院放射科护理工作模式改革效果进行回顾性评价.改革前采用传统护理方法,在传统的放射科窗口内护理;改革后在传统护理方法的基础上增没放射科窗口外护理,主要为患者行放射线检查前提供各项服务及健康咨询工作.两组通过年度统计的对比剂渗漏、碘过敏不良反应及其他不良事件和患者满意度调查等项目进行效果评价.结果 改革前后总碘过敏反应发生率(x2=0.58,P>0.05)及对比剂渗漏发生率(x2=0.33,P>0.05)两组间比较差异无统计学意义;不良事件两组间比较,差异具有统计学意义(x2 =310.8,P<0.01);患者满意度由改制前的81.74%上升至91.81%,二者组间比较,差异具有统计学意义(x2 =52.7,P<0.01).结论 该医院增设放射科窗口外护理对对比剂渗漏及碘过敏反应的控制帮助不大,对不良事件和患者满意度影响大,该模式的运行有助于减少放射科不良事件的发生率和提高患者满意度,对缓解紧张的医患关系意义重大.%[Objective] To explore the influence of different nursing models on doctor-patient relationship in the department of radiology, improve the quality of medical service. [ Methods ] The effect of nursing model reformation in the department of radiology in a hospital was evaluated retrospectively. Before reformation, the patients were given the traditional nursing service at the window of the department of radiology. After reformation, patients received the nursing service outside the window on the basis of traditional nursing service, which included the nursing services before radiographie examination and health consulting. The incidence rates of contrast agent extravasation, iodine allergy and other adverse events, as well as patient satisfaction in two groups were evaluated. [Results]There was no significant difference in

  20. Women Doctors in 1914


    THE five women shown here are doctors. Eighty-four years ago, they sat for this photographic portrait. The photo depicts the tasteful combination of East and West. While the photographic studio was decorated in the European style, the women doctors were dressed in traditional Chinese fashion with their hair coiled in Japanese style. We can also see that though the ladies were in vogue for their time, they still displayed shyness facing a male photographer, as most can be observed shifting their eyesight away from the lens.

  1. Surviving the Doctoral Years

    Scott P. Kerlin


    Full Text Available This article probes the implications of neo-conservative public education policies for the future of the academic profession through a detailed examination of critical issues shaping contemporary doctoral education in U.S. and Canadian universities. Institutional and social factors such as financial retrenchment, declining support for affirmative action, downward economic mobility, a weak academic labor market for tenure-track faculty, professional ethics in graduate education, and backlash against women's progress form the backdrop for analysis of the author's survey of current doctoral students' opinions about funding, support, the job market, and quality of learning experiences.

  2. Changing doctor prescribing behaviour

    Gill, P.S.; Mäkelä, M.; Vermeulen, K.M.


    The aim of this overview was to identify interventions that change doctor prescribing behaviour and to derive conclusions for practice and further research. Relevant studies (indicating prescribing as a behaviour change) were located from a database of studies maintained by the Cochrane Collabora......The aim of this overview was to identify interventions that change doctor prescribing behaviour and to derive conclusions for practice and further research. Relevant studies (indicating prescribing as a behaviour change) were located from a database of studies maintained by the Cochrane...

  3. German Business in Russia

    Irakliy D. Gvazava


    Full Text Available Since Perestroika German-Russian relationships have been steadily developing fueled by close contacts between the leaders of both countries. Boris Yeltsin and Helmut Kohl, Vladimir Putin and Gerhard Schröder, Dmitry Medvedev and Angela Merkel had friendly relations resulted in some fruitful business projects, intergovernmental economic forums etc. In my article I will consider the activities of German companies in Russia, advantages, barriers and expectations

  4. Mandatory notification of impaired doctors.

    Beran, R G


    Mandatory reporting of impaired doctors is compulsory in Australasia. Australian Health Practitioner Regulation Agency guidelines for notification claim high benchmark though the Royal Australasian College of Surgeons and the Royal Australasian College of Physicians suggest they still obstruct doctors seeking help. Western Australia excludes mandatory reporting of practitioner-patients. This study examines reporting, consequences and international experiences with notification. Depressed doctors avoid diagnosis and treatment, fearing consequences, yet are more prone to marital problems, substance dependence and needing psychotherapy. South African research confirms isolation of impaired doctors and delayed seeking help with definable characteristics of those at risk. New Zealand data acknowledge: errors occur; questionable contribution from mandatory reporting; issues concerning competence assessment; favouring reporting to senior colleagues or self-intervention to compliance with mandatory reporting. UK found an anaesthetist guilty of professional misconduct for not reporting and sanctioned doctors regarding Harold Shipman. Australians are reluctant to report, fearing legalistic intrusion into care. Australian research confirmed definable characteristics for doctors with psychiatric illness or alcohol abuse. Exposure to legal medicine evokes personal disenchantment for doctors involved. Medicine poses barriers for impaired doctors. Spanish and UK doctors do not use general practitioners and may have suboptimal care. US and European doctors self-medicate using samples. US drug-dependent doctors also prescribe for spouses. Junior doctors are losing empathy with the profession. UK doctors favour private care, avoiding public scrutiny. NZ and Brazil created specific services for doctors, which appear effective. Mandatory reporting may be counterproductive requiring reappraisal.

  5. The quality perception gap between employees and patients in hospitals.

    Willems, Jurgen; Ingerfurth, Stefan


    To assess hospital performance, quality perceptions of various stakeholders are increasingly taken into account. However, because of substantial background differences, various stakeholder groups might have different and even contrasting quality perceptions. We test the hypothesis that an overall perception gap exists between employees and patients with respect to perceived hospital quality. We additionally elaborate on how various employee groups differ from each other and from patients. We use primary survey data on perceived hospital quality from 9,979 patients and 4,306 employees from 11 German hospitals. With a multilevel regression and variance analysis, we test the impact of respondent type (employee or patient) on quality perception scores and test the interaction with hospital size. We additionally contrast different employee groups and test differences for various quality dimensions. Hospital employees score hospital quality consistently lower than patients and are also more heterogeneous in their assessments. This makes it from a managerial point of view relevant to subdivide employees in more homogeneous subgroups. Hospital size has no clear effect on the perception gap. Doctors compared to patients and other employee groups have substantially different perceptions on hospital quality. Our findings fuel the practical and ethical debate on the extent that perception gaps could and should be allowed in the context of high-quality and transparent hospital performance. Furthermore, we recommend that the quality perception gap is a substantial part of the overall hospital evaluation for ethical reasons but also to enable managers to better understand the (mis)match between employees' priorities and patients' preferences. However, we do warn practitioners that perceptions are only to a limited extent related to the organizational level (in contrast to the individual level), and only minimal improvements can thus be reached by differentiating from other

  6. How doctors search

    Lykke, Marianne; Price, Susan; Delcambre, Lois


    to context-specific aspects of the main topic of the documents. We have tested the model in an interactive searching study with family doctors with the purpose to explore doctors’ querying behaviour, how they applied the means for specifying a search, and how these features contributed to the search outcome...

  7. Fourth Doctoral Student Assembly

    Ingrid Haug


    On 10 May, over 130 PhD students and their supervisors, from both CERN and partner universities, gathered for the 4th Doctoral Student Assembly in the Council Chamber.   The assembly was followed by a poster session, at which eighteen doctoral students presented the outcome of their scientific work. The CERN Doctoral Student Programme currently hosts just over 200 students in applied physics, engineering, computing and science communication/education. The programme has been in place since 1985. It enables students to do their research at CERN for a maximum of three years and to work on a PhD thesis, which they defend at their University. The programme is steered by the TSC committee, which holds two selection committees per year, in June and December. The Doctoral Student Assembly was opened by the Director-General, Fabiola Gianotti, who stressed the importance of the programme in the scientific environment at CERN, emphasising that there is no more rewarding activity than lear...

  8. Ludolph Brauer, German aeromedical pioneer.

    Harsch, Viktor


    Ludolph Brauer (1865-1951) played an influential role in the history of aviation medicine in Germany. The Treaty of Versailles had put a stop to the development of German aviation and associated medical activities at the end of World War I. Brauer deserves credit for restarting civilian aviation medicine in Germany in the 1920s, paving the way for it to flourish in the 1930s. As Medical Director of the Hamburg-Eppendorf General Hospital, Brauer established the first German Institute of Aviation Medicine (GIAM) in 1927 in affiliation with the Tuberculosis Research Institute with its two large pneumatic chambers. The GIAM was active in altitude research and the selection of pilots, as well as educating medical students in aviation medicine, training Aviation Medical Examiners, and exploring clinical applications of hypobaric and climatic therapy. Brauer was forced to retire in 1934 for political reasons as the GIAM came under the influence of the military; in 1939 it was made part of the Aeromedical Research Institute of the "Reichsluftfahrt" Ministry. Brauer was a co-editor of the journal Luftfahrtmedizin in the 1930s and 1940s. He died in Munich on November 25th, 1951.

  9. Penumbra: Doctoral support as drama

    Wisker, Gina; Robinson, Gill; Bengtsen, Søren Smedegaard


    Much international doctoral learning research focuses on personal, institutional and learning support provided by supervisors, managed relationships,‘nudging’ robust, conceptual, critical, creative work. Other work focuses on stresses experienced in supervisor-student relationships and doctoral j...

  10. Reinventing The Doctor

    Moyez Jiwa


    Full Text Available There has been a seismic shift in the lives of people because of technology. People are far better informed than they were in the 1980s and 1990s. Much of this information is available through the media but even more is available and archived on the internet. The forces pushing the internet into health and health care are strong and unstoppable, ensuring that the internet and the choices it offers must be part of the design of our future health care system. We are no longer content to wait in queues as we live at a faster pace than earlier generations — we don’t not have time to wait for appointments months, weeks or even days in advance. The internet offers the prospect of online consultations in the comfort of your own home. The physical examination will change as new devices are developed to allow the necessary sounds and signals emitted by our malfunctioning bodies to be recorded, interpreted and captured at a remote location. Meanwhile, for those who prefer to see a health care practitioner in person the options to consult practitioners other than doctors who can advise on our health is expanding. The reality is we can’t afford to train or pay for all the doctors we need under the current “doctor-knows-best” system of health care. Patients no longer believe the rhetoric and are already voting with their feet. Pharmacists, nurses and other allied health professionals are beginning to play a much greater role in offering relief from symptoms and monitoring of chronic diseases. Of course, the doctor of the future will still need to offer face-to-face consultations to some people most of the time or most people some of the time. The social role doctors play will continue to be important as humans will always need other humans to personally respond to their distress. As doctors reinvent themselves, the internet and the value of time with patients will be the driving forces that move us into a more sustainable future in health care.

  11. Entrepreneurship and UK Doctoral Graduates

    Hooley, Tristram; Bentley, Kieran; Marriott, John


    This paper discusses the experience of UK doctoral graduates in pursuing entrepreneurial careers: there is evidence that this applies to a substantial number--about 10%--of doctoral graduates. The nature of their experience was explored using 37 interviews with doctoral entrepreneurs. The research was funded by Vitae (, an…

  12. Doctorateness as a Threshold Concept

    Trafford, Vernon; Leshem, Shosh


    Achieving a doctorate presents candidates with certain challenges--undertaking the research, writing the thesis and defending both at their viva. Throughout that doctoral journey, candidates are expected to display doctorateness in their thesis via the characteristics of high-quality scholarly research. The blockages that occur and prevent…

  13. Doctorateness as a Threshold Concept

    Trafford, Vernon; Leshem, Shosh


    Achieving a doctorate presents candidates with certain challenges--undertaking the research, writing the thesis and defending both at their viva. Throughout that doctoral journey, candidates are expected to display doctorateness in their thesis via the characteristics of high-quality scholarly research. The blockages that occur and prevent…

  14. Doctor's perception of doctor-patient relationships in emergency departments: What roles do gender and ethnicity play?

    Borde Theda


    Full Text Available Abstract Background Emergency departments continuously provide medical treatment on a walk-in basis. Several studies investigated the patient's perception of the doctor-patient relationship, but few have asked doctors about their views. Furthermore, the influence of the patient's ethnicity and gender on the doctor's perception remains largely unanswered. Methods Based on data collated in three gynaecology (GYN/internal medicine (INT emergency departments in Berlin, Germany, we evaluated the impact of the patient's gender and ethnicity on the doctors' satisfaction with the course of the treatment they provided. Information was gathered from 2.429 short questionnaires completed by doctors and the medical records of the corresponding patients. Results The patient's ethnicity had a significant impact on the doctors' satisfaction with the doctor-patient relationship. Logistic regression analysis showed that the odds ratio (OR for physician satisfaction was significantly lower for patients of Turkish origin (OR = 2.6 INT and 5.5 GYN than for those of German origin. The main reasons stated were problems with communication and a perceived lack of urgency for emergency treatment. The odds ratios for dissatisfaction due to a lack of language skills were 4.48 (INT and 6.22 (GYN, and those due to perceived lack of urgency for emergency treatment were 0.75 (INT and 0.63 (GYN. Sex differences caused minor variation. Conclusion The results show that good communication despite language barriers is crucial in providing medical care that is satisfactory to both patient and doctors, especially in emergency situations. Therefore the use of professional interpreters for improved communication and the training of medical staff for improved intercultural competence are essential for the provision of adequate health care in a multicultural setting.

  15. Doctor's perception of doctor-patient relationships in emergency departments: What roles do gender and ethnicity play?

    Babitsch, Birgit; Braun, Tanja; Borde, Theda; David, Matthias


    Emergency departments continuously provide medical treatment on a walk-in basis. Several studies investigated the patient's perception of the doctor-patient relationship, but few have asked doctors about their views. Furthermore, the influence of the patient's ethnicity and gender on the doctor's perception remains largely unanswered. Based on data collated in three gynaecology (GYN)/internal medicine (INT) emergency departments in Berlin, Germany, we evaluated the impact of the patient's gender and ethnicity on the doctors' satisfaction with the course of the treatment they provided. Information was gathered from 2.429 short questionnaires completed by doctors and the medical records of the corresponding patients. The patient's ethnicity had a significant impact on the doctors' satisfaction with the doctor-patient relationship. Logistic regression analysis showed that the odds ratio (OR) for physician satisfaction was significantly lower for patients of Turkish origin (OR = 2.6 INT and 5.5 GYN) than for those of German origin. The main reasons stated were problems with communication and a perceived lack of urgency for emergency treatment. The odds ratios for dissatisfaction due to a lack of language skills were 4.48 (INT) and 6.22 (GYN), and those due to perceived lack of urgency for emergency treatment were 0.75 (INT) and 0.63 (GYN). Sex differences caused minor variation. The results show that good communication despite language barriers is crucial in providing medical care that is satisfactory to both patient and doctors, especially in emergency situations. Therefore the use of professional interpreters for improved communication and the training of medical staff for improved intercultural competence are essential for the provision of adequate health care in a multicultural setting.


    Medical Service


    GENEVA EMERGENCY SERVICES GENEVA AND VAUD 144 FIRE BRIGADE 118 POLICE 117 CERN FIREMEN 767-44-44 ANTI-POISONS CENTRE Open 24h/24h 01-251-51-51 Patient not fit to be moved, call family doctor, or: GP AT HOME, open 24h/24h 748-49-50 Association Of Geneva Doctors Emergency Doctors at home 07h-23h 322 20 20 Patient fit to be moved: HOPITAL CANTONAL CENTRAL 24 Micheli-du-Crest 372-33-11 ou 382-33-11 EMERGENCIES 382-33-11 ou 372-33-11 CHILDREN'S HOSPITAL 6 rue Willy-Donzé 372-33-11 MATERNITY 32 la Cluse 382-68-16 ou 382-33-11 OPHTHALMOLOGY 22 Alcide Jentzer 382-33-11 ou 372-33-11 MEDICAL CENTRE CORNAVIN 1-3 rue du Jura 345 45 50 HOPITAL DE LA TOUR Meyrin EMERGENCIES 719-61-11 URGENCES PEDIATRIQUES 719-61-00 LA TOUR MEDICAL CENTRE 719-74-00 European Emergency Call 112 FRANCE EMERGENCY SERVICES 15 FIRE BRIGADE 18 POLICE 17 CERN FIREMEN AT HOME 00-41-22-767-44-44 ANTI-POISONS CENTRE Open 24h/24h 04-72-11-69-11 All doctors will come to your home. Cal...

  17. German for physicists

    Stein, Ben


    "German is the language of science" I remember my father telling me as a boy growing up in the Bronx in New York during the 1970s. As I watched astronomy programmes on TV with my father and older brothers, I imagined having to speak ceaselessly in fluent German if I was ever to become a scientist as a grown-up. But when I started my studies at university in New York in the 1980s, I realized my father's advice - sought from weekly trips to the neighbourhood public library - was way out of date. Not only did my physics professors present their research in English at conferences all around the world, but they also published in English-language journals - thus seemingly not needing a single word of German.

  18. Doctors and romance: not only of interest to Mills and Boon readers.

    Callister, Paul; Badkar, Juthika; Didham, Robert


    media coverage, the NZ public is well aware of local and national doctor shortages. There is also awareness, often through personal visits to a GP or hospital, of the significant rise in number of female and of foreign-born doctors. The choices doctors are making in living arrangements need to be taken into account when considering both national and international recruitment of medical staff. Researchers and policy makers may need to consider family migration issues more than they have in the past for doctors as well as for other migrant groups.

  19. Dirty German everyday slang

    Chaffey, Daniel


    GET D!RTYNext time you're traveling or just chattin' in German with your friends, drop the textbook formality and bust out with expressions they never teach you in school, including:•Cool slang•Funny insults•Explicit sex terms•Raw swear wordsDirty German teaches the casual expressions heard every day on the streets of Germany:•What's up?Wie geht's?•I'm smashed.Ich bin total angeschickert.•Fuckin' Munich fans.Scheiß München Fans.•That shit reeks.Das riecht aber ü

  20. Find a Doctor - American Optometric Association

    ... Doctor Login Join Find a Doctor Find a Doctor Search our database of 28,417 Optometrists. 1 ... Guidelines Evidence-based Optometry Marketplace Home > Find a Doctor Basic Search Advanced Search Fine Tune Your Results ...

  1. Contextual dynamics in clinical workplaces: learning from doctor-doctor consultations.

    Pimmer, Christoph; Pachler, Norbert; Genewein, Urs


    Some studies have explored the role of learning context in clerkships and in clinical teams. Very little is known, however, about the relationship between context and competence development in more loosely framed, day-to-day practices such as doctor-doctor consultations, although such interactions are frequent and typical in clinical work. To address this gap in the literature, a study was conducted using semi-structured interviews in four different hospitals and participant observation at one site. Inductive content analysis was used to develop a framework. Special reference was made to the principles of situated cognition. The framework illustrates how different situational, personal and organisational factors interact in every learning situation. The interplay manifests in three different roles that doctors assume in highly dynamic ways: doctors learn as 'actors' (being responsible), as 'participants' (being involved) and as 'students' (being taught); contextual influences also impact on the quality of learning within these roles. The findings add to the current literature on clinical workplace learning and to the conceptualisation of context in the field of education. The practical contribution of the research lies in disentangling the complex dynamics of learning in clinical environments and in helping doctors and medical educators to increase their responsiveness to contextual factors. © Blackwell Publishing Ltd 2013.

  2. Doctoral education from a distance.

    Effken, Judith A


    This article describes the environmental factors that have contributed to the recent rapid growth of nursing doctoral education at a distance. Early and recent efforts to deliver distance doctoral education are discussed, using The University of Arizona College of Nursing experience as the key exemplar. The Community of Inquiry model is introduced as an appropriate model for doctoral education and then used as a framework to evaluate the current state of the art in distance doctoral nursing education. Successes and challenges in delivering doctoral education from a distance are described.

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

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

  4. Doctoral Dissertations Related to Education for Peace and Multicultural Awareness. Peace Education Miniprints No. 43.

    Bjerstedt, Ake, Ed.

    This bibliography lists recent doctoral dissertations, written in English and German, related to peace education, multicultural education, and related topics. Dissertations from India on nonviolence, Mahatma Gandhi, and related subjects are listed in a separate appendix (with Hindi titles translated into English). (Author/DB)

  5. Doctoral Dissertations Related to Education for Peace and Multicultural Awareness. Peace Education Miniprints No. 43.

    Bjerstedt, Ake, Ed.

    This bibliography lists recent doctoral dissertations, written in English and German, related to peace education, multicultural education, and related topics. Dissertations from India on nonviolence, Mahatma Gandhi, and related subjects are listed in a separate appendix (with Hindi titles translated into English). (Author/DB)

  6. 加强医院宣传工作对构建和谐医患关系的作用%Enhance the hospital propaganda work and build a harmonious doctor-patient relationship



    Objective: With the development of China's society and economy, Chinese people's materialandculturallifeandhealthservicedemandimprovesfast.Meanwhile,medicaldisputesriserapidlyanddoctor-patientcontradictions are growing. For this reason, hospitals should pay attention to the important role of propaganda inimproving the doctor-patient relationship and build a harmonious doctor-patient relationship by providing goodmethodstohelpdoctorsandpatientscommunicatewellwitheachother.%随着人民群众对医疗卫生服务的需求日益增长,医患间的矛盾日益突出,医疗纠纷呈现上升趋势。医院在开展宣传工作时,应重视发挥宣传工作在改善医患关系中的重要作用,为医患的沟通了解提供途径和帮助,该文对此进行了初步探讨。

  7. Survey among doctors related with bronchial asthma patients in central hospitals of region level cities in Shaanxi province%陕西省地区级城市中心医院支气管哮喘相关科室医师的调查分析

    宋立强; 吴昌归; 呼彩莲; 李海东; 李文革; 何小鹏; 张和平


    表示为每位接诊的哮喘患者制定了长期用药方案及随访计划.结论 通过调查了解了陕西省地区级城市中心医院医师对哮喘知识的掌握程度.总体来看,呼吸内科医师的掌握程度高于其他专科,但距离普及规范化治疗理念还任重而道远.这些资料将为联盟在西部地区的医师教育工作提供参考.%Objective To evaluate the situation of grasping bronchial asthma(asthma) knowledge ofdoctors related with asthma patients in central hospitals of region level cities in Shaanxi province, and toappraise the effect of doctor education in order to provide evidence for the next step of education. MethodsSix hospitals were selected from six region level cities, where questionnaire survey was completed in thedorctors from the department of respiratory medicine, internal medicine, emergency or pediatrics. Thequestionnaire involved pathogenesy, prevention, treatment and advencement of global initiative for asthma(GINA). Results 187 doctors completed the qusetionnaire,and the ratio of every speciality was 29.9%,23.0%,26.7% and 20.3%, respectively. 58.9%-62.5% dorctors in respiratory knew the organization ofasthma clearly and the ratio was very higher than that in other spciality. But 10.7% dorctors did not knowthe significance of GINA. World Asthma Day was known in 87.6%. 69.9% doctors understood thepathogenesy of slow airway inflammation, while the highest ratio was 78.6% in repiralogy and the lowestone was 55.8% in internal medcine. Repiratory doctor knew the classification of asthma according tocontroled level most clearly in all people. 54.8%-75.0% doctors knew the importance of inhaledcorticosteroid (ICS)in therapy. But the effect of asthma control test and stort-acting β2-agonist wasunderstood only by 7.1% and 42.9% respiratory doctors. 37.8% doctors knew the use of long-actingβ2-agonist should be combined with ICS. 52.0%-76.4% doctors knew the blocker of leukotriene receptorwas control medcine. 51

  8. Giving German universities a boost.

    Tuffs, Annette


    Although well respected, German universities are no longer considered world class. Efforts to rejuvenate the German university system include a competition to confer elite status on the country's ten leading universities.

  9. Teaching German Modal Particles.

    Rosler, Dietmar


    Believes modern linguistics has done little to explore German modal particles because by focusing on sentences as the basic category for linguistic thinking these words did not seem to matter. Describes model which gives students experience with these particles in meaningful communication. (Author/BK)

  10. Teaching German with TPRS.

    Davidheiser, James


    Outlines the research leading to Total Physical Response (TRP) and later Total Physical Response Storytelling (TPRS) methods. Discusses the day-to-day use in the German classroom of TPRS by an experienced practitioner and explains the reasons for its success. Presents student evaluations of the method and the material available for its use. (AS)

  11. [Physician's role in "medical drama" pitfall? Reflection of stereotypical images of doctors in context of contemporary doctor's series].

    Köhler, M; Grabsch, C; Zellner, M; Noll-Hussong, M


    In contemporary U.S. doctor's series, the characters are usually represented by good-looking or typical character actors. The aim of our pilot study was to investigate whether the long-term impact of this format on German television viewers could have an influence on the choice of doctor in Germany. Two different groups of people anticipating TV consumption patterns were questioned: a first group of younger adults who knew theTV series was asked to judge their doctor choice using a web-based survey tool with respect to three criteria (sympathy, expertise and own treatment preference). The second group of adults beyond the 40th year of life who need not know theTV series were shown photos of the serial figures. Study participants should select the "doctor" of which they would most likely want to be treated and this based on two predetermined reasons (sympathy or expertise). Our results indicate that stereotypical images of doctors found high approval only in the first group of people, while the participants in the second group decided in majorityfora more realistic representation of average appearance.

  12. 口腔专科医院医护合作水平对护士工作满意度及离职意愿的影响研究%Impact of doctor-nurse collaboration on job satisfaction and turnover intention among nurses in stomatological hospital

    张琳; 刘萌; 严红; 李秀娥


    Objective To explore the influences of doctor-nurse collaboration on job satisfaction and turnover intention among nurses in stomatological hospital. Methods A total of 545 nurses from grade Ⅲ-A stomatological hospital were investigated by convenience sampling method from January 2015 to February 2015 using general data questionnaire, doctor-nurse collaboration scale, nurses′ job satisfaction scale and turnover intention questionnaire. Results The scores of doctor-nurse collaboration scale, job satisfaction and turnover intention were (86. 46 ± 14. 52), (136. 08 ± 14. 88) and (20. 31 ± 3. 67). The doctor-nurse collaboration level was positively correlated with job satisfaction (r=0. 328, P<0. 01) and negatively correlated with turnover intention (r= -0. 220, P<0. 01). Doctor-nurse collaboration level could be positive to predict the situation of job satisfaction (t=2. 871, P <0. 01), and negative to predict the possibility of quitting current job (t =-6. 209, P < 0. 01). Conclusions The situation of nurse job satisfaction and turnover intention is not optimistic in stomatological hospital. Improving the level of doctor-nurse collaboration can help to improve job satisfaction and reduce turnover intention.%目的 探讨口腔专科医院医护合作水平对护士工作满意度及离职意愿的影响. 方法 采用一般资料问卷、医护合作量表、工作满意指数量表和离职意愿量表,于2015年1-2月方便取样选择某三级甲等口腔专科医院545 名护士进行调查. 结果 口腔专科医院护士医护合作水平为(86. 46 ± 14. 52)分,工作满意度水平为(136. 08 ± 14. 88)分,离职意愿水平为(20. 31 ± 3. 67)分;医护合作水平与工作满意度呈正相关(r=0. 328,P<0. 01),与离职意愿呈负相关(r= -0. 220,P<0. 01);医护合作水平能正向预测工作满意度(t=2. 871,P<0. 01),负向预测离职意愿中辞去目前工作的可能性(t= -6. 209, P<0. 01). 结论 口腔专科医院护士工作满意度

  13. German Jewish Intellectuals and the German Occupation of Belgium

    Ulrich Wyrwa


    Full Text Available In August 1914 the majority of German Jews expressed their patriotic approval of the war and their loyalty to the German state. They identified with Germany, and a large number signed up voluntarily for military service at the front. The Jewish population in Germany affirmed the war not least because it was directed against Russia, the harshest adversary of the Jews. This paper concentrates on the first acts of war conducted by the German military forces during the German occupation of Belgium; it examines whether and in what way German-Jewish Intellectuals perceived Germany’s violation of Belgian neutrality and the new feature of war as a war against a civilian population. The first part examines autobiographical sources to reconstruct the experiences and the perception of German Jewish soldiers, German military rabbis, and other German Jewish witnesses to the war. The second part then analyzes the coverage of German Jewish newspapers regarding the warfare against Belgium; and, finally, the third and last part scrutinizes the commentaries of German Jewish intellectuals and socialist Jews [Jewish socialists?] regarding the German war against Belgium.

  14. Doctor Alberto Zabaleta Lombana


    El Doctor Alberto Zabaleta Lombana nació en la población de Turbaco, Bolívar, el nueve de Abril de 1923. Toda su formación intelectual transcurrió en los claustros de la Universidad de Cartagena. En 1936 ingresó a la Facultad de Filosofía y Letras (Bachillerato), luego pasó a la Facultad de Medicina hasta obtener su grado de Médico en 1953. Posteriormente en 1959 inició la Jefatura de Clínica Obstetricia (Residencia como se denominan en el presente) en la Universidad de Cartagena y en la Clín...

  15. [Ten years' German Protection against Infection Act. Evaluation of the implementation of infection control visits in the ambulatory medical setting].

    Heudorf, U; Eikmann, T; Exner, M


    In 2001, the German Protection against Infection Act came into force, implementing a variety of new regulations. For the first time, obligatory infection control visits of the public health departments in surgical ambulatory practices were implemented, as well as optional infection control visits in all medical, dental and paramedical practices using invasive methods. Based on the data of the public health department of the city of Frankfurt am Main, Germany, an evaluation of this new regulation is given in this paper. First, prioritization of these new tasks was mandatory. First priority was given to the obligatory visits in surgical practices, second priority to the hygiene visits in practices performing endoscopy in gastroenterology as well as in urology and in practices of traditional healers, and third priority was given to all other doctors' practices. After receiving preliminary information and further training of the doctors etc., the control visits were performed by members of the public health department, using a checklist based on the guidelines of the German Commission on Hospital Infection Prevention ("Kommission für Krankenhaushygiene und Infektionsprävention"). Since 2001, more than 1100 infection control visits in medical practices in Frankfurt am Main were documented. Not only in surgical, but also in gastroenterological and urological practices great improvement could be achieved, regarding not only hand hygiene and reprocessing surface areas, but especially in reprocessing medical devices. In practices for internal medicine and those of general practitioners, errors in hand hygiene, skin antiseptic and surface disinfection also decreased. According to our results, especially regarding the improved quality of structure as well as quality of process and with regard to the public discussion on this hygiene topic, our evaluation is absolutely positive. The new regulation proved worthwhile.

  16. 县级医疗和谐医患关系的构建路径%Routes of Constructing Harmonious Doctor-Patient Relationship in County-Level Hospitals



    Medical service condition is relatively backward in mid-western counties,and medical disputes occur frequently there.From the perspective of patients,three factors causing doctor-patient disputes are patients' dissatisfaction with medical process,result and cost.The roots can be found both in medical service suppliers and consumers.In order to achieve harmonious doctor-patient relationship,the reform in medical service supply should be carried out to improve medical services,enhance doctors-patient communication,resolve medical disputes and strengthen medical law construction.%中西部县级医疗条件较为落后,医疗纠纷多发、易发。县级医患纠纷有三种主要类型,即对医疗过程不满意的医患纠纷、对医疗结果不满意的医患纠纷和对医疗费用不满意的医患纠纷,而医患纠纷的产生则可以从供给和需求两侧寻找原因。县级和谐医患关系构建需要县级医疗的供给侧改革,即从改善医疗服务、医患沟通、医疗纠纷化解、医疗法治建设等方面来营造和谐医患关系的条件。

  17. Medical restrictions to driving: the awareness of patients and doctors.

    Kelly, R; Warke, T; Steele, I


    The study was set up to investigate the awareness of elderly patients and medical doctors of medical restrictions to driving. Separate questionnaires were completed by patients and doctors. All were interviewed face-to-face, without prior warning and their immediate answers were recorded. In total, 150 elderly patients from the acute elderly care wards, rehabilitation wards and day hospital, and 50 doctors (including all grades from consultant to junior house officer) were interviewed. The main outcome measures were numbers of patients currently driving and previously driving; patients' awareness of how their medical condition affected their ability to drive; doctors' spontaneous knowledge of medical conditions which restrict driving, current licensing policy, and restrictions for five specific medical conditions (epilepsy, myocardial infarction, stroke, 5-cm abdominal aortic aneurysm, and diabetes). Only 21 patients were current drivers, and six of these should not have been driving. While 103 perceived themselves eligible to drive, 46 had medical restrictions to driving. Seventeen of the 47 patients who perceived themselves not eligible to drive possibly did not have restrictions to driving. Doctors' knowledge of the current licensing policy and action to be taken if a patient was not eligible to drive was very poor. Knowledge of medical restrictions to driving was scanty, with few doctors giving the correct driving restrictions for the five specific conditions. We recommend that education of doctors regarding medical restrictions to driving should begin at an undergraduate level and be continued throughout their postgraduate career.

  18. [The birth of the hospital].

    Le Coz, R


    Hospitals were founded as early as the forth century, by the Church in the Byzantine Empire. However, it was not before the sixth century, with the Reform of Justinian, that the hospital got its definitive organization. In Bagdad, as soon as the eight century, the christian-nestorian doctors organized the first hospitals in the Arab-Muslim world.

  19. The Impact of Information on Doctors' Attitudes Toward Generic Drugs.

    Tsaprantzi, Aggeliki V; Kostagiolas, Petros; Platis, Charalampos; Aggelidis, Vassilios P; Niakas, Dimitris


    The objective of this study is to assess the impact of information on doctors' attitudes and perceptions toward generics. A cross-sectional survey based on a specially designed 21-item questionnaire was conducted. The survey involved doctors of different specialties working in a public hospital in Greece. The analysis includes descriptive and inferential statistics, reliability and validity tests, as well as structural equation modeling to evaluate the causal model. Statistical analysis was accomplished by using SPSS 20 and Amos 20. A total of 134 questionnaires out of 162 were received, providing a response rate of 82.71%. A number of significant associations were found between information and perceptions about generic medicines with demographic characteristics. It seems that the provision of quality information on generic drugs influences doctors' attitudes and prescription practices toward generic drugs. This is not a static process but a rather dynamic issue involving information provision policies for strengthening the proper doctors' attitudes toward generic drugs.

  20. More than just clowns--Clown doctor rounds and their impact for children, families and staff.

    Ford, Karen; Courtney-Pratt, Helen; Tesch, Leigh; Johnson, Caddi


    Admission to hospital is recognised as a difficult time for children and families. This study explored clown doctor activities in an acute paediatric setting and the impact their activities have on children, their families, other health professionals and clown doctors themselves. We used observation, semi-structured interviews and focus groups with children and parents and staff and clown doctors and results provide a rich description of the work of clown doctors. The major themes were 'the encounter - in the moment' of the interaction of the child and the clown doctor and 'beyond the encounter'. The findings show that the impact of clown doctor visits is experienced beyond the immediate interaction, and this has not been clearly articulated in previous studies. This study highlights the multifaceted and complex nature of the work of the clown doctors and the high level of skill required as they modify and interpret play, activities and environment based on individual need and response.

  1. Insufficient knowledge about battered child syndrome among doctors in the emergency department

    Villadsen, Jenny Korsgaard; Bersang, Ann Buhl; Thorninger, Rikke;


    The aim of the study was to determine the present knowledge regarding battered child syndrome (BCS) among doctors in the emergency department. Nineteen doctors with different educational levels from seven hospitals in Denmark were interviewed. For children younger than 18 months, 68%, 65% and 25......% of the participants related femur-, collum costae- and corner fractures to BCS respectively. We found that more than one third of the 19 doctors did not know which fractures to look for when suspecting BCS....

  2. Language of the doctorate: Doctorateness as a threshold concept in doctoral literacy

    Bitzer, Eli


    Full Text Available In academia, the definition of literacy has evolved from a focus on reading and writing to encompass more inclusive and expansive perspectives. Such perspectives have come from researchers involved in exploring literacy among diverse populations and across traditional divides such as cultural, political and socioeconomic boundaries. Changing definitions of literacy include usage in expressions such as ‘computer literacy’, ‘civic literacy’, ‘health literacy’, ‘cultural literacy’ and others. Recently, new directions in literacy research were foregrounded by critical questions that seek to discover how literacy functions in doctoral studies and within research communities. For instance, what does it mean to be ‘literate’ as a doctoral member of a research culture, within a field of research, within the academic profession and so on? In addition, doctoral candidates often grapple with what may be termed ‘threshold concepts’. Such concepts include the meaning of the doctorate as a qualification, its aims, its narrative and the level of literacy required to succeed with a doctorate. Against this background the article explores firstly how the concept of being literate has been broadened to include literacy for doctoral learning; secondly, it explains why doctorateness remains a threshold concept for many doctoral candidates and supervisors, and thirdly it provides some evidence from at least five years of working with doctoral education and doctoral supervisor development workshops to support an argument for doctoral literacy. Finally, the article provides some implications which emerged from a better understanding of the language and requirements of doctorateness as an essential literacy requirement for doctoral candidates and their supervisors.

  3. German cancer statistics 2004


    Abstract Background For years the Robert Koch Institute (RKI) has been annually pooling and reviewing the data from the German population-based cancer registries and evaluating them together with the cause-of-death statistics provided by the statistical offices. Traditionally, the RKI periodically estimates the number of new cancer cases in Germany on the basis of the available data from the regional cancer registries in which registration is complete; this figure, in turn, forms the basis fo...

  4. Doctor Gonzalo Esguerra Gómez

    Academia Nacional de Medicina


    Nació en Bogotá (Colombia) el 24 de enero de 1902
    Bachiller de la Escuela Nacional de Comercio (Bogotá), diciembre de 1919.
    Ayudante del Laboratorio de Radiología del Hospital de San Juan de Dios (Facultad de Medicina de Bogotá), 1920-1922.
    Jefe de trabajos del mismo laboratorio (1926-1928).
    Doctor en medicina y cirugía de la Universidad Nacional de Colombia. (Bogotá 19 de noviembre de 1927).<...

  5. Transfers from rural hospitals in New Zealand.

    Lloyd, Trevor; Blattner, Katharina; Nixon, Garry


    To canvass the experience of a group of New Zealand rural hospital doctors of transfers from their hospitals. Ten rural hospital doctors were required to write an assignment on patient transfer as part of their assessment for a postgraduate diploma. The information from the completed assignments was grouped into themes for analysis. The responses from the ten doctors could be grouped into six themes: resources at the rural hospital, clinical conditions, mode of transfer, communication, issues during transfer, and health system issues. The experience of this group of doctors is consistent with the available published information. Transfer of patients is an inevitable part of rural hospital practice. The outcome for patients could be improved through better resourcing of rural hospitals and education for staff, improved communication with transport services and with base hospital specialists, and involvement in the development of regionalised transport protocols.

  6. Re-Imagining Doctoral Education: Professional Doctorates and beyond

    Lee, Alison; Brennan, Marie; Green, Bill


    Portents of the demise of the Professional Doctorate have emerged in some recent policy and institutional circles in Australia, raising questions about the meaning and relevance of the Professional Doctorate in an era of "league tables" and research assessment in Australia. This article argues that such portents, based largely on narrow…

  7. Professionalism for future humanistic doctors



    Full Text Available Dear editor Clinical environments encounter is an important part of studying medicine (1. Patient contact as an integral part of medical education occurs in various formats in the clinical settings (2, 3. During clinical training, medical students may experience high levels of stress, and some may not deal with it well. The abruptness of students’ transition to the clinical setting generated positive and negative emotions. Due to being a novice, they did not receive adequate training on how to get emotionally prepared for meeting seriously ill people. In such circumstances, the shortage of training will have predictably crucial consequences. Early clinical contact has been suggested to reduce these stresses and help the students adapt effectively to changes in the hospital climate (2. Patient contact creates an environment where each student appreciates cultural diversity and reinforces the development of clinical professional interpersonal skills through social, emotional and cognitive experiences (4, 5. It encourages validating of the relationship between patients and doctors and allows students to experience a more personal relationship with patients and nurture the ability to empathize with them, providing considerable benefits for trainees and patients. In this way, the social emotions that students experience when empathizing with a patient represent a uniquely human achievement. By internalizing their subjective interpretations of patient’s beliefs and feelings, the student’s body, brain and mind come together to produce cognition and emotion . They construct culturally relevant knowledge and make decisions about how to act and think about the patient’s problems as if they were their own. On the other hand, patient interaction in undergraduate education offers students a valuable early insight into the day-to-day role of a doctor and the patients’ perspective on specific conditions. Early experience provides a greater knowledge

  8. India's Doctor Shortage Reflects Problems in Medical Education

    Neelakantan, Shailaja


    This article reports that India's medical profession is in a crisis. For every 10,000 people in India there are only six doctors, compared with nearly 55 in the United States and nearly 21 in Canada. The problem is likely to get worse before it gets better. Professors are leaving medical schools for better-paying jobs in private hospitals and in…

  9. Patient-doctor communication.

    Teutsch, Carol


    Communication is an important component of patient care. Traditionally, communication in medical school curricula was incorporated informally as part of rounds and faculty feedback, but without a specific or intense focus on skills of communicating per se. The reliability and consistency of this teaching method left gaps, which are currently getting increased attention from medical schools and accreditation organizations. There is also increased interest in researching patient-doctor communication and recognizing the need to teach and measure this specific clinical skill. In 1999, the Accreditation of Council for Graduate Medical Education implemented a requirement for accreditation for residency programs that focuses on "interpersonal and communications skills that result in effective information exchange and teaming with patients, their families, and other health professionals." The National Board of Medical Examiners, Federation of State Medical Boards. and the Educational Commission for Foreign Medical Graduates have proposed an examination between the. third and fourth year of medical school that "requires students to demonstrate they can gather information from patients, perform a physical examination, and communicate their findings to patients and colleagues" using standardized patients. One's efficiency and effectiveness in communication can be improved through training, but it is unlikely that any future advances will negate the need and value of compassionate and empathetic two-way communication between clinician and patient. The published literature also expresses belief in the essential role of communication. "It has long been recognized that difficulties in the effective delivery of health care can arise from problems in communication between patient and provider rather than from any failing in the technical aspects of medical care. Improvements in provider-patient communication can have beneficial effects on health outcomes". A systematic review of

  10. [Free choice of doctors in Germany in retrospect].

    Kunstmann, W; Butzlaff, M; Böcken, J


    Due to discussions on the cost and quality of health care and a new legislation on the German statutory sickness insurance system in 1999, the free choice of doctors has recently become topical. To assess its legitimation for the German health care system, its history and the groups of interest involved should be taken into consideration. Before the period of industrialization no homogeneous pattern of the medical profession existed. In case of illness individuals who lived within reach and were known for their competence in disease matters were approached. However, industrialization destroyed existing social networks, and establishment of new structures of health care in rural as well as metropolitan areas became necessary. The government approached this challenge by structuring medical education, passing regulations on the settlement of doctors and promoting the foundation of statutory sickness funds. The Health Insurance Law of 1883 established a mandatory insurance system for a broad array of industries. As it was the sickness funds' responsibility to provide sufficient resources for medical care, a sick member was tied to the physician under contract with his insurance. After a rapid increase in practising physicians at the end of the 19(th) century, doctors' organisations were eager to gain access to the new market segment of insurance members by calling for the free choice of physicians. The Leipzig association (Hartmannbund) was founded in 1900 to organize strikes of doctors in order to get their goals accepted. After 30 years of conflicts an appeasement was achieved by a presidential emergency law in 1931. It transferred the responsibility for the provision of sufficient health care resources from the sickness funds to the newly created body of the Association of Sickness Fund Physicians (Kassenärztliche Vereinigung) and determined the patients' free choice among licensed sickness fund physicians.

  11. Investigation and research of the reasonable use of antibiotics in treating respiratory infections by young doctors in primary hospitals%基层医院中青年医师对呼吸道感染性疾病抗菌药物合理应用的调查研究

    周九洲; 马媛; 韦霖


    OBJECTIVE To investigate the condition of rational use of antibiotics in treating respiratory tract infec‐tions by young doctors in primary hospitals ,so as to provide the basis for the rational use of antimicrobial drugs for young doctors in primary hospitals .METHODS Stratified sampling was used to research young doctors from 5 primary hospitals in Beijing .Totally 411 valid questionnaires were collected .The questionnaires were designed to investigate how well the young doctors knew about rational use of antibiotics .And medical records and prescrip‐tions of the 400 patients underwent respiratory tract infections were retrospectively analyzed .All data were ana‐lyzed by SPSS 19 .0 software .RESULTS The young doctors in primary hospitals knew little about precaution and combined use of antibiotics with the cognitive rate of only 30 .09% and 32 .85% .The cognition of drug sensitivity proved to be better with the rate of 77 .61% .About 70 .07% of them thought the reason of poor antibiotic efficacy was antibiotics and 52 .80% thought the antibiotic resistance of bacteria .Among the 400 prescriptions for respira‐tory tract infections ,about 86 .75% of them used antibiotics .Unreasonable application of antibiotics mainly con‐tained :the use of super expensive antibiotics ,unreasonable combination therapy ,over‐course drug use ,pharma‐cological antagonism , inappropriate solvent and repeated use of antibiotics and so on . CONCLUSION Young doctors in primary hospitals lack the knowledge about the use of antibiotics ,and unreasonable use of antibiotics is common to see .Young doctors should strengthen their professional ethics education and improve their professional knowledge level so that they can use antibiotics normatively and rationally .%目的:调查分析基层医院中青年医师对呼吸道感染性疾病抗菌药物合理应用情况,为提高基层医院中青年医师抗菌药物合理应用提供依据。方法采取分层抽样

  12. The Social Work Practice Doctorate

    Hartocollis, Lina; Cnaan, Ram A.; Ledwith, Kate


    This article provides a systematic review of the emerging practice doctorate in social work. Based on the experience of the first such Doctor of Social Work (DSW) program, we provide information regarding the program origins and rationale, development, current structure, and future direction. Such information will enrich the discussion on the role…

  13. Will Medical Technology Deskill Doctors?

    Lu, Jingyan


    This paper discusses the impact of medical technology on health care in light of the fact that doctors are becoming more reliant on technology for obtaining patient information, making diagnoses and in carrying out treatments. Evidence has shown that technology can negatively affect doctor-patient communications, physical examination skills, and…

  14. Talking to Your Child's Doctor

    ... a Better Relationship en español Cómo conversar con el médico de su hijo Your child's doctor can ... don't be afraid to give the doctor feedback about your office visit experience, such as whether ...

  15. 教学医院医患关系与医德医风评价研析%Analysis of Doctor-patient Relationship and Appraisal of Medical Ethics in Teaching Hospitals



    Objective To research appraisal of medical ethics from medical personnel and patients. Methods Questionnaires are done to survey 306 patients and 266 doctors and patients through investigation by Epidata and statistical description and analysis by SPSS13.0. Results There are differences in medical personnel's service attitude, medical personnel's response to patients' needs, right of informed consent of respecting patients, medical cost, patients' respect and doctor-patient communication, etc. Conclusion Several aspects should be improved from the following aspects: improving the management system of medical ethics; focusing on education to enhance medical personnel's overall quality; focusing on the belief of medical ethics for medical students; changing medical ethics education mode; and improving the remuneration of medical personnel.%目的 调查医护人员医德自我评价和患者对医护人员医德评价.方法 对某教学医院306名患者、266名医护人员进行问卷调查,调查信息通过Epidata录入,使用SPSS13.0软件进行统计描述和分析.结果 在医护人员的服务态度、医护人员对患者需求的反应、尊重患者的知情同意权、医药费用问题、患者的信任、医患沟通等方面存在差异.结论 主要从以下几方面进行改善:完善医德医风管理制度;提高医护人员整体素质:注重对医学生医德信念的培养;转变医德医风的教育方式:提高医务人员的待遇.

  16. [The balanced scorecard. "Tool or toy" in hospitals].

    Brinkmann, A; Gebhard, F; Isenmann, R; Bothner, U; Mohl, U; Schwilk, B


    The change in hospital funding with diagnosis related groups (DRG), medical advances as well as demographic changes will call for new quantitative and qualitative standards imposed on German hospitals. Increasing costs and competition in the health care sector requires new and innovative strategies for resource management. Today's policy is mainly defined by rationing and intensified workload. The introduction of DRGs will presumably further constrict management perspectives on pure financial aspects. However, to ensure future development, compassionate services and continued existence of hospitals, a balance of seemingly conflicting perspectives, such as finance, customer, process, learning and growth are of utmost importance. Herein doctors and nurses in leading positions should play a key role in changing management practice. For several years the balanced scorecard has been successfully used as a strategic management concept in non-profit organizations, even in the health care sector. This concept complies with the multidimensional purposes of hospitals and focuses on policy deployment. Finally it gives the opportunity to involve all employees in the original development, communication and execution of a balanced scorecard approach.

  17. [The fate of Polish psychiatry under German occupation during World War II].

    Leidinger, Friedrich


    Polish psychiatry was since its origin deeply influenced by German (Austrian) and Russian psychiatry. After the German assault Polish psychiatric patients were the first victims of mass executions, and the first to be killed by new developed "gassing" technology. Especially cruel was the fate of Jewish patients. German "health policy" in occupied Poland was only "starvation or shooting". Some hospitals continued working under German rule and received patients from Germany in the framework of Nazi-"euthanasia". The article describes the mostly ignored facts of the close link between the medical programme of annihilation of the "unfit" and the genocide of Poles and Jews. © Georg Thieme Verlag KG Stuttgart · New York.

  18. Haemorrhage Control in the German Army - Lessons Learned


    coagulopathy is not recommended in civilian German hospitals. Compared with blood components that can be processed, tested, freeze-dried, packaged, stored...component (RBC´s, plasma, platelets) is indicated for treatment and not available, or if transfusion of available blood components in a 1:1:1 ratio

  19. The perceptions of rural women doctors about their work | De Vries ...

    The perceptions of rural women doctors about their work. ... Results: The main theme was balance. ... reason for working at a rural hospital, attitudes to rural life, opportunities for personal and professional growth, the feeling of being needed in ...

  20. The German drought monitor

    Zink, Matthias; Samaniego, Luis; Kumar, Rohini; Thober, Stephan; Mai, Juliane; Schäfer, David; Marx, Andreas


    The 2003 drought event in Europe had major implications on many societal sectors, including energy production, health, forestry and agriculture. The reduced availability of water accompanied by high temperatures led to substantial economic losses on the order of 1.5 Billion Euros, in agriculture alone. Furthermore, soil droughts have considerable impacts on ecosystems, forest fires and water management. Monitoring soil water availability in near real-time and at high-resolution, i.e., 4 × 4 km2, enables water managers to mitigate the impact of these extreme events. The German drought monitor was established in 2014 as an online platform. It uses an operational modeling system that consists of four steps: (1) a daily update of observed meteorological data by the German Weather Service, with consistency checks and interpolation; (2) an estimation of current soil moisture using the mesoscale hydrological model; (3) calculation of a quantile-based soil moisture index (SMI) based on a 60 year data record; and (4) classification of the SMI into five drought classes ranging from abnormally dry to exceptional drought. Finally, an easy to understand map is produced and published on a daily basis on Analysis of the ongoing 2015 drought event, which garnered broad media attention, shows that 75% of the German territory underwent drought conditions in July 2015. Regions such as Northern Bavaria and Eastern Saxony, however, have been particularly prone to drought conditions since autumn 2014. Comparisons with historical droughts show that the 2015 event is amongst the ten most severe drought events observed in Germany since 1954 in terms of its spatial extent, magnitude and duration.

  1. Clusters propel German universities

    Banks, Michael


    The annual publication of a list of the world's top universities by the Times Higher Education newspaper must make grim reading for researchers in Germany. The list, drawn up in partnership with education provider Quacquarelli Symonds, last year included only three German universities in the top 100 - Heidelberg in 57th spot, followed by the Technical University (TU) in Munich (78th) and the Ludwig-Maximilians-University (LMU), also in Munich, coming in a lowly 93rd. The US in contrast, has 37 of the top 100 universities, while the UK boasts 17.

  2. The German Humpback

    Aabo, Tom; Ploeen, Rasmus


    hedging (matching of cash flows and operational flexibility). We employ multivariate regression analysis and find an inverse U-shape relationship (“humpback”) for large listed non-financial German firms. Foreign exchange hedging activity peaks when half of sales (or long-term assets) is outside Europe. We......Previous studies find a monotonic positive relationship between a firm’s internationalization and its foreign exchange hedging. We argue that high levels of internationalization can reduce the need for foreign exchange hedging through diversification (e.g. sales to several markets) and operational...

  3. [Civil, criminal and ethical liability of medical doctors].

    Udelsmann, Artur


    In the last years doctors have been the target of a growing number of civil, criminal law suits, as well as ethical procedures. Medicine is a widely targeted career, not only owing to its inherent risks, but also owing to a mistaken approach of the Judiciary Power about the obligations of medical doctors. Decisions of the Medical Board in ethical procedures have an impact in civil and criminal justice and therefore should be followed closely. The purpose of this review is to provide a wide view from a doctor-lawyer perspective of cases involving civil, criminal liability of anesthesiologists as well as ethical procedures against them, in an effort to make them comprehensible to doctors. After a brief historical introduction civil liability foundations and legal articles are examined. Responsibilities of doctors, hospitals and health insurance providers are discussed separately, as well as reparation mechanisms. Crimes possible to occur during medical practice and respective penalties are described; the direct relationship between crime and civil reparation is demonstrated. The administrative nature of ethical procedure is described, emphasizing that the legal character of its penalties often serve as grounds for civil and criminal justice decisions. Prevention is still the best medicine. Good medical practice and a good medical-patient relationship are still the best ways to minimize lawsuits and their repercussions. Doctors should have some knowledge of juridical mechanisms in lawsuits and ethical procedures, but should not take defense initiatives without prior consultation of an attorney. Civil, criminal and ethical liability of physicians.

  4. Ethical erosion in newly qualified doctors: perceptions of empathy decline.

    Stratta, Emily C; Riding, David M; Baker, Paul


    This study sought to understand whether UK Foundation doctors perceived the phenomena of ethical erosion and empathy decline during their initial period of clinical practice, and if so, why this occurred. This qualitative study used semi-structured interviews with nine doctors in their first year of clinical practice at Royal Bolton Hospital, UK. Participants were invited to discuss the definition of empathy, how individuals acquire and maintain empathic ability, perceptions of ethical erosion in the self and others, and how clinical experiences have influenced their empathic ability. The interviews were transcribed, and analysed to identify emergent themes. Each participant reported a conscious acknowledgement of empathy decline in their own and their colleagues' early clinical experiences as doctors. Stressful working environments, the prioritisation of patients' physical rather than psychological well-being, and the attitudes of senior colleagues were all suggested as possible causes. Some doctors believed that specialties with reduced patient contact had a culture which precluded empathy, and influenced their own practice. In addition, some described how their value judgements of patients had affected their ability to empathise. However, all doctors perceived that empathy skills were desirable in senior clinicians, and some believed that educational interventions may be useful in arresting ethical erosion. Newly qualified doctors are aware of ethical erosion in themselves and their colleagues as they begin clinical practice. This has serious implications for patient care. Improving working conditions may reverse this trend. Empathy skills training within undergraduate and postgraduate curricula may be a useful intervention.

  5. Dementia - what to ask your doctor

    What to ask your doctor about dementia; Alzheimer disease - what to ask your doctor; Cognitive impairment - what to ask your doctor ... who is losing or has lost their memory? What type of words should I use? What is ...

  6. Epilepsy - what to ask your doctor - adult

    What to ask your doctor about epilepsy - adult; Seizures - what to ask your doctor - adult; Seizure - what to ask your doctor ... call to find more information about driving and epilepsy? What should I discuss with my boss at ...

  7. [Relations of German anesthesiology to east European societies of anesthesiology].

    Benad, G


    boards of East European anaesthesia societies in order to discuss the further development of anaesthesiology as an independent new academic field of medicine. Both East and West German anaesthetists were very often invited as guest lecturers by various East European societies and anaesthesiological departments. They were always deeply impressed by the tremendous hospitality of their hosts. During the "Cold War", many anaesthetists from East European countries were also invited as guests by anaesthesia departments of East and West Germany. Most of the East European anaesthetists preferred West German departments because they were better equipped and some of them used these trips to the West also to escape from communism. Shortly before and mainly after the political changes in 1989 and the dissolving of the "Society of Anaesthesiology and Intensive Therapy of the GDR" in 1990, the "German Society of Anaesthesiology and Intensive Care Medicine" improved its contacts to the East European anaesthesiological societies. The "Bavarian Section" of the "German Society of Anaesthesiology and Intensive Care Medicine" organized joint meetings with the Romanian, Bulgarian, Latvian and Russian societies of anaesthesiology in Bucharest (1987), Riga (1989), Moscow (1989) and Sofia (1991). In 1996, an "Association of German and Russian Anaesthetists" (ADRA) was founded in Moscow, which now has both a German (Prof. Dr. Dr. h.c. Joachim Nadstawek/Bonn) and a Russian (Prof. Dr. Armen Buniatian/Moscow) President. The German members of this association, in particular its Secretary-General, Prof. Dr. Reinhard Purschke/Dortmund, organize postgraduate courses including theoretical lectures and practical work not only in Russia but also in Armenia and Usbekistan.

  8. Diagnosing the doctors' departure: survey on sources of dissatisfaction among Irish junior doctors.

    Bruce-Brand, R


    There has been a significant decline in the number of applications for non-consultant hospital doctor (NCHD) posts in Ireland over the last 18 months. We conducted an online, anonymous survey of Irish NCHDs to establish levels of satisfaction, sources of dissatisfaction and the major reasons for junior doctors seeking work abroad. 522 NCHDs took the survey, including 64 (12.3%) currently working outside of the Republic. 219 (45.8%) were slightly dissatisfied and 142 (29.7%) were extremely dissatisfied with practising medicine in Ireland. Major sources of dissatisfaction included the state of the health care system, staffing cover for leave and illness, the dearth of consultant posts and the need to move around Ireland. The most important reason for NCHDs wishing to leave was to seek better training and career opportunities abroad.

  9. Germanic-Slavic Hybrid Names in the East German Toponymy

    Karlheinz Hengst


    Full Text Available The article focuses on the toponymy of the Eastern part of modern Germany where Slavic and Germanic tribes were in contact during several centuries: in the 7th century the Slavs ousted Germanic tribes from this territory; then, since the early 10th century, the area started being repopulated by the Germans, which led to a Slavic-Germanic bilingualism (by the 13th century the domination of the Germanic population became evident. The author argues that these ethnic and linguistic contacts are reflected in the borrowing of geographic names and terms, as well as in Germanic-Slavic “hybrid” place names that the author proposes to call hybridonyms. The Slavs readily borrowed Old Germanic (“Pre-German” toponyms, the hybridonyms bearing traces of the late Proto-Slavic language. The author thoroughly analyzes a number of hybrid place names (Borgishain, Jenz, Leipzig, Jenzig reducing them to one toponymic type consisting of a Germanic stem and Slavic suffixes. A large part of the paper discusses the terms hybrid and hybridization as applied to place names and seeks to theoretically substantiate the term hybridonym.

  10. Masculinity in the doctor's office: Masculinity, gendered doctor preference and doctor-patient communication.

    Himmelstein, Mary S; Sanchez, Diana T


    Mortality and morbidity data suggest that men have shorter life expectancies than women and outrank women on several leading causes of death. These gendered disparities may be influenced by psychosocial factors like masculinity. Three studies (Total N=546) examined the role of masculinity in men's doctor choices and doctor-patient interactions. In Studies 1 and 2, men completed measures of masculinity, gender bias, and doctor preference. Using structural equation modeling, we tested the direct relationship between masculinity and male doctor preference and the indirect relationship of masculinity on male doctor preference through an association with gendered competence stereotypes. Participants in Study 3 disclosed symptoms in private followed by disclosure to a male or female interviewer in a clinical setting. Using repeated measures analysis of variance (ANOVA), we examined the interaction among symptom reporting, masculinity and doctor gender, controlling for participant comfort. In Study 1, results suggested that masculinity encouraged choice of a male doctor directly and indirectly via beliefs that men make more competent doctors than women; Study 2 directly replicated the results of Study 1. In Study 3, independent of participant comfort, an interaction between interviewer gender and masculinity emerged such that men scoring higher on masculinity reported symptoms less consistently to male interviewers (relative to higher scoring men reporting to female interviewers); the reverse was found for men scoring low on masculinity. Taken together these studies suggest that masculinity may affect men's health by encouraging choice of a male doctor with whom doctor-patient communication may be impaired. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. 湖南省乡镇卫生院精神疾病防治人员精神卫生知识知晓情况调查%Mental health knowledge among the mental disorders prevention and control doctors in township hospitals of Hunan Province

    付文彬; 罗邦安; 刘学军; 谌良民


    目的:调查湖南省乡镇卫生院精神疾病防治人员的精神卫生知识知晓情况,为采取措施进一步提高其精神卫生服务能力提供科学参考依据。方法以参加培训班的乡镇卫生院精神疾病防治人员为研究对象,共发放问卷1700份,得到有效问卷1447份。采用卫生部推荐的精神卫生与心理保健知识问卷进行评估。结果湖南省乡镇卫生院精神疾病防治人员精神卫生知识总体知晓率为81.9%,平均得分为(16.40±2.13)分;错误率排在前3位的条目分别为“精神疾病就是思想上出了问题”(32.6%)、“有些人的性格不好,比较容易出现心理问题”(30.0%)、“绝大多数精神疾病是治不好的”(24.0%);4个国际节日中,世界预防自杀日和世界睡眠日的知晓率分别为30.1%、42.2%;不同性别、文化程度、职称、工作年限组之间的得分差异无统计学意义。结论湖南省乡镇卫生院精神疾病防治人员的精神卫生知识总体知晓率较高,但对部分条目的知晓率还需要进一步提高。%Objective To investigate mental health knowledge among the mental disorders preven‐tion and control doctors in township hospitals in Hunan ,and provide evidence for taking measures to im‐prove the mental health service ability .Methods The Mental Health Knowledge Questionnaire (MH‐KQ) was used to measure mental health knowledge among the mental disorders prevention doctors in township hospitals . A total of 1 447 doctors who participated training classes were assessed . Results The correct rate of mental health knowledge was 81 .9% ,the average score was (16 .40 ± 2 .13);er‐ror rate about items in the top three were“Is mental health a problem on the thought”(32 .6% );“Bad-tempered people are more likely to experience mental disorders (30 .0% )” ;“Most of mental disorders cannot be cured(24 .0% )” .The correct rate about

  12. Digital Curation and Doctoral Research

    Daisy Abbott


    Full Text Available This article considers digital curation in doctoral study and the role of the doctoral supervisor and institution in facilitating students’ acquisition of digital curation skills, including some of the potentially problematic expectations of the supervisory relationship with regards to digital curation. Research took the form of an analysis of the current digital curation training landscape, focussing on doctoral study and supervision. This was followed by a survey (n=116 investigating attitudes towards importance, expertise, and responsibilities regarding digital curation. This research confirms that digital curation is considered to be very important within doctoral study but that doctoral supervisors and particularly students consider themselves to be largely unskilled at curation tasks. It provides a detailed picture of curation activity within doctoral study and identifies the areas of most concern. A detailed analysis demonstrates that most of the responsibility for curation is thought to lie with students and that institutions are perceived to have very low responsibility and that individuals tend to over-assign responsibility to themselves. Finally, the research identifies which types of support system for curation are most used and makes suggestions for ways in which students, supervisors, institutions, and others can effectively and efficiently address problematic areas and improve digital curation within doctoral study.

  13. Turning Doctors Into Employees

    Matthew Anderson


    Full Text Available Background: Much of the contentious debate surrounding the Patient Protection and Affordable Care Act (“Obamacare” concerned its financing and its attempt to guarantee (near universal access to healthcare through the private insurance market.  Aside from sensationalist stories of “death panels,” much less attention went to implications of the bill for the actual provision of healthcare. Methodology: This paper examines the "patient-centered medical home" (PCMH model which has been widely promoted as a means of reviving and improving primary care (i.e. general internal medicine, family medicine, and pediatrics. Argument: The PCMH and many of its components (e.g pay-for-performance, electronic medical records were interventions that were implemented on a massive basis without any evidence of benefit. Recent research has not generally supported clinical benefits with the PCMH model. Instead it seems to designed to de-professionalize (make proletarians of health care workers and enforce corporate models of health. The core values of professional work are undermined while the PCMH does nothing to address the structural marginalization of primary care within US health care. Conclusions: The development of alternative models will require political changes. Both doctors and teachers are in a position of advocate for more progressive systems of care and education.

  14. Doctor-patient relationships (DPR) in China.

    Ma, Shaozhuang; Xu, Xuehu; Trigo, Virginia; Ramalho, Nelson J C


    Purpose The purpose of this paper is twofold: first, to develop and test theory on how commitment human resource (HR) practices affect hospital professionals' job satisfaction that motivates them to generate desirable patient care and subsequently improve doctor-patient relationships (DPR) and second, to examine how commitment HR practices influence hospital managers and clinicians in different ways. Design/methodology/approach Using a cross-sectional survey, the authors collected data from 508 clinicians and hospital managers from 33 tertiary public hospitals in China. Structural equation model was employed to test the relationships of the variables in the study. Findings Commitment HR practices positively affect the job satisfaction of the healthcare professionals surveyed and a positive relationship is perceived between job satisfaction and DPR. Overall, the model shows a reversal on the strongest path linking job satisfaction and DPR whereby managers' main association operates through extrinsic job satisfaction while for clinicians it occurs through intrinsic satisfaction only. Practical implications DPR might be improved by applying commitment HR practices to increase healthcare professional's intrinsic and extrinsic satisfaction. In addition, while recognizing the importance of compensation and benefits to address the underpayment issue of Chinese healthcare professionals, empowerment and autonomy in work, and the use of subjects' expertise and skills may serve as stronger motivators for clinicians rather than hard economic incentives in achieving DPR improvements. Originality/value This study contributes to the small but growing body of research on human resource management (HRM) in the healthcare sector with new evidence supporting the link between commitment HR practice and work attitudes, as well as work attitudes and patient care from the perspective of clinicians and hospital managers. This study represents an initial attempt to examine the associations

  15. [Academician Li Lianda talking about doctors doing scientific research].

    He, Ping; Li, Yi-kui


    At present, Chinese medical field faces with an important problem of how to correctly handle the relationship between medical and scientific research. Academician Li Lianda advocates doctors doing scientific research under the premise of putting the medical work first. He points out that there are many problems in the process of doctors doing scientific research at present such as paying more attention to scientific research than medical care, excessively promoting building scientific research hospital, only paying attention to training scientific talents, research direction be flashy without substance, the medical evaluation system should be improved and so on. Medical, scientific research and teaching are inseparable because improving medical standards depends on scientific research and personnel training. But not all doctors need to take into account of medical treatment, scientific research and teaching in the same degree while not all hospitals need to turn into three-in-one hospital, scientific research hospital or teaching hospital. It must be treated differently according to the actual situation.

  16. Cultures of resistance? A Bourdieusian analysis of doctors' antibiotic prescribing.

    Broom, Alex; Broom, Jennifer; Kirby, Emma


    The prospect of an 'antimicrobial perfect storm' in the coming decades through the emergence and proliferation of multi-resistant organisms has become an urgent public health concern. With limited drug discovery solutions foreseeable in the immediate future, and with evidence that resistance can be ameliorated by optimisation of prescribing, focus currently centres on antibiotic use. In hospitals, this is manifest in the development of stewardship programs that aim to alter doctors' prescribing behaviour. Yet, in many clinical contexts, doctors' antibiotic prescribing continues to elude best practice. In this paper, drawing on qualitative interviews with 30 Australian hospital-based doctors in mid-2013, we draw on Bourdieu's theory of practice to illustrate that 'sub-optimal' antibiotic prescribing is a logical choice within the habitus of the social world of the hospital. That is, the rules of the game within the field are heavily weighted in favour of the management of immediate clinical risks, reputation and concordance with peer practice vis-à-vis longer-term population consequences. Antimicrobial resistance is thus a principal of limited significance in the hospital. We conclude that understanding the habitus of the hospital and the logics underpinning practice is a critical step toward developing governance practices that can respond to clinically 'sub-optimal' antibiotic use.

  17. Immobile Complex Verbs in Germanic

    Vikner, Sten


    Certain complex verbs in Dutch, German, and Swiss German do not undergo verb movement. The suggestion to be made in this article is that these ‘‘immobile'' verbs have to fulfill both the requirements imposed on complex verbs of the V° type (=verbs with non-separable prefixes) and the requirements...... are immobile, - why such verbs are not found in Germanic VO-languages such as English and Scandinavian.......Certain complex verbs in Dutch, German, and Swiss German do not undergo verb movement. The suggestion to be made in this article is that these ‘‘immobile'' verbs have to fulfill both the requirements imposed on complex verbs of the V° type (=verbs with non-separable prefixes) and the requirements...

  18. Doctor, Clinic, and Dental Visits

    ... Viral Suppression Doctor, Clinical & Dental Visits Treatment Adherence Mental Health Substance Abuse Issues Sexual Health Nutrition & Food Safety Exercise Immunizations Aging with HIV/AIDS Women’s Health Housing ...

  19. Questions to Ask Your Doctor

    ... to MBCN Contact Us Questions to ask your doctor Medical appointments can be stressful. To better deal ... for you. If diagnosed by your primary care physician Where do you send your metastatic patients for ...

  20. [Haeckel: a German Darwinian?].

    Schmitt, Stéphane


    German biologist Ernst Haeckel (1834-1919) is often considered the most renowned Darwinian in his country since, as early as 1862, he declared that he accepted the conclusions Darwin had reached three years before in On the Origin of Species, and afterwards, he continuously proclaimed himself a supporter of the English naturalist and championed the evolutionary theory. Nevertheless, if we examine carefully his books, in particular his General Morphology (1866), we can see that he carries on a tradition very far from Darwin's thoughts. In spite of his acceptance of the idea of natural selection, that he establishes as an argument for materialism, he adopts, indeed, a conception of evolution that is, in some respects, rather close to Lamarck's views. He is, thus, a good example of the ambiguities of the reception of Darwinism in Germany in the second part of the 19th century.

  1. German visits to CERN


    State secretary to Germany's Federal Ministry of Education and Research, Frieder Meyer-Krahmer, with CERN's Director-General Robert Aymar.On 21 February, Professor Frieder Meyer-Krahmer, State Secretary to Germany's Federal Ministry of Education and Research, came to CERN. He visited the ALICE and ATLAS experiments and the computing centre before meeting the CERN's Director-General, some German physicists and members of the top management. The Minister of Science, Research and the Arts of the Baden-Württemberg regional government, Peter Frankenberg, and CERN's Director-General, Robert Aymar, signing an agreement on education. In the background: Sigurd Lettow, CERN's Director of Finance and Human Resources, and Karl-Heinz Meisel, Rector of the Fachhochschule Karlsruhe. The Minister of Science, Research and the Arts of the Baden-Württemberg regional government, Prof. Peter Frankenberg, visited CERN on 23 February. He was accompanied by the Rector of the Fachhochschule Karlsruhe, Prof. Karl-Heinz Meisel, and b...

  2. Moral distress among Norwegian doctors.

    Førde, R; Aasland, O G


    Medicine is full of value conflicts. Limited resources and legal regulations may place doctors in difficult ethical dilemmas and cause moral distress. Research on moral distress has so far been mainly studied in nurses. To describe whether Norwegian doctors experience stress related to ethical dilemmas and lack of resources, and to explore whether the doctors feel that they have good strategies for the resolution of ethical dilemmas. Postal survey of a representative sample of 1497 Norwegian doctors in 2004, presenting statements about different ethical dilemmas, values and goals at their workplace. The response rate was 67%. 57% admitted that it is difficult to criticize a colleague for professional misconduct and 51% for ethical misconduct. 51% described sometimes having to act against own conscience as distressing. 66% of the doctors experienced distress related to long waiting lists for treatment and to impaired patient care due to time constraints. 55% reported that time spent on administration and documentation is distressing. Female doctors experienced more stress that their male colleagues. 44% reported that their workplace lacked strategies for dealing with ethical dilemmas. Lack of resources creates moral dilemmas for physicians. Moral distress varies with specialty and gender. Lack of strategies to solve ethical dilemmas and low tolerance for conflict and critique from colleagues may obstruct important and necessary ethical dialogues and lead to suboptimal solutions of difficult ethical problems.

  3. Healthy Doctors – Sick Medicine

    Olaf Gjerløw Aasland


    Full Text Available Doctors are among the healthiest segments of the population in western countries. Nevertheless, they complain strongly of stress and burnout. Their own explanation is deprofessionalisation: The honourable art of doctoring has been replaced by standardised interventions and production lines; professional autonomy has withered. This view is shared by many medical sociologists who have identified a “golden age of medicine,” or “golden age of doctoring,” starting after World War II and declining around 1970. This article looks at some of the central sociological literature on deprofessionalisation, particularly in a perspective of countervailing powers. It also looks into another rise-and-fall model, proposed by the medical profession itself, where the fall in professional power was generated by the notion that there are no more white spots to explore on the map of medicine. Contemporary doctoring is a case of cognitive dissonance, where the traditional doctor role seems incompatible with modern health care.Keywords: deprofessionalisation, professional autonomy, cognitive dissonance, golden age of doctoring

  4. Ethics and professional development: a primer for doctors in training

    Jammula P. Patro


    Full Text Available While dealing with colleagues, patients and relatives of patients, doctors have to practice ethical behavior. This paper describes some basics on etiquette, ethics, people management skills, team work, politeness, etc which will give doctors 3 C's: Competence, Confidence and Compassion, which in turn will enable doctors ascend rapidly in health care organizations. It is suggested that principles of etiquette and ethics be acquired by medical students while in training itself so that they can implement them and use them from day one in the hospital they join. Whether these principles should be part of medical curriculum is a matter to be decided by appropriate authorities. [Int J Res Med Sci 2016; 4(5.000: 1778-1782

  5. Fully leverage the role of hospital journal, establish a bridge between patients and doctors%充分发挥院报作用建立医患沟通桥梁

    陈秀春; 刘丽娜; 吴鹏; 杨蕊; 刘斯; 周蕊


    This article gives an introduction of the hospital’s experiences and methods in issuing its journals. A corresponding team is organized to actively retrieve information, thus ensuring the sufifciency of journal article resource;Emphasis is laid on layout design to create a popular journal in the public;opinions and suggestions from different levels are taken seriously as to raise the quality of the journal;the latest situation is highlighted in each journal’s planning;publishing of the journal is carried out in a multi-channel way to widely propagandize the image of the hospital and disseminate health knowledge;positive and upward spirit is carried forward through the inclusion of humanity essays. The hospital has promoted its culture establishment and development though the publishing of hospital journals.%介绍了该院创办院报的经验及其做法,即通过组建通讯员队伍动态地获取信息并保证稿源充足;重视其版面设计从而打造老百姓喜闻乐见的健康读物;倾听不同层面的意见和建议提高了办报质量;每期都结合形势进行重点策划;多渠道开展院报发行工作,从而广泛宣传医院形象及传播健康知识;通过推出人文精品文章以弘扬积极向上的精神,该院通过创办院报促进了其医院文化的建设和发展。

  6. Langenbeck's Archives--an international communication forum between Japanese and German surgeons.

    Kitajima, Masaki; Hiki, Yoshiki


    Japan's first encounter with Western Medicine was in 1543. Japanese doctors were introduced to surgical treatment by Portuguese missionaries who visited Japan mainly to propagate Christianity and trade with Japan. Until that time, Japanese doctors have treated internal diseases by using mainly traditional Chinese medicine and had not experienced modern Western medicine, particularly surgery. In 1639, the Tokugawa shogunate issued the policy of seclusion (national isolation policy) and prohibited contacts with foreign countries except the Netherlands and China. All European culture came into Japan through Dutch traders. Japanese doctors studied medical books written in Dutch, but could not imagine that the original versions had been written by German doctors. Japanese doctors who studied Dutch medicine founded private schools in various places nationwide, prompting the development of Western medicine. In 1868 the Edo shogunate collapsed, and the newly established Meiji government opened Japan to the rest of the world. In an effort to introduce European civilization, which had been closed to the Japanese under the 250 years, the Meiji government followed Western styles when framing policy and building social systems. In terms of medicine, for the sake of reaching the world's highest level, the government decided to learn from Germans. Many of the young Japanese doctors travelled to Germany. However, as a world war loomed ahead, interchange with foreign countries became difficult. Peace was threatened, and even the progress of science was impeded. Although the United States led the world in the medical field, some Japanese doctors still studied in Germany after World War II to learn their medical traditions and look at the starting point of clinical medicine; and they continued the interchange between Japan and Germany. While continuing active relationship, in 1990, the German and Japanese Surgical Societies was established, and planned to hold a triennial joint

  7. Emergency medical equipment on board German airliners.

    Hinkelbein, Jochen; Neuhaus, Christopher; Wetsch, Wolfgang A; Spelten, Oliver; Picker, Susanne; Böttiger, Bernd W; Gathof, Birgit S


    Medical emergencies often occur on commercial airline flights, but valid data on their causes and consequences are rare. Therefore, it is unclear what emergency medical equipment is necessary. Although a minimum standard for medical equipment is defined in regulations, additional material is not standardized and may vary significantly between different airlines. German airlines operating aircrafts with more than 30 seats were selected and interviewed with a 5-page written questionnaire between August 2011 and January 2012. Besides pre-packed and required emergency medical material, drugs, medical devices, and equipment lists were queried. If no reply was received, airlines were contacted another three times by e-mail and/or phone. Descriptive analysis was used for data presentation and interpretation. From a total of 73 German airlines, 58 were excluded from analysis (eg, those not providing passenger transport). Fifteen airlines were contacted and data of 13 airlines were available for analysis (two airlines did not participate). A first aid kit was available on all airlines. Seven airlines reported having a doctor's kit, and another four provided an "emergency medical kit." Four airlines provided an automated external defibrillator (AED)/electrocardiogram (ECG). While six airlines reported providing anesthesia drugs, a laryngoscope, and endotracheal tubes, another four airlines did not provide even a resuscitator bag. One airline did not provide any material for cardiopulmonary resuscitation (CPR). Although the minimal material required according to European aviation regulations is provided by all airlines for medical emergencies, there are significant differences in the provision of additional material. The equipment on most airlines is not sufficient for the treatment of specific emergencies according to published medical guidelines (eg, for CPR or acute myocardial infarction). © 2014 International Society of Travel Medicine.

  8. [Contamination of workwear in medical doctors and nursing stuff].

    Lenski, M; Scherer, M A


    The hands of medical stuff are the most important vectors for the transmission of pathogens in the hospital. Furthermore a "bare below the elbows dress code" has been introduced in Great Britain. Aim of this study was to investigate whether workwear contamination of the medical stuff by pathogens is similar to the contamination of their hands and whether wearing workwear is associated with increased transmission risk. In total 54 swabs were collected from nursing stuff, medical doctors, patients and hospital work material. Patients had a statistically significant more dense colonization with bacteria (median = 73 colony-forming units (CFU)), than the sleeves of the doctor's coat (median = 36 CFU, p = 0,005), followed by workwear of the nursing stuff at the end of a shift (median = 23 CFU, p < 0,001) and the hospital work material (median = 15 CFU, p < 0,001). Isolated pathogens were coagulase-negative staphylococci, Staphylococcus aureus, Enterobacter cloacae and Acinetobacter species. Contaminated work wear presents a relevant risk for the transmission of pathogens. A "bare below the elbow dress-code" or the daily change of the doctor's coat appear both to represent reasonable measures to reduce the transmission risk of pathogens in hospitals.

  9. … but You Are Not German." -- Afro-German Culture and Literature in the German Language Classroom

    Schenker, Theresa; Munro, Robert


    Units and classes dedicated to multiculturalism in Germany have predominantly focused on Turkish-German literature and culture. Afro-Germans have been a minority whose culture and literature have only marginally been included in German classes, even though Afro-Germans have been a part of Germany for centuries and have undergone efforts at…

  10. Firm or Faculty? Evidence on Characteristics of German-Speaking Accounting PhD Students and Their Career Preferences

    Grottke, Markus; Pelger, Christoph; Schmiedeberg, Claudia


    In this paper we focus on the choice that accounting doctoral students from the German-speaking area make, between a future career either in academia or business practice. Based on the results of an online survey, we show that prospective scholars exhibit certain characteristics of passionate researchers more pronouncedly than do future…

  11. Firm or Faculty? Evidence on Characteristics of German-Speaking Accounting PhD Students and Their Career Preferences

    Grottke, Markus; Pelger, Christoph; Schmiedeberg, Claudia


    In this paper we focus on the choice that accounting doctoral students from the German-speaking area make, between a future career either in academia or business practice. Based on the results of an online survey, we show that prospective scholars exhibit certain characteristics of passionate researchers more pronouncedly than do future…

  12. Cruise ship's doctors - company employees or independent contractors?

    Dahl, Eilif


    Traditionally, cruise companies have stated that they are in the transport business but not in the business of providing medical services to passengers. They have claimed not to be able to supervise or control the ship's medical personnel and cruise ship's doctors have therefore mostly been signed on as independent contractors, not employees. A United States court decision from 1988, Barbetta versus S/S Bermuda Star, supported this view and ruled that a ship's owner cannot be held vicariously liable for the negligence of the ship's doctor directed at the ship's passengers. Some years ago a cruise passenger fell and hit his head while boarding a trolley ashore. Hours later he was seen aboard by the ship's doctor, who sent him to a local hospital. He died 1 week later, and his daughter filed a complaint alleging the cruise company was vicariously liable for the purported negligence of the ship's doctor and nurse, under actual or apparent agency theories. A United States district court initially dismissed the case, but in November 2014 the United States Court of Appeals for the Eleventh Circuit disagreed and reversed. From then on independently contracted ship's doctors may be considered de facto employees of the cruise line. The author discusses the employment status of physicians working on cruise ships and reviews arguments for and against the Appellate Court's decision.

  13. Sticks and stones: investigating rude, dismissive and aggressive communication between doctors.

    Bradley, Victoria; Liddle, Samuel; Shaw, Robert; Savage, Emily; Rabbitts, Roberta; Trim, Corinne; Lasoye, Tunji A; Whitelaw, Benjamin C


    Destructive communication is a problem within the NHS; however previous research has focused on bullying. Rude, dismissive and aggressive (RDA) communication between doctors is a more widespread problem and underinvestigated. We conducted a mixed method study combining a survey and focus groups to describe the extent of RDA communication between doctors, its context and subsequent impact. In total, 606 doctors were surveyed across three teaching hospitals in England. Two structured focus groups were held with doctors at one teaching hospital. 31% of doctors described being subject to RDA communication multiple times per week or more often, with junior and registrar doctors affected twice as often as consultants. Rudeness was more commonly experienced from specific specialties: radiology, general surgery, neurosurgery and cardiology. 40% of respondents described that RDA moderately or severely affected their working day. The context for RDA communication was described in five themes: workload, lack of support, patient safety, hierarchy and culture. Impact of RDA communication was described as personal, including emotional distress and substance abuse, and professional, including demotivation. RDA communication between doctors is a widespread and damaging behaviour, occurring in contexts common in healthcare. Recognition of the impact on doctors and potentially patients is key to change.

  14. Junior doctors and undergraduate teaching: the influence of gender on the provision of medical education.

    Prichard, David


    BACKGROUND: International experience has demonstrated that the medical profession is becoming less dominated by men. This "feminization of medicine" has been a topic of much debate in the medical literature. As the gender ratio in the profession changes, it is likely that a greater proportion of undergraduate education will be provided by women. Whether this shift away from the male-dominated provision of medical education will have an effect on undergraduate education is unknown. PURPOSE: The aim of this research was to clarify whether there are differences between the attitudes and practices of male and female junior doctors regarding the practice of undergraduate teaching. METHOD: A survey methodology among a cohort of nonconsultant hospital doctors in a major Irish teaching hospital was utilized. The overall response rate was 93%. The cohort held a positive attitude toward teaching undergraduates, and the majority were actively engaged in this activity. Doctors of both genders expressed a willingness to undertake teacher training. RESULTS: There were no significant differences between the genders regarding the self-reported quantity of teaching provided to undergraduates. Male doctors perceived themselves as more confident educators when compared to female doctors, but this is likely to reflect cohort demographics in which a greater proportion of male doctors were more senior. CONCLUSIONS: This study demonstrates that male and female doctors have similar attitudes toward, and practices in, voluntary undergraduate teaching. As a result, any gender shift in medicine is unlikely to result in a significant change in junior doctors\\' attitudes toward undergraduate medical education.

  15. Doctors' strikes and mortality: a review.

    Cunningham, Solveig Argeseanu; Mitchell, Kristina; Narayan, K M; Yusuf, Salim


    A paradoxical pattern has been suggested in the literature on doctors' strikes: when health workers go on strike, mortality stays level or decreases. We performed a review of the literature during the past forty years to assess this paradox. We used PubMed, EconLit and Jstor to locate all peer-reviewed English-language articles presenting data analysis on mortality associated with doctors' strikes. We identified 156 articles, seven of which met our search criteria. The articles analyzed five strikes around the world, all between 1976 and 2003. The strikes lasted between nine days and seventeen weeks. All reported that mortality either stayed the same or decreased during, and in some cases, after the strike. None found that mortality increased during the weeks of the strikes compared to other time periods. The paradoxical finding that physician strikes are associated with reduced mortality may be explained by several factors. Most importantly, elective surgeries are curtailed during strikes. Further, hospitals often re-assign scarce staff and emergency care was available during all of the strikes. Finally, none of the strikes may have lasted long enough to assess the effects of long-term reduced access to a physician. Nonetheless, the literature suggests that reductions in mortality may result from these strikes.

  16. Study on value of Extended-Focused Abdominal Scan For Trauma (e-FAST performed by non-radiologist emergency care doctors in Management of Trauma at Emergency Trauma Centre, Teaching Hospital, Karapitiya,Galle, Sri Lanka

    Seneviratne RW


    Full Text Available Background This study was designed to evaluate the accuracy and usefulness of ultrasound in the hands of emergency physicians and medical officers who are non-radiologistsin assessing Trauma patients at Emergency Trauma Centre(ETC at Teaching Hospital, Karapitiya, Galle, Sri Lanka Methodology We performed an observational study on Trauma patients admitted to Emergency Department at Teaching Hospital, Karapitiya from 1.12.2014 to 31.12.2014 who fulfilled indications for e-FAST using a specially designed performa. Accuracy of eFAST was tested by comparing the original with subsequent imaging, clinical decision by surgeons, findings at surgery or more than one of the above. Results 69 patients fulfilled the entry criteria.Nineteen of the scans were performed by consultants while rest was done by senior medical officers. All of them were trained in eFAST. Of the 20 scans which were positive there were four pneumothoraxes and one haemothorax. 15 scans which were positive for intraperitoneal free fluid were later. Out of 49 Patients who had negative scans 47 did not require surgery or any interventions. Other two required laparotomy later. Sensitivity and specificity ofeFast was 90.4% and 97.9% respectively. Positive predictive value was 95.0% while Negative predictive value was at 95.9% . Conclusions eFAST is a rapidand reliable alternative in detecting free intra-abdominal fluid as well as pneumotorax and haemothorax. It is a safe decision making tool which can be used with confidence and accuracy after brief training and experience by non radiologists which will reduce morbidity and mortality in trauma patients of Sri Lanka.

  17. [Nationwide evaluation of German university teaching methods in neurology].

    Biesalski, A-S; Zupanic, M; Isenmann, S


    Germany is confronted with a lack of medical doctors and an increasing need for neurologists in particular. In order to recruit future doctors in neurology it is essential to attract young students when still at university. This article presents the first German national survey of medical students' acceptance of teaching methods in neurology. The participants evaluated teaching methods and examination formats and were asked about their preferences. The survey was based on a questionnaire distributed to 22 German medical schools and 1245 participating students. Interactive teaching methods, especially courses in practical examinations, clinical internships and bedside teaching were highly rated among the students. In contrast, multiple choice tests, as one of the most widespread examination methods, were poorly rated compared to practical and oral examinations. For most of the students it was not decisive, in which semester teaching of neurology took place, while the majority asked for additional and more intensive neurological education. The data give an overview of teaching of neurology in Germany and students' assessment of various approaches. The results should be utilized towards reorientation of future curricula that should aim at innovative and even more practically oriented teaching.

  18. Hygiene guideline for the planning, installation, and operation of ventilation and air-conditioning systems in health-care settings - Guideline of the German Society for Hospital Hygiene (DGKH).

    Külpmann, Rüdiger; Christiansen, Bärbel; Kramer, Axel; Lüderitz, Peter; Pitten, Frank-Albert; Wille, Frank; Zastrow, Klaus-Dieter; Lemm, Friederike; Sommer, Regina; Halabi, Milo


    Since the publication of the first "Hospital Hygiene Guideline for the implementation and operation of air conditioning systems (HVAC systems) in hospitals" ( in 2002, it was necessary due to the increase in knowledge, new regulations, improved air-conditioning systems and advanced test methods to revise the guideline. Based on the description of the basic features of ventilation concepts, its hygienic test and the usage-based requirements for ventilation, the DGKH section "Ventilation and air conditioning technology" attempts to provide answers for the major air quality issues in the planning, design and the hygienically safe operation of HVAC systems in rooms of health care.

  19. Learning through inter- and intradisciplinary problem solving: using cognitive apprenticeship to analyse doctor-to-doctor consultation.

    Pimmer, Christoph; Pachler, Norbert; Nierle, Julia; Genewein, Urs


    Today's healthcare can be characterised by the increasing importance of specialisation that requires cooperation across disciplines and specialities. In view of the number of educational programmes for interdisciplinary cooperation, surprisingly little is known on how learning arises from interdisciplinary work. In order to analyse the learning and teaching practices of interdisciplinary cooperation, a multiple case study research focused on how consults, i.e., doctor-to-doctor consultations between medical doctors from different disciplines were carried out: semi-structured interviews with doctors of all levels of seniority from two hospital sites in Switzerland were conducted. Starting with a priori constructs based on the 'methods' underpinning cognitive apprenticeship (CA), the transcribed interviews were analysed according to the principles of qualitative content analysis. The research contributes to three debates: (1) socio-cognitive and situated learning, (2) intra- and interdisciplinary learning in clinical settings, and (3), more generally, to cooperation and problem solving. Patient cases, which necessitate the cooperation of doctors in consults across boundaries of clinical specialisms, trigger intra- as well as interdisciplinary learning and offer numerous and varied opportunities for learning by requesting doctors as well as for on-call doctors, in particular those in residence. The relevance of consults for learning can also be verified from the perspective of CA which is commonly used by experts, albeit in varying forms, degrees of frequency and quality, and valued by learners. Through data analysis a model for collaborative problem-solving and help-seeking was developed which shows the interplay of pedagogical 'methods' of CA in informal clinical learning contexts.

  20. Mark Twain and "The Awful German Language."

    Hedderich, Norbert


    Analyzes Mark Twain's 1869 essay "The Awful German Language" in terms of Twain's comments on morphological, syntactical, lexical, and phonological features of German. The topic is presented in the context of Twain's German language learning experience. Relevance of the article for German language instruction today is also described. (Author/VWL)

  1. Clown doctors: shaman healers of Western medicine.

    Van Blerkom, L M


    The Big Apple Circus Clown Care Unit, which entertains children in New York City hospitals, is compared with non-Western healers, especially shamans. There is not only superficial resemblance--weird costumes, music, sleight of hand, puppet/spirit helpers, and ventriloquism--but also similarity in the meanings and functions of their performances. Both clown and shaman violate natural and cultural rules in their performances. Both help patient and family deal with illness. Both use suggestion and manipulation of medical symbols in attempting to alleviate their patients' distress. Just as traditional ethnomedical systems have been integrated with Western medicine in other societies, clown doctors can provide complementary therapy that may enhance the efficacy of medical treatment in developed nations, particularly for children.

  2. Training generalist doctors for rural practice in New Zealand.

    Nixon, Garry; Blattner, Katharina; Williamson, Martyn; McHugh, Patrick; Reid, James


    Targeted postgraduate training increases the likelihood young doctors will take up careers in rural generalist medicine. This article describes the postgraduate pathways that have evolved for these doctors in New Zealand. The Cairns consensus statement 2014 defined rural medical generalism as a scope of practice that encompasses primary care, hospital or secondary care, emergency care, advanced skill sets and a population-based approach to the health needs of rural communities. Even as work goes on to define this role different jurisdictions have developed their own training pathways for these important members of the rural healthcare workforce. In 2002 the University of Otago developed a distance-taught postgraduate diploma aimed at the extended practice of rural general practitioners (GPs) and rural hospital medical officers. This qualification has evolved into a 4-year vocational training program in rural hospital medicine, with the university diploma retained as the academic component. The intentionally flexible and modular nature of the rural hospital training program and university diploma allow for a range of training options. The majority of trainees are taking advantage of this by combining general practice and rural hospital training. Although structured quite differently the components of this combined pathway looks similar to the Australian rural generalist pathways. There is evidence that the program has had a positive impact on the New Zealand rural hospital medical workforce.

  3. Knowledge of medical doctors in Turkey about the relationship between periodontal disease and systemic health.

    Taşdemir, Zekeriya; Alkan, Banu Arzu


    Understanding the relationship between periodontal disease (PD) and systemic health (SH) is necessary for the accurate diagnosis and treatment of both. The aim of this study was to evaluate the knowledge of medical doctors in Turkey with regard to the association between PD and SH. This study was carried out using self-reported questionnaires that were sent to medical doctors who work at various universities and public and private hospitals in different cities in Turkey. The questionnaires consisted of questions about the demographic information of the medical doctors, as well as the knowledge of those doctors about the relationship between PD and SH. In total, 1,766 responses were received and 90.8% of the participants agreed that there was a relationship between PD and SH. Diabetes mellitus was the most frequent systemic disease (66.8%) known to be related to PD. Of the participants, 56.5% of the medical doctors referred their patients to periodontists for different reasons. Gingival bleeding was the most frequent reason for patient referrals, with 44% of doctors giving such referrals. Doctors who worked in basic medical sciences were significantly less aware of the relationship between PD and SH than the doctors in other specialties. Although the vast majority of the medical doctors reported that they knew the relationship between PD and SH, the findings of this study showed that this awareness was not supported by precise knowledge, and often failed to translate into appropriate clinical practice.

  4. Teaching Prescribing: Just What the Doctor Ordered? A Thematic Analysis of the Views of Newly Qualified Doctors

    Christina R. Hansen


    Full Text Available Undergraduate medical education has been criticised for failing to adequately prepare doctors for the task of prescribing. Pharmacists have been shown to improve medication use in hospitals. This study aims to elicit the views of intern doctors on the challenges of prescribing, and to suggest changes in education to enhance prescribing practice and potential role of the pharmacist. Semi-structured, qualitative interviews were conducted with intern doctors in their first year post qualification in an Irish hospital. Data collection was conducted until no new themes emerged and thematic analysis was performed. Thirteen interviews took place. Interns described training in practical prescribing as limited and felt the curriculum failed to convey the reality of actual prescribing. Pharmacists were perceived to be a useful, but underutilised, information source in the prescribing process. They requested an earlier introduction, and repeated exposure, to prescribing, and suggested the involvement of peers and pharmacists in this teaching. Intern doctors reported difficulties in applying knowledge gained in medical school to clinical practice. New strategies are needed to enhance the clinical relevance of the medical curriculum by rethinking the learning outcomes regarding prescribing practice and the involvement of pharmacists in prescribing education.


    Osuoji, Roland I; Adebanji, Atinuke; Abdulsalam, Moruf A; Oludara, Mobolaji A; Abolarinwa, Abimbola A


    This study examined medical specialty selection by Nigerian resident doctors using a marketing research approach to determine the selection criteria and the role of perceptions, expected remuneration, and job placement prospects of various specialties in the selection process. Data were from the Community of residents from April 2014 to July 2014. The cohort included 200 residents, but only 171 had complete information. Data were obtained from a cross section of resident doctors in the Lagos State University Teaching Hospital and at the 2014 Ordinary General Meeting of the National Association of Resident Doctors(NARD) where representatives from over 50 Teaching hospitals in Nigeria attended. Using a client behaviour model as a framework, a tripartite questionnaire was designed and administered to residents to deduce information on their knowledge about and interests in various specialties, their opinions of sixteen specialties, and the criteria they used in specialty selection. A total of 171 (85.5%) questionnaires were returned. ln many instances, consistency between selection criteria and perceptions of a specialty were accompanied by interest in pursuing the specialty. Job security, job availability on completion of programme, duration of training and qualifying examinations were highly correlated with p value training and practice related variables loaded on it while the second component was loaded with job security and financial remuneration related variables. Using marketing research concepts for medical specialty selection (Weissmanet al 2012) stipulates that choice of speciality is influenced by criteria and perception. This study shows that job security expected financial remuneration, and examination requirements for qualification are major determinants of the choice of speciality for residents.

  6. Doctoral research on cadastral development

    Cagdas, Volkan; Stubkjær, Erik


    . The article focuses on the methodological aspect of doctoral research by analyzing ten doctoral dissertations. Our analysis is based on a taxonomy of methodological elements and aims at identifying commonalities and differences among the dissertations in the use of concepts and methods. Having completed......The multitude of rights in land and the recording of these rights are addressed by a number of studies, yet a recognized paradigm for such studies seems missing. Rights in land are recorded and managed through either cadastral systems or land administration systems depending on the legal system...... of cadastral development. This research is multi-disciplinary and draws on elements of theories and methodologies from the natural, the social, the behavioral, and the formal sciences. During the last decade or so, doctoral dissertations have come to constitute a substantial part of this research effort...

  7. [The clown doctor: an introduction].

    Rösner, M


    In the literature, increasing numbers of practitioners have reported their experience using clown doctors in geriatric settings. The reports agree on the positive effects on persons with dementia and also on their caregivers. However, empirical studies on its effectiveness are rare. This article presents the field of activity of a clown doctor in geriatric settings as well as an overview of current scientific research on the topic and the effects on persons with dementia and nursing staff. It will be become clear that the clown doctor is a supporting therapeutic intervention. Through the clown representation, it is possible to obtain access to and interact with a person with dementia, thus, maintaining social contact of the patient with his/her environment. This effect leads to an increase of well-being and contributes to a reduction of problematic behavior. In addition to reduced workload and relief for the nursing staff, it has a positive effect on the working atmosphere.

  8. Learning Dynamics in Doctoral Supervision

    Kobayashi, Sofie

    This doctoral research explores doctoral supervision within life science research in a Danish university. From one angle it investigates doctoral students’ experiences with strengthening the relationship with their supervisors through a structured meeting with the supervisor, prepared as part...... investigates learning opportunities in supervision with multiple supervisors. This was investigated through observations and recording of supervision, and subsequent analysis of transcripts. The analyses used different perspectives on learning; learning as participation, positioning theory and variation theory....... The research illuminates how learning opportunities are created in the interaction through the scientific discussions. It also shows how multiple supervisors can contribute to supervision by providing new perspectives and opinions that have a potential for creating new understandings. The combination...

  9. Solo doctors and ethical isolation.

    Cooper, R J


    This paper uses the case of solo doctors to explore whether working in relative isolation from one's peers may be detrimental to ethical decision-making. Drawing upon the relevance of communication and interaction for ethical decision-making in the ethical theories of Habermas, Mead and Gadamer, it is argued that doctors benefit from ethical discussion with their peers and that solo practice may make this more difficult. The paper identifies a paucity of empirical research related to solo practice and ethics but draws upon more general medical ethics research and a study that identified ethical isolation among community pharmacists to support the theoretical claims made. The paper concludes by using the literary analogy of Soderberg's Doctor Glas to illustrate the issues raised and how ethical decision-making in relative isolation may be problematical.

  10. Research on the relationship for perceptions of payment fairness to job satisfaction and turnover intention of ;doctors in public hospitals%公立医院医师薪酬公平感与工作满意度、离职倾向的关系研究

    于倩倩; 尹文强; 黄冬梅; 孙葵; 魏艳


    目的:分析不同级别公立医院、不同收入医师的工作满意度、离职倾向及收入分配现状,探讨薪酬公平感对医师工作满意度、离职倾向的预测能力。方法:利用医师薪酬公平感量表、工作满意度量表及离职倾向量表,对山东省三地市1910名公立医院医师实施调查,采用描述、相关分析及层次回归分析等分析资料。结果:医师薪酬公平感均分(2.75±1.10)分;工作满意度均分(3.12±0.85)分;离职倾向均分(2.23±1.03)分。薪酬公平感对医师工作满意度、离职倾向分别具有明显的正负向预测作用,分别解释变异的26.3%和11.6%。结论:薪酬公平感是医师工作满意度和稳定性的重要影响因素,但目前基层医疗机构、低收入医师薪酬公平感较低。设计医师薪酬制度时需了解医师报酬与付出的职业心态,体现其技术劳务价值。%Objective:To analyze the job satisfaction,turnover intention and the current situation of doctors’ income distribution of different hospitals and at different income levels,and to explore predictive ability of perceptions of payment fairness to doctors’ job satisfaction and turnover intention. Methods:Perceptions of payment scale,job satisfaction scale and turnover intention scale were used and 1 910 doctors from three cities in Shandong Province were investigated. Descriptive analysis,correlation analysis and hierarchical regression analysis were used to analyze the data. Results:The average score of fairness payment perceptions was(2.75±1.10)points;the average score of job satisfaction was(3.12±0.85)points;the average score of turnover intention was(2.23±1.03)points. Perceptions of payment fairness for doctors to job satisfaction and turnover intention were obvious positive and negative predictive;the explained variance was 26.3%and 11.6%,respectively. Conclusion:Perceptions of payment fairness is an important factor of job

  11. 海南三甲医院医护人员慢性疲劳与睡眠质量相关分析%Correlation analysis on chronic fatigue and sleep quality of doctors and nurses in third-grade class-A hospital of Hainan Province

    高允锁; 王小丹; 杨威科


    目的 了解海南省三甲医院医护人员慢性疲劳现况及其与睡眠质量的关系,为早期诊断慢性疲劳和寻找有效的预防措施提供科学依据.方法 采用横断面研究的方法,用多级随机抽样的方法抽取1 042名医护人员,用疲劳量表14(FS-14)和睡眠质量量表(PSQI)进行测评.结果 FS-14总平均得分为(7.43±3.04)分,慢性疲劳的发生率为38.77%(404/1042),躯体疲劳得分(4.79±2.31)分,脑力疲劳得分(2.63±1.40)分;躯体疲劳、脑力疲劳、疲劳总分与PSQI各因子分的相关分析表明,均呈正相关,其差异有统计学意义(r=0.22~0.43,P<0.05);多重线回归分析表明,日间功能障碍、睡眠障碍、睡眠效率、睡眠质量与疲劳呈正相关.结论 医护人员慢性疲劳与睡眠质量有关,睡眠质量越低,慢性疲劳程度越高.所以应保证医护人员的充足睡眠,以提高工作效率.%[Objective] To understand the relationship between chronic fatigue and sleep quality of doctors and nurses in thirdgrade class-A hospital of Hainan Province,provide scientific basis for the early diagnosis and effective prevention of chronic fatigue.[Methods] With the cross-sectional study,1042 doctors and nurses were collected by the multistage random sampling,and were assessed by the Fatigue scale-14 (FS-14) and Pittsburgh sleep quality index (PSQI).[Results] The total scores of FS-14 was (7.43±3.04),the incidence of chronic fatigue was 38.77% (404/1 042),and the scores of body fatigue and mental fatigue was (4.79±2.31) and (2.63±1.40) respectively.The body fatigue scores,mental fatigue scores and total scores of FS-14 were positively correlated with the PSQI factor scores,and the differences were statistically significant (r=0.22-0.43,P<0.05).The multiple linear regression analysis showed that the daytime dysfunction,sleep disorders,sleep efficiency,sleep quality were positively correlated with the fatigue.[Conclusion] The chronic fatigue is correlated

  12. Der Unterricht zur Arzt-Patientin-Beziehung (APB im Fach Medizinische Soziologie an den medizinischen Fakultäten der Bundesrepublik Deutschland nach Änderung der Approbationsordnung für ��rzte [Teaching the doctor-patient relationship in medical sociology within German medical faculties following revisions to licensing regulations for physicians

    Kiessling, Claudia


    Full Text Available [english] Background: Changes in requirements governing licensing regulations for physicians in Germany (ÄAppO in 2002, has led to complex discussions within the German Society of Medical Sociology (DGMS. In order to support the process of curricular agreement, the DGMS workgroup entitled ‘teaching’ conducted a survey on how the doctor–patient relationship is taught in medical sociology. Method: The survey was conducted in spring 2005 via e-mail. A standardized questionnaire including a total of thirty educational objectives comprised the survey, whereby each objective was evaluated by five criteria. Thirteen experts in the field of medical sociology variously representing eleven medical faculties responded. According to suggested methods of the Delphi survey, means and ranges were calculated. Results: Of the thirty educational objectives surveyed, two were evaluated negatively by a majority of individuals. Twenty objectives showed variances in evaluation (i.e., controversial objectives. Eight objectives, for example, the social framing of the doctor–patient relationship, the elaborateness of language use, or the asymmetry of the doctor–patient relationship, were generally judged positively. Controversial objectives revealed some areas of contradiction. Some objectives – for example, exploring the social background of a patient – were evaluated as important items but were not frequently taught during regular sociology courses. Conclusions: The results show an interesting picture of present teaching practices in eleven medical faculties and will likely stimulate further discussion in the field of medical sociology. The response rate and discussions held in recent years demonstrate the need to discuss questions of relevance to medical education before a wider audience, both within the DGMS and other disciplines. Educational objectives and didactic methods need to be further developed to bring teaching in step with actual practice as

  13. [Analyzing the attributes of surgeons and working environment required for a successful career path and work-life balance: results of a survey administered to doctors working at Kyoto University Hospital].

    Okoshi, Kae; Tanabe, Tomoko; Hisamoto, Norio; Sakai, Yoshiharu


    We conducted a survey in March 2010 of all physicians at Kyoto University Hospital on working environments, levels of satisfaction, and level of exhaustion. A comparison of surgeons with other physicians showed tendencies among surgeons toward longer working hours and lower income. The findings indicated that surgeons experienced satisfaction from teamwork with fellow physicians, opportunities to manage interesting cases, and patient gratitude. Surgeons tended to have low fatigue level and were satisfied with their working environments, despite their low wages and long working hours. Although surgical treatment is currently built upon the feelings of accomplishment and satisfaction of individual surgeons, there is always a limit to his/her psychological strength. Indeed, the number of young surgeons is not increasing. In the future, efforts must be taken to prevent the departure of currently practicing surgeons. Consideration must also be given to reducing nonsurgical duties by increasing the numbers of medical staff, and making work conditions more appealing to young surgeons by guaranteeing income and prohibiting long working hours, particularly consecutive working hours.

  14. [The "Psychiatrie-Enquete" - the German Report on the State of Psychiatry in 1975].

    Finzen, Asmus


    Forty years ago an expert-commission submitted a report on the deplorable state of German psychiatric care, called the "Psychiatrie-Enquete" to the Bundestag, the German parliament. The Report initiated a substantial change of Psychiatric services in the country. Inhuman treatment and living conditions were superseded. Mental hospitals were not completely abolished. But they lost their importance in favour of decentralized psychiatric services including departments at general hospitals, day hospitals and outpatient services. Custodial care was largely successfully developed into therapeutic and rehabilitative care. This article attempts a mildly critical evaluation of the Enquête 40 years after.

  15. Comparison of German and American law concerning clinical trials.

    Deutsch, E


    In German and American law, clinical trials require a positive benefit-risk evaluation, free and informed consent, medical and scientific qualification of the doctor, and a written research protocol. American law requires a written consent, which is free of undue influence, the subject being instructed that he is free to withdraw from the trial. In German law, an orally given consent is sufficient for therapeutic trials. With minor or incompetent research subjects, informed consent to therapeutic clinical experimentation has to be given by their parents or guardians, the permissibility of which, in other trials, is controversial. In non-therapeutic trials, blind studies, double-bind studies, and trials involving placebos, special attention has to be paid to the risk-benefit analysis and to informed consent, which in these cases, even in Germany, must be written. The most outstanding feature of American law of clinical trial is that the experimentation is subject to previous control and approval by institutional review boards. The most interesting difference in German law is the investigator's duty to effect an insurance against the risks of the research subject's death or invalidity.

  16. Hygiene guideline for the planning, installation, and operation of ventilation and air-conditioning systems in health-care settings – Guideline of the German Society for Hospital Hygiene (DGKH

    Külpmann, Rüdiger


    Full Text Available Since the publication of the first “Hospital Hygiene Guideline for the implementation and operation of air conditioning systems (HVAC systems in hospitals” ( in 2002, it was necessary due to the increase in knowledge, new regulations, improved air-conditioning systems and advanced test methods to revise the guideline. Based on the description of the basic features of ventilation concepts, its hygienic test and the usage-based requirements for ventilation, the DGKH section “Ventilation and air conditioning technology” attempts to provide answers for the major air quality issues in the planning, design and the hygienically safe operation of HVAC systems in rooms of health care.

  17. [Doctoral thesis projects for medical students? Retrospective estimation of the fraction of successfully completed medical doctoral thesis projects at Witten/Herdecke University].

    Scharfenberg, Janna; Schaper, Katharina; Krummenauer, Frank


    The German "Dr med" plays a specific role in doctoral thesis settings since students may start the underlying doctoral project during their studies at medical school. If a Medical Faculty principally encourages this approach, then it should support the students in performing the respective projects as efficiently as possible. Consequently, it must be ensured that students are able to implement and complete a doctoral project in parallel to their studies. As a characteristic efficiency feature of these "Dr med" initiatives, the proportion of doctoral projects successfully completed shortly after graduating from medical school is proposed and illustrated. The proposed characteristic can be estimated by the time period between the state examination (date of completion of the qualifying medical examination) and the doctoral examination. Completion of the doctoral project "during their medical studies" was then characterised by a doctoral examination no later than 12 months after the qualifying medical state examination. To illustrate the estimation and interpretation of this characteristic, it was retrospectively estimated on the basis of the full sample of all doctorates successfully completed between July 2009 and June 2012 at the Department of Human Medicine at the Faculty of Health of the University of Witten/Herdecke. During the period of investigation defined, a total number of 56 doctoral examinations were documented, 30 % of which were completed within 12 months after the qualifying medical state examination (95% confidence interval 19 to 44 %). The median duration between state and doctoral examination was 27 months. The proportion of doctoral projects completed parallel to the medical studies increased during the investigation period from 14 % in the first year (July 2009 till June 2010) to 40 % in the third year (July 2011 till June 2012). Only about a third of all "Dr med" projects at the Witten/Herdecke Faculty of Health were completed during or close to

  18. Practices and attitudes of doctors and patients to downward referral in Shanghai, China

    Yu, Wenya; Li, Meina; Nong, Xin; Ding, Tao; Ye, Feng; Liu, Jiazhen; Dai, Zhixing; Zhang, Lulu


    Objectives In China, the rate of downward referral is relatively low, as most people are unwilling to be referred from hospitals to community health systems (CHSs). The aim of this study was to explore the effect of doctors' and patients' practices and attitudes on their willingness for downward referral and the relationship between downward referral and sociodemographic characteristics. Methods Doctors and patients of 13 tertiary hospitals in Shanghai were stratified through random sampling. The questionnaire surveyed their sociodemographic characteristics, attitudes towards CHSs and hospitals, understanding of downward referral, recognition of the community first treatment system, and downward referral practices and willingness. Descriptive statistics, χ2 test and stepwise logistic regression analysis were employed for statistical analysis. Results Only 20.8% (161/773) of doctors were willing to accept downward referrals, although this proportion was higher among patients (37.6%, 326/866). Doctors' willingness was influenced by education, understanding of downward referral, and perception of health resources in hospitals. Patients' willingness was influenced by marital status, economic factors and recognition of the community first treatment system. Well-educated doctors who do not consider downward referral would increase their workloads and those with a more comprehensive understanding of hospitals and downward referral process were more likely to make a downward referral decision. Single-injury patients fully recognising the community first treatment system were more willing to accept downward referral. Patients' willingness was significantly increased if downward referral was cost-saving. A better medical insurance system was another key factor for patients to accept downward referral decisions, especially for the floating population. Conclusions To increase the rate of downward referral, the Chinese government should optimise the current referral system and

  19. 从美国医师、医院、医保机构的制约关系探讨我国医药费用控制%Discussion on Medical Costs Control in China from the Perspective of the Relationship among Doctors, Hospitals and Health Insurance Institutions in the United States

    宗毛毛; 尤晓敏; 赵瑞; 袁丽; 杨悦


    目的:为我国医药费用的控制提供参考。方法:运用信息不对称与委托代理、弗里德曼的消费理论,结合美国医疗卫生服务体系的主要特点,分析美国医师、医院、医保机构三者之间均衡的制约关系在控制医药费用和提高诊疗质量方面的优势;同时比较我国与美国在医药费用增长率、药占比等方面的差异,论证上述制约关系对医药费用控制的作用。结果与结论:美国的医疗服务实行分级诊疗与双向转诊制度、盈利性医院与非盈利性医院相互补充、不同性质的医保体系并存、实行不同的付费方式、实行严格的商业贿赂监管制度,其医师、医院、医保机构三者之间形成的是一种相互制约的均衡关系。其不仅在理论上存在诸多优势,在实际控制费用增长率、药占比等方面也优于我国,在一定程度上控制了医疗费用的快速增长。结合我国国情,有必要借鉴美国的经验,从降低信息不对称与规范支付审核、建立科学的混合型支付方式、加强医保机构对医师和医院的间接影响等方面,构建我国医师、医院、医保机构三者之间的均衡制约关系,从而有效控制我国医药费用的增长。%OBJECTIVE:To provide reference for medical costs control in China. METHODS:Based on main characteristics of the United States health service system,information asymmetry,principal-agent theory and Freedman’s consumption theory were used to analyze the advantages of restrictive relationship among doctors,hospitals and health insurance institutions in control-ling medical costs and improving the quality of diagnosis and treatment. The growth rate of medical cost,the percentage of drug ex-penditure and other aspects were compared between China and the United States;the effect of restrictive relationship on medical cost control was demonstrated. RESULTS & CONCLUSIONS:In the United States,there are

  20. The Revista Médica project: medical journals as instruments of German foreign cultural policy towards Latin America, 1920-1938.

    Wulf, Stefan


    After the First World War, foreign cultural policy became one of the few fields in which Germany could act with relative freedom from the restrictions imposed by the Treaty of Versailles. In this context the Hamburg doctors Ludolph Brauer, Bernhard Nocht and Peter Mühlens created the Revista Médica de Hamburgo (as of 1928 Revista Médica Germano-Ibero-Americana), a monthly medical journal in Spanish (and occasionally in Portuguese), to increase German influence especially in Latin American countries. The focus of this article is on the protagonists of this project, the Hamburg doctors, the Foreign Office in Berlin, the German pharmaceutical industry, and the publishing houses involved.

  1. Critical Reflection as Doctoral Education

    Brookfield, Stephen D.


    This chapter considers how doctoral education, particularly in applied settings such as education, social work, counseling, and health care, could be reimagined if it was organized around the idea and process of critical reflection: of helping students to better understand how power operates in educational environments and how students' sense of…

  2. Industry-Oriented Doctorate Established.

    Chemical and Engineering News, 1982


    Describes an industry-related program at the University of Texas (Arlington) leading to a Doctorate of Science in Applied Chemistry. The program requires an industrial internship and a dissertation based on research involving both the university's chemistry faculty and chemists in industry. (SK)

  3. Robert Paine Doctor Honoris Causa

    Per Mathiesen


    Full Text Available Professor Emeritus Dr. Robert Paine was conferred the degree of Doctor Honoris Causa at the University of Tromsø on August 27 1998 as a recognition of his long lasting and continuing influence on the anthropological study of modern society, and in particular his many contributions to the understanding of Sami reindeer husbandry and the Sami culture in general.

  4. Doctoral Students' Conceptions of Research

    Pitcher, Rod


    In this paper I report a study of the conceptions of research held by a sample of doctoral students at an Australian research-intensive university. I take a unique approach by using metaphor analysis to study the students' conceptions. The students in this study were recruited for an on-line survey in which they answered questions relating to…

  5. Literature Reviews: Advising Doctoral Students

    Muirhead, Brent


    The rapid expansion of available information has created new opportunities and challenges for today's research students. Academic and public libraries have developed sophisticated electronic databases to better manage knowledge to make it more accessible to researchers. Literature reviews are a major challenge for doctoral students. The focus of…

  6. Instigating change: trainee doctors' perspective.

    Parvizi, Nassim; Shahaney, Sumera; Martin, Guy; Ahmad, Ahmir; Moghul, Masood


    In the 21st century, the core skills of trainee doctors are evolving as clinicians, leaders and innovators. Leadership skills are an essential tool for all doctors and need to be an integral part of their training and learning as set out in the General Medical Council's Good Medical Practice. It is essential to develop these skills at an early stage and continually improve them. A group of junior doctors participated in a pilot programme for leadership with the aim of executing a quality improvement (QI) project. This article describes our experiences of both the course itself and the project undertaken by our group. As part of the process of implementing change, we faced a number of challenges which contributed to our learning. These have been explored as well as potential ways to overcome them to enable the swift and smooth development of future QI projects. Using an example of a QI project looking at handover, this article demonstrates how a trainee doctor can implement their project for both professional and institutional improvement.

  7. Moral distress and professional freedom of speech among doctors.

    Førde, Reidun; Aasland, Olaf Gjerløw


    Previous studies indicate that Norwegian doctors experience distress in their encounter with differing and partly contradictory ideals, such as the obligation to criticise unethical and inappropriate practices. The objective of this study was to investigate the perception of moral distress and professional freedom of speech among Norwegian doctors as of today, as well as identify changes that have occurred since the previous study undertaken in 2004. A total of 1,522 economically active doctors received a questionnaire listing various statements describing the perception of moral distress and professional freedom of speech. The responses were compared to responses to the 2004 study. Altogether 67% of the doctors responded to the questionnaire. The proportion who reported «fairly strong» or «strong» moral distress varied from 24% to 70% among the different statements. On the whole, the «rank and file» hospital doctors reported the highest degree of moral distress. Nevertheless, a decrease in the scores for moral distress could be observed from 2004 to 2010. During the same period, the perception of professional freedom of speech increased slightly. A reduced level of distress associated with ethical conflicts in working life may be due to improved methods for handling distressing situations, or because the consequences of the health services reorganisations are perceived as less threatening now than in 2004, immediately after the introduction of the hospital reform. However, the perceived lower distress level may also be due to professional and ethical resignation. These findings should be followed up by a qualitative study.

  8. Challenges for the German Health Care System.

    Dietrich, C F; Riemer-Hommel, P


    The German Health Care System (GHCS) faces many challenges among which an aging population and economic problems are just a few. The GHCS traditionally emphasised equity, universal coverage, ready access, free choice, high numbers of providers and technological equipment; however, real competition among health-care providers and insurance companies is lacking. Mainly in response to demographic changes and economic challenges, health-care reforms have focused on cost containment and to a lesser degree also quality issues. In contrast, generational accounting, priorisation and rationing issues have thus far been completely neglected. The paper discusses three important areas of health care in Germany, namely the funding process, hospital management and ambulatory care, with a focus on cost control mechanisms and quality improving measures as the variables of interest. Health Information Technology (HIT) has been identified as an important quality improvement tool. Health Indicators have been introduced as possible instruments for the priorisation debate.

  9. Attitude and practice of patients and doctors towards complementary and alternative medicine.

    Junaid, Rabyyan; Abaas, Mustafa; Fatima, Batool; Anis, Irma; Hussain, Mehwish


    To determine the attitude towards complementary and alternative medicine among the doctors and patients. The study was carried out at Civil Hospital Karachi and Liaquat National University Hospital, Karachi during April to September 2010. Two sets of questionnaires were developed separately for doctors and patients. Each set consisted of queries regarding demographic data of patients and doctors. The questionnaire for the patients contained questions reflecting the general attitude, mode of complimentary and alternative medicine usage, disease referred and the underlined reasons behind pricking the options. The questionnaires for doctors in general laid focus on the personal opinion about the practice not only for their own use, but also related to their concern towards those patients who used complimentary and alternative medicine. Predictive analysis software statistics 18 was used for statistical analysis. Of the patients, 237 (59.3%) used complimentary and alternative medicine. Herbal medicine followed by homeopathic medicine were the most commonly used therapies. Fever and cough were the most common diseases for which patients used the options. The preference was mainly based on inter-personal communications, reliance on complimentary and alternative medicine, and financial restriction. Concealing from the doctors was common in patients. Only 62 (34.4%) out of 180 doctors used complimentary and alternative medicine themselves. Refusal by other doctors was because they considered the option ineffective, obsolete and unsatisfactory. About half of the doctors forbade the patients to use such therapies, but 31% (n=73) patients ignored the doctor's advice. The use of complimentary and alternative medicine is highly prevalent in our society by patients irrespective of their social class. Preference for such therapies, on the other hand, is quite low among medical doctors as they consider allopathic medicine to be effective.

  10. Knowledge and attitude of medical resident doctors toward antihistamines

    Esha Chainani


    Full Text Available Background: Allergic rhinitis and urticaria are chronic persistent allergic conditions that need proper management as they significantly reduce quality of life measures. Of the many pharmacological options of allergic rhinitis and urticaria, second-generation antihistamines are the mainstay of therapy. Aims: This review focuses on the knowledge of medical residents toward prescribing antihistamines, according to the new ARIA and GA2LEN guidelines for allergic rhinitis and urticaria, attempting to find the cause of less prescription of newer second-generation antihistamines by finding out the knowledge and attitude of the doctors prescribing them to the patients. Materials and Methods: The study was carried out among resident doctors at a tertiary care teaching hospital. Primary data from 100 resident doctors, who gave their informed consent, was collected. A prevalidated questionnaire regarding knowledge, attitude and prescribing practice of antihistamines was filled up. The data was then analyzed with suitable statistical tests. Every question was first validated using the Chi-square test, and significance was below 10% hence proving validity of the questions. Results: Out of the doctors surveyed, 82% of doctors said they prescribed second-generation antihistamines, while 18% still prescribed first-generation antihistamines. Out of the 82% that prescribed second-generation antihistamines, 8.9% also prescribed first-generation antihistamines as well. 23% of doctors surveyed had heard about the ARIA and GAL2EN guidelines and their recommendations for prescribing second-generation antihistamines over the older first-generation antihistamines, while 77% of them had not heard of these position papers. Conclusion: First-generation or classic antihistamines are still overused due to the lack of knowledge of various guidelines that have been published. The main reason for not prescribing the second-generation antihistamines was due to the increased

  11. Student assistantships: bridging the gap between student and doctor

    Crossley JGM


    Full Text Available James GM Crossley,1,2 Pirashanthie Vivekananda-Schmidt1 1University of Sheffield School of Medicine, Sheffield, 2Chesterfield Royal Hospital NHS Foundation Trust, Chesterfield, UK Abstract: In 2009, the General Medical Council UK (GMC published its updated guidance on medical education for the UK medical schools – Tomorrow's Doctors 2009. The Council recommended that the UK medical schools introduce, for the first time, a clinical placement in which a senior medical student, “assisting a junior doctor and under supervision, undertakes most of the duties of an F1 doctor”. In the UK, an F1 doctor is a postgraduation year 1 (PGY1 doctor. This new kind of placement was called a student assistantship. The recommendation was considered necessary because conventional UK clinical placements rarely provided medical students with opportunities to take responsibility for patients – even under supervision. This is in spite of good evidence that higher levels of learning, and the acquisition of essential clinical and nontechnical skills, depend on students participating in health care delivery and gradually assuming responsibility under supervision. This review discusses the gap between student and doctor, and the impact of the student assistantship policy. Early evaluation indicates substantial variation in the clarity of purpose, setting, length, and scope of existing assistantships. In particular, few models are explicit on the most critical issue: exactly how the student participates in care and how supervision is deployed to optimize learning and patient safety. Surveys indicate that these issues are central to students' perceptions of the assistantship. They know when they have experienced real responsibility and when they have not. This lack of clarity and variation has limited the impact of student assistantships. We also consider other important approaches to bridging the gap between student and doctor. These include supporting the

  12. Doctor--how do I use my EpiPen?

    Mehr, Sam; Robinson, Marnie; Tang, Mimi


    Parents and children who have been prescribed an Epipen are often unable to demonstrate its correct administration. One contributory factor may be that doctors are unfamiliar with the EpiPen and are unable to demonstrate the correct administration of the pen to the family. The aim of this study was to determine the rate of correct EpiPen demonstration by junior and Senior Medical Staff at a major tertiary paediatric Hospital. Junior and Senior medical staff were scored on their ability to correctly use the EpiPen trainer. A 6 step scoring system was used. One-hundred doctors were recruited (Residents n = 31, Senior Residents n = 39, Fellow/Consultants n = 30). Junior and Senior Medical staff had similar scores for EpiPen demonstration, the number that needed to read the EpiPen instructions prior to use and the frequancy of accidental self-injection into the thumb. Only two doctors (2%) demonstrated all 6 administration steps correctly. The most frequent errors made were not holding the pen in place for >5 seconds (57%), failure to apply pressure to activate (21%), and self-injection into the thumb (16%). Ninety five doctors needed to read the instructions, and of these, only 39 (41%) then proceeded to correctly demonstrate the remaining 5 steps. Forty-five doctors had previously dispensed an EpiPen, but only three demonstrated its use to parents/children with a trainer. The majority of doctors do not know how to use an Epipen and are unable to provide appropriate education to parents/children. In 37% of cases, the demonstration would not have delivered adrenaline to a patient.

  13. Statistics teaching in medical school: opinions of practising doctors.

    Miles, Susan; Price, Gill M; Swift, Louise; Shepstone, Lee; Leinster, Sam J


    The General Medical Council expects UK medical graduates to gain some statistical knowledge during their undergraduate education; but provides no specific guidance as to amount, content or teaching method. Published work on statistics teaching for medical undergraduates has been dominated by medical statisticians, with little input from the doctors who will actually be using this knowledge and these skills after graduation. Furthermore, doctor's statistical training needs may have changed due to advances in information technology and the increasing importance of evidence-based medicine. Thus there exists a need to investigate the views of practising medical doctors as to the statistical training required for undergraduate medical students, based on their own use of these skills in daily practice. A questionnaire was designed to investigate doctors' views about undergraduate training in statistics and the need for these skills in daily practice, with a view to informing future teaching. The questionnaire was emailed to all clinicians with a link to the University of East Anglia Medical School. Open ended questions were included to elicit doctors' opinions about both their own undergraduate training in statistics and recommendations for the training of current medical students. Content analysis was performed by two of the authors to systematically categorize and describe all the responses provided by participants. 130 doctors responded, including both hospital consultants and general practitioners. The findings indicated that most had not recognised the value of their undergraduate teaching in statistics and probability at the time, but had subsequently found the skills relevant to their career. Suggestions for improving undergraduate teaching in these areas included referring to actual research and ensuring relevance to, and integration with, clinical practice. Grounding the teaching of statistics in the context of real research studies and including examples of

  14. Statistics teaching in medical school: Opinions of practising doctors

    Shepstone Lee


    Full Text Available Abstract Background The General Medical Council expects UK medical graduates to gain some statistical knowledge during their undergraduate education; but provides no specific guidance as to amount, content or teaching method. Published work on statistics teaching for medical undergraduates has been dominated by medical statisticians, with little input from the doctors who will actually be using this knowledge and these skills after graduation. Furthermore, doctor's statistical training needs may have changed due to advances in information technology and the increasing importance of evidence-based medicine. Thus there exists a need to investigate the views of practising medical doctors as to the statistical training required for undergraduate medical students, based on their own use of these skills in daily practice. Methods A questionnaire was designed to investigate doctors' views about undergraduate training in statistics and the need for these skills in daily practice, with a view to informing future teaching. The questionnaire was emailed to all clinicians with a link to the University of East Anglia Medical School. Open ended questions were included to elicit doctors' opinions about both their own undergraduate training in statistics and recommendations for the training of current medical students. Content analysis was performed by two of the authors to systematically categorise and describe all the responses provided by participants. Results 130 doctors responded, including both hospital consultants and general practitioners. The findings indicated that most had not recognised the value of their undergraduate teaching in statistics and probability at the time, but had subsequently found the skills relevant to their career. Suggestions for improving undergraduate teaching in these areas included referring to actual research and ensuring relevance to, and integration with, clinical practice. Conclusions Grounding the teaching of statistics

  15. Neuropathological research at the "Deutsche Forschungsanstalt fuer Psychiatrie" (German Institute for Psychiatric Research) in Munich (Kaiser-Wilhelm-Institute). Scientific utilization of children's organs from the "Kinderfachabteilungen" (Children's Special Departments) at Bavarian State Hospitals.

    Steger, Florian


    During National Socialism, the politically motivated interest in psychiatric genetic research lead to the founding of research departments specialized in pathological-anatomical brain research, the two Kaiser Wilhelm-Institutes (KWI) in Berlin and Munich. The latter was indirectly provided with brain material by Bavarian State Hospitals, to three of which "Kinderfachabteilungen" (Special Pediatric Units) were affiliated. As children became victims of the systematically conducted child "euthanasia" in these Special Pediatric Units, this paper will address the question whether and to which extent the organs from victims of child "euthanasia" were used for (neuro-) pathological research at the KWI in Munich. By means of case studies and medical histories (with focus on the situation in Kaufbeuren-Irsee), I will argue that pediatric departments on a regular base delivered slide preparations, that the child "euthanasia" conduced in these departments systematically contributed to neuropathological research and that slide preparations from victims of child "euthanasia" were used in scientific publications after 1945.

  16. Hygiene guideline for the planning, installation, and operation of ventilation and air-conditioning systems in health-care settings – Guideline of the German Society for Hospital Hygiene (DGKH)

    Külpmann, Rüdiger; Christiansen, Bärbel; Kramer, Axel; Lüderitz, Peter; Pitten, Frank-Albert; Wille, Frank; Zastrow, Klaus-Dieter; Lemm, Friederike; Sommer, Regina; Halabi, Milo


    Since the publication of the first “Hospital Hygiene Guideline for the implementation and operation of air conditioning systems (HVAC systems) in hospitals” ( in 2002, it was necessary due to the increase in knowledge, new regulations, improved air-conditioning systems and advanced test methods to revise the guideline. Based on the description of the basic features of ventilation concepts, its hygienic test and the usage-based requirements for ventilation, the DGKH section “Ventilation and air conditioning technology” attempts to provide answers for the major air quality issues in the planning, design and the hygienically safe operation of HVAC systems in rooms of health care. PMID:26958457

  17. Trends in Job Satisfaction among German Nurses from 1990 to 2012

    Alameddine, Mohamad; Bauer, Jan Michael; Richter, Martin


    Objective: Improving the job satisfaction of nurses is essential to enhance their productivity and retention and to improve patient care. Our aim was to analyse trends in German nurses' job satisfaction to enhance understanding of the nursing labour market and inform future policies. Methods: We...... used 1990–2012 German Socioeconomic Panel data for trends in nurses' job satisfaction. Comparisons were drawn with doctors, other health care workers, and employees in other sectors of employment. Analysis explored associations between job satisfaction trends and other aspects of employment......, such as whether full time or part time and pay. To account for fluctuations across the period of analysis, linear trends were generated using ordinary least squares. Results: Over 23 years, job satisfaction of German nurses underwent a steady and gradual decline, dropping by an average 7.5%, whereas...

  18. Lyme disease - what to ask your doctor

    What to ask your doctor about Lyme disease; Lyme borreliosis - questions; Bannwarth syndrome - questions ... I am treated with antibiotics? How can my doctor diagnose me with Lyme disease? Can I be ...

  19. Concussion - what to ask your doctor - child

    What to ask your doctor about concussion - child; Mild brain injury - what to ask your doctor - child ... school people I should tell about my child's concussion? Can my child stay for a full day? ...

  20. Cholesterol - what to ask your doctor

    ... your doctor; What to ask your doctor about cholesterol ... What is my cholesterol level? What should my cholesterol level be? What are HDL ("good") cholesterol and LDL ("bad") cholesterol? Does my cholesterol ...

  1. Stress and burnout in junior doctors

    Wen discussing stress and burnour with doc- tors, I was ... of perceived stress and burnout in doctors who had recently graduated. ..... management. Poorly functioning doctors ... developing and maintaining human resources. The concepts of ...

  2. Enlarged prostate - what to ask your doctor

    What to ask your doctor about enlarged prostate; Benign prostatic hypertrophy - what to ask your doctor; BPH - what to ... . Roehrborn CG. Benign prostatic hyperplasia: Etiology, pathophysiology, epidemiology, and natural history. In: Wein ...

  3. [Intercultural adaptation of the AIMS in German language: A scale for abnormal involuntary movements].

    Buhmann, C; Rizos, A; Emmans, D; Jost, W H


    Dyskinesias are abnormal involuntary movements and occur across many movement disorders. In Parkinson's disease dyskinesias can be troublesome and are a determinant of the quality of life throughout the course of the disease. Assessment and rating of dyskinesias is thus important for clinical assessment of patients, as well as for academic studies and clinical trials. The abnormal involuntary movement scale (AIMS) is an English language standardised, reliable and validated scale to evaluate dyskinesias. In this article we present a linguistically validated German version of AIMS. The intercultural adaptation of the German translation was performed following an internationally accepted procedure. Firstly, two neurologists independently translated the original into German. Taking both versions into account, a consensus version was agreed on by both translators and was tested on 10 patients. This preliminary German version was then independently translated back into the original language by two different neurologists, and again, a consensus version was agreed on. All translators then compared this English version to the original. Subsequently, the German version was linguistically modified until it resulted in a final German version, which was agreed on by all translators, deemed linguistically acceptable, and the translation back into English was considered to be as unambiguous as possible. This final German version of AIMS was applied to 50 patients in two different hospitals for diagnostic purposes and tested for feasibility and comprehension. In this paper, we present an intercultural adaptation of a linguistically validated German version of AIMS.

  4. Doctor Roberto Serpa Novoa

    Hernando Groot


    complacencia, ya enfrentando problemas dramáticos como la alta mortalidad infantil, la fiebre amarilla y la lepra, ya apersonándose para dirigir la solución de graves problemas de salud pública desde posiciones tan importantes como la de Secretario de Salud de Bogotá, Director de la Compañía Antileprosa y Secretario General del Ministerio de Salud.

    Estas actividades y otras muchas, todas de especial relevancia, fueron complementadas con su vida académicas en el Hospital San Juan de Dios y más tarde en esta misma Academia Nacional de Medicina donde sus lúcidas intervenciones fueron recibidas siempre con profundo respeto. Entendiendo su papel como líder de la medicina en un país donde había, como las hay hoy, toda suerte de necesidades en materia de salud, tuvo por fuerza que intervenir en política, no como escalón para alcanzar preeminencia y poder sino para lograr oportunidades de servicio mejor a su pueblo, haciendo gala siempre de su gran sensibilidad social, de su profundo sentido liberal y democrático, y de su enorme preocupación por toda clase de injusticias. Aún le puedó tiempo para la literatura y fueron muchos los periódicos y revistas que guardan sus escritos y sus cuentos.

    De sus múltiples actividades médicas habré de referirme esta noche -por razones elementales de tiempo- sólo a su contribución al estudio de la fiebre amarilla en Santander, enfermedad que ha sido y debería seguir siendo motivo de preocupación permanente para la medicina nacional, no sin antes hacer una breve descripción de los antecedentes y del ambiente que en este cam po le tocó afrontar a Serpa.

    En efecto, entre las muchas epidemias que han azotado la patria tiene un puesto especial esta grave dolencia. Por ejemplo, ya casi no nos acordamos de la viruela que diezmó a la población indígena y que era frecuente en Bogotá hasta hace cuarenta años, todo gracias a esa maravillosa hazaña de la medicina preventiva que es haberla borrado de la faz del

  5. From Doctors' Stories to Doctors' Stories, and Back Again.

    Childress, Marcia Day


    Stories have always been central to medicine, but during the twentieth century bioscience all but eclipsed narrative's presence in medical practice. In Doctors' Stories, published in 1991, Kathryn Montgomery excavated medicine's narrative foundations and functions to reveal new possibilities for how to conceive and characterize medicine. Physicians' engagement with stories has since flourished, especially through the narrative medicine movement, although in the twenty-first century this has been challenged by the health care industry's business-minded and data-driven clinical systems. But doctors' stories-and Montgomery's text-remain crucial, schooling clinicians in reflection, ethical awareness, and resilience. Physicians who write even short, 55-word reflective stories can hold to humanistic and ethical understandings of patient care and of themselves as healers even as they practice in systematized settings and employ evidence-based expertise. © 2017 American Medical Association. All Rights Reserved.

  6. Should doctors inform terminally ill patients? The opinions of nationals and doctors in the United Arab Emirates.

    Harrison, A; al-Saadi, A M; al-Kaabi, A S; al-Kaabi, M R; al-Bedwawi, S S; al-Kaabi, S O; al-Neaimi, S B


    OBJECTIVES: To study the opinions of nationals (Emiratis) and doctors practising in the United Arab Emirates (UAE) with regard to informing terminally ill patients. DESIGN: Structured questionnaires administered during January 1995. SETTING: The UAE, a federation of small, rich, developing Arabian Gulf states. PARTICIPANTS: Convenience samples of 100 Emiratis (minimum age 15 years) and of 50 doctors practising in government hospitals and clinics. RESULTS: Doctors emerged as consistently less in favour of informing than the Emiratis were, whether the patient was described as almost certain to die during the next six months or as having a 50% chance of surviving, and even when it was specified that the patient was requesting information. In the latter situation, a third of doctors maintained that the patient should not be told. Increasing survival odds reduced the number of doctors selecting to inform; but it had no significant impact on Emiratis' choices. When Emiratis were asked whether they would personally want to be informed if they had only a short time to live, less than half responded in the way they had done to the in principle question. CONCLUSIONS: The doctors' responses are of concern because of the lack of reference to ethical principles or dilemmas, the disregard of patients' wishes and dependency on survival odds. The heterogeneity of Emiratis' responses calls into question the usefulness of invoking norms to explain inter-society differences. In the current study, people's in principle choices did not provide a useful guide to how they said they would personally wish to be treated. PMID:9134491


    Florin-Alexandru LUCA


    Full Text Available A survey in 2013 of Division Market Research Group Rentrop Straton Romanian-German - "state services and private clinics. Comparative Analysis ", highlights the fact that into urban population in Romania, the internet is the most popular source of information on health services. According to the survey, 81.9% of respondents use the Internet to find out about the best doctors available to them. Preferences of respondents to the online environment as the main source of information translates into ease of access and the possibility of interaction, but also trust recommendations based on personal experiences, recommendations can be found through discussion forums, mostly or comments left on pages on social networking sites. In the present study we try to emphasize the specificity of communication physician - patient online through social networks.

  8. The doctor-patient relationship as a toolkit for uncertain clinical decisions.

    Diamond-Brown, Lauren


    Medical uncertainty is a well-recognized problem in healthcare, yet how doctors make decisions in the face of uncertainty remains to be understood. This article draws on interdisciplinary literature on uncertainty and physician decision-making to examine a specific physician response to uncertainty: using the doctor-patient relationship as a toolkit. Additionally, I ask what happens to this process when the doctor-patient relationship becomes fragmented. I answer these questions by examining obstetrician-gynecologists' narratives regarding how they make decisions when faced with uncertainty in childbirth. Between 2013 and 2014, I performed 21 semi-structured interviews with obstetricians in the United States. Obstetricians were selected to maximize variation in relevant physician, hospital, and practice characteristics. I began with grounded theory and moved to analytical coding of themes in relation to relevant literature. My analysis renders it evident that some physicians use the doctor-patient relationship as a toolkit for dealing with uncertainty. I analyze how this process varies for physicians in different models of care by comparing doctors' experiences in models with continuous versus fragmented doctor-patient relationships. My key findings are that obstetricians in both models appealed to the ideal of patient-centered decision-making to cope with uncertain decisions, but in practice physicians in fragmented care faced a number of challenges to using the doctor-patient relationship as a toolkit for decision-making. These challenges led to additional uncertainties and in some cases to poor outcomes for doctors and/or patients; they also raised concerns about the reproduction of inequality. Thus organization of care delivery mitigates the efficacy of doctors' use of the doctor-patient relationship toolkit for uncertain decisions. These findings have implications for theorizing about decision-making under conditions of medical uncertainty, for understanding

  9. The German social democratic party (SPD) and the debate on the fertility decline in the German Empire (1870~1918).

    Mun, Soo-Hyun


    This paper aimed to examine the debate over the fertility decline in the German Empire, focusing on the role of the SPD. During the German Empire, the fertility rate dramatically declined and the growing awareness of a continuous decline in the birth rate prompted a massive debate among politicians, doctors, sociologists, and feminist activists. The fertility decline was negatively evaluated and generated consciousness of crisis. However, it was not the only way to face this new phenomenon. Indeed, the use of birth control among the upper class was interpreted as a part of a modernizing process. As the same phenomenon reached the working class, it suddenly became a social problem and was attributed to the SPD. The debate over the fertility decline in imperial German society ridden with a fierce class conflict was developed into a weapon against the SPD. Contrary to the assumption of conservative politicians, the SPD had no clear-cut position on this issue. Except for a few politicians like Kautsky and the doctors who came into frequent contact with the workers, the "birth strike" was not listed as the main interest of the SPD. Even Clara Zetkin, the leader of the Social Democratic women's organization viewed it as a concern of the individual person which could not be incorporated in the party program. The women's organization of the SPD put priority on class conflict rather than issues specific to women. As a result, the debate over the birth rate decline within the SPD was not led by the women themselves. There could have been various means to stimulate the birth rate. Improvement in the welfare system, such as tax relief for large families, better housing conditions, and substantial maternity protection, could have been feasible solutions to the demographic crisis. However, Germany chose to respond to this crisis by imposing legal sanctions against birth control. In addition to paragraphs 218-220 of the German criminal law enacted in 1872 which prescribed penal

  10. Politeness in Doctor-Potient Diolog



    In our everyday communication, we often use Euphemism to express our thought indirectly, for example, doctors usually do not tell the patients the truth when treating serious patients. This paper aims at exploring the nature of euphemism in doctor-patient interactions and how do doctors use euphemism to attain the goal of politeness on the basis of the Face Theory and Politeness theory.

  11. An Exploration of Darkness within Doctoral Education

    Bengtsen, Søren Smedegaard


    In doctoral education, the formal structures include the Graduate School system, PhD courses, and supervision contracts, etc. Doctoral education also takes place on informal and tacit levels, where doctoral students learn about the institutional regulations, the research field, academic craftsman...

  12. The Learning Alliance: Ethics in Doctoral Supervision

    Halse, Christine; Bansel, Peter


    This paper is concerned with the ethics of relationships in doctoral supervision. We give an overview of four paradigms of doctoral supervision that have endured over the past 25 years and elucidate some of their strengths and limitations, contextualise them historically and consider their implications for doctoral supervision in the contemporary…

  13. Asthma - what to ask the doctor - adult

    What to ask your doctor about asthma - adult ... For what side effects should I call the doctor? How will I know when my inhalers are ... worse and that I need to call the doctor? What should I do when I feel short ...

  14. Asthma - what to ask your doctor - child

    What to ask your doctor about asthma - child ... For what side effects should I call the doctor? How will I know when the inhalers are ... worse and that I need to call the doctor? What should I do when my child feels ...

  15. Invisible Roles of Doctoral Program Specialists

    Bachman, Eva Burns; Grady, Marilyn L.


    The purpose of this study was to investigate the roles of doctoral program specialists in Big Ten universities. Face-to-face interviews with 20 doctoral program specialists employed in institutions in the Big Ten were conducted. Participants were asked to describe their roles within their work place. The doctoral program specialists reported their…

  16. Hybrid Doctoral Program: Innovative Practices and Partnerships

    Alvich, Dori; Manning, JoAnn; McCormick, Kathy; Campbell, Robert


    This paper reflects on how one mid-Atlantic University innovatively incorporated technology into the development of a hybrid doctoral program in educational leadership. The paper describes a hybrid doctoral degree program using a rigorous design; challenges of reworking a traditional syllabus of record to a hybrid doctoral program; the perceptions…


    Leuca Mirela


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

  18. Knowledge, attitude and practice of healthcare ethics among resident doctors and ward nurses from a resource poor setting, Nepal.

    Adhikari, Samaj; Paudel, Kumar; Aro, Arja R; Adhikari, Tara Ballav; Adhikari, Bipin; Mishra, Shiva Raj


    Healthcare ethics is neglected in clinical practice in LMICs (Low and Middle Income Countries) such as Nepal. The main objective of this study was to assess the current status of knowledge, attitude and practice of healthcare ethics among resident doctors and ward nurses in a tertiary teaching hospital in Nepal. This was a cross sectional study conducted among resident doctors (n = 118) and ward nurses (n = 86) in the largest tertiary care teaching hospital of Nepal during January- February 2016 with a self-administered questionnaire. A Cramer's V value was assessed to ascertain the strength of the differences in the variables between doctors and nurses. Association of variables were determined by Chi square and statistical significance was considered if p value was less than 0.05. Our study demonstrated that a significant proportion of the doctors and nurses were unaware of major documents of healthcare ethics: Hippocratic Oath (33 % of doctors and 51 % of nurses were unaware), Nuremberg code (90 % of both groups were unaware) and Helsinki Declaration (85 % of doctors and 88 % of nurses were unaware). A high percentage of respondents said that their major source of information on healthcare ethics were lectures (67.5 % doctors versus 56.6 % nurses), books (62.4 % doctors versus 89.2 % nurses), and journals (59 % doctors versus 89.2 % nurses). Attitude of doctors and nurses were significantly different (p ethics. More nurses had agreement than doctors on the tested statements pertaining to different aspects of healthcare ethics except for need of integration of medical ethics in ungraduate curricula (97.4 % doctors versus 81.3 % nurses),paternalistic attitude of doctor was disagreed more by doctors (20.3 % doctors versus 9.3 % nurses). Notably, only few (9.3 % doctors versus 14.0 % nurses) doctors stood in support of physician-assisted dying. Significant proportion of doctors and nurses were unaware of three major documents on

  19. Why German? Motivation of Students Studying German at English Universities

    Busse, Vera; Williams, Marion


    What drives students to study German at university level? Although motivational research has been booming in recent years, students' motivation to pursue a modern foreign language beyond school level has not received much attention in the UK. This article sheds light on the various reasons that drive students in the UK to pursue a modern foreign…

  20. 50 years ago: the Nuremberg Doctors' Tribunal. Part 3: The failure of coming to terms with the past.

    Ernst, E


    After the sentences at the Nuremberg Doctors' Tribunal, the German and Austrian medical profession tried to avoid the subject of medicine during the Third Reich at almost any cost. Only under persistent pressure did the subject gradually became a topic for more open discussion. many of the perpetrators within the ranks of the medical profession were not properly punished and were allowed to remain members of the profession. The German and Austrian medical profession may have forfeited the chance to learn an important lesson relating to its own past.


    Rahul Sanjeev Chaudhary


    Full Text Available BACKGROUND Hand hygiene practices of health care workers has been shown to be an effective measure in preventing hospital acquired infections. This concept has been aptly used to improve understanding, training, monitoring, and reporting hand hygiene among healthcare workers. We conducted this study to assess the knowledge of doctors and health care workers regarding hand scrub. METHODS A study was conducted among doctors and health care workers in a tertiary care hospital. Knowledge was evaluated by using self-structured questionnaire based on the guidelines of hand hygiene prescribed by WHO. RESULTS The awareness and knowledge of preoperative surgical hand scrubbing was moderate in doctors, but unfortunately poor in HCWs. CONCLUSION Our study highlights the need for introducing measures in order to increase the knowledge of preoperative hand scrub in teaching hospital which may translate into good practices.

  2. 南通市5家三级医院青年医师思想状况调查分析%An investigation and analysis of the ideological situation among young doctors in the third-grade hospitals in Nantong City

    王建军; 陈建荣; 何书; 陆洁玉; 陈卫军; 缪旭东; 黄宇


    Objective:To understand the current ideological situation among young doctors and to provide empirical evidences for improving the pertinence of the ideological and political education and the sound development of young doc-tors. Methods:A self-designed questionnaire was applied to survey 356 clinical doctors under the age of 40 years old from five third-grade hospitals in Nantong City, and the statistical analysis of the investigation was made. Results: Young doc-tors adopted proper mainstream values and good professional ethics with relatively stronger sense of belonging to their pro-fession, but there were also noteworthy ideological conditions: high working pressure, financial pressure in living, profes-sional disappointment, solely professional skills-centered tendency, and potential moral cognition problems, and so on. Conclusion: Guiding their enthusiasms for career development in the right direction and correcting their unhealthy views and values to reduce harmful influence are the key points of the ideological and political work among young doctors. Sug-gestions made here include:enhancing ideological education and guidance, providing guarantee for career development, re-inforcing professionalism construction, and bettering psychological support system.%目的:了解青年医师思想现状,为加强思想政治教育针对性、促进青年医师健康成长提供依据。方法:采用自制问卷系统抽样调查的方法,对南通市5家三级医院356名40岁以下临床医师进行调查和统计分析。结果:(1)生活压力首要来源占45.7%的是经济负担过重,超过住房紧张、家庭矛盾等因素。面对医疗改革深化,担心收入下降占33.5%。社会压力、经济压力太大,“啃老”难以避免占35.1%;变换工作与收入福利待遇有关占42.0%。(2)热爱本职工作占47.6%,工作繁忙但仍有自己目标占34.0%。在工作取得重大业绩时,能得到激励和发展机会占50

  3. Another successful Doctoral Student Assembly

    Katarina Anthony


    On Wednesday 2 April, CERN hosted its third Doctoral Student Assembly in the Council Chamber.   CERN PhD students show off their posters in CERN's Main Building. Speaking to a packed house, Director-General Rolf Heuer gave the assembly's opening speech and introduced the poster session that followed. Seventeen CERN PhD students presented posters on their work, and were greeted by their CERN and University supervisors. It was a very successful event!

  4. Mastectomy and breast reconstruction - what to ask your doctor

    Mastectomy - what to ask your doctor; Breast reconstruction - what to ask your doctor; TRAM flap - what to ... your doctor; What to ask your doctor about mastectomy and breast reconstruction; Breast cancer - mastectomy - what to ...

  5. Levelling in the German Verb Paradigm

    Newman, John


    Levelling processes in the history of the German verb paradigm from Old High German to the present are discussed. It is asserted that the theory of transformational generative grammar provides a proper framework for the study of linguistic change. (RM)

  6. Levelling in the German Verb Paradigm

    Newman, John


    Levelling processes in the history of the German verb paradigm from Old High German to the present are discussed. It is asserted that the theory of transformational generative grammar provides a proper framework for the study of linguistic change. (RM)

  7. The Danish Press during the German Occupation

    Roslyng-Jensen, Palle


    Censorship, self-censorship in Danish newspapers and Danish Radio during the German occupation of Denmark 1940-45......Censorship, self-censorship in Danish newspapers and Danish Radio during the German occupation of Denmark 1940-45...

  8. Das deutsche Adverbialsystem (The German Adverbial System)

    Droescher, W. O.


    Describes the surface structure of German adverbs proceeding from the standpoint of dependence-valence grammar. On the basis of their meaning, adverbs are classified as modal, temporal and locational. (Text is in German.) (IFS/WGA)

  9. Brazilian doctors' perspective on the second opinion strategy before a C-section.

    Osis, Maria José Duarte; Cecatti, José Guilherme; de Pádua, Karla Simônia; Faúndes, Anibal


    To describe the opinion of doctors who participated in the Latin American Study on Cesarean section in Brazil regarding the second opinion strategy when faced with the decision of performing a C-section. Seventy-two doctors from the hospitals where the study took place (where the second opinion was routinely sought) and 70 from the control group answered a pre-tested self-administered structured questionnaire. Descriptive tables were prepared based on the frequency of relevant variables on opinion of physicians regarding: effectiveness of the application of the second opinion strategy; on whether they would recommend implementation of this strategy and reasons for not recommending it in private institutions; feasibility of the strategy implementation and reasons for not considering this implementation feasible in private institutions. Half of the doctors from the intervention hospitals (50%) and about two thirds of those in the control group (65%) evaluated the second opinion as being or having the potential of being effective/very effective in their institutions. The great majority of those interviewed from both intervention and control hospitals considered this strategy feasible in public (87% and 95% respectively) but not in private hospitals (64% and 70% respectively), mainly because in the latter the doctors would not accept interference from a colleague in their decision-making process. Although the second opinion strategy was perceived as effective in reducing C-section rates, doctors did not regard it feasible outside the public health system in Brazil.

  10. Doktorgrade in Naturwissenschaftsdidaktik: Voraussetzungen und Forschungsbereiche fur Dissertationen = Doctorates in Science Education: Prerequisites and Research Areas for Dissertations. IPN Report in Brief 29.

    Nentwig, Peter; And Others

    Doctoral degrees in science education have been established in several European countries during the past years. This study attempts to survey this development in nine European countries (Austria, Federal Republic of Germany, Finland, France, German Democratic Republic, Netherlands, Sweden, Switzerland, United Kingdom) and in the United States.…

  11. Fever as a predictor of doctor shopping in the paediatric population.

    Hariman, Keith W; Lam, Stacey C; Lam, Yvette W S; Luk, Karen H K; Poon, K K; Li, Albert M


    To estimate prevalence and assess factors associated with doctor shopping among caregivers of children acutely admitted to a hospital in Hong Kong, and examine the reasons for such behaviour and caregivers' awareness of its possible dangers. Cross-sectional study with face-to-face surveys. A paediatric unit in a teaching hospital in Hong Kong. Caregivers of children admitted to acute paediatric wards between April and July 2011. MAIN OUTCOME MEASURES; Socio-demographic characteristics of the interviewee, personal history and clinical data of the patient, presence of doctor shopping (consulting more than one doctor for medical advice without referral) for each episode, the reasons behind such behaviour, and awareness of potential dangers. Data retrieved were analysed to estimate the prevalence and logistic regression was used to assess factors associated with doctor shopping. In all, 649 such patients were admitted into hospital during the study period, of which 336 were recruited, with about a half being absent or given home leave. Thirty-four patients were excluded due to absent caregivers or refusal, and 302 were included in the study. More than half (79.5%) were female and the caregivers' monthly household incomes were between HK$10 001 and HK$15 000 (21.2%), similar to the median household income in Hong Kong. The prevalence of doctor shopping was 53%. The only significant clinical parameter associated with doctor shopping was presence of fever (odds ratio=2.4; 95% confidence interval, 1.4-3.9). Persistence of symptoms was the commonest reason given by interviewees for doctor shopping, and the majority (75.5%) were unaware of the possible dangers of this behaviour. Doctor shopping is highly prevalent among caregivers of children with acute paediatric conditions. Most caregivers do not know the potential complications of this behaviour. Further measures should be taken to educate subjects on the associated dangers of this behaviour and the natural course of

  12. Metrical Phonology: German Sound System.

    Tice, Bradley S.

    Metrical phonology, a linguistic process of phonological stress assessment and diagrammatic simplification of sentence and word stress, is discussed as it is found in the English and German languages. The objective is to promote use of metrical phonology as a tool for enhancing instruction in stress patterns in words and sentences, particularly in…

  13. Immobile Complex Verbs in Germanic

    Vikner, Sten


    (and why this single prefix-like part may NOT be a particle), - why immobile verbs even include verbs with two prefix-like parts, where each of these are separable particles (as in, e.g., German voranmelden ‘preregister'), - why there is such a great amount of speaker variation as to which verbs...

  14. Reflexive choice in Dutch and German

    Hendriks, Petra; Hoeks, John C. J.; Spenader, Jennifer


    Standard Dutch and German have two reflexive forms: a weak form ('zich' in Dutch and 'sich' in German) and a strong form ('zichzelf' in Dutch and 'sich selbst' in German). The choice between the two reflexive forms in Dutch has been explained by the selectional restrictions of the verb, distinguishi

  15. Layers of root nouns in Germanic

    Hansen, Bjarne Simmelkjær Sandgaard


    The root-noun declension became productive in early Germanic, containing (I) inherited root nouns, (IIa) original substrate or loan words, and transitions from other declensions in (IIb) Proto-Germanic and (III) North Germanic. As ablaut was abolished, the inherited type would display ablaut grad...

  16. Verbal Aspects in Germanic, Slavic, and Baltic.

    Senn, Alfred


    This study examines the theory of Prokosch concerning the Germanic-Slavic-Baltic tense and aspect systems. The interrelatedness and influence of languages and dialects in Slavic (Russian and Old Church Slavic), Baltic (Lithuanian), and Germanic (Old High German and Gothic) are demonstrated. Examples illustrating the use of the perfective present…

  17. Three essays on regulated markets. Renewable energies, hospital competition and health insurance

    Unfried, Matthias


    This doctoral thesis presents an analysis of regulated markets especially focusing on the behavior of the actors, the effects of regulatory interventions on market outcome, and the necessity of the regulation itself. With respect to the particular characteristics, three different markets are analyzed: the German market for photovoltaic capacity, the German hospital sector, and the market for health insurance with respect to outpatient care. Chapter two provides an analysis of the German system of feed-in tariffs for photovoltaic power with respect to effectiveness and efficiency. To ensure a certain volume of investment in photovoltaic capacity investors receive fixed feed-in tariffs for 20 years for each unit of energy they feed into the grid. This remuneration is reduced according to a certain cut-off scheme for devices which will be installed in the future. In the past view years, an enormous volume of photovoltaic devices has been installed, especially in the weeks before the cut-offs. To analyze the efficiency and the effectiveness of the German feed-in tariff system, first, the determinants of such investment are analyzed by estimating an Error Correction model. The results of the estimation are used to simulate alternative mechanisms of adjusting the feed-in tariffs and compare them to the current regime in terms of target achievement and social costs. One of the key results is that the current system causes early investments, but does not induce over-investment. Moreover, it is shown that a system of continuously adjusted feed-in tariffs could be more appropriate than the current regime and that the adjustment should be related to the investment costs. In chapter three, the German hospital market which is characterized by regulated treatment fees and several different ownership types is analyzed. This part of the thesis tries to answer the question how the existence of non-profit hospitals influences market outcome and welfare compared to a market where

  18. One-day point prevalence of emerging bacterial pathogens in a nationwide sample of 62 German hospitals in 2012 and comparison with the results of the one-day point prevalence of 2010.

    Wegner, Christian; Hübner, Nils-Olaf; Gleich, Sabine; Thalmaier, Ulrike; Krüger, Colin M; Kramer, Axel


    Hintergrund: Die Resistenzentwicklung gegen Antibiotika ist eine weltweit bedrohliche Situation. Zur Bekämpfung von multiresistenten Erregern (MRE) wurden in allen deutschen Bundesländern infektiologische Netzwerke der Leistungserbringer aufgebaut. Das HICARE-Netzwerk, ein vom Bundesministerium für Bildung und Forschung gefördertes Projekt, hat 2010 in Zusammenarbeit mit der Deutschen Gesellschaft für Krankenhaushygiene Ergebnisse einer auf freiwilliger Basis durchgeführten multizentrischen Punktprävalenzerhebung veröffentlicht. Mit der vorliegenden Studie sollten die Ergebnisse 2012 reevaluiert werden.Methode: Die Erhebung wurde auf freiwilliger Basis anonymisiert als Punktprävalenz im Mai 2012 unter Zugrundelegung von Routinedaten der mikrobiologischen Diagnostik der Krankenhäuser durchgeführt. Wie in der vorangegangenen Erhebung von 2010 wurde zwischen Krankenhäusern der Maximal-, Schwerpunkt- und Regelversorgung unterschieden, und es wurden nur Daten von Intensivpflegeeinheiten sowie internistischen und chirurgischen Abteilungen erhoben. Die 2010 zugrunde gelegte Methode wurde in einigen Punkten korrigiert und um weitere MREs ergänzt. Eingeschlossen wurden Methicillin-resistente Staphylococcus aureus (MRSA) (insgesamt und unterschieden in Hospital-acquired (HA), Community-acquired (CA) and Lifestock-associated (LA) MRSA), Vancomycin resistente Staphylococcus aureus (VRSA/GRSA), Vancomycin resistente Enterococcus faecalis resp. Enterococcus faecium (VR-E. faecalis resp. VR-E. faecium), Extended-Spectrum-Beta-Lactamase bildende (ESBL) E. coli (ESBL-EC) und Klebsiella pneumoniae (ESBL-KP), multiresistente Acinetobacter spp. (MAB), multiresistente Pseudomonas spp. (MRP), Carbapenemase-bildende Enterobacteriaceae (CRE) und Clostridium difficile (CD) Infektionen einschließlich schwerer, intensivpflichtiger Verlaufsformen. Ergänzend wurden die Screeningstrategie, die Ausstattung mit Hygienefachpersonal und mögliche Confounder erfasst.Ergebnisse: Von 1

  19. Stress among medical doctors working in public hospitals of the ...

    situation to another.4 For the purpose of this study, work stress is ... and Primary Health Care, Faculty of Health Science, University of Limpopo (Medunsa Campus), Pretoria ... problems, which sometimes end in divorce,10,12 physical illness,.

  20. Knowledge and utilization amongst Doctors in Government hospitals ...


    Mar 17, 2015 ... procedures being undertaken, medico‑legal and safety aspects as well ... The patient is at the center of any discussion on the benefits of POCT. ... specimen, proper interpretation and documentation of .... Medical officer. 9. 5.1.

  1. Adverse effects on health and wellbeing of working as a doctor: views of the UK medical graduates of 1974 and 1977 surveyed in 2014.

    Smith, Fay; Goldacre, Michael J; Lambert, Trevor W


    Objective To report on any adverse effects on health and wellbeing of working as a doctor, as described by senior doctors. Design Questionnaires sent in 2014 to all medical graduates of 1974 and 1977. Participants 3695 UK medical graduates. Setting United Kingdom. Main outcome measures Statements about adverse effects upon health, wellbeing and career. Results The aggregated response rate from contactable doctors was 84.6% (3695/4369). In response to the question 'Do you feel that working as a doctor has had any adverse effects on your own health or wellbeing?', 44% of doctors answered 'yes'. More GPs (47%) than hospital doctors (42%) specified that this was the case. Three-quarters of doctors who answered 'yes' cited 'stress/work-life balance/workload' as an adverse effect, and 45% mentioned illness. In response to the statement 'The NHS of today is a good employer when doctors become ill themselves', 28% of doctors agreed, 29% neither agreed nor disagreed and 43% disagreed. More women doctors (49%) than men doctors (40%) disagreed with this statement. More general practitioners (49%) disagreed than hospital doctors (37%). Conclusions Chronic stress and illness, which these doctors attributed to their work, were widely reported. Although recent changes may have alleviated some of these issues, there are lessons for the present and future if the NHS is to ensure that its medical workforce receives the support which enables current doctors to enjoy a full and satisfying career and to contribute fully to health service provision in the UK. Older doctors, in particular, need support to be able to continue successfully in their careers.

  2. Doctors' use of mobile devices in the clinical setting: a mixed methods study.

    Nerminathan, Arany; Harrison, Amanda; Phelps, Megan; Scott, Karen M; Alexander, Shirley


    Mobile device use has become almost ubiquitous in daily life and therefore includes use by doctors in clinical settings. There has been little study as to the patterns of use and impact this has on doctors in the workplace and how negatively or positively it impacts at the point of care. To explore how doctors use mobile devices in the clinical setting and understand drivers for use. A mixed methods study was used with doctors in a paediatric and adult teaching hospital in 2013. A paper-based survey examined mobile device usage data by doctors in the clinical setting. Focus groups explored doctors' reasons for using or refraining from using mobile devices in the clinical setting, and their attitudes about others' use. The survey, completed by 109 doctors, showed that 91% owned a smartphone and 88% used their mobile devices frequently in the clinical setting. Trainees were more likely than consultants to use their mobile devices for learning and accessing information related to patient care, as well as for personal communication unrelated to work. Focus group data highlighted a range of factors that influenced doctors to use personal mobile devices in the clinical setting, including convenience for medical photography, and factors that limited use. Distraction in the clinical setting due to use of mobile devices was a key issue. Personal experience and confidence in using mobile devices affected their use, and was guided by role modelling and expectations within a medical team. Doctors use mobile devices to enhance efficiency in the workplace. In the current environment, doctors are making their own decisions based on balancing the risks and benefits of using mobile devices in the clinical setting. There is a need for guidelines around acceptable and ethical use that is patient-centred and that respects patient privacy. © 2016 Royal Australasian College of Physicians.

  3. Improving Emergency Department Door to Doctor Time and Process Reliability

    El Sayed, Mazen J.; El-Eid, Ghada R.; Saliba, Miriam; Jabbour, Rima; Hitti, Eveline A.


    Abstract The aim of this study is to determine the effectiveness of using lean management methods on improving emergency department door to doctor times at a tertiary care hospital. We performed a before and after study at an academic urban emergency department with 49,000 annual visits after implementing a series of lean driven interventions over a 20 month period. The primary outcome was mean door to doctor time and the secondary outcome was length of stay of both admitted and discharged patients. A convenience sample from the preintervention phase (February 2012) was compared to another from the postintervention phase (mid-October to mid-November 2013). Individual control charts were used to assess process stability. Postintervention there was a statistically significant decrease in the mean door to doctor time measure (40.0 minutes ± 53.44 vs 25.3 minutes ± 15.93 P < 0.001). The postintervention process was more statistically in control with a drop in the upper control limits from 148.8 to 72.9 minutes. Length of stay of both admitted and discharged patients dropped from 2.6 to 2.0 hours and 9.0 to 5.5 hours, respectively. All other variables including emergency department visit daily volumes, hospital occupancy, and left without being seen rates were comparable. Using lean change management techniques can be effective in reducing door to doctor time in the Emergency Department and improving process reliability. PMID:26496278

  4. Improving outcomes using German Inpatient Quality Indicators in conjunction with peer review procedures.

    Mansky, Thomas; Völzke, Tatjana; Nimptsch, Ulrike


    Some hospital comparisons seem to generate confusion because different methods of outcome comparisons lead to different results in hospital rankings. This article questions the concept of overall comparisons of hospitals, which are multiproduct enterprises and may have specialties that provide good results in some areas despite having worse outcomes in others. Therefore, the authors argue for a disease specific view of outcome measurement. The concept of the German Inpatient Quality Indicators is explained. These indicators cover volume, mortality, and other information by a disease specific approach, which includes information for potential patients as well as specific feedback to the physicians responsible for the respective specialty. This article focuses on the feedback to the hospitals and explains how these indicators can be used for improvement in conjunction with a peer review process. The indicators provide information to the hospitals regarding their relative position because German reference values are available for all indicators. Thus, the indicators can serve as a trigger instrument for identifying possible quality problems. Based on these indications, peer review can be used to analyze the treatment processes and to eventually verify weaknesses and define actions for improvement. The first studies indicate that the use of this approach within hospital quality management can largely improve hospital outcomes in hospitals with subpar results compared to the German average.

  5. Word order in the Germanic languages

    Holmberg, Anders; Rijkhoff, Jan


    The Germanic branch of Indo-European consists of three main groups (Ruhlen 1987: 327):- East Germanic: Gothic, Vandalic, Burgundian (all extinct);- North Germanic (or: Scandinavian): Runic (extinct), Danish, Swedish, Norwegian, Icelandic, Faroese;- West Germanic: German, Yiddish, Luxembourgeois......, Dutch, Afrikaans, Frisian, English.Here we will only consider the languages that are currently spoken in geographical Europe. Thus Afrikaans, which is spoken in South Africa, and the extinct languages Gothic, Vandalic, Burgundian, and Runic will not be taken into account (but see e.g. König & van der...

  6. [German Urological Associations under National Socialism].

    Krischel, M; Moll, F; Fangerau, H


    The Deutsche Gesellschaft für Urologie (German Urological Association), established in 1907, was a German-Austrian medical society in which Jewish physicians held important positions. When the Nazis seized power in 1933, the Austrian Hans Rubritius was president of the society. The non-German presidency and the exclusion of Jewish colleagues from the professional society and medical practice led to a halt of the society's activities. At the same time in the mid 1930s, German urologists founded the Gesellschaft Reichsdeutscher Urologen (Association of Reichs-German Urologists) whose members aligned themselves with Nazi health policies and in turn received professional and personal benefits.

  7. Protest of doctors: a basic human right or an ethical dilemma.

    Abbasi, Imran Naeem


    Peaceful protests and strikes are a basic human right as stated in the United Nations' universal declaration on human rights. But for doctors, their proximity to life and death and the social contract between a doctor and a patient are stated as the reasons why doctors are valued more than the ordinary beings. In Pakistan, strikes by doctors were carried out to protest against lack of service structure, security and low pay. This paper discusses the moral and ethical concerns pertaining to the strikes by medical doctors in the context of Pakistan. The author has carefully tried to balance the discussion about moral repercussions of strikes on patients versus the circumstances of doctors working in public sector hospitals of a developing country that may lead to strikes. Doctors are envisaged as highly respectable due to their direct link with human lives. Under Hippocrates oath, care of the patient is a contractual obligation for the doctors and is superior to all other responsibilities. From utilitarian perspective, doctors' strikes are justifiable only if there is evidence of long term benefits to the doctors, patients and an improvement in service delivery. Despite that, it is hard to justify such benefits against the risks to the patients. Harms that may incur to the patients include: prolongation of sufferings, irreversible damage to health, delay in treatment, death, loss of work and waste of financial resources.In a system of socialized medicine, government owing to greater control over resources and important managerial decisions should assume greater responsibility and do justice to all stakeholders including doctors as well as patients. If a doctor is underpaid, has limited options for career growth and is forced to work excessively, then not only quality of medical care and ability to act in the best interests of patients is adversely affected, it may also lead to brain drain. There is no single best answer against or in favor of doctors' industrial

  8. Towards a doctorate in physics

    Greeff, M


    Full Text Available 2009 1990’s and the 21st Century are more likely to be supporting children, spouses, aging parents or extended families [8] [5] D. J. Grayson, A Baseline Study of Women Physics Graduates, Report to DST, 2008 [8] M.A. Hellberg et al... myself and function independently I need to support my family I am not interested in research I want to change my career I will earn more money in industry I am considering relocating to another country Lysko et al., Towards a Doctorate in Physics...

  9. What Makes a Good Doctor?

    C. Richard Coati


    @@ Introduction In the United States and I suspect in all parts of the world, a good doctor is an individual who, in addition to training in their area of interest, i.e., family practice, internal medicine, or a subspecialty area, has participated actively in the educational programs relating to their training which make them eligible to take examinations in those areas (if they are available) and pass them.All physicians generally like to have some procedural skills,but the most important part of their skills relate to their cognitive knowledge which in the long term insures optimal patient care.


    Revista Ciencias Biomedicas


    El doctor Jaime Antonio Barrios Amaya, nació en Cartagena de Indias, Colombia, el 4 de noviembre de 1935. Realizó estudios de primaria en el colegio Fernández Baena y de secundaria en el Liceo de Bolívar, donde se graduó de Bachiller superior en 1956. Inmediatamente ingresó a la Universidad de Cartagena, adelantando estudios médicos y egresó en 1963 con el título de Médico Cirujano. Poco tiempo después regresó a la Universidad de Cartagena e ...

  11. A tribute to Achim Trebst at the time of his doctor honoris causa, University of Düsseldorf.

    Strotmann, Heinrich


    On June 9, 2009, we celebrate the 80th birthday of Achim Trebst. I present below the "Tribute" (Laudatio) that I read on February 11, 2000 on the occasion of his receiving Doctor honoris causa of the Faculty of Mathematics and Natural Sciences of the Heinrich Heine University in Düsseldorf. The text below is a translation from the original German to English with minor editorial changes by Govindjee.

  12. Family Doctors Seen through the Eyes of Specialists: A Qualitative Study

    Anna Probst


    Full Text Available Germany is facing a shortage of young family doctors. In search of possible reasons the aim of this study was to explore the perception of specialists on family doctors. Within a qualitative study 16 medical specialists from different fields in hospital and outpatient care setting were interviewed. Interviews were analysed using qualitative content analysis according to Mayring. Most of the interviewed specialists have a positive view on family doctors although a certain depreciative assumption is resonated in a number of statements. According to the specialists, family doctors enjoy a high status in public, even if social processes of change may have a negative influence on their rather old-fashioned image. Specialists find that family medicine is underrepresented in university education suffering from an upgrading of specialized disciplines. Altogether the majority of the interviewed specialists certify family doctors in Germany a positive image. Lecturer in medical education and training should be aware of their key role in the career choices of young trainees and avoid degradation or upgrading of certain medical disciplines. Interlinked measures on different levels focusing on the improvement of working conditions and representation at the universities would be needed to regain attractiveness for the family doctor's profession as a career choice for young doctors.

  13. Women Doctors and Lady Nurses: Class, Education, and the Professional Victorian Woman.

    Heggie, Vanessa


    The lives of the first women doctors in Britain have been well studied by historians, as have the many debates about the right of women to train and practice as doctors. Yet the relationship between these women and their most obvious comparators and competitors-the newly professionalized hospital nurses-has not been explored. This article makes use of a wide range of sources to explore the ways in which the first lady doctors created "clear water" between themselves and the nurses with whom they worked and trained. In doing so, it reveals an identity that may seem at odds with some of the clichés of Victorian femininity, namely that of the intelligent and ambitious lady doctor.

  14. A survey on the attitudes of doctors towards health insurance payment in the medical consortium

    SHI Ge; WU Tao; XU Wei-guo


    Background Medical consortium is a specific vertical integration model of regional medical resources.To improve medical resources utilization and control the health insurance costs by fee-for-service plans (FFS),capitation fee and diagnosis-related groups (DRGs),it is important to explore the attitudes of doctors towards the different health insurance payment in the medical consortium in Shanghai.Methods A questionnaire survey was carried out randomly on 50 doctors respectively in 3 different levels medical institutes.Results The statistical results showed that 90% of doctors in tertiary hospitals had the tendency towards FFS,whereas 78% in secondary hospitals towards DRGs and 84% in community health centers towards capitation fee.Conclusions There are some obvious differences on doctors' attitudes towards health insurance payment in 3 different levels hospitals.Thus,it is feasible that health insurance payment should be supposed to the doctors' attitudes using the bundled payments along with the third-party payment as a supervisor within consortium.

  15. Doctoral education in a successful ecological niche

    Christensen, Mette Krogh; Lund, Ole


    explore the microclimate in an ecological niche of doctoral education. Based on a theoretical definition of microclimate as the emotional atmosphere that ties group members together and affects their actions, we conducted a case study that aimed to describe the key features of the microclimate...... in a successful ecological niche of doctoral education, and the ways in which the microclimate support the doctoral students’ learning. The methods we applied in the case study were based on short-term ethnographic fieldwork. The results reveal four key features of the emotional atmosphere in the microclimate...... successful doctoral education because it: 1) fleshes out the professional attitude that is necessary for becoming a successful researcher in the department, 2) shapes and adapts the doctoral students’ desires to grasp and identify with the department’s practices, and 3) provides the doctoral students...

  16. Women who doctor shop for prescription drugs.

    Worley, Julie; Thomas, Sandra P


    Doctor shopping is a term used to describe a form of diversion of prescription drugs when patients visit numerous prescribers to obtain controlled drugs for illicit use. Gender differences exist in regard to prescription drug abuse and methods of diversion. The purpose of this phenomenological study guided by the existential philosophy of Merleau-Ponty was to understand the lived experience of female doctor shoppers. Interviews were conducted with 14 women, which were recorded, transcribed, and analyzed. Included in the findings are figural aspects of the participants' experience of doctor shopping related to the existential grounds of world, time, body, and others. Four themes emerged from the data: (a) feeding the addiction, (b) networking with addicts, (c) playing the system, and (d) baiting the doctors. The findings suggest several measures that nurses can take to reduce the incidence of doctor shopping and to provide better care for female doctor shoppers.

  17. Attempt to promote hospital management by IM Public Platform

    Hui CHEN


    Full Text Available Thisarticle has analyzed the contribution of modern IT to hospital management: using public platform of IM (instant message/communication will make it more convenient and efficient to conduct communication with (prior to the treatment, conduct treatment, and provide post-treatment service for patients and their family; withthe set-up of a smooth and efficient information channel set up, the relationship between patients and doctors will be greatly improved ,thus reputation and credibility of the hospital and its doctors will be promoted; when the public has better received the hospital and its doctors, social harmony will be achieved. 

  18. Entangled Histories: German Veterinary Medicine, c.1770-1900.

    Mitsuda, Tatsuya


    Medical historians have recently become interested in the veterinary past, investigating the development of animal health in countries such as France, the Netherlands, the United Kingdom and the United States. An appreciation of the German context, however, is still lacking - a gap in the knowledge that the present article seeks to fill. Providing a critical interpretation of the evolution of the veterinary profession, this investigation explains why veterinary and medical spheres intersected, drifted apart, then came back together; it also accounts for the stark differences in the position of veterinarians in Germany and Britain. Emphasis is placed on how diverse traditions, interests and conceptualisations of animal health shaped the German veterinary profession, conditioned its field of operation, influenced its choice of animals and diseases, and dictated the speed of reform. Due to a state-oriented model of professionalisation, veterinarians became more enthusiastic about public service than private practice, perceiving themselves to be alongside doctors and scientists in status, rather than next to animal healers or manual labourers. Building on their expertise in epizootics, veterinarians became involved in zoonoses, following outbreaks of trichinosis. They achieved a dominant position in meat hygiene by refashioning abattoirs into sites for the construction of veterinary knowledge. Later, bovine tuberculosis helped veterinarians cement this position, successfully showcasing their expertise and contribution to society by saving as much meat as possible from diseased livestock. Ultimately, this article shows how veterinarians were heavily 'entangled' with the fields of medicine, food, agriculture and the military.

  19. Entangled Histories: German Veterinary Medicine, c.1770–1900

    Mitsuda, Tatsuya


    Medical historians have recently become interested in the veterinary past, investigating the development of animal health in countries such as France, the Netherlands, the United Kingdom and the United States. An appreciation of the German context, however, is still lacking – a gap in the knowledge that the present article seeks to fill. Providing a critical interpretation of the evolution of the veterinary profession, this investigation explains why veterinary and medical spheres intersected, drifted apart, then came back together; it also accounts for the stark differences in the position of veterinarians in Germany and Britain. Emphasis is placed on how diverse traditions, interests and conceptualisations of animal health shaped the German veterinary profession, conditioned its field of operation, influenced its choice of animals and diseases, and dictated the speed of reform. Due to a state-oriented model of professionalisation, veterinarians became more enthusiastic about public service than private practice, perceiving themselves to be alongside doctors and scientists in status, rather than next to animal healers or manual labourers. Building on their expertise in epizootics, veterinarians became involved in zoonoses, following outbreaks of trichinosis. They achieved a dominant position in meat hygiene by refashioning abattoirs into sites for the construction of veterinary knowledge. Later, bovine tuberculosis helped veterinarians cement this position, successfully showcasing their expertise and contribution to society by saving as much meat as possible from diseased livestock. Ultimately, this article shows how veterinarians were heavily ‘entangled’ with the fields of medicine, food, agriculture and the military. PMID:27998327



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