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  1. prevalance of alcohol abuse in calabar south local government ...

    African Journals Online (AJOL)

    Eyamba

    sample consisted of 400 respondents aged 10-50 years resident in Calabar South. Life time ... easily brand it as a norm to drink alcohol across the whole social spectrum with the student population constituting a .... TABLE 5: Ranking of the various brands of Alcoholic beverages according to order of preference by gender.

  2. Neonatal Morbidity And Mortality In Calabar, Nigeria: A Hospital ...

    African Journals Online (AJOL)

    Background: The morbidity and mortality pattern amongst neonates admitted into the University of Calabar Teaching Hospital were reviewed from 1st June 2003 to 30th November 2004. Results: The major indications for admission for inborn babies were infections (27.4%), jaundice (21%) and low birth weight (LBW) ...

  3. (ucth), calabar, nigeria

    African Journals Online (AJOL)

    NURSES AT UNIVERSITY OF CALABAR TEACHING HOSPITAL. (UCTH), CALABAR ... infection control in view of many diseases that are transmitted through unsafe injection practices. ..... were given to a panel of experts in the field of nursing.

  4. The pattern of diabetic admissions in UCTH Calabar, South Eastern ...

    African Journals Online (AJOL)

    Alasia Datonye

    majority of patients who left against medical advice were admitted for DFS ... Studies in Nigeria have come ... This study was carried out in the University of Calabar ... of study. There were 2202 males and 1288 females giving a 1.7: 1 male:.

  5. Cancer of the Larynx at the University of Calabar Teaching Hospital ...

    African Journals Online (AJOL)

    Treatment of Ca larynx in Calabar South eastern Nigeria is a management challenge with considerable morbidity and mortality. Cure rate and prognosis are very poor because of late presentation and patient's preference for inappropriate treatment modality in advanced disease. Refusal of laryngeal surgery as treatment ...

  6. Perceptions of burden of caregiving by informal caregivers of cancer patients attending University of Calabar Teaching Hospital, Calabar, Nigeria

    Science.gov (United States)

    Akpan-Idiok, Paulina Ackley; Anarado, Agnes Nonye

    2014-01-01

    Introduction Cancer care is devastating to families. This research studied the informal caregivers’ perceptions of burden of caregiving to cancer patients attending University of Calabar Teaching Hospital, Calabar. Methods The research adopted a cross-sectioned descriptive design and 210 caregivers providing care to advanced cancer patients were purposively selected. Data were collected using a researcher developed questionnaire and standardized Zarit Burden Interview scale (ZBIS). Data collected were analysed using descriptive and chi-square statistics with the help of SPSS 18.0 and PAS 19.0 softwares. Results The results indicated that the caregivers were in their youthful and active economic age, dominated by females, Christians, spouses, partners and parents. The burden levels experienced by the caregivers were as follows: severe (46.2%), moderate (36.2%) and trivial of no burden (17.6%). The forms of burden experienced were physical (43.4%), psychological (43.3%), financial (41.1%) and social (46.7%), quite frequently and nearly always. Psychological and social forms of burden had the highest weighted score of 228 in terms of magnitude of burden. The result further showed that there was a significant (P = 0.001) and inverse association between caregivers’ burden and the care receivers’ functional ability. The level of burden also increased significantly (P = 0.000) with the duration of care, while there was also a significant (P = 0.01) relationship between caregivers’ experience of burden and their desire to continue caregiving. Conclusion Caregiving role can be enhanced by provision of interventions such as formal education programme on cancer caregiving, oncology, home services along side with transmural care. PMID:25419297

  7. Prevalence of Bilirubin Encephalopathy in Calabar, South-South Nigeria: A Five-year Review Study

    Directory of Open Access Journals (Sweden)

    Sunny Oteikwu Ochigbo

    2016-03-01

    Full Text Available Background: Bilirubin encephalopathy is a clinical syndrome, associated with bilirubin toxicity in the central nervous system, resulting in chronic and permanent sequelae. It has been estimated that approximately 60% and 80% of term and preterm newborns develop jaundice in the first week of life, respectively. In the present study, we aimed to determine the prevalence, morbidity, and mortality of bilirubin encephalopathy in the neonatal unit of the University of Calabar Teaching Hospital, Calabar, Nigeria. Methods: In this retrospective, descriptive review, medical records of all newborns, diagnosed with bilirubin encephalopathy over the past five years (from January 2010 to December 2014, were studied. Information retrieved from the medical records included age, sex, presence of fever, duration of disease, place of delivery, causes of the disease, and selected treatments. Variables such as hospital discharge, discharge against medical advice, and mortality were also evaluated. Results: Out of 2,820 newborns, 21 (0.74% cases were admitted on account of bilirubin encephalopathy. Among these affected cases, 17 (81% were male and 4 (19% were female (male-to-female ratio of 5:1. Based on the findings, 18 newborns (85.7% had pyrexia, while 8 (38.1% and 6 (28.6% cases were hypertonic and hypotonic, respectively upon admission. Only 33.3% of deliveries took place in healthcare facilities. The established factors responsible for jaundice included infection, i.e., septicemia (n=15, 71.4%, ABO incompatibility (n=4, 19.1%, and glucose-6-phosphate-dehydrogenase (G6PD deficiency (n=2, 9.5%. The mean maximum total bilirubin level in subjects was 321.3 μmol/L (range: 242.5–440.3 μmol/L. Also, mortality was reported in 4 (19% out of 21 cases. Conclusion: Based on the findings, neonatal septicemia is associated with bilirubin encephalopathy. Therefore, identification and prompt treatment are of utmost importance in preventing the associated morbidity and

  8. Hydatidiform mole in university of Calabar teaching hospital, Nigeria ...

    African Journals Online (AJOL)

    Suction evacuation was done in all the cases. About 63% of patients had 1-3 months follow up, while 2.9% continued beyond 1 year. The case fatality was 1.47%. However. 12 patients never came back to the hospital after evacuation. Conclusion : Molar pregnancy is a common cause of first trimester miscarriages and ...

  9. Knowledge Practice and Outcome of Quality Nursing Care among Nurses in University of Calabar Teaching Hospital (UCTH)

    Science.gov (United States)

    Oyira, Emilia James; Ella, R. E.; Chukwudi, Usochukwu Easter; Paulina, Akpan Idiok

    2016-01-01

    Objectives: The main purpose of this study was to determine knowledge practice and outcome of quality nursing care among nurses in University of Calabar Teaching Hospital (UCTH). Three research questions and one hypothesis were formulated to guide this study. Literature related to the variables under study was reviewed according to the research…

  10. Prevalence of anemia in women with asymptomatic malaria parasitemia at first antenatal care visit at the University of Calabar Teaching Hospital, Calabar, Nigeria

    Directory of Open Access Journals (Sweden)

    TU Agan

    2010-07-01

    Full Text Available TU Agan1, JE Ekabua1, AE Udoh1, EI Ekanem1, EE Efiok1, MA Mgbekem21Department of Obstetrics and Gynecology, 2Department of Nursing, College of Medical Sciences, University of Calabar, NigeriaBackground: Anemia in pregnancy in malaria endemic areas is a public health challenge that has contributed either directly or indirectly to maternal morbidity and mortality in our environment. Anemia and malaria during pregnancy are highly preventable and treatable.Objective: The aim of this study is to assess the prevalence of anemia in asymptomatic malaria parasitemic women at first antenatal visit in a tertiary hospital facility.Method: The study was conducted at the antenatal clinic of the University of Calabar Teaching Hospital, Calabar, Nigeria over a three-month period. Five hundred and forty-five pregnant women were recruited after obtaining an informed consent. A structured questionnaire was administered to each participant and two thin and thick blood films were used to identify the malaria parasites and estimate density. The average of two packed cell volumes at booking was determined using two capillary tubes and read from a Hawksleys microhematocrit reader.Results: A total of 545 pregnant women participated in the study. The mean ages of primigravidas and multigravidas were 21.4 ± 3.1 and 24.3 ± 4.0 years. Two hundred and ninety (53.2% were primigravidas while 255 (46.8% were multigravidas. The parasite density in primigravidas was 1297 ± 1234 while that for multigravidas was 661 ± 497 (t = 7.7, P < 0.001. The prevalence of anemia in the study population was 59.6%. There was no statistically significant difference in the prevalence of anemia among the primigravidas (60.3% and the multigravidas (58.8% (χ2 = 1.3, P = 0.08. There was a statistically significant association between severity of parasitemia and degree of anemia (χ2 = 441.1, P < 0.001. There was a statistically significant association between antimalarials use before booking and

  11. Trends in maternal mortality at the University of Calabar Teaching Hospital, Nigeria, 1999–2009

    Directory of Open Access Journals (Sweden)

    TU Agan

    2010-08-01

    Full Text Available TU Agan1, EI Archibong1, JE Ekabua1, EI Ekanem1, S E Abeshi1, TA Edentekhe2, EE Bassey21Department of Obstetrics and Gynecology and 2Department of Anesthesia, College of Medical Sciences, University of Calabar Teaching Hospital, NigeriaBackground: Maternal mortality remains a major public health challenge, not only at the University of Calabar Teaching Hospital, but in the developing world in general.Objective: The objective of this study was to assess trends in maternal mortality in a tertiary health facility, the maternal mortality ratio, the impact of sociodemographic factors in the deaths, and common medical and social causes of these deaths at the hospital.Methodology: This was a retrospective review of obstetric service delivery records of all maternal deaths over an 11-year period (01 January 1999 to 31 December 2009. All pregnancy-related deaths of patients managed at the hospital were included in the study.Results: A total of 15,264 live births and 231 maternal deaths were recorded during the period under review, giving a maternal mortality ratio of 1513.4 per 100,000 live births. In the last two years, there was a downward trend in maternal deaths of about 69.0% from the 1999 value. Most (63.3% of the deaths were in women aged 20–34 years, 33.33% had completed at least primary education, and about 55.41% were unemployed. Eight had tertiary education. Two-thirds of the women were married. Obstetric hemorrhage was the leading cause of death (32.23%, followed by hypertensive disorders of pregnancy. Type III delay accounted for 48.48% of the deaths, followed by Type I delay (35.5%. About 69.26% of these women had no antenatal care. The majority (61.04% died within the first 48 hours of admission.Conclusion: Although there was a downward trend in maternal mortality over the study period, the extent of the reduction is deemed inadequate. The medical and social causes of maternal deaths identified in this study are preventable, especially

  12. Prevalence of anemia in women with asymptomatic malaria parasitemia at first antenatal care visit at the University of Calabar Teaching Hospital, Calabar, Nigeria

    OpenAIRE

    TU Agan; JE Ekabua; AE Udoh; et al

    2010-01-01

    TU Agan1, JE Ekabua1, AE Udoh1, EI Ekanem1, EE Efiok1, MA Mgbekem21Department of Obstetrics and Gynecology, 2Department of Nursing, College of Medical Sciences, University of Calabar, NigeriaBackground: Anemia in pregnancy in malaria endemic areas is a public health challenge that has contributed either directly or indirectly to maternal morbidity and mortality in our environment. Anemia and malaria during pregnancy are highly preventable and treatable.Objective: The aim of this study is to a...

  13. Utilization and discontinuation of contraceptive methods: the University of Calabar Teaching Hospital (UCTH experience

    Directory of Open Access Journals (Sweden)

    Njoku CO

    2014-09-01

    Full Text Available Background: Contraception has an important role to play in reducing the high rate of maternal morbidity and mortality in developing countries. Objective: The objective is to determine the prevalence rate, methods and reasons for discontinuation of contraceptive methods at UCTH, Calabar. Method: This was a retrospective study of all clients that utilised different forms of contraceptives at UCTH, Calabar from 1st January, 2009 to 31st December, 2013. Results: A total of 5,381 clients used various methods of contraception while 13,492 live births were recorded giving the prevalence rate of 39.9% of total live birth. Common methods were intrauterine contraceptive device (IUCD 1,745(32.8% and injectable contraceptives 1,268(23.8%. Most clients 1,876(35.2% were graduates while 81(1.5% had no formal education. A total of 535(10.1% clients discontinued different family planning method commonly due to desire for pregnancy and side effects. IUCD had the highest discontinuation rate. Conclusion: The study revealed low prevalence rate of contraceptive use which was more among teenagers and illiterate women. The main reasons for discontinuation of different methods were desire for pregnancy, side effects and menopause. Creating more contraceptive awareness, improvement in contraceptive counselling and female education will help to improve contraceptive utilisation rate and reduce discontinuation rate.

  14. Knowledge of women’s issues in epilepsy: A survey of residents at a tertiary hospital in Calabar, Niger Delta Region of Nigeria

    OpenAIRE

    Oparah Sidney Kelechi

    2012-01-01

    Background: Reports reveal deficiencies in the knowledge of women related issues in epilepsy, among health care professionals, with consequent inadequate health education and poor health care delivery to this set of patients.Aim: To assess the knowledge of women`s issues in epilepsy among residents at the University of Calabar Teaching Hospital, Nigeria.Method: Seventy two consenting residents from the Internal medicine, Family Medicine and Obstetrics & Gynecology departments of the hospital,...

  15. Knowledge of women`s issues in epilepsy: a survey of residents at a tertiary hospital in Calabar, Niger delta region of Nigeria

    OpenAIRE

    Williams Uduak; Njoku Charles; Oparah Sidney Kelechi

    2012-01-01

    Background: Reports reveal deficiencies in the knowledge of women related issues in epilepsy, among health care professionals, with consequent inadequate health education and poor health care delivery to this set of patients.Aim: To assess the knowledge of women`s issues in epilepsy among residents at the University of Calabar Teaching Hospital, Nigeria.Method: Seventy two consenting residents from the Internal medicine, Family Medicine and Obstetrics & Gynecology departments of the hospital,...

  16. HIV infection in pregnancy: maternal and perinatal outcomes in a tertiary care hospital in Calabar, Nigeria.

    Science.gov (United States)

    Ikpim, Ekott Mabel; Edet, Udo Atim; Bassey, Akpan Ubong; Asuquo, Otu Akaninyene; Inyang, Ekanem Etim

    2016-04-01

    Human immunodeficiency virus (HIV) infection is likely to have untoward effects on pregnancy and its outcome. This study assessed the impact of maternal HIV infection on pregnancy outcomes in a tertiary centre in Calabar, Nigeria. This retrospective study analysed delivery records of 258 HIV-positive and 257 HIV-negative women for pregnancy and delivery complications. Maternal and fetal outcomes of HIV-positive pregnancies were compared with those of HIV-negative controls. Adverse pregnancy outcomes significantly associated with HIV status were: anaemia: 33 (8.1%) vs. 8 (3.1%) in controls; puerperal sepsis: 18 (7%) vs. 2 (0.8%); and low birth weight: 56 (21.7%) vs. 37 (14.4%). Caesarean delivery was higher among HIV-positive women than controls: 96 (37.2%) vs. 58 (22.6%). Preterm births were higher in those HIV cohorts who did not receive antiretroviral therapy (ART): 13 (16.9%) vs. 7 (3.9%). HIV-positive status increased adverse birth outcome of pregnancy. ART appeared to reduce the risk of preterm births in HIV-positive cohorts. © The Author(s) 2015.

  17. incidence of ectopic pregnancy in calabar, nigeria: two halves of the ...

    African Journals Online (AJOL)

    user

    Reports of a rising incidence of ectopic pregnancy (EP) in the country and beyond prompted ... O. Udofia, Dept. of Psychiatry, University of Calabar Teaching Hospital, Calabar, Nigeria .... on reproductive performance among EP patients.

  18. Factors influencing the incidence of pre-term birth in Calabar, Nigeria

    African Journals Online (AJOL)

    Women who had pre-term birth in the University of Calabar Teaching Hospital, Calabar, over a 2 ½ year period were studied. The aim was to establish the factors influencing the incidence of pre-term birth in Calabar. Factors which significantly increase the incidence of pre-term delivery included: previous induced abortion ...

  19. Infertility among Nigerian couples as seen in Calabar | Ekwere | Port ...

    African Journals Online (AJOL)

    Infertility among Nigerian couples as seen in Calabar. ... and the male fertility clinics of University of Calabar Teaching Hospital over a five-year ... Keywords: Infertility, Infection, Nigerians Port Harcourt Medical Journal Vol. 2 (1) 2007: pp. 35-40 ...

  20. Prevalence of anemia in women with asymptomatic malaria parasitemia at first antenatal care visit at the University of Calabar Teaching Hospital, Calabar, Nigeria

    OpenAIRE

    Agan, TU; Ekabua, JE; Udoh, AE; Ekanem, EI; Efiok, EE; Mgbekem, MA

    2010-01-01

    Background: Anemia in pregnancy in malaria endemic areas is a public health challenge that has contributed either directly or indirectly to maternal morbidity and mortality in our environment. Anemia and malaria during pregnancy are highly preventable and treatable. Objective: The aim of this study is to assess the prevalence of anemia in asymptomatic malaria parasitemic women at first antenatal visit in a tertiary hospital facility. Method: The study was conducted at the antenatal clinic of ...

  1. Knowledge of women’s issues in epilepsy: A survey of residents at a tertiary hospital in Calabar, Niger Delta Region of Nigeria

    Directory of Open Access Journals (Sweden)

    Oparah Sidney Kelechi

    2012-01-01

    Full Text Available Background: Reports reveal deficiencies in the knowledge of women related issues in epilepsy, among health care professionals, with consequent inadequate health education and poor health care delivery to this set of patients.Aim: To assess the knowledge of women`s issues in epilepsy among residents at the University of Calabar Teaching Hospital, Nigeria.Method: Seventy two consenting residents from the Internal medicine, Family Medicine and Obstetrics & Gynecology departments of the hospital, were requested to complete the KOWIE II questionnaire designed to assess knowledge of women`s issues in epilepsy. Results: One fifth of the respondents knew about the effects of sex hormones on seizures. Two fifths knew of the higher incidence of sexual dysfunction among women with epilepsy, the undesirable effects of anti-epileptic drugs (AEDs on bone health, and the best choice of anti- epileptic drug in pregnancy. Two thirds knew of reduction in contraceptive efficacy by some AEDs, and the need to administer vitamin K to neonates of women on AEDs. Four fifths knew that women on AEDs should be given folic acid, and that majority of women with epilepsy have healthy children. Half of the respondents knew that women on AEDs can safely breast feed. The overall mean KOWIE II score was 56.7%. Conclusion: The Residents were poorly informed about the issues affecting women with epilepsy. There is need for continuing medical education efforts to bridge the gap in knowledge.

  2. Knowledge of women`s issues in epilepsy: a survey of residents at a tertiary hospital in Calabar, Niger delta region of Nigeria

    Directory of Open Access Journals (Sweden)

    Williams Uduak

    2012-11-01

    Full Text Available Background: Reports reveal deficiencies in the knowledge of women related issues in epilepsy, among health care professionals, with consequent inadequate health education and poor health care delivery to this set of patients.Aim: To assess the knowledge of women`s issues in epilepsy among residents at the University of Calabar Teaching Hospital, Nigeria.Method: Seventy two consenting residents from the Internal medicine, Family Medicine and Obstetrics & Gynecology departments of the hospital, were requested to complete the KOWIE II questionnaire designed to assess knowledge of women`s issues in epilepsy. Results: One fifth of the respondents knew about the effects of sex hormones on seizures. Two fifths knew of the higher incidence of sexual dysfunction among women with epilepsy, the undesirable effects of anti-epileptic drugs (AEDs on bone health, and the best choice of anti-epileptic drug in pregnancy. Two thirds knew of reduction in contraceptive efficacy by some AEDs, and the need to administer vitamin K to neonates of women on AEDs. Four fifths knew that women on AEDs should be given folic acid, and that majority of women with epilepsy have healthy children. Half of the respondents knew that women on AEDs can safely breast feed. The overall mean KOWIE II score was 56.7%. Conclusion: The Residents were poorly informed about the issues affecting women with epilepsy. There is need for continuing medical education efforts to bridge the gap in knowledge.

  3. Uptake Of Eye Care Services In University Of Calabar Teaching ...

    African Journals Online (AJOL)

    This study was carried out to determine the importance of alternative sources of eye care services in delay in seeking ophthalmic treatment in University of Calabar teaching hospital (UCTH).Atotal of 580 patients who visited the hospital within 3 months of the study period October 2003 to December 2003, were examined ...

  4. Post Neonatal Tetanus in Calabar, Nigeria: A 10 Year Review ...

    African Journals Online (AJOL)

    1997-01-01

    A 10 year retrospective study of post neonatal tetanus in University of Calabar Teaching Hospital was carried out. The study period spanned from January 1, 1997 to December 31, 2006. The aim was to determine the incidence of post neonatal tetanus and associated bio-characteristics. Information was extracted from case ...

  5. Breast Evaluation Findings in Calabar, Nigeria

    Directory of Open Access Journals (Sweden)

    Anthonia Ikpeme

    2014-12-01

    CONCLUSION: Patients presenting for breast evaluation in Calabar do so for screening mainly. Patients below 38 are nearly equally affected by malignant breast disease as their older counterparts. The commonest breast pattern was fatty replaced. Digital mammography should be available in all tertiary institutions.

  6. the case study of calabar, nigeria

    African Journals Online (AJOL)

    PROF. BARTH EKWEME

    Assessment of 2005 (MEA, 2005), wetlands have ... of the Ramsar Convention as “areas of marsh, ... in the human environment and also make very ... eliminating the risks of eutrophication in the .... rate of urbanization, mining, oil and industrial ... Fig 3a: Map of Cross River State showing Calabar close to the Cross River ...

  7. Climatic condition of Calabar as typified by some meteorological ...

    African Journals Online (AJOL)

    This study aims at analysing some meteorological data collected by the meteorological department of the Margaret Ekpo International Airport, Calabar between 1985 and 2003. The main objectives were to provide average figures and curves of Calabar climate, and to identify possible trends since 1985. Results show that ...

  8. Prevalence, sociodemographic characteristics and risk factors for hepatitis C infection among pregnant women in Calabar municipality, Nigeria.

    Science.gov (United States)

    Mboto, Clement Ibi; Andy, Iniobong Ebenge; Eni, Ogban Ibor; Jewell, Andrew Paul

    2010-01-01

    The epidemiology and risk factors for hepatitis C virus (HCV) infection in developing countries where intravenous drug use (IDU) is uncommon its poorly understood. This study therefore aims to determine the prevalence of HCV and its associated risk factors among pregnant women in Calabar municipality. A total of 506 out of 716 antenatal care (ANC) patients seen at the General Hospital, Mary Slessor Avenue, Calabar between August and November 2005 and the University of Calabar Teaching Hospital (UCTH) between October and November 2005 were evaluated for their HCV status using the One Step HCV Test kit (Binomial diagnostics, UK), with reference to the subjects' demographic and behavioural risk factors. HCV prevalence was determined to be 0.4% (2/506) and was only seen in women aged 38 years and over. Histories of blood transfusion, surgery, involvement in polygamous marriage, sharing of a toothbrush and female circumcision were all non-significant risk factors for the infecion. This study reveals a low HCV prevalence among pregnant women in Calabar municipality with no identifiable risk factor. The study calls for a re-evaluation of the transmission modes of HCV especially in developing countries where intravenous drug use is rare.

  9. Adverse Effects of Waste Generation in Calabar Urban, Nigeria ...

    African Journals Online (AJOL)

    Adverse Effects of Waste Generation in Calabar Urban, Nigeria. ... degradation, blocking of drainage and emission of greenhouse gases. We found a number of health hazards, ranging from pollution to diseases on both human and animals.

  10. ear nose and throat changes observed in pregnancy in calabar

    African Journals Online (AJOL)

    Global Journal

    This paper studies changes observed in pregnant women at the 3 stages of pregnancy in Calabar. Eighty pregnant ... Vomiting, loss of appetite, excess salivation, Nausea gastro – .... swimmers changes the Ph of the metal skin from that of.

  11. an empirical study of poverty in calabar and its environs.

    African Journals Online (AJOL)

    DJFLEX

    2009-06-17

    Jun 17, 2009 ... AN EMPIRICAL STUDY OF POVERTY IN CALABAR AND ITS. ENVIRONS. ... one of the poorest nations in the world (CBN, 2001). Specifically, these .... rural development in poor regions, inadequate access to education ...

  12. Malaria: Knowledge and prevention practices among school adolescents in a coastal community in Calabar, Nigeria

    Science.gov (United States)

    Gyuse, Abraham N.; Etokidem, Aniekan J.

    2010-01-01

    ABSTRACT Background Malaria prevention and treatment constitute an unbearable economic burden to most African countries, especially south of the Sahara, where about 500 million cases occur annually. The problem of malaria among adolescents has largely been overshadowed by the huge burden of the disease among young children. Attention to malaria among adolescents has also been diverted by the huge burden of HIV/AIDS among adolescents. Some surveys reveal a lack of knowledge and many misconceptions about the transmission and treatment of malaria, which could adversely affect malaria control measures and antimalarial therapy. Such a knowledge gap could have an adverse effect on school children, who could be used as change agents and as role models for their siblings and peers in the malaria control strategy. Objectives To determine the malaria prevention practices of school adolescents in the coastal community of Calabar, Nigeria. Method This was a cross-sectional survey involving secondary schools in southern Calabar. Four hundred adolescents were randomly selected from the 4565 learners in 5 out of 17 secondary schools in southern Calabar, Cross River State, Nigeria. A self-administered, semi-structured questionnaire was administered to the respondents. Results Most respondents (77.5%) were aware that the vector transmits the malaria parasite through biting. Fewer respondents would prevent malaria attacks by clearing the vegetation in the peri-domestic environment (13.5%), filling up potholes (16.9%), opening up drainage (11%), using insecticide-treated nets (25.7%) or using antimalarial drugs (11.2%). Less than one-tenth (8%) would use various other methods such as not accepting unscreened blood, while only 11% obtained the information from their teachers. Conclusion The study identified knowledge gaps among school children. There is a need to empower teachers with information about the cause of malaria and prevention strategies.

  13. HIV Infection in hospitalized under-5 children with acute watery ...

    African Journals Online (AJOL)

    Prof Ezechukwu

    2011-12-31

    Dec 31, 2011 ... HIV with acute watery diarrhea as a clinical manifesta- tion.5,6,9,10 This study therefore attempts to find out the prevalence of HIV among children admitted into the. Diarrhoea Treatment and Training Unit of the University of Calabar Teaching Hospital, Calabar, Nigeria. This study will help in identifying ...

  14. Calabar Humaphors: An Analysis of Selected Jokes in Nigerian ...

    African Journals Online (AJOL)

    Nigeria's stand-up comedy bears some uniqueness that sets it apart as distinctively Nigerian. It mirrors certain societal resemblance and awake in the audience reactions towards such: acceptance or rejection, tolerance or outright repudiation. One of the ways through which this is done, is by the use of Calabar humaphors.

  15. ASSESSMENT OF UN-AFRICAN IDEALS IN CALABAR CARNIVAL ...

    African Journals Online (AJOL)

    Dean SPGS NAU

    Being a performance that thrives on exhibition of culture and parade of outfits, costume .... French planters, African slaves, Indian indentured labourers, and the many other .... siblings who posed nude on a sacred Malaysian mountain of. Kinabalu. ... fate of Carnival Calabar in the wake of the influence of foreign costumes on ...

  16. Youth unemployment and its consequences in Calabar metropolis ...

    African Journals Online (AJOL)

    In this paper, consequences of youth unemployment in Nigeria were examined using Calabar metropolis in Cross River State as a case study. The literature is full of scholarly research on the social phenomenon of youth unemployment around the globe. This phenomenon has continued in Nigeria in the face of unfulfilled ...

  17. Antibiotic Misuse among High School Students in Calabar Nigeria ...

    African Journals Online (AJOL)

    Five hundred and sixty high school students from five secondary schools in Calabar, Nigeria were studied for antibiotic usage. Questionnaires where administered to determine the following parameters: Knowledge of antibiotics, types of infections for which antibiotics were taken, sources of prescription and procurement of ...

  18. Aspects of the crime geography of Calabar urban | Afangideh ...

    African Journals Online (AJOL)

    The main focus of this research is to established, through an objective empirical process, the spatial pattern and trend with regards to the crime geography of Calabar Urban. Six, of the Police posts in the town, two from each of the three zones into which the town has been sub-divided became the sample points. The crime ...

  19. Environmental Consequences of Volumetric Traffic Flow in Calabar ...

    African Journals Online (AJOL)

    User

    2011-05-20

    May 20, 2011 ... a capitalist economy, goods can be allocated either by pricing (ability to pay) or by queueing ... accommodate the total demand for peak-hour vehicle travel (a supply-side solution) ... increase in taxes as a transportation mode in Calabar has generally increase .... electric equipment among others. Beside ...

  20. Urban slums and youth criminality in Calabar Municipality of Cross ...

    African Journals Online (AJOL)

    In the diagnosis of contemporary threat to state stability, urbanization is inevitably included among the litany of emerging challenges. This study sets out to examine the relationship between urban slums and youth criminality in Calabar urban area of Cross River State, Nigeria. To achieve this objective, 400 respondents ...

  1. Management accounting for hospitals | Leyenaar | South African ...

    African Journals Online (AJOL)

    South African Medical Journal. Journal Home · ABOUT · Advanced Search · Current Issue · Archives · Journal Home > Vol 87, No 10 (1997) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Download this PDF file. The PDF file you selected should load here if your ...

  2. Gastroenterology training in private hospitals: India vs South Africa

    Science.gov (United States)

    Mulder, Chris Jacob Johan; Puri, Amarender Singh; Reddy, Duvvur Nageshwar

    2010-01-01

    In South Africa, nurses and doctors are emigrating in significant numbers. Job satisfaction, safety and ensuring career progression are important in retaining doctors to make a career in Republic of South Africa (RSA). Due to budgetary constraints many hospitals have not been upgraded. Coming home after overseas training seems difficult. In RSA it takes a minimum of 13 years for a young specialist to become registered and 15 years for subspecialists. Career progression, creating more specialist trainees in public and private hospitals and shortening the period of professional training are potential solutions to the problem. India, which has a population of more than 1 billion people, is struggling with similar problems. For the past 10-15 years, private hospitals have assisted in manpower development for medical specialist and subspecialist careers. Currently their private sector trains 60% of their recognised (sub)specialities fellows. A national task force for specialist training in RSA should be instituted. It should discuss, based on the current status and projected specialist and subspecialist personnel requirements, the future structure and logistics of training needs. This is required in all subspecialities including gastroenterology, as has been done in India. It is hoped that as a consequence well-trained doctors, similar to those in India, might move to provincial hospitals in rural areas, upgrading the medical services and keeping medical power in South Africa. South Africa should become a model for Sub-Saharan Africa, as India already is for South-East Asia. PMID:20180232

  3. The role ofprivate hospitals in South Africa

    African Journals Online (AJOL)

    effect in April 1980, and were implemented subse- quent to the .... cannot be left to the workings of the market, but will require a ... able to plan in advance and would have strong in- centives to .... ered by the basic package of goods and may be allowed to take out .... of these hospitals might remain to provide luxury care.

  4. Management of snakebites at a rural South African hospital ...

    African Journals Online (AJOL)

    ... snakebites at this rural hospital where they were treated frequently. It is crucial for primary care physicians to be familiar with the most common venomous snakes in South Africa and the management of their bites in humans. Elevation of the affected limb, administration of intravenous fluids and administration of analgesia, ...

  5. Primary prevention in psychiatry in general hospitals in South Asia

    Science.gov (United States)

    Sood, Mamta; Chadda, Rakesh Kumar; Kallivayalil, Roy Abraham

    2017-01-01

    The focus of primary prevention is on reducing the disease incidence. Primary prevention in mental health has been given minimal priority in low-resource settings with no significant investments. General hospitals are one of the main providers of mental health services in South Asia. This paper focuses on primary prevention activities, which can be undertaken in a general hospital in South Asia with abysmally low-mental health resources. For implementing primary prevention in psychiatry, a general hospital may be conceptualized as a population unit, located in a well-populated area with easy accessibility where different kinds of communities, for example, students and resident doctors, consultants, patients and their caregivers, and paramedical, nursing, administrative and other supportive staff, coexist and have varied functions. All the functional components of the general hospital psychiatric units (GHPUs) offer scope for introducing primary preventive psychiatry services. Psychiatrists in GHPUs can lead efforts for primary prevention in mental health in the hospital by employing strategies in the framework of universal, selective, and indicated prevention. The preventive strategies could be targeted at the patients visiting the hospital for various health services and their caregivers, employees, and the trainees. Similar principles can be employed in teaching and training. PMID:29497199

  6. Ocular effects of chronic exposure to welding light on calabar welders

    African Journals Online (AJOL)

    It was generally observed that welders in Calabar, Nigeria did not always wear their protective goggles during welding. Since chronic exposure to welding light can impair vision this study was done to assess the effect of exposure to welding light on ocular function of welders in Calabar, Nigeria. There were 195 subjects ...

  7. Management of incomplete abortion in South African public hospitals.

    Science.gov (United States)

    Brown, H C; Jewkes, R; Levin, J; Dickson-Tetteh, K; Rees, H

    2003-04-01

    To describe the current management of incomplete abortion in South African public hospitals and to discuss the extent to which management is clinically appropriate. A multicentre, prospective descriptive study. South African public hospitals that manage gynaecological emergencies. Hospitals were selected using a stratified random sampling method. All women who presented to the above sampled hospitals with incomplete abortion during the three week data collection period in 2000 were included. A data collection sheet was completed at the time of discharge for each woman admitted with a diagnosis of incomplete, complete, missed or inevitable abortion during the study period. Information gathered included demographic data, clinical signs and symptoms at admission, medical management, surgical management, anaestetic management, use of blood products and antibiotics and complications. Three clinical severity categories were used for the purpose of data analysis and interpretation. Detail of medical management, detail of surgical management, use of blood products and antibiotics, methods of analgesia and anaesthesia used, and use of abortifacients. There is a trend towards low cost technology such as the use of manual vacuum aspiration and sedation anaesthesia; however, this is mainly limited to the better resourced tertiary hospitals linked to academic units. The use of antibiotics and blood products has decreased but much of the use is inappropriate. The use of abortifacients does include some use of misoprostol but merely as an adjunct to surgical evacuation. The management of incomplete abortion remains a problem in South Africa, a low income country that is still managing a common clinical problem with costly interventions. The evidence of a trend towards low cost technology is promising, albeit limited to tertiary centres. This study has given us information as how to best address this problem. More training in low cost methods is needed, targeting in particular the

  8. How a south Florida hospital targeted Hispanic consumers.

    Science.gov (United States)

    Weinstein, A

    1988-02-01

    Last month's "Case in Point" presented AMI Parkway Regional Medical Center, a 412-bed acute care hospital in North Miami Beach, Fla. The hospital's administration has recognized the ethnic make-up of the South Florida market (white, black and Hispanic) and wants to increase its penetration into the large and potentially lucrative Latin market. The hospital is one of six in South Florida that are owned by American Medical International Inc., Los Angeles. Parkway recently completed a modernization and development program that resulted in an expanded emergency department, state-of-the-art critical care units, a cost-saving ambulatory unit and facilities for outpatient and community education programs. Positioned in a fiercely competitive market, Parkway has adopted an aggressive marketing posture. The marketing function has been elevated to one of six hospital divisions, sharing equal footing with finance, professional services, administrative services, nursing and human resources. Given the hospital's reputation for action and the previous success of programs based on market research, the assistant administrator for marketing and business development secured support for research on the Latin market.

  9. Seroprevalence of transfusion-transmissible infections (HBV, HCV, syphilis and HIV) among prospective blood donors in a tertiary health care facility in Calabar, Nigeria; an eleven years evaluation.

    Science.gov (United States)

    Okoroiwu, Henshaw Uchechi; Okafor, Ifeyinwa Maryann; Asemota, Enosakhare Aiyudubie; Okpokam, Dorathy Chioma

    2018-05-22

    Provision of constant and safe blood has been a public health challenge in Sub-Saharan Africa with high prevalence of transfusion-transmissible infections (TTIs). This study was aimed at determining the trend and seroprevalence of HBV, HCV, syphilis and HIV across the years within study among prospective blood donors at blood bank in University of Calabar Teaching Hospital (UCTH), Calabar, Nigeria. A retrospective analysis of blood donor data from January 2005 to December 2016 was conducted in Blood Bank/Donor Clinic of University of Calabar Teaching Hospital, Calabar, Nigeria. Sera samples were screened for hepatitis B surface antigen (HBsAg), antibodies to hepatitis C virus (HCV), human immunodeficiency virus (HIV) 1 and 2 and Treponema pallidum using commercially available immunochromatic based kits. Out of the 24,979 screened prospective donors in the 2005-2016 study period, 3739 (14.96%) were infected with at least one infective agent. The overall prevalence of HBV, HCV, syphilis and HIV were 4.1, 3.6, 3.1 and 4.2%, respectively. During the period of study, the percentage of all transfusion-transmissible infections declined significantly with remarkable decline in HIV. The study showed male dominated donor pool (98.7%) with higher prevalence (4.2%) of transfusion-transmissible infections than in female donors (0.0%). Commercial donors constituted majority (62.0%) of the donors and as well had the highest prevalence of transfusion-transmissible infections. Majority (62.9%) of the donors were repeat donors. HBV, HCV, syphilis and HIV have remained a big threat to safe blood transfusion in Nigeria and Sub-Saharan Africa at large. Strict adherence to selection criteria and algorithm of donor screening are recommended.

  10. Prevalance of Alcohol Abuse in Calabar South Local Government ...

    African Journals Online (AJOL)

    Decreased work performance 77.25%, increase in violence and crime 77%, poverty 50.75%, wife and childbearing 73.75%, increase in accident rate 80.5%, children inability to continue schooling 83.5% Nigerian culture, it appears that there is a culture of alcohol implicitly institutionalized that one could easily brand it as a ...

  11. Response of planktonic bacteria of New Calabar River to zinc stress ...

    African Journals Online (AJOL)

    Response of planktonic bacteria of New Calabar River to zinc stress. ... The result of the in vitro study indicated that the bacterial strains are sensitive to Zn2+ stress. Therefore, Zn2+ contamination would ... Featuring journals from 32 Countries:.

  12. Comparison of cold water sponging and acetaminophen in control of fever among children attending a tertiary hospital in South Nigeria

    Directory of Open Access Journals (Sweden)

    Tony M Aluka

    2013-01-01

    Full Text Available Background: A wide range of childhood illnesses are accompanied by fever, leading to varied attempts at treatment by caregivers at home before coming to a hospital. Common modalities of treatment include use of antipyretics and physical methods such as cold water sponging, fanning and removal of clothing. These treatment modalities have been received with varied attitudes among physicians and the scientific community. This study was to assess the efficacy of both modalities in first-line management of fever in our area. Objectives: The main aim of the study is to compare the effectiveness of cold water sponging with that of oral paracetamol in the treatment of fever in children attending the University of Calabar Teaching Hospital, Calabar. Subjects and Methods: This is a randomized clinical trial. Eighty-eight children aged 12-120 months who presented to the Children Outpatient Clinic (CHOP and the Children Emergency Room (CHER of University of Calabar Teaching Hospital, Calabar, with acute febrile illness and axillary temperatures spanning ≥ 38.0-40.0°C. All children within the age limit whose caregivers gave consent were recruited into the study and were randomized to receive either cold water sponging or oral paracetamol. Axillary temperature, pulse rate, respiratory rate and assessment of discomforts (crying, shivering, goose pimples and convulsions were recorded every 30 min for 2 h. The results were analyzed using the SPSS statistical software and have been presented in the tables. Results: Cold water sponging was very effective in temperature reduction within the first 30 min, with 29 (70.73% having their temperature reduced to within normal limits. This declined to 12 (29.26% at 60 min and 4 (10.53% at 120 min, with the mean temperature differences from the baseline value following the same trends (1.63°C by 30 min, 0.91°C by 60 min and 0.39°C by 120 min. When compared with paracetamol, cold water sponging was more effective in

  13. JOB SATISFACTION AND PSYCHOLOGICAL HEALTH OF MEDICAL DOCTORS IN CALABAR, SOUTHERN NIGERIA.

    Science.gov (United States)

    Bello, S; Asuzu, M C; Ofili, A N

    2013-06-01

    Employees should be happy at their work, considering the amount of time they devote to it throughout their working life. There is paucity of data on the job satisfaction and psychological health of medical doctors in Nigeria. To assess the level of job satisfaction and its relationship to psychological health among medical doctors in a southern city of Nigeria. A cross-sectional descriptive survey. Three major public hospitals in Calabar, Nigeria. Medical doctors who had worked for at least six months in the hospitals. Response rate was 73.0%. More than half (56.7%) of the respondents expressed overall satisfaction with their job. Inadequate pay and work overload were the most commonly mentioned reasons for job dissatisfaction. About a fifth of the respondents were at increased likelihood of psychological disorder. There was a statistically significant negative correlation between job satisfaction scores and GHQ scores. Satisfied respondents were least likely to have psychological disorder. Causes of job dissatisfaction among medical doctors should be addressed to improve their psychological health.

  14. Workplace Violence Against Nurses: Vhembe District Hospitals, South Africa.

    Science.gov (United States)

    Mahani, Tshifularo Olga; Akinsola, Henry Abayomi; Mabunda, Jabu; Oni, Helen Tosin

    2017-02-01

    Work-related violence is a common problem worldwide. In South Africa, the Medical Research Council conducted a study on workplace violence in the health care industry and reported that most respondents had experienced it in different forms. This study aimed to identify the types and causes of workplace violence toward nurses in Thulamela hospitals, Vhembe district. The study employed a quantitative approach using a cross-sectional design. The target population was all nurses working in one regional and two district hospitals in the municipality. The sample consisted of 100 randomly selected participants from each hospital giving a total sample size of 300. Prior to the data collection, an ethical clearance and written informed consent were obtained from each participant. Data were collected using a self-administered questionnaire. Analysis was done using SPSS Version 20.0. The study revealed that 85% of the respondents (255) had experienced workplace violence in the last 12 months with a range of 95% for threats to 60% for bullying. Regarding the gender of the perpetrators, females (71%) were the main perpetrators. This study concludes that workplace violence is a major occupational health issue in the district, most especially among the psychiatric nurses.

  15. Hospital solid waste management practices in Limpopo Province, South Africa: A case study of two hospitals

    International Nuclear Information System (INIS)

    Nemathaga, Felicia; Maringa, Sally; Chimuka, Luke

    2008-01-01

    The shortcomings in the management practices of hospital solid waste in Limpopo Province of South Africa were studied by looking at two hospitals as case studies. Apart from field surveys, the generated hospital waste was weighed to compute the generation rates and was followed through various management practices to the final disposal. The findings revealed a major policy implementation gap between the national government and the hospitals. While modern practices such as landfill and incineration are used, their daily operations were not carried according to minimum standards. Incinerator ash is openly dumped and wastes are burned on landfills instead of being covered with soil. The incinerators used are also not environmentally friendly as they use old technology. The findings further revealed that there is no proper separation of wastes according to their classification as demanded by the national government. The mean percentage composition of the waste was found in the following decreasing order: general waste (60.74%) > medical waste (30.32%) > sharps (8.94%). The mean generation rates were found to be 0.60 kg per patient per day

  16. Notes from a field hospital south of Mosul.

    Science.gov (United States)

    Quinn V, John M; Amouri, Omar F; Reed, Pete

    2018-03-06

    This short letter from the field is offered as a rapid communiqué of the emergency medical situation in Mosul and surrounding areas on the eve of the final onslaught to liberate the city. This letter is based on emergency medical work at two World Health Organization (WHO) and Ministry of Health (MoH) Iraq lead Role II+ Field Hospital facilities south of Mosul City from April to June 2017; these facilities are currently and temporarily managed and administered by private medical industry until full handover to MoH Iraq, with WHO support and expert facilitation. The prominence of non-state actors in the conflict, using hybrid warfare tactics that maximize casualties, makes health security a particular challenge for the global community. This challenge requires health leaders and other actors in the region to set clear strategic goals that support public health of the many millions displaced, maimed and affected by the war. Whether in clinical medicine, development, peace and stability operations, or global health diplomacy, the shared values and conviction to best serve vulnerable communities and mitigate morbidity must embrace the lessons of evidenced based practice derived from military medical experience. WHO is leading the charge in disaster response for the conflict in Iraq, and many challenges remain. This might also include developing a new process in emergency medical response that utilizes private contracting to improve efficiency in delivery and overall sustainability.

  17. Comparison of the Efficacy of Serum Creatinine and Microalbuminuria in Early Diagnosis of Renal Injury in Asphyxiated Infants in Calabar, Southern Nigeria

    Directory of Open Access Journals (Sweden)

    Sunny Oteikwu Ochigbo

    2017-06-01

    Full Text Available Background: Microalbuminuria and serum creatinine are the specific markers of acute renal injury. Perinatal asphyxia is responsible for 50% of all neonatal deaths and nonoliguric acute renal injuryis one of its complications. This study was undertaken to determine the efficacy of serum creatinine and microalbuminuria for early diagnosis of renal injury in severely asphyxiated neonates in Calabar, Nigeria.Methods: This prospective cross-sectional study was performed among severely asphyxiated newborns admitted into the neonatal wards of the University of Calabar Teaching Hospital (UCTH. Standard methods for the determination of blood urea and electrolyte were executed. Micral-test strips have been applied using urine dipstick and the result of the test was negative only for albumin. The developed colors have been compared five minutes after the first test.Results: Fifty full-term newborns were enrolled and their serum electrolytes, creatinine and the creatinine clearance were essentially normal. Six neonates demonstrated positive results in the microalbominuria assessment, while the rest were negative in this regard. The test has 0% sensitivity and 100% specificity, while the positive and negative predictive values were 0% and 88%, respectively.Conclusion: Microalbuminuria is not a useful marker for early diagnosis of acute renal failure in the newborns with severe prenatal asphyxia, but further studies are recommended.

  18. Medical costs, Cesarean delivery rates, and length of stay in specialty hospitals vs. non-specialty hospitals in South Korea.

    Directory of Open Access Journals (Sweden)

    Seung Ju Kim

    Full Text Available Since 2011, specialty hospitals in South Korea have been known for providing high- quality care in specific clinical areas. Much research related to specialty hospitals and their performance in many such areas has been performed, but investigations about their performance in obstetrics and gynecology are lacking. Thus, we aimed to compare specialty vs. non-specialty hospitals with respect to mode of obstetric delivery, especially the costs and length of stay related to Cesarean section (CS procedures, and to provide evidence to policy-makers for evaluating the success of hospitals that specialize in obstetric and gynecological (OBGYN care.We obtained National Health Insurance claim data from 2012 to 2014, which included information from 418,141 OBGYN cases at 214 hospitals. We used a generalized estimating equation model to identify a potential association between the likelihood of CS at specialty hospitals compared with other hospitals. We also evaluated medical costs and length of stay in specialty hospitals according to type of delivery.We found that 150,256 (35.9% total deliveries were performed by CS. The odds ratio of CS was significantly lower in specialty hospitals (OR: 0.95, 95% CI: 0.93-0.96compared to other hospitals Medical costs (0.74% and length of stay (1% in CS cases increased in specialty hospitals, although length of stay following vaginal delivery was lower (0.57% in specialty hospitals compared with other hospitals.We determined that specialty hospitals are significantly associated with a lower likelihood of CS delivery and shorter length of stay after vaginal delivery. Although they are also associated with higher costs for delivery, the increased cost could be due to the high level of intensive care provided, which leads to improve quality of care. Policy-makers should consider incentive programs to maintain performance of specialty hospitals and promote efficiency that could reduce medical costs accrued by patients.

  19. The push factors of intra-urban residential mobility in Calabar, Nigeria

    African Journals Online (AJOL)

    The paper takes a critical look at the push factors of intra-urban residential mobility in Calabar. Push factors are defined as those which operate to induce or encourage households to change their residence in the city. The paper notes that changing of residence by urban households in Western cities is a common ...

  20. Strategies for School Environmental Management in Nigerian Secondary Schools: A Case of Calabar, Nigeria

    Science.gov (United States)

    Obong, Linus Beba; Okey, Stella-Maris; Aniah, E. J.; Okaba, Lydia A.

    2010-01-01

    This paper on strategies for school environmental management in Nigerian secondary schools was carried out in Calabar, Nigeria. To guide the study three research questions were formulated. This was achieved through administration of structured questionnaires in three randomly sampled schools. Findings show regular grass clearing, sweeping of the…

  1. rainfall runoff model for cala noff model for calabar metropolis u

    African Journals Online (AJOL)

    eobe

    developed for drains design and analysis for Calabar. Keywords: .... urban growth has, over the years, resulted in land use changes and ... network, reduce the flood storage and overwhelm the carrying ... quality issues, as well as regional issues [3]. Storm water ..... SWAT: Case Study Of Upstream watershed of Jebba.

  2. The Role of Health Education on Breast Cancer Awareness among University of Calabar Female Undergraduates

    Science.gov (United States)

    Asuquo, I. M.; Olajide, T. E.

    2015-01-01

    The study sought to determine the role of health education on breast cancer awareness among University of Calabar female undergraduates. To achieve the purpose of the study, three hypotheses were formulated to guide the study. Related literature was reviewed, while a survey research design was adopted for the study. Appropriately develop and…

  3. Environmental Awareness and School Sanitation in Calabar Metropolis of Cross Rivers State, Nigeria

    Science.gov (United States)

    Anijaobi-Idem, F. N.; Ukata, B. N.; Bisong, N. N

    2015-01-01

    This descriptive survey designed study explored the influence of environmental awareness on secondary school sanitation in Calabar Metropolis. 1 hypothesis was formulated to direct the investigation. 300 subjects made up of 30 principals and 270 teachers constituted the sample drawn from the population of principals and teachers in secondary…

  4. Marketing Strategies and Students' Enrolment in Private Secondary Schools in Calabar Municipality, Cross River State, Nigeria

    Science.gov (United States)

    Uchendu, Chika C.; Nwafor, Innocent A.; Nwaneri, Mary G.

    2015-01-01

    The study investigated marketing strategies and students' enrolment in private secondary schools in Calabar Municipality, Cross River State. One research question was raised and two null hypotheses formulated to guide the study. Thirty two (32) school administrators in 32 private secondary schools in the study area constitute the study population…

  5. Accidental childhood poisoning in Calabar at the turn of the 20 th ...

    African Journals Online (AJOL)

    Background: Accidental poisoning is a preventable cause of childhood morbidity and mortality. Therefore, knowledge of the common causative agents is necessary in order to create awareness among caregivers towards its prevention. Objectives: To document the pattern of accidental childhood poisoning in Calabar from ...

  6. The profile of meningitis in a tertiary paediatric hospital in South Africa

    African Journals Online (AJOL)

    Background. Meningitis in children is a major health problem worldwide, leading to high rates of mortality and morbidity. Objectives. To describe the profile of patients treated for meningitis at a leading tertiary paediatric hospital (Red Cross War Memorial Children's Hospital) in South Africa. Methods. This study describes all ...

  7. A case study investigation of the indoor environmental noise in four urban South African hospitals

    CSIR Research Space (South Africa)

    Van Reenen, CA

    2015-11-01

    Full Text Available This multiple case study was designed to investigate acoustics in multi-bed general wards in four urban South African hospitals. Evidence-based research shows that a quiet indoor environment has positive outcomes for hospital patients and staff...

  8. Influences on hospital admission for asthma in south Asian and white adults: qualitative interview study.

    Science.gov (United States)

    Griffiths, C; Kaur, G; Gantley, M; Feder, G; Hillier, S; Goddard, J; Packe, G

    2001-10-27

    To explore reasons for increased risk of hospital admission among south Asian patients with asthma. Qualitative interview study using modified critical incident technique and framework analysis. Newham, east London, a deprived area with a large mixed south Asian population. 58 south Asian and white adults with asthma (49 admitted to hospital with asthma, 9 not admitted); 17 general practitioners; 5 accident and emergency doctors; 2 out of hours general practitioners; 1 asthma specialist nurse. Patients' and health professionals' views on influences on admission, events leading to admission, general practices' organisation and asthma strategies, doctor-patient relationship, and cultural attitudes to asthma. South Asian and white patients admitted to hospital coped differently with asthma. South Asians described less confidence in controlling their asthma, were unfamiliar with the concept of preventive medication, and often expressed less confidence in their general practitioner. South Asians managed asthma exacerbations with family advocacy, without systematic changes in prophylaxis, and without systemic corticosteroids. Patients describing difficulty accessing primary care during asthma exacerbations were registered with practices with weak strategies for asthma care and were often south Asian. Patients with easy access described care suggesting partnerships with their general practitioner, had better confidence to control asthma, and were registered with practices with well developed asthma strategies that included policies for avoiding hospital admission. The different ways of coping with asthma exacerbations and accessing care may partly explain the increased risk of hospital admission in south Asian patients. Interventions that increase confidence to control asthma, confidence in the general practitioner, understanding of preventive treatment, and use of systemic corticosteroids in exacerbations may reduce hospital admissions. Development of more sophisticated

  9. Management of snakebites at a rural South African hospital

    African Journals Online (AJOL)

    antivenom, inappropriate first aid, the regional effects of envenomation ... is crucial for primary care physicians to be familiar with the most common venomous snakes in South Africa and the ..... Pediatric and Neonatal Emergency Care.

  10. Work-related well-being of South African hospital pharmacists

    Directory of Open Access Journals (Sweden)

    Sebastiaan Rothmann

    2011-06-01

    Research purpose: The objective of this study was to investigate whether job stress and coping strategies could predict the work-related well-being (burnout and work engagement of hospital pharmacists in South Africa. Motivation for the study: Information about the work-related well-being and coping strategies of hospital pharmacists could be used to plan individual and organisational interventions which can be used to retain them and to manage their well-being and performance. Research design, approach and method: A survey design was used. A stratified random sample (N = 187 of pharmacists in South African hospitals was studied. The Maslach Burnout Inventory – Human Services Survey, Utrecht Work Engagement Scale, Pharmacist Stress Inventory and the COPE questionnaire were administered. Main findings: The results showed that job related stress and three coping strategies (approach coping, avoidant coping, and turning to religion predicted burnout and work engagement of South African hospital pharmacists. Practical implications: Job stressors that are in the main responsible for the unfavourable work environment and that lead to the development of burnout amongst hospital pharmacists should be addressed. It is also important to enhance the coping capabilities of the hospital pharmacists. Contribution/value-add: The findings of this study provide insight into the factors impacting on the work-related well-being of hospital pharmacists in South Africa.

  11. The relationship between bed size and profitability in South Carolina hospitals.

    Science.gov (United States)

    Kim, Yang K; Glover, Saundra H; Stoskopf, Carleen H; Boyd, Suzan D

    2002-01-01

    The purpose of the study is to identify factors affecting hospital profitability and to find the optimal hospital bed size that assures maximum profit. This is a cross-sectional study using survey data obtained from acute care hospitals in South Carolina in 1997. The relationship of hospital profitability and hospital bed size revealed that when bed size increases, hospital profitability increases, decreases, and then increases again. For the patient profit proportion, the turning points in bed size are 238.22 and 560.08. For the total profit proportion, the turning points in bed size are 223.31 and 503.86. The results on the relationship between bed size and hospital profitability indicate that medium-size hospitals have less profitability.

  12. Management of incomplete abortions at South African public hospitals

    African Journals Online (AJOL)

    Journal Home > Vol 87, No 4 (1997) > ... Length of hospital stay, details of medical management, details of surgical ... Of these, 767 (95.9%) were in hospital for 1 day or more, and 753 (95.3%) women underwent evacuation of the uterus.

  13. Prevalence of Legionella spp. in water systems of hospitals and hotels in South Western Greece.

    Science.gov (United States)

    Fragou, K; Kokkinos, P; Gogos, C; Alamanos, Y; Vantarakis, A

    2012-01-01

    The aim of the present study was to determine the prevalence of Legionella spp. in water systems of hospitals and hotels located in South Western Greece, to study the molecular epidemiology of the isolated strains and their possible association with bacterial contamination (total count and Pseudomonas aeruginosa), the water pH, and temperature. A prevalence survey for Legionella spp. by culturing techniques in water distribution systems of eight hospitals and nine hotels occurred in South Western Greece. Water sampling and microbiological analysis were carried out following the ISO methods. Legionella pneumophila was detected in 33% and 36% of the distribution systems of hospitals and hotels, respectively. Our survey results suggest a frequent prevalence of elevated concentrations of Legionella spp. in water systems of hospitals and hotels. Our investigation has confirmed the need to regularly monitor the microbiological condition of water systems in hospitals and hotels.

  14. Hilton's Rest and Pain, Guy's Hospital personalities and Guy's South ...

    African Journals Online (AJOL)

    H Dubovsky. Guy's Hospital occupies a unique position in medical history. John Hilton (1805 ... unsuitability of temperament, became a leading English poet. ... existed at the time a keen competitive rugby league among ... rugby football side.

  15. Childhood liver diseases in Ga-Rankuwa Hospital, South Africa ...

    African Journals Online (AJOL)

    Rankuwa Hospital Histopathology Laboratory. Design: A retrospective study. Setting: Ga-Rankuwa Histopathology Laboratory. Subjects: Seventy two patients who underwent a liver biopsy during the study period. Methods: Laboratory records ...

  16. The development of hospitalbased palliative care services in public hospitals in the Western Cape South Africa

    Directory of Open Access Journals (Sweden)

    L Gwyther

    2018-02-01

    Full Text Available With the recent approval of a South African (SA National Policy Framework and Strategy for Palliative Care by the National Health Council, it is pertinent to reflect on initiatives to develop palliative care services in public hospitals. This article reviews the development of hospital-based palliative care services in the Western Cape, SA. Palliative care services in SA started in the non-governmental sector in the 1980s. The first SA hospital-based palliative care team was established in Charlotte Maxeke Johannesburg Academic Hospital in 2001. The awareness of the benefit of palliative care in the hospital setting led to the development of isolated pockets of excellence providing palliative care in the public health sector in SA. This article describes models for palliative care at tertiary, provincial and district hospital level, which could inform development of hospital-based palliative care as the national policy for palliative care is implemented in SA.

  17. The activities of hospital nursing unit managers and quality of patient care in South African hospitals: a paradox?

    Directory of Open Access Journals (Sweden)

    Susan J. Armstrong

    2015-05-01

    Full Text Available Background: Improving the quality of health care is central to the proposed health care reforms in South Africa. Nursing unit managers play a key role in coordinating patient care activities and in ensuring quality care in hospitals. Objective: This paper examines whether the activities of nursing unit managers facilitate the provision of quality patient care in South African hospitals. Methods: During 2011, a cross-sectional, descriptive study was conducted in nine randomly selected hospitals (six public, three private in two South African provinces. In each hospital, one of each of the medical, surgical, paediatric, and maternity units was selected (n=36. Following informed consent, each unit manager was observed for a period of 2 hours on the survey day and the activities recorded on a minute-by-minute basis. The activities were entered into Microsoft Excel, coded into categories, and analysed according to the time spent on activities in each category. The observation data were complemented by semi-structured interviews with the unit managers who were asked to recall their activities on the day preceding the interview. The interviews were analysed using thematic content analysis. Results: The study found that nursing unit managers spent 25.8% of their time on direct patient care, 16% on hospital administration, 14% on patient administration, 3.6% on education, 13.4% on support and communication, 3.9% on managing stock and equipment, 11.5% on staff management, and 11.8% on miscellaneous activities. There were also numerous interruptions and distractions. The semi-structured interviews revealed concordance between unit managers’ recall of the time spent on patient care, but a marked inflation of their perceived time spent on hospital administration. Conclusion: The creation of an enabling practice environment, supportive executive management, and continuing professional development are needed to enable nursing managers to lead the provision

  18. Oesophageal squamous cell cancer in a South African tertiary hospital

    African Journals Online (AJOL)

    Background. Oesophageal cancer is the eighth most common cancer .... patients from the entire eastern seaboard of South Africa. Patients ... a school graduate and a household income of more than R10 .... (p = 0.63); however a significant difference in dental care .... Coping with esophageal cancer approaches worldwide.

  19. Oesophageal squamous cell cancer in a South African tertiary hospital

    African Journals Online (AJOL)

    The site of tumour location was in the middle 96 (60.4%), distal 42(26.4%) and proximal 17(10.6%) oesophagus. The male to female ratio was 1:1 ... with HIV negative patients. Key words: Oesophageal cancer, squamous cell cancer, HIV, dental hygiene, socioeconomic status, South Africa, esophageal cancer, risk factors ...

  20. Factors predisposing to low birth weight in Jimma Hospital South ...

    African Journals Online (AJOL)

    Background: Low birth weight continues to remain a major public health problem in Ethiopia in contrast to what is observed in many developing countries. Objectives: To assess some of the predisposing factors to low birth weight among deliveries in Jimma hospital. Design: Cross-sectional case referent study.

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

    African Journals Online (AJOL)

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

  2. Glass injuries seen in the emergency department of a South African district hospital

    OpenAIRE

    Nzaumvila, Doudou; Govender, Indiran; Kramer, Efraim B.

    2015-01-01

    BACKGROUND: The emergency department of Embhuleni Hospital frequently manages patients with glass-related injuries. This study assessed these injuries and the glass that caused them in more detail. AIM: The objectives of our study included determining the type of glass causing these injuries and describing the circumstances associated with different types of glass injuries. SETTING: The emergency department of Embhuleni Hospital in Elukwatini, Mpumalanga province, South Africa. METHODS: This ...

  3. Disciplinary Procedures Used by Secondary School Teachers in Calabar Municipality, Nigeria

    OpenAIRE

    N. N. Nkomo; M. L. Mayanchi

    2016-01-01

    The present study investigated various forms of disciplinary procedures or punishment used by teachers in secondary schools in Calabar Municipality, Nigera. There are agitations amongst parents and educators on the use of corporal punishment as a disciplinary measure against children. Those against the use of corporal punishment argue that this form of punishment does not teach, it only terminates behaviour temporarily and inculcates violence. Those in support are of the view that corporal pu...

  4. Malaria: Knowledge and prevention practices among school adolescents in a coastal community in Calabar, Nigeria

    Directory of Open Access Journals (Sweden)

    Ndifreke E. Udonwa

    2010-04-01

    Objectives: To determine the malaria prevention practices of school adolescents in the coastal community of Calabar, Nigeria. Method: This was a cross-sectional survey involving secondary schools in southern Calabar. Four hundred adolescents were randomly selected from the 4565 learners in 5 out of 17 secondary schools in southern Calabar, Cross River State, Nigeria. A self-administered, semi-structured questionnaire was administered to the respondents. Results: Most respondents (77.5% were aware that the vector transmits the malaria parasite through biting. Fewer respondents would prevent malaria attacks by clearing the vegetation in the peri-domestic environment (13.5%, filling up potholes (16.9%, opening up drainage (11%, using insecticide-treated nets (25.7% or using antimalarial drugs (11.2%. Less than one-tenth (8% would use various other methods such as not accepting unscreened blood, while only 11% obtained the information from their teachers. Conclusion: The study identified knowledge gaps among school children. There is a need to empower teachers with information about the cause of malaria and prevention strategies.

  5. Community/hospital indicators in South African public sector mental health services.

    Science.gov (United States)

    Lund, Crick; Flisher, Alan J

    2003-12-01

    The need to balance resources between community and hospital-based mental health services in the post-deinstitutionalisation era has been well-documented. However, few indicators have been developed to monitor the relationship between community and hospital services, in either developed or developing countries. There is a particular need for such indicators in the South African context, with its history of inequitable services based in custodial institutions under apartheid, and a new policy that proposes the development of more equitable community-based care. Indicators are needed to measure the distribution of resources and the relative utilisation of community and hospital-based services during the reform process. These indicators are potentially useful for assessing the implementation of policy objectives over time. To develop and document community/hospital indicators in public sector mental health services in South Africa. A questionnaire was distributed to provincial mental health coordinators requesting numbers of full-time equivalent (FTE) staff who provide mental health care at all service levels, annual patient admissions to hospitals and annual patient attendances at ambulatory care facilities. The information was supplemented by consultations with mental health coordinators in each of the 9 provinces. Population data were obtained from preliminary findings of the 1996 census. The community/hospital indicator measuring staff distribution was defined as the ratio of staff employed in community settings to all staff, expressed as a percentage. The community/hospital indicator measuring patient service utilisation was defined as the ratio of the annual ambulatory care attendance rate per 100,000 population to the sum of this rate and the annual hospital admission rate per 100,000 population, expressed as a percentage. Of psychiatric public sector staff, 25% are located in community settings in South Africa (provincial range: 11-70%). If hospital outpatient

  6. The opinion of patients at a local South Africa teaching hospital on ...

    African Journals Online (AJOL)

    Objectives: This study aimed to determine how South African patients at a regional state hospital perceived the practice of physicians accepting gifts from the pharmaceutical industry. The physician-patient relationship is built on trust, with an understanding that the physician will act ethically and in patients' best interests.

  7. A review of governance of maternity services at South Tipperary general hospital

    LENUS (Irish Health Repository)

    Flory, David

    2015-09-01

    This review of the governance of maternity services at South Tipperary General Hospital has focussed on the systems and processes for assurance of service quality, risk management and patient safety primarily inside the hospital but also in the Hospital Group structure within which it operates. The effectiveness of the governance arrangements is largely determined by the quality of the leadership and management – both clinical and general – which designs, implements, and oversees those systems and processes and is ultimately responsible and accountable.\\r\

  8. Exploring interhospital transfers and partnerships in the hospital sector in New South Wales, Australia.

    Science.gov (United States)

    Assareh, Hassan; Achat, Helen M; Levesque, Jean-Frederic; Leeder, Stephen R

    2017-12-01

    Objective The aim of the present study was to explore characteristics of interhospital transfers (IHT) and sharing of care among hospitals in New South Wales (NSW), Australia. Methods Data were extracted from patient-level linked hospital administrative datasets for separations from all NSW acute care hospitals from 1 July 2013 to 30 June 2015. Patient discharge and arrival information was used to identify IHTs. Characteristics of patients and related hospitals were then analysed. Results Transfer-in patients accounted for 3.9% of all NSW admitted patients and, overall, 7.3% of NSW admissions were associated with transfers (IHT rate). Patients with injuries and circulatory system diseases had the highest IHT rate, accounting for one-third of all IHTs. Patients were more often transferred to larger than smaller hospitals (61% vs 29%). Compared with private hospitals, public hospitals had a higher IHT rate (8.4% vs 5.1%) and a greater proportion of transfer-out IHTs (52% vs 28%). Larger public hospitals had lower IHT rates (3-8%) compared with smaller public hospitals (13-26%). Larger public hospitals received and retransferred higher proportions of IHT patients (52-58% and 11% respectively) than their smaller counterparts (26-30% and 2-3% respectively). Less than one-quarter of IHTs were between the public and private sectors or between government health regions. The number of interacting hospitals and their interactions varied across hospital peer groups. Conclusion NSW IHTs were often to hospitals with greater speciality services. The patterns of interhospital interactions could be affected by organisational and regional preferences. What is known about the topic? IHTs aim to provide efficient and effective care. Nonetheless, information on transfers and the sharing of care among hospitals in an Australian setting is lacking. Studies of transfers and hospital partnership patterns will inform efforts to improve patient-centred transfers and hospital accountability

  9. Parasuicide among youth in a general hospital in South Africa

    Directory of Open Access Journals (Sweden)

    T Mhlongo

    1999-09-01

    Full Text Available Parasuicide cases among youth (15-24 years referred to the clinical psychology section of a regional hospital from 1995 to 1998 were reviewed. In all 100 cases (37 males and 63 females were identified being about 10% of the caseload. As part of the clinical psychological assessment sociodemographic, clinical characteristics, trigger factors, employed methods and suicide intentions were analysed. Most patients were students (79% or unemployed (16%. The major method employed to attempt suicide was ingestion of harmful substances (like paraffin, pesticides or battery acid(73%. Acute social conflicts (38%, socio-economic deprivation (17%, AIDS phobia (17%, academic failure (14%, teenage pregnancy (10% and mental illness (5% triggered suicide attempts. Fifty-eight percent of the attempts were categorised as demonstrative and 27% as genuine. The psychodynamics of parasuicides are discussed in case studies and with reference to other studies.

  10. Safety climate and attitude toward medication error reporting after hospital accreditation in South Korea.

    Science.gov (United States)

    Lee, Eunjoo

    2016-09-01

    This study compared registered nurses' perceptions of safety climate and attitude toward medication error reporting before and after completing a hospital accreditation program. Medication errors are the most prevalent adverse events threatening patient safety; reducing underreporting of medication errors significantly improves patient safety. Safety climate in hospitals may affect medication error reporting. This study employed a longitudinal, descriptive design. Data were collected using questionnaires. A tertiary acute hospital in South Korea undergoing a hospital accreditation program. Nurses, pre- and post-accreditation (217 and 373); response rate: 58% and 87%, respectively. Hospital accreditation program. Perceived safety climate and attitude toward medication error reporting. The level of safety climate and attitude toward medication error reporting increased significantly following accreditation; however, measures of institutional leadership and management did not improve significantly. Participants' perception of safety climate was positively correlated with their attitude toward medication error reporting; this correlation strengthened following completion of the program. Improving hospitals' safety climate increased nurses' medication error reporting; interventions that help hospital administration and managers to provide more supportive leadership may facilitate safety climate improvement. Hospitals and their units should develop more friendly and intimate working environments that remove nurses' fear of penalties. Administration and managers should support nurses who report their own errors. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. Intimate partner violence, psychopathology and the women with schizophrenia in an outpatient clinic South-South, Nigeria.

    Science.gov (United States)

    Afe, Taiwo Opekitan; Emedoh, Thomas Chimezie; Ogunsemi, Olawale; Adegbohun, Abosede Adekeji

    2016-06-10

    Women with schizophrenia are a vulnerable risk group for intimate partner violence (1PV). There are few surveys that highlight the pattern, prevalence and association of IPV with psychopathology in these vulnerable group of women in South-South Nigeria. The aim of the study was to survey the forms, prevalence and association of Intimate partner violence with psychopathology. The study was a cross-sectional survey of 77 female patients diagnosed with schizophrenia who were outpatients at the Federal Neuro-psychiatric Hospital, Calabar, Cross-River State in South-South region of Nigeria. A total of 58 out of 77 (75 %) reported at least a form of IPV, Verbal abuse was the most prevalent form of IPV reported by participants (73 %, n = 56). Women who were younger were more likely to report verbal and sexual assault at p psychopathology. There is a need to identify risk of IPV among this vulnerable group by routine enquiry by clinicians' and plan therapy accordingly. Holistic management is needed in management of victims in their care.

  12. Planned home and hospital births in South Australia, 1991-2006: differences in outcomes.

    Science.gov (United States)

    Kennare, Robyn M; Keirse, Marc J N C; Tucker, Graeme R; Chan, Annabelle C

    2010-01-18

    To examine differences in outcomes between planned home births, occurring at home or in hospital, and planned hospital births. Population-based study using South Australian perinatal data on all births and perinatal deaths during the period 1991-2006. Analysis included logistic regression adjusted for predictor variables and standardised perinatal mortality ratios. Perinatal death, intrapartum death, death attributed to intrapartum asphyxia, Apgar score home births accounted for 0.38% of 300,011 births in South Australia. They had a perinatal mortality rate similar to that for planned hospital births (7.9 v 8.2 per 1000 births), but a sevenfold higher risk of intrapartum death (95% CI, 1.53-35.87) and a 27-fold higher risk of death from intrapartum asphyxia (95% CI, 8.02-88.83). Review of perinatal deaths in the planned home births group identified inappropriate inclusion of women with risk factors for home birth and inadequate fetal surveillance during labour. Low Apgar scores were more frequent among planned home births, and use of specialised neonatal care as well as rates of postpartum haemorrhage and severe perineal tears were lower among planned home births, but these differences were not statistically significant. Planned home births had lower caesarean section and instrumental delivery rates, and a seven times lower episiotomy rate than planned hospital births. Perinatal safety of home births may be improved substantially by better adherence to risk assessment, timely transfer to hospital when needed, and closer fetal surveillance.

  13. Seasonal variation and trends in stroke hospitalizations and mortality in a South American community hospital.

    Science.gov (United States)

    Díaz, Alejandro; Gerschcovich, Eliana Roldan; Díaz, Adriana A; Antía, Fabiana; Gonorazky, Sergio

    2013-10-01

    Numerous studies have reported the presence of temporal variations in biological processes. Seasonal variation (SV) in stroke has been widely studied, but little data have been published on this phenomenon in the Southern Hemisphere, and there have been no studies reported from Argentina. The goals of the present study were to describe the SV of admissions and deaths for stroke and examine trends in stroke morbidity and mortality over a 3-year period in a community hospital in Argentina. Hospital discharge reports from the electronic database of vital statistics between 1999 and 2001 were examined retrospectively. Patients who had a main discharge diagnosis of stroke (ischemic or hemorrhagic) or cerebrovascular accident (International Classification of Diseases, Ninth Revision codes 431, 432, 434, and 436) were selected. The study sample included 1382 hospitalizations by stroke (3.5% of all admissions). In-hospital mortality demonstrated a winter peak (25.5% vs 17% in summer; P = .001). The crude seasonal stroke attack rate (ischemic and hemorrhagic) was highest in winter (164 per 100,000 population; 95% CI, 159-169 per 100,000) and lowest in summer (124 per 100,000; 95% CI, 120-127 per 100,000; P = .008). Stroke admissions followed a seasonal pattern, with a winter-spring predominance (P = .008). Our data indicate a clear SV in stroke deaths and admissions in this region of Argentina. The existence of SV in stroke raises a different hypothesis about the rationale of HF admissions and provides information for the organization of care and resource allocation. Copyright © 2013 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  14. HOSPITALIZATIONS DUE TO RESPIRATORY PROBLEMS DURING DIWALI FESTIVAL IN A TERTIARY CARE HOSPITAL IN SOUTH INDIA

    Directory of Open Access Journals (Sweden)

    Raghu

    2016-02-01

    Full Text Available BACKGROUND The burning of firecrackers during Diwali festival produces an adverse respiratory outcome. However, there are no published articles on the impact of fireworks on hospital admission due to acute respiratory issues, hospital stay, and respiratory mortality during Diwali in India. MATERIALS AND METHODS This was a prospective, open label, observational study. It was conducted in patients admitted to the pulmonary emergency unit with respiratory symptoms 15 days before and after Diwali. It was conducted after the approval of ethics committee and written informed consent. RESULTS The number of admissions post-Diwali were significantly more compared to pre-Diwali from both rural and urban locations (p<0.001. The mean duration of hospital stay was significantly less pre-Diwali (7.59±0.74 days compared to post-Diwali (9.46±0.44 days. Also, significantly increased number of patients required ventilator support post Diwali. CONCLUSION The findings from the present study validate the deterioration of respiratory health during Diwali festival in India. There should be more awareness campaigns about the harmful effects of fire-crackers. Patients suffering from respiratory problems should be advised to avoid heavy exposure to fireworks

  15. IAEA/WHO postal dose audits for radiotherapy hospitals in Eastern and South-Eastern Europe

    International Nuclear Information System (INIS)

    Izewska, J.; Vatnitsky, S.; Shortt, K.R.

    2004-01-01

    The IAEA/WHO TLD programme has been in operation for 34 years. In this period the calibration of approximately 5200 high-energy photon beams in over 1300 radiotherapy hospitals in 115 countries worldwide was checked. Of these, 18% of the audits were performed in Eastern and South-Eastern Europe. There are large contrasts in the region; while the results are very good for most countries, a few countries struggle with basic problems in dosimetry. The hospitals operating radiotherapy services without qualified medical physicists or dosimetry equipment have poorer results than those properly equipped and staffed. Only about 2/3 of TLD audit participants in Eastern Europe have the appropriate dosimetry equipment. To achieve consistency of the audit results within Eastern and South-Eastern Europe, strengthening of radiotherapy infrastructure in a few countries would be necessary. (authors)

  16. Nurse Interaction With Clients In Communication Therapeutic Study Analysis Of Symbolic Interactionism Hospital South Sulawesi

    OpenAIRE

    Hj.Indirawaty; Syamsuddin AB

    2015-01-01

    ABSTRACT This study aimed to describe briefly on the application of social interaction which made nurses to clients while performing therapeutic communication at the Hospital of South Sulawesi with frame symbolic interactionism. Result achieved against the system carried nurse interaction with clients who patterned on therapeutic communication. At the stage of pre-interaction system is applied such as before the nurse interacts with the client well in advance to prepare the way of dressing re...

  17. Pattern of cardiovascular admissions at Nnamdi Azikiwe University Teaching Hospital Nnewi, South East Nigeria

    OpenAIRE

    Osuji, Charles Ukachukwu; Onwubuya, Emmanuel Ikechukwu; Ahaneku, Gladys Ifesinachi; Omejua, Emeka Godwin

    2014-01-01

    Introduction Cardiovascular disease (CVD) is one of the top killer diseases in the world sparing neither developed or developing countries. The study was carried out to determine the pattern of cardiovascular admissions at Nnamdi Azikiwe University Teaching Hospital Nnewi South East Nigeria. Methods The study was a retrospective study covering the period January 2007 to December 2009. SPSS version 13 software was used to analyze data. Results 537 (15%) patients were admitted into the study ou...

  18. Prevalence of psychological distress and associated factors in urban hospital outpatients in South Africa

    Directory of Open Access Journals (Sweden)

    Karl Peltzer

    2012-02-01

    Full Text Available Objective. The aim of this study was to assess the prevalence of psychological distress and associated factors among outpatients in an urban hospital in South Africa. Method. A sample of 1 532 consecutively selected patients (56.4% men and 43.6% women from various hospital outpatient departments were interviewed with a structured questionnaire. Results. Based on assessment with the Kessler Psychological Distress Scale, a measure of psychological distress, 17.1% of the patients (15.5% of men and 19.4% of women had severe psychological distress. Logistic multiple regression identified no income, poor health status, migraine headache and tuberculosis as significant factors associated with severe psychological stress for men. For women the factors identified were lower education, no income, having been diagnosed with a sexually transmitted disease, stomach ulcer and migraine headache. Conclusion. The study found a high prevalence of psychological distress among hospital outpatients in South Africa. Brief psychological therapies for adult patients with anxiety, depression or mixed common mental health problems treated in hospital outpatient departments are indicated. Accurate diagnosis of co-morbid depressive and anxiety disorders in patients with chronic medical illness is essential in understanding the cause and optimising the management of somatic symptom burden.

  19. Development of nutrition standards and therapeutic diet specifications for public hospitals in New South Wales.

    Science.gov (United States)

    Williams, Peter; Hazlewood, Tanya; Pang, Glen

    2014-09-01

    In New South Wales (NSW), a new suite of nutrition standards for menus and specifications for therapeutic diets to be used in hospitals has been developed. These standards were required to facilitate centralised menu planning and food production, with the move to management of most hospital food services by HealthShare NSW, a state-wide business unit of NSW Health. The standards also aim to improve communication between health professionals, particularly with the increasing use of computerised meal-ordering systems. Nutrition standards have been developed for adult, paediatric and mental health inpatients, and specifications for 147 different adult and paediatric therapeutic diets. There is still significant variation in the nutrition standards for nutrition and therapeutic diets in hospitals across the Australian states, and a move to a more nationally harmonised approach would be welcome. Further research is required to examine the impact of these standards on operating efficiency and patient care outcomes.

  20. Anaesthesia and hospital links: strengthening healthcare through South-North hospital partnerships.

    Science.gov (United States)

    Parry, E H O; Percy, D B

    2007-12-01

    Health services can respond to the needs of the poorest people in developing countries if those who work in the front line of health care are supported and motivated and if development needs in services and training programmes can be filled. This can be achieved when a Health Link between a southern hospital and/or training school and its northern counterpart is designed to build a disciplined and long-term programme of staff development including the needs of anaesthetic services, which meets the needs identified by the southern partner. Development of anaesthetic practice is best carried out in the context of an institution-wide Health Link where not only the staff and systems involved in anaesthesia but all the essential 'back office' or support services are also supported and developed.

  1. Promoting Peace Education for Behaviourial Changes in Public Secondary Schools in Calabar Municipality Council Area, Cross River State, Nigeria

    Science.gov (United States)

    Uko, E. S.; Igbineweka, P. O.; Odigwe, F. N.

    2015-01-01

    This study aimed at investigating the promotion of peace education for behavioural changes in public secondary schools in Calabar Municipal Council Area of Cross River State. A descriptive survey design was adopted for the study. A set of questionnaire items were validated and used for the collection of data involving 310 respondents, selected…

  2. An essential hospital package for South Africa--selection criteria, costs and affordability.

    Science.gov (United States)

    Söderlund, N

    1999-07-01

    In 1995 the Committee of Enquiry into National Health Insurance (NHI) recommended that formally employed individuals and their employers be required to fund at least a minimum package of hospital cover for workers and their dependents. This has recently been echoed in a Department of Health policy paper on social health insurance. This research aims to define and cost a minimum package of essential hospital care for competing (public and private) health insurers in South Africa. CRITERIA FOR PACKAGE DEFINITION: Based on the objectives implict in the NHI Committee report, the following criteria were used to define the essential package: (i) the extent to which there was another appropriate responsible party who should pay for treatment; (ii) the degree of discretion in deciding whether or not to provide treatment (roughly equivalent to 'urgency'); and (iii) the cost and effectiveness of treatment. On the basis of the above criteria, 396 out of 598 possible interventions were included in the package. Using local mine hospital and private sector utilisation rates and mine hospital cost data, it was estimated that the essential inpatient package would cost around R502 per enrollee per year, using 1998 prices, for a working age population and their dependents. Age-sex standardised outpatient care costs in the mine hospital population studied were estimated at R183 per person per year. It was therefore estimated that the total inpatient and outpatient hospital package would cost around R685 per person per year. The results presented in this paper are intended to inform the process of defining a national essential hospital benefit package. Assuming that contributions were proportionally related to income, and that costs should not exceed 6% of wages, the package should be affordable to all of those earning above R20,000 per year. Significant additional work is required, firstly at a technical level to assess the appropriateness of the prioritization approach used here

  3. "A dictate of both interest and mercy"? Slave hospitals in the antebellum South.

    Science.gov (United States)

    Kenny, Stephen C

    2010-01-01

    As a contribution to debates on slave health and welfare, this article investigates the variety, functions, and overall significance of infirmaries for the enslaved in the antebellum South. Newspapers, case histories, and surviving institutional records of antebellum Southern infirmaries providing medical treatment for slaves offer a unique opportunity to examine the development of modern American medicine within the "peculiar institution," and to explore a complex site of interactions between the enslaved, physicians, and slave owners. The world of the medical college hospital in South Carolina and an experimenting clinic in Alabama are reconstructed using newspapers and medical case histories. The Patient Register of the Hotel Dieu (1859-64) and the Admission Book of Touro Infirmary (1855-60) are used to highlight the types of enslaved patients sent to these two New Orleans commercial hospitals and to explore connections between the practice of medicine and the business of slave trading in the city. In addition to providing physicians with a steady income, slave infirmaries were key players in the domestic slave trade, as well as mechanisms for professionalization and the mobilization of medical ideas in the American South.

  4. Seizure-related hospital admissions, readmissions and costs: Comparisons with asthma and diabetes in South Australia.

    Science.gov (United States)

    Bellon, Michelle L; Barton, Christopher; McCaffrey, Nikki; Parker, Denise; Hutchinson, Claire

    2017-08-01

    Seizures are listed as an Ambulatory Care Sensitive Condition (ACSC), where, in some cases, hospitalisation may be avoided with appropriate preventative and early management in primary care. We examined the frequencies, trends and financial costs of first and subsequent seizure-related hospital admissions in the adult and paediatric populations, with comparisons to bronchitis/asthma and diabetes admissions in South Australia between 2012 and 2014. De-identified hospital separation data from five major public hospitals in metropolitan South Australia were analysed to determine the number of children and adults admitted for the following Australian Refined Diagnosis Related Groups: seizure related conditions; bronchitis/asthma; and diabetes. Additional data included length of hospital stay and type of admission. Demographic data were analysed to identify whether social determinants influence admission, and a macro costing approach was then applied to calculate the financial costs to the Health Care System. The rate of total seizure hospitalizations was 649 per 100,000; lower than bronchitis/asthma (751/100,000), yet higher than diabetes (500/100,000). The highest proportions of subsequent separations were recorded by children with seizures regardless of complexity (47% +CSCC; 17% -CSCC) compared with asthma (11% +CSCC; 14% -CSCC) or diabetes (14% +CSCC; 13% -CSCC), and by adults with seizures with catastrophic or severe complications/comorbidity (25%), compared with diabetes (22%) or asthma (14%). The mean cost per separation in both children and adults was highest for diabetes (AU$4438/$7656), followed by seizures (AU$2408/$5691) and asthma (AU$2084/$3295). Following the lead of well-developed and resourced health promotion initiatives in asthma and diabetes, appropriate primary care, community education and seizure management services (including seizure clinics) should be targeted in an effort to reduce seizure related hospitalisations which may be avoidable

  5. A strategy for enhancing financial performance: a study of general acute care hospitals in South Korea.

    Science.gov (United States)

    Choi, Mankyu; Lee, Keon-Hyung

    2008-01-01

    In this study, the determinants of hospital profitability were evaluated using a sample of 142 hospitals that had undergone hospital standardization inspections by the South Korea Hospital Association over the 4-year period from 1998 to 2001. The measures of profitability used as dependent variables in this study were pretax return on assets, after-tax return on assets, basic earning power, pretax operating margin, and after-tax operating margin. Among those determinants, it was found that ownership type, teaching status, inventory turnover, and the average charge per adjusted inpatient day positively and statistically significantly affected all 5 of these profitability measures. However, the labor expenses per adjusted inpatient day and administrative expenses per adjusted inpatient day negatively and statistically significantly affected all 5 profitability measures. The debt ratio negatively and statistically significantly affected all 5 profitability measures, with the exception of basic earning power. None of the market factors assessed were shown to significantly affect profitability. In conclusion, the results of this study suggest that the profitability of hospitals can be improved despite deteriorating external environmental conditions by facilitating the formation of sound financial structures with optimal capital supplies, optimizing the management of total assets with special emphasis placed on inventory management, and introducing efficient control of fixed costs including labor and administrative expenses.

  6. Differences in Hospital Readmission Risk across All Payer Groups in South Carolina.

    Science.gov (United States)

    Chakraborty, Hrishikesh; Axon, Robert Neal; Brittingham, Jordan; Lyons, Genevieve Ray; Cole, Laura; Turley, Christine B

    2017-06-01

    To evaluate differences in hospital readmission risk across all payers in South Carolina (SC). South Carolina Revenue and Fiscal Affairs Office (SCRFA) statewide all payer claims database including 2,476,431 hospitalizations in SC acute care hospitals between 2008 and 2014. We compared the odds of unplanned all-cause 30-day readmission for private insurance, Medicare, Medicaid, uninsured, and other payers and examined interaction effects between payer and index admission characteristics using generalized estimating equations. SCRFA receives claims and administrative health care data from all SC health care facilities in accordance with SC state law. Odds of readmission were lower for females compared to males in private, Medicare, and Medicaid payers. African Americans had higher odds of readmission compared to whites across private insurance, Medicare, and Medicaid, but they had lower odds among the uninsured. Longer length of stay had the strongest association with readmission for private and other payers, whereas an increased number of comorbidities related to the highest readmission odds within Medicaid. Associations between index admission characteristics and readmission likelihood varied significantly with payer. Findings should guide the development of payer-specific quality improvement programs. © Health Research and Educational Trust.

  7. HIV-Related Medical Admissions to a South African District Hospital Remain Frequent Despite Effective Antiretroviral Therapy Scale-Up

    NARCIS (Netherlands)

    Meintjes, Graeme; Kerkhoff, Andrew D.; Burton, Rosie; Schutz, Charlotte; Boulle, Andrew; van Wyk, Gavin; Blumenthal, Liz; Nicol, Mark P.; Lawn, Stephen D.

    2015-01-01

    The public sector scale-up of antiretroviral therapy (ART) in South Africa commenced in 2004. We aimed to describe the hospital-level disease burden and factors contributing to morbidity and mortality among hospitalized HIV-positive patients in the era of widespread ART availability. Between June

  8. Contraceptive Awareness and Practice Among Antenatal Attendees in a Tertiary Hospital in South-South Nigeria

    Directory of Open Access Journals (Sweden)

    Aniekan Monday Abasiattai

    2011-02-01

    Full Text Available Background: Use of effective contraceptive methods has been shown to improve health, sexual life and partner relations and also significantly reduce maternal and infant mortality by protecting against unplanned pregnancy, high fertility and high parity. The aim of this study is to determine the degree of awareness and practice of contraception by women in Uyo, Nigeria. Materials and Methods: Semi-structured questionnaires were administered to three hundred and seventy women in the antenatal clinic of the University of Uyo Teaching Hospital. Results: Majority of the respondents were 21-30 years old (64.1%, 53.8% were multiparous and 66.5% had tertiary level education. Three hundred and twenty women (87.6% had heard about contraception (OR=49.6, P< 0.001, while only 49.5% of the respondents had practiced contraception previously (OR=0.96, P=0.76 of which the male condom (40.0% and the safe period/calendar method (31.1% were the most commonly practiced methods. Majority of the respondents (66.8% preferred to have 3 to 4 children and 78.4% of the respondents would want to used a method of contraception to either space their family or limit child bearing (OR=13.14, P< 0.001. Fear of side effects (20.0% and previous bad experience (8.8% were the most common reasons given by those respondents who would not want to practice contraception. Conclusion: This study reveals a high level of awareness of contraception but a significant unmet need among the respondents. There is need to intensify public enlightenment campaigns in our environment emphasizing the benefits and safety of modern contraceptive methods. Community leaders and heads of social groups and women organisations should be co-opted in the dissemination of accurate information on contraception. [TAF Prev Med Bull 2011; 10(1.000: 29-34

  9. Combined Oral Contraceptive Pills: Profile of Acceptors in a Tertiary Hospital in South-South Nigeria.

    Science.gov (United States)

    Abasiattai, A M; Utuk, M N; Ojeh, S O; Eyo, U E

    2011-01-01

    BACKGROUND: Combined oral contraceptive pills were the first contraceptive method to provide sexual freedom of choice for women through reliable, personal and private control of fertility. They are the most widely used hormonal contraceptives and also the most popular non-surgical method of contraception. OBJECTIVE: To review the profile of acceptors of combined oral contraceptive pills at the University of Uyo Teaching Hospital, Uyo. METHODOLOGY: An 8 year review of all clients that accepted combined oral contraceptive pills in the family planning clinic. RESULTS: There were 1,146 new contraceptive acceptors during the period of study out of which 309 (27.9%) accepted the pills. Majority of the clients were between 20 and 29 years of age (54.0%), were multiparous (72.8%), Christians (99.7%) and 61.2% had tertiary level education. Two hundred and fifty-five women (82.5%) desired to use combined oral contraceptive pills to space births while 7.8% wanted to limit child bearing. There was a high discontinuation rate among the women (45.0%) and out of these 87.9% of the clients changed to other contraceptive methods. All the clients commenced their pills within seven days of menstruation and only the low dose monophasic preparations were available in the family planning unit and thus were given to the clients. CONCLUSION: Women who accept to initiate combined oral contraceptive pills in our center are young, well educated, multiparous women who want to space their pregnancies. However, due to the high discontinuation rate among the clients, there is need for further studies evaluating reasons for the high discontinuation rate, exploring interactions between clients and providers' and also providers' attitude towards combined pills in our environment.

  10. Geothermal heating project at St. Mary's Hospital, Pierre, South Dakota. Final report

    Energy Technology Data Exchange (ETDEWEB)

    1984-12-01

    St. Mary's Hospital, Pierre, South Dakota, with the assistance of the US Department of Energy, drilled a 2176 ft well into the Madison Aquifer ot secure 108/sup 0/F artesian flow water at 385 gpm (475 psig shut-in pressure). The objective was to provide heat for domestic hot water and to space heat 163,768 sq. ft. Cost savings for the first three years were significant and, with the exception of a shutdown to replace some corroded pipe, the system has operated reliably and continuously for the last four years.

  11. Pattern of sudden death at Ladoke Akintola University of Technology Teaching Hospital, Osogbo, South West Nigeria

    Directory of Open Access Journals (Sweden)

    Akinwusi PO

    2013-06-01

    Full Text Available Patience Olayinka Akinwusi,1,2 Akinwumi Oluwole Komolafe,3 Olanrewaju Olayinka Olayemi,2 Adeleye Abiodun Adeomi41Department of Medicine, College of Health Sciences, Osun State University, 2Department of Medicine, LAUTECH Teaching Hospital, Osogbo, 3Department of Morbid Anatomy, Obafemi Awolowo University Teaching, Hospitals Complex, Ile-Ife, Osun State, 4Department of Community Medicine, LAUTECH Teaching Hospital, Ogbomoso, Oyo State, NigeriaBackground: The purpose of this study was to determine the etiology and epidemiologic characteristics of sudden death at Ladoke Akintola University of Technology (LAUTECH Teaching Hospital, South West Nigeria.Methods: This was a retrospective descriptive study of all cases of natural unexpected death, either occurring out of hospital or less than 24 hours after admission to LAUTECH Teaching Hospital, over a nine-year period from January 2003 to December 2011. Data were generated from information in the case notes and autopsy reports for these cases.Results: Sudden death accounted for 29 (4.0% of 718 adult medical deaths and 1.0% of all adult medical admissions. Out-of-hospital deaths occurred in 72.4% of cases. The mean age of the patients was 46.8 ± 11.5 (range 25–74 years. The male to female ratio was 6.25:1. Cardiovascular disease were the most common cause of death (51.7%, followed by respiratory disease (20.7%, pulmonary thromboembolism (10.4%, central nervous system disease (13.8%, gastrointestinal disorders (13.8%, severe chemical/drug poisoning (13.8%, and combined cardiovascular and central nervous system disease (13.8%. Hypertension-related causes were responsible for 14/29 (48.3% of the sudden deaths. Hypertensive heart disease accounted for 86.7% of the cardiovascular deaths, hypertensive heart failure accounted for 73.3%, whilst all heart failure cases accounted for 80.0%. Left ventricular hypertrophy was present in 69.2% of the patients with hypertensive heart disease. Moderate to severe

  12. Hospital Nurses' Competencies in Disaster Situations: A Qualitative Study in the South of Brazil.

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    Marin, Sandra M; Witt, Regina R

    2015-12-01

    Introduction Hospital nurses play a key role in the aftermath of the occurrence of disasters and need specific competencies to work in these situations. From a global perspective, few models exist that focus on disaster nursing. This study aimed to identify hospital nurses' competencies in disaster situations. A qualitative, descriptive, exploratory study was developed using focus groups as a method of data collection. Three meetings were held from June through September 2012 with nurses who worked at a hospital used as reference for disaster situations in the South of Brazil. Thematic analysis of collected data generated the competencies. For statement standardization, a format consistent with a verb, a noun, and a complement was adopted. The group validated 17 competencies, which were organized according to the phases of emergency management described by the World Health Organization (WHO) and classified in domain areas of management, health care, communication, and education. The competencies identified in this study can contribute to the education and practice of nurses in the hospital ambience, strengthening its capacity to face disaster situations.

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

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    Sang Heon Lee

    2017-01-01

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

  14. Psychiatric hospital beds and prison populations in South America since 1990: does the Penrose hypothesis apply?

    Science.gov (United States)

    Mundt, Adrian P; Chow, Winnie S; Arduino, Margarita; Barrionuevo, Hugo; Fritsch, Rosemarie; Girala, Nestor; Minoletti, Alberto; Mitkiewicz, Flávia; Rivera, Guillermo; Tavares, María; Priebe, Stefan

    2015-02-01

    In 1939, English mathematician, geneticist, and psychiatrist Lionel Sharples Penrose hypothesized that the numbers of psychiatric hospital beds and the sizes of prison populations were inversely related; 75 years later, the question arises as to whether the hypothesis applies to recent developments in South America. To explore the possible association of changes in the numbers of psychiatric hospital beds with changes in the sizes of prison populations in South America since 1990. We searched primary sources for the numbers of psychiatric hospital beds in South American countries since 1990 (the year that the Latin American countries signed the Caracas Declaration) and compared these changes against the sizes of prison populations. The associations between the numbers of psychiatric beds and the sizes of prison populations were tested using fixed-effects regression of panel data. Economic variables were considered as covariates. Sufficiently reliable and complete data were obtained from 6 countries: Argentina, Bolivia, Brazil, Chile, Paraguay, and Uruguay. The numbers of psychiatric beds and the sizes of prison populations. Since 1990, the numbers of psychiatric beds decreased in all 6 countries (ranging from -2.0% to -71.9%), while the sizes of prison populations increased substantially (ranging from 16.1% to 273.0%). Panel data regression analysis across the 6 countries showed a significant inverse relationship between numbers of psychiatric beds and sizes of prison populations. On average, the removal of 1 bed was associated with 5.18 more prisoners (95% CI, 3.10-7.26; P = .001), which was reduced to 2.78 prisoners (95% CI, 2.59-2.97; P prison populations remained practically unchanged when income inequality was considered as a covariate (-4.28 [95% CI, -5.21 to -3.36]; P prison populations have increased against a background of strong economic growth. The changes appear to be associated because the numbers of beds decreased more extensively when and

  15. Cefazolin high-inoculum effect in methicillin-susceptible Staphylococcus aureus from South American hospitals.

    Science.gov (United States)

    Rincón, Sandra; Reyes, Jinnethe; Carvajal, Lina Paola; Rojas, Natalia; Cortés, Fabián; Panesso, Diana; Guzmán, Manuel; Zurita, Jeannete; Adachi, Javier A; Murray, Barbara E; Nannini, Esteban C; Arias, Cesar A

    2013-12-01

    Clinical failures with cefazolin have been described in high-inoculum infections caused by methicillin-susceptible Staphylococcus aureus (MSSA) producing type A β-lactamase. We investigated the prevalence of the cefazolin inoculum effect (InE) in MSSA from South American hospitals, since cefazolin is used routinely against MSSA due to concerns about the in vivo efficacy of isoxazolyl penicillins. MSSA isolates were recovered from bloodstream (n = 296) and osteomyelitis (n = 68) infections in two different multicentre surveillance studies performed in 2001-02 and 2006-08 in South American hospitals. We determined standard-inoculum (10(5)cfu/mL) and high-inoculum (10(7) cfu/mL) cefazolin MICs. PFGE was performed on all isolates that exhibited a cefazolin InE. Multilocus sequence typing (MLST) and sequencing of part of blaZ were performed on representative isolates. The overall prevalence of the cefazolin InE was 36% (131 isolates). A high proportion (50%) of MSSA isolates recovered from osteomyelitis infections exhibited the InE, whereas it was observed in 33% of MSSA recovered from bloodstream infections. Interestingly, Ecuador had the highest prevalence of the InE (45%). Strikingly, 63% of MSSA isolates recovered from osteomyelitis infections in Colombia exhibited the InE. MLST revealed that MSSA isolates exhibiting the InE belonged to diverse genetic backgrounds, including ST5, ST8, ST30 and ST45, which correlated with the prevalent methicillin-resistant S. aureus clones circulating in South America. Types A (66%) and C (31%) were the most prevalent β-lactamases. Our results show a high prevalence of the cefazolin InE associated with type A β-lactamase in MSSA isolates from Colombia and Ecuador, suggesting that treatment of deep-seated infections with cefazolin in those countries may be compromised.

  16. The rhinoceros among Serpents: Comparative anatomy and experimental biophysics of Calabar burrowing python (Calabaria reinhardtii) skin.

    Science.gov (United States)

    Han, Dawei; Young, Bruce A

    2018-01-01

    The Calabar burrowing python (Calabaria reinhardtii) has a unique combination of marked thickness of the integumentary layers, a highly organized lamellate arrangement of the dermal collagen bundles, and a reduction in the size of the interscale hinge region of the integument. Biomechanical testing demonstrates that the skin of C. reinhardtii is more resistant to penetration than the skin of other snakes. The laminar arrangement of the collagen bundles provides for penetrative resistance, even while maintaining the flexibility characteristic of snake skin. Considering the life history of this species, it is hypothesized that the specialized integument of C. reinhardtii is a passive defensive mechanism against penetrative bites from maternal rodents and predators. © 2017 Wiley Periodicals, Inc.

  17. Safety and affordability of an elective Saturday list at Pietersburg Hospital Limpopo South Africa

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    R Mavhungu

    2018-02-01

    Full Text Available Background. The backlog of patients waiting for operations continues to be a problem in many public hospitals in South Africa (SA, with elective surgery procedures being postponed for up to 2 years.Objective. To determine the rate of death in hospital or out of hospital within 30 days of an elective procedure performed on a Saturday, and to determine the cost incurred by paying staff members who perform these operations.Method. A prospective, observational descriptive cohort study of all patients undergoing inpatient general surgery operations during weekdays and weekends between 1 September 2015 and 31 August 2016 (1 year at Pietersburg Hospital (PBH, Limpopo, SA. Microsoft Excel 2010 (Microsoft, USA was used to analyse and derive descriptive statistics. The finance department at the hospital calculated the overtime pay for theatre staff who operated on Saturdays.Results. The study included 1 352 operations (607 elective and 745 emergency procedures. Saturday elective operations contributed 133/607 (22%, and the rate of death for these operations was 1.5%. The most common procedures performed on a Saturday were hernia repair and amputation. The cost for 8 hours of work on a Saturday was ZAR13 900, amounting to a total of ZAR333 600 for 24 Saturdays.Conclusion. Performing minor surgery on a Saturday had a mortality rate of 1.5%, and a theatre staff cost of ~ZAR2 317 per patient, excluding surgeons’ fees. If surgeons were to be paid the costs would be ZAR3 450 per patient.

  18. Vulnerabilities to Temperature Effects on Acute Myocardial Infarction Hospital Admissions in South Korea

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    Bo Yeon Kwon

    2015-11-01

    Full Text Available Most previous studies have focused on the association between acute myocardial function (AMI and temperature by gender and age. Recently, however, concern has also arisen about those most susceptible to the effects of temperature according to socioeconomic status (SES. The objective of this study was to determine the effect of heat and cold on hospital admissions for AMI by subpopulations (gender, age, living area, and individual SES in South Korea. The Korea National Health Insurance (KNHI database was used to examine the effect of heat and cold on hospital admissions for AMI during 2004–2012. We analyzed the increase in AMI hospital admissions both above and below a threshold temperature using Poisson generalized additive models (GAMs for hot, cold, and warm weather. The Medicaid group, the lowest SES group, had a significantly higher RR of 1.37 (95% CI: 1.07–1.76 for heat and 1.11 (95% CI: 1.04–1.20 for cold among subgroups, while also showing distinctly higher risk curves than NHI for both hot and cold weather. In additions, females, older age group, and those living in urban areas had higher risks from hot and cold temperatures than males, younger age group, and those living in rural areas.

  19. Post-traumatic stress disorder among paramedic and hospital emergency personnel in south-east Iran

    Institute of Scientific and Technical Information of China (English)

    Sedigheh Iranmanesh; Batool Tirgari; Hojat Sheikh Bardsiri

    2013-01-01

    BACKGROUND:Paramedic and emergency personnel may encounter directly many events that threat their own wellbeing during their daily work.This study was conducted to examine the prevalence rate of post-traumatic stress disorder(PTSD) among two groups of paramedic and emergency personnel in south-east Iran.METHODS:The study employed a descriptive design and was conducted in four hospital emergency wards and a pre-hospital emergency base supervised by Kerman Medical University.Using Mississippi PTSD,we assessed the prevalence rate in paramedics(n=150) and emergency personnel(n=250).RESULTS:The two groups had different levels of education,marital status,experience of traumatic events,work hours per month,and gender.Most(94%) of paramedic and hospital emergency personnel reported moderate PTSD.The two groups had significant different levels of PTSD in all subscale.CONCLUSION:The study suggests that health care managers should organize systematic and dynamic policies and procedures in dealing with PTSD to assist both groups of personnel.

  20. Integrating biomedical and herbal medicine in Ghana - experiences from the Kumasi South Hospital: a qualitative study.

    Science.gov (United States)

    Boateng, Millicent Addai; Danso-Appiah, Anthony; Turkson, Bernard Kofi; Tersbøl, Britt Pinkowski

    2016-07-07

    Over the past decade there has been growing interest in the use of herbal medicine both in developed and developing countries. Given the high proportion of patients using herbal medicine in Ghana, some health facilities have initiated implementation of herbal medicine as a component of their healthcare delivery. However, the extent to which herbal medicine has been integrated in Ghanaian health facilities, how integration is implemented and perceived by different stakeholders has not been documented. The study sought to explore these critical issues at the Kumasi South Hospital (KSH) and outline the challenges and motivations of the integration process. Qualitative phenomenological exploratory study design involving fieldwork observations, focus group discussion, in-depth interviews and key informants' interviews was employed to collect data. Policies and protocols outlining the definition, process and goals of integration were lacking, with respondents sharing different views about the purpose and value of integration of herbal medicine within public health facilities. Key informants were supportive of the initiative. Whilst biomedical health workers perceived the system to be parallel than integrated, health personnel providing herbal medicine perceived the system as integrated. Most patients were not aware of the herbal clinic in the hospital but those who had utilized services of the herbal clinic viewed the clinic as part of the hospital. The lack of a regulatory policy and protocol for the integration seemed to have led to the different perception of the integration. Policy and protocol to guide the integration are key recommendations.

  1. Prevalence of Alcohol Use and Associated Factors in Urban Hospital Outpatients in South Africa

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    Hendry Van der Heever

    2011-06-01

    Full Text Available The aim of this study was to assess the prevalence of alcohol use and associated factors among outpatients in an urban hospital in South Africa. The sample included 1,532 (56.4% men and women 43.6% consecutively selected patients from different hospital outpatient departments. Results indicate that 41.2% of men and 18.3% of women were found to be hazardous drinkers, and 3.6% of men and 1.4% of women meet criteria for probable alcohol dependence or harmful drinking as defined by the Alcohol Use Disorder Identification Test (AUDIT. Two in five patients (40.5% were hazardous or harmful drinkers and/or had anxiety or depression. Logistic multiple regression found that for men tobacco use and not having been diagnosed with diabetes and for women tobacco use and having been diagnosed with migraine headache was associated with hazardous and harmful drinking. Although the study is cross-sectional, it does identify groups that may be at high risk of alcohol misuse and for whom intervention is urgent. Because prevalence of hazardous and harmful alcohol use is high in this population, routine screening should be introduced in hospital out-patient settings.

  2. Let him not be alone: perspectives of older British South Asian minority ethnic patients on dying in acute hospitals.

    Science.gov (United States)

    Venkatasalu, Munikumar Ramasamy

    2017-09-02

    To investigate older British South Asians' views on dying at acute hospitals. Older people, including those from ethnic minorities prefer 'home as a haven' for their last days of life; however, they are more likely to die in hospital. Constructive grounded theory was used as a methodological approach that informed data collection to data analysis. Open meetings with 11 local South Asian community organisations enabled the researchers to recruit a total of 55 older South Asians in this study. Data were collected using gender-based focus groups (n=5) and in-depth, semi-structured interviews (n=29). Transcripts were analysed using Nvivo 9. Three key themes were identified: 'mistrust', 'let him not be alone' and 'family as a protective shield'. The theme 'mistrust' is explored through examination of beliefs, attitudes and expectations about 'hospital' as a place in the care of the dying. The theme of 'let him not be alone' draws the family's preferences and concerns in relation to leaving their older dying relative alone in the hospital. The final theme of 'family as a protective shield' describes the element of family care as a protective shield for their older one to have peaceful end-of-life care moments in the hospital. Allowing older relatives to die in hospital seems to evoke feelings of missed filial responsibilities and guilt among family carers among older ethnic minorities. The presence of cultural paranoia and mistrust often led minorities to experience sub-standard end-of-life care in acute hospitals.

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

    International Nuclear Information System (INIS)

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

    2001-12-01

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

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

    International Nuclear Information System (INIS)

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

    2001-12-01

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

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

    International Nuclear Information System (INIS)

    Angeles C, A.; Vizuet G, J.

    2001-09-01

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

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

    International Nuclear Information System (INIS)

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

    2002-01-01

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

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

    International Nuclear Information System (INIS)

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

    2002-01-01

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

  8. Severe Enterovirus Infections in Hospitalized Children in the South of England: Clinical Phenotypes and Causative Genotypes.

    Science.gov (United States)

    de Graaf, Hans; Pelosi, Emanuela; Cooper, Andrea; Pappachan, John; Sykes, Kim; MacIntosh, Iain; Gbesemete, Diane; Clark, Tristan W; Patel, Sanjay V; Faust, Saul N; Tebruegge, Marc

    2016-07-01

    Most enterovirus surveillance studies lack detailed clinical data, which limits their clinical usefulness. This study aimed to describe the clinical spectrum and outcome of severe enterovirus infections in children, and to determine whether there are associations between causative enterovirus genotypes and clinical phenotypes. Retrospective analysis of microbiological and clinical data from a tertiary children's hospital in the South of England over a 17-month period (2012-2013). In total, 30 patients were identified, comprising sepsis (n = 9), myocarditis (n = 8), meningitis (n = 8) and encephalitis (n = 5). Cases with sepsis or myocarditis were significantly younger than those with central nervous system disease (median age 21 and 15 days vs. 79 days; P = 0.0244 and P = 0.0310, respectively). There was considerable diversity in the causative genotypes in each of the clinical phenotypes, with some predominance of echoviruses in the meningitis group, and coxsackie B viruses in the myocarditis group. Thirteen cases required mechanical ventilation, 11 cases inotropic support, 3 cases dialysis and 3 cases extracorporal membrane oxygenation. The overall mortality was 10% (sepsis group, n = 1; myocarditis group, n = 2). Of the survivors, 5 (19%) had long-term sequelae (myocardial dysfunction, n = 2; neurological sequelae, n = 3). Patients with encephalitis had the longest hospital stay (median: 16 days), compared with 9, 6 and 3 days in patients with myocarditis, sepsis and meningitis, respectively (P = 0.005). Enterovirus infections, particularly enteroviral myocarditis and encephalitis, can cause significant morbidity and mortality. The results show that there are currently no strong associations between clinical phenotypes and particular causative enterovirus genotypes in the South of England.

  9. Severe Enterovirus Infections in Hospitalized Children in the South of England

    Science.gov (United States)

    de Graaf, Hans; Pelosi, Emanuela; Cooper, Andrea; Pappachan, John; Sykes, Kim; MacIntosh, Iain; Gbesemete, Diane; Clark, Tristan W.; Patel, Sanjay V.; Faust, Saul N.

    2016-01-01

    Background: Most enterovirus surveillance studies lack detailed clinical data, which limits their clinical usefulness. This study aimed to describe the clinical spectrum and outcome of severe enterovirus infections in children, and to determine whether there are associations between causative enterovirus genotypes and clinical phenotypes. Methods: Retrospective analysis of microbiological and clinical data from a tertiary children’s hospital in the South of England over a 17-month period (2012–2013). Results: In total, 30 patients were identified, comprising sepsis (n = 9), myocarditis (n = 8), meningitis (n = 8) and encephalitis (n = 5). Cases with sepsis or myocarditis were significantly younger than those with central nervous system disease (median age 21 and 15 days vs. 79 days; P = 0.0244 and P = 0.0310, respectively). There was considerable diversity in the causative genotypes in each of the clinical phenotypes, with some predominance of echoviruses in the meningitis group, and coxsackie B viruses in the myocarditis group. Thirteen cases required mechanical ventilation, 11 cases inotropic support, 3 cases dialysis and 3 cases extracorporal membrane oxygenation. The overall mortality was 10% (sepsis group, n = 1; myocarditis group, n = 2). Of the survivors, 5 (19%) had long-term sequelae (myocardial dysfunction, n = 2; neurological sequelae, n = 3). Patients with encephalitis had the longest hospital stay (median: 16 days), compared with 9, 6 and 3 days in patients with myocarditis, sepsis and meningitis, respectively (P = 0.005). Conclusions: Enterovirus infections, particularly enteroviral myocarditis and encephalitis, can cause significant morbidity and mortality. The results show that there are currently no strong associations between clinical phenotypes and particular causative enterovirus genotypes in the South of England. PMID:26882165

  10. Childhood burns in south eastern Nigeria.

    Science.gov (United States)

    Archibong, A E; Antia, U E; Udosen, J

    1997-06-01

    In a ten year retrospective study of burns in children in University of Calabar Teaching Hospital (UCTH), Calabar, the main causes were hot water, hot soup or oil (56.6%) involving children mostly in the one to three year age group. The relative safety of the home environment seen in other forms of paediatric trauma is not observed in burns in children. A changing pattern of burns in children has emerged within the region with naked flames/bush fire coming second and affecting 22.7% of the children. Chemical burns hitherto a rare occurrence is now frequent because of the storage of caustic soda and acids in living rooms by soap making parents. Burns affecting the perineum, axilla and buttocks are difficult to keep clean and frequently lead to infections, with associated increased morbidity. Causes of childhood burns are largely preventable requiring active social/medical education and public enlightenment campaigns on the various methods of prevention.

  11. The prevalence of HIV among blood donors at Juba Teaching Hospital Blood Bank, South Sudan

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    Kenneth L L Sube

    2014-11-01

    Full Text Available Objectives The aim of this study is to determine the prevalence of HIV among blood donors in Juba Teaching Hospital Blood Bank, South Sudan in 2013. Method and Materials This is a retrospective study that involved the abstraction of data from registers at the blood bank. Data were collected onto data sheets and entered into a computer database. Statistical analysis was performed using SPSS Version 20 Software. A p value of <0.05 was considered statistically significant. Results Out of 1095 blood donors, 1074 (98.1% were males and 21 (1.9% were females. The mean age and the range for the whole group was 29+7.16 (15-69 yrs. The prevalence of HIV was higher among males than females 85 (7.9% vs 1 (4.8% respectively but this was not statistical significant (p=0.6. The 20 to 29 year age group had the highest prevalence of 49 (57% with no statistical significance (p=0.3.The prevalence of HIV was 7.0 % (86 and there were co-infections between HIV and HBV, HCV and syphilis of 14 (50%, 5 (18%, 9 (32% with p=0.7, p=0.1, p=0.8 respectively. Blood group O positive had the highest percentage 58.1 % (n=50 and was the commonest group. Conclusion In this study, HIV prevalence is very high among blood donors at the Juba Teaching Hospital blood bank.

  12. An analysis of diagnostic practices in a mammography unit in a tertiary hospital in South Africa

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    Clare A. Surridge

    2017-03-01

    Objectives: To perform an audit of the UGCNB biopsies performed at the Grey’s Hospital Mammography Department and assess the accuracy of the radiologists’ use of the BI-RADS scoring system. Methods: Records of all patients who underwent UGCNB biopsy between 01 January 2014 and 31 October 2015 were reviewed. A retrospective study was performed. Results: A total of 304 UGCNB biopsies were performed on 291 patients. The mean age was 49.2 (s.d. = 15.9 years. Tissue samples from 303 lesions were adequate for histological assessment, and of these, 51% of the lesions were malignant whilst 49% were benign. The most common malignant and benign diagnoses were invasive ductal carcinoma and fibroadenoma respectively. The BI-RADS scoring of the radiologists demonstrated a positive predictive value of 61.6% for the identification of possible malignant lesions. Conclusion: This study describes the patient and lesion profile and unit practices in a tertiary hospital setting in South Africa. The radiologists’ application of the BI-RADS scoring largely conforms to the BI-RADS guidelines. The study highlights several challenges encountered by a breast imaging programme in an under-resourced setting as well as making recommendations in overcoming these challenges.

  13. Disparities in acute in-hospital cardiovascular care for Aboriginal and non-Aboriginal South Australians.

    Science.gov (United States)

    Tavella, Rosanna; McBride, Katharine; Keech, Wendy; Kelly, Janet; Rischbieth, Amanda; Zeitz, Christopher; Beltrame, John F; Tideman, Philip A; Brown, Alex

    2016-09-05

    To assess differences in the rates of angiography and subsequent revascularisation for Aboriginal and non-Aboriginal South Australians who presented with an acute coronary syndrome (ACS); to explore the reasons for any observed differences. Analysis of administrative data with logistic regression modelling to assess the relationship between Aboriginal status and the decision to undertake diagnostic angiography. A detailed medical record review of Aboriginal admissions was subsequently undertaken. Emergency ACS admissions to SA cardiac catheterisation hospitals, 2007-2012. 13 701 admissions of patients with an ACS, including 274 Aboriginal patients (2.1%). Rates of coronary angiography and revascularisation; documentation of justification for non-invasive management. After adjustment for age, comorbidities and remoteness, Aboriginal patients presenting with an ACS were significantly less likely than non-Aboriginal patients to undergo angiography (odds ratio [OR], 0.4; 95% CI, 0.3-0.5; P Aboriginal and non-Aboriginal patients who had undergone angiography. Reasons for Aboriginal patients not undergoing angiography included symptoms being deemed non-cardiac (16%), non-invasive test performed (8%), and discharge against medical advice (11%); the reasons were unclear for 36% of Aboriginal patients. After controlling for age and other factors, the rate of coronary angiography was lower among Aboriginal patients with an ACS in SA. The reasons for this disparity are complex, including patient-related factors and their preferences, as well as the appropriateness of the intervention. Improved consideration of the hospital experience of Aboriginal patients must be a priority for reducing health care disparities.

  14. Nurse Interaction With Clients In Communication Therapeutic Study Analysis Of Symbolic Interactionism Hospital South Sulawesi

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    Hj.Indirawaty

    2015-08-01

    Full Text Available ABSTRACT This study aimed to describe briefly on the application of social interaction which made nurses to clients while performing therapeutic communication at the Hospital of South Sulawesi with frame symbolic interactionism. Result achieved against the system carried nurse interaction with clients who patterned on therapeutic communication. At the stage of pre-interaction system is applied such as before the nurse interacts with the client well in advance to prepare the way of dressing reception duties of nurse and studying the book status of each client. Introduction or orientation phase nurses visit each client and when the first met uttered a greeting before asking the clients condition when the interaction takes place he uses verbal and non-verbal language and attitude shown in full client hospitality and courtesy. Stage work nurses do an evaluation or action on the clients condition in accordance with the termination task. Midwife stage nurse re-evaluate the client and conclude the development of the clients condition and report a doctor who handles client. The fourth aspect of the application using the analysis of symbolic interactionism

  15. Antibiotic-Related Adverse Drug Reactions at a Tertiary Care Hospital in South Korea

    Directory of Open Access Journals (Sweden)

    In Young Jung

    2017-01-01

    Full Text Available Background. Adverse drug reactions (ADRs are any unwanted/uncomfortable effects from medication resulting in physical, mental, and functional injuries. Antibiotics account for up to 40.9% of ADRs and are associated with several serious outcomes. However, few reports on ADRs have evaluated only antimicrobial agents. In this study, we investigated antibiotic-related ADRs at a tertiary care hospital in South Korea. Methods. This is a retrospective cohort study that evaluated ADRs to antibiotics that were reported at a 2400-bed tertiary care hospital in 2015. ADRs reported by physicians, pharmacists, and nurses were reviewed. Clinical information reported ADRs, type of antibiotic, causality assessment, and complications were evaluated. Results. 1,277 (62.8% patients were considered antibiotic-related ADRs based on the World Health Organization-Uppsala Monitoring Center criteria (certain, 2.2%; probable, 35.7%; and possible, 62.1%. Totally, 44 (3.4% patients experienced serious ADRs. Penicillin and quinolones were the most common drugs reported to induce ADRs (both 16.0%, followed by third-generation cephalosporins (14.9%. The most frequently experienced side effects were skin manifestations (45.1% followed by gastrointestinal disorders (32.6%. Conclusion. Penicillin and quinolones are the most common causative antibiotics for ADRs and skin manifestations were the most frequently experienced symptom.

  16. E-health readiness assessment for e-health framework for Africa: a case study of hospitals in South Africa

    CSIR Research Space (South Africa)

    Coleman, A

    2011-11-01

    Full Text Available This study assessed e-healthcare readiness of rural and urban hospitals in North West Province of South Africa. Outcome of assessment led to creation of e-health architectural framework for e-health solutions. Assessment was conducted in usage...

  17. Healthcare Costs for Acute Hospitalized and Chronic Heart Failure in South Korea: A Multi-Center Retrospective Cohort Study.

    Science.gov (United States)

    Ku, Hyemin; Chung, Wook Jin; Lee, Hae Young; Yoo, Byung Soo; Choi, Jin Oh; Han, Seoung Woo; Jang, Jieun; Lee, Eui Kyung; Kang, Seok Min

    2017-09-01

    Although heart failure (HF) is recognized as a leading contributor to healthcare costs and a significant economic burden worldwide, studies of HF-related costs in South Korea are limited. This study aimed to estimate HF-related costs per Korean patient per year and per visit. This retrospective cohort study analyzed data obtained from six hospitals in South Korea. Patients with HF who experienced ≥one hospitalization or ≥two outpatient visits between January 1, 2013 and December 31, 2013 were included. Patients were followed up for 1 year [in Korean won (KRW)]. Among a total of 500 patients (mean age, 66.1 years; male sex, 54.4%), the mean 1-year HF-related cost per patient was KRW 2,607,173, which included both, outpatient care (KRW 952,863) and inpatient care (KRW 1,654,309). During the post-index period, 22.2% of patients had at least one hospitalization, and their 1-year costs per patient (KRW 8,530,290) were higher than those of patients who had only visited a hospital over a 12-month period (77.8%; KRW 917,029). Among 111 hospitalized patients, the 1-year costs were 1.7-fold greater in patients (n=52) who were admitted to the hospital via the emergency department (ED) than in those (n=59) who were not (KRW 11,040,453 vs. KRW 6,317,942; pSouth Korea was related to hospitalization, especially admissions via the ED. Appropriate treatment strategies including modification of risk factors to prevent or decrease hospitalization are needed to reduce the economic burden on HF patients. © Copyright: Yonsei University College of Medicine 2017

  18. The indirect costs of agency nurses in South Africa: a case study in two public sector hospitals.

    Science.gov (United States)

    Rispel, Laetitia C; Moorman, Julia

    2015-01-01

    Globally, flexible work arrangements - through the use of temporary nursing staff - are an important strategy for dealing with nursing shortages in hospitals. The objective of the study was to determine the direct and indirect costs of agency nurses, as well as the advantages and the problems associated with agency nurse utilisation in two public sector hospitals in South Africa. Following ethical approval, two South African public sector hospitals were selected purposively. Direct costs were determined through an analysis of hospital expenditure information for a 5-year period from 2005 until 2010, obtained from the national transversal Basic Accounting System database. At each hospital, semi-structured interviews were conducted with the chief executive officer, executive nursing services manager, the maternity or critical care unit nursing manager, the human resource manager, and the finance manager. Indirect costs measured were the time spent on pre-employment checks, and nurse recruitment, orientation, and supervision. All expenditure is expressed in South African Rands (R: 1 USD=R7, 2010 prices). In the 2009/10 financial year, Hospital 1 spent R38.86 million (US$5.55 million) on nursing agencies, whereas Hospital 2 spent R10.40 million (US$1.49 million). The total estimated time spent per week on indirect cost activities at Hospital 1 was 51.5 hours, and 60 hours at Hospital 2. The estimated monetary value of this time at Hospital 1 was R962,267 (US$137,467) and at Hospital 2 the value was R300,121 (US$42,874), thus exceeding the weekly direct costs of nursing agencies. Agency nurses assisted the selected hospitals in dealing with problems of nurse recruitment, absenteeism, shortages, and skills gaps in specialised clinical areas. The problems experienced with agency nurses included their perceived lack of commitment, unreliability, and providing sub-optimal quality of patient care. Hospital managers and policy-makers need to address the effective

  19. The indirect costs of agency nurses in South Africa: a case study in two public sector hospitals

    Directory of Open Access Journals (Sweden)

    Laetitia C. Rispel

    2015-05-01

    Full Text Available Background: Globally, flexible work arrangements – through the use of temporary nursing staff – are an important strategy for dealing with nursing shortages in hospitals. Objective: The objective of the study was to determine the direct and indirect costs of agency nurses, as well as the advantages and the problems associated with agency nurse utilisation in two public sector hospitals in South Africa. Methods: Following ethical approval, two South African public sector hospitals were selected purposively. Direct costs were determined through an analysis of hospital expenditure information for a 5-year period from 2005 until 2010, obtained from the national transversal Basic Accounting System database. At each hospital, semi-structured interviews were conducted with the chief executive officer, executive nursing services manager, the maternity or critical care unit nursing manager, the human resource manager, and the finance manager. Indirect costs measured were the time spent on pre-employment checks, and nurse recruitment, orientation, and supervision. All expenditure is expressed in South African Rands (R: 1 USD=R7, 2010 prices. Results: In the 2009/10 financial year, Hospital 1 spent R38.86 million (US$5.55 million on nursing agencies, whereas Hospital 2 spent R10.40 million (US$1.49 million. The total estimated time spent per week on indirect cost activities at Hospital 1 was 51.5 hours, and 60 hours at Hospital 2. The estimated monetary value of this time at Hospital 1 was R962,267 (US$137,467 and at Hospital 2 the value was R300,121 (US$42,874, thus exceeding the weekly direct costs of nursing agencies. Agency nurses assisted the selected hospitals in dealing with problems of nurse recruitment, absenteeism, shortages, and skills gaps in specialised clinical areas. The problems experienced with agency nurses included their perceived lack of commitment, unreliability, and providing sub-optimal quality of patient care. Conclusion

  20. Challenges associated with the management of gynecological cancers in a tertiary hospital in South East Nigeria

    Directory of Open Access Journals (Sweden)

    Iyoke CA

    2014-01-01

    Full Text Available Chukwuemeka Anthony Iyoke,1 George Onyemaechi Ugwu,1 Euzebus Chinonye Ezugwu,1 Frank Okechukwu Ezugwu,2 Osaheni Lucky Lawani,3 Azubuike Kanayo Onyebuchi3 1Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, 2Department of Obstetrics and Gynaecology, Enugu State University Teaching Hospital, Park Lane, Enugu, 3Department of Obstetrics and Gynaecology, Federal Teaching Hospital, Abakaliki, Ebonyi State, Nigeria Background: There are reports of increasing incidence of gynecological cancers in developing countries and this trend increases the need for more attention to gynecological cancer care in these countries. Objective: The purpose of this study was to describe the presentation and treatment of gynecological cancers and identify barriers to successful gynecological cancer treatment in a tertiary hospital in South East Nigeria. Methods: This study was a retrospective longitudinal analysis of the presentation and treatment of histologically diagnosed primary gynecological cancers from 2000 to 2010. Analysis was by descriptive and inferential statistics at the 95% level of confidence using Statistical Package for the Social Sciences version 17 software. Results: Records of 200 gynecological cancers managed during the study period were analyzed. Over 94% of cervical cancers presented in advanced stages of the disease and received palliative/symptomatic treatment. Only 1.9% of cervical cancer patients had radical surgical intervention, and postoperative mortality from these radical surgeries was 100%. Approximately 76% of patients with ovarian cancer had debulking surgery as the mainstay of treatment followed by adjuvant chemotherapy. Postoperative mortality from ovarian cancer surgery was 63%. Cutting edge cytotoxic drugs were not used as chemotherapy for ovarian and chorionic cancers. Compliance with chemotherapy was poor, with over 70% of ovarian cancer patients failing to complete the

  1. Management of physical child abuse in South Africa: literature review and children's hospital data analysis.

    Science.gov (United States)

    Janssen, T L; van Dijk, M; Al Malki, I; van As, A B

    2013-11-01

    The reason for this review is the lack of data on the management of physical abused children in Africa. The primary goal of the first part is to outline the management of physical child abuse in (South) Africa and provide suggestions for other governments in Africa on which to base their management of physical child abuse, at both governmental and hospital management level. The main aim of the second part is to outline the extent of the problem as seen at the Red Cross Memorial Children's Hospital (RCH) in Cape Town. The National Library of Medicine's PubMed database was searched for articles specifically about the management of physical child abuse. Hospital data were analysed in two phases: one addressed various types of assault in order to assess the number of patients admitted to the trauma unit of RCH between 1991 and 2009, and the other to identify all children with suspected non-accidental injury (NAI) presenting to the trauma unit at RCH from January 2008 until December 2010. Information on physical abuse of children in Africa in the English scientific literature remains disappointing with only two articles focusing on its management. RCH data for the period 1991-2009 recorded a total number of 6415 children hospitalised with injuries following assault, who accounted for 4.2% of all trauma admissions. Types of abuse included assault with a blunt or sharp instrument, rape/sexual assault and human bite wounds. Over the last 2 decades, there has been a minor decline in the number of cases of severe abuse requiring admission; admissions for other injuries have remained stable. More detailed analysis of hospital data for 2008-2010, found that boys were far more commonly assaulted than girls (70.5% vs 29.5%). Physical abuse appeared to be the most common cause of abuse; 89.9% of all boys and 60.5% of all girls presented after physical abuse. In order to eradicate child abuse, awareness of it as to be promoted in the community at large. Because the types of child

  2. 'This place is making me more depressed': The organisation of care for suicide attempters in a South African hospital.

    Science.gov (United States)

    Bantjes, Jason; Nel, Annemi; Louw, Kerry-Ann; Frenkel, Louise; Benjamin, Ereshia; Lewis, Ian

    2017-09-01

    People who attend hospital following a suicide attempt represent a well-delineated high-risk group of patients who may be amenable to targeted interventions to reduce the risk of suicidal behaviour. Little is, however, known about how hospitals in South Africa respond to suicide attempters, what quality of care these patients receive or what possibilities exist for hospital-based suicide prevention interventions. We describe an ethnographic study conducted at a large hospital in South Africa to investigate the impact of current procedures and practices on the care received by those who attempt suicide. Findings suggest that the organisation of care within the hospital is a significant barrier to patients receiving optimal care and represents a lost opportunity for suicide prevention. Findings highlight the mismatch between the needs of suicide attempters and current services and call attention to the need for greater psychological input as well as hospital-based suicide prevention interventions that can be offered to patients without necessitating admissions.

  3. Exposure of Petrol Station Attendants and Auto Mechanics to Premium Motor Sprit Fumes in Calabar, Nigeria

    Directory of Open Access Journals (Sweden)

    N. E. Udonwa

    2009-01-01

    Full Text Available A population-based-cross-sectional survey was carried out to investigate the potential risk of exposure to premium motor spirit (PMS fumes in Calabar, Nigeria, among Automobile Mechanics (AM, Petrol Station Attendants (PSA and the general population. Structured questionnaire was administered on the randomly chosen subjects to elicit information on their exposure to PMS. Duration of exposure was taken as the length of work in their various occupations. Venous blood was taken for methaemoglobin (MetHb and packed cells volume (PCV. Mean MetHb value was higher in AM (7.3% and PSA (5.8% than in the subjects from the general population (2.7%. PCV was lower in PSA (30.8%, than AM (33.3% and the subjects from the general population (40.8%. MetHb level was directly proportional, and PCV inversely related, to the duration of exposure. The study suggested increased exposure to petrol fumes among AM, PSA, and MetHb as a useful biomarker in determining the level of exposure to benzene in petrol vapour.

  4. Midwives’ knowledge and use of partographs at Juba Teaching Hospital, South Sudan

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    Clara Roba Alfred

    2017-11-01

    Full Text Available Background: Evidence shows that good knowledge of partographs and proper application of this knowledge results in a remarkable reduction in prolonged and obstructed labour and reduces maternal mortality. Obstructed labour can be prevented by a simple and cost-effective health intervention tool, the partograph. A partograph is a graphical record of the progress of labour and salient conditions of the mother and foetus plotted against time in hours. This provides an opportunity for early identification of deviation from normal progress. Early detection of prolonged labour greatly contributes to prevention of obstructed labour and related complications. Objective: To assess midwives’ knowledge and use of partographs in the maternity ward of Juba Teaching Hospital, South Sudan. Methods: A cross-sectional descriptive study was conducted to assess utilisation of partographs among healthcare providers in Juba Teaching Hospital. All providers working at the time of the study were included. An interviewer administered questionnaire prepared in English was used to assess socio-demographic and other related variables of respondents as well as knowledge and practice. Ethical procedures were followed at every step. Results: Only 20% of the 30 respondents were registered midwives, 67% knew the components -of a partograph, and 93% could differentiate between normal and abnormal labour with the use of a partograph. The factors affecting the use of partographs included; shortage of partographs in the ward, lack of protocols on partograph use, understanding semantics of the English language, absence of refresher training, late reporting of mothers to the ward, and a shortage of staff. Conclusions: Despite good knowledge of the partograph, about half of the providers do not use them. We recommend training and recruitment of more qualified midwives, a continuous supply of partographs to improve use of partographs continuous supportive supervision, mentoring of

  5. Pattern of cardiovascular admissions at Nnamdi Azikiwe University Teaching Hospital Nnewi, South East Nigeria.

    Science.gov (United States)

    Osuji, Charles Ukachukwu; Onwubuya, Emmanuel Ikechukwu; Ahaneku, Gladys Ifesinachi; Omejua, Emeka Godwin

    2014-01-01

    Cardiovascular disease (CVD) is one of the top killer diseases in the world sparing neither developed or developing countries. The study was carried out to determine the pattern of cardiovascular admissions at Nnamdi Azikiwe University Teaching Hospital Nnewi South East Nigeria. The study was a retrospective study covering the period January 2007 to December 2009. SPSS version 13 software was used to analyze data. 537 (15%) patients were admitted into the study out of 3546 patients {females 1756 and 1790} admitted into medical wards. 322 (60%) of study population were males and 215 (40%) females. 359(67.5%) were discharged, 170 (32%) died and 8 (0.5%) were discharged against medical advice. The majority of the deaths 105(61.8%), were in patients with CVA. Most of the deaths (111 or 65.3%) occurred within the first seven days of admission. The mean age of the population was 60.7 years ±15.9 with a range of 18 to 110 years. The length of stay in hospital ranged between 1 and 140 days with a mean of 13.5 ± 13.9 days and a median of 10 days. 33 of the subjects were single, 406 were married, 94 were widowed (11 males and 83 females) and 4 were divorced. 46.7% (251) were admitted for CVA and 30.9% (166) for heart failure. Cardiomyopathy/valvular heart diseases (clinical diagnosis due to absence of echocardiography) constituted 3.9%, hypertension 20.5% and pre-existing hypertension with uremia 1.9%. The study has shown that cardiovascular disease contributed significantly to medical admissions the elderly accounting for a significant proportion. There is thus the need for intensification of primary preventive strategies for cardiovascular diseases.

  6. Nature and pattern of primary teeth extractions in a tertiary care hospital setting in South India

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    Shini Susan Samuel

    2018-01-01

    Full Text Available Background: Many studies have been carried out on the prevalence of dental diseases in children although not much information is available regarding its outcome among Indian children. Aim: The aim of the present study was to analyze the type of primary tooth extracted and the reasons for the extraction among children attending a tertiary care hospital in the Southern part of India. Materials and Methods: The dental records of pediatric patients who had visited the dental clinic of a tertiary care hospital located in Tamil Nadu, South India from December 2013 to November 2016 were reviewed. Patients who underwent extraction of at least one primary tooth under local or general anesthesia were included in the study. Results: A total of 943 primary teeth were extracted from 447 patients over 3 years. The most commonly extracted tooth type was the first primary molar followed by the primary central incisor. Grouping by age, the most frequently extracted tooth type between 2 and 5 years was the primary central incisor, the first primary molar among the 6–9-year-old and the second primary molar among 10–15-year-old. The majority of primary teeth extractions were performed in the age group of 6–9 years. No significant gender differences were noted. The most common reason for extraction of primary teeth in children was dental caries. Conclusions: This study demonstrates a high prevalence of untimely primary teeth extractions in young children and dental caries continues to be the leading cause. It clearly reflects on the lack of infant oral health care, the inadequacy of awareness and underutilization of oral health services among children in India.

  7. 'Waiting for' and 'waiting in' public and private hospitals: a qualitative study of patient trust in South Australia.

    Science.gov (United States)

    Ward, Paul R; Rokkas, Philippa; Cenko, Clinton; Pulvirenti, Mariastella; Dean, Nicola; Carney, A Simon; Meyer, Samantha

    2017-05-05

    Waiting times for hospital appointments, treatment and/or surgery have become a major political and health service problem, leading to national maximum waiting times and policies to reduce waiting times. Quantitative studies have documented waiting times for various types of surgery and longer waiting times in public vs private hospitals. However, very little qualitative research has explored patient experiences of waiting, how this compares between public and private hospitals, and the implications for trust in hospitals and healthcare professionals. The aim of this paper is to provide a deep understanding of the impact of waiting times on patient trust in public and private hospitals. A qualitative study in South Australia, including 36 in-depth interviews (18 from public and 18 from private hospitals). Data collection occurred in 2012-13, and data were analysed using pre-coding, followed by conceptual and theoretical categorisation. Participants differentiated between experiences of 'waiting for' (e.g. for specialist appointments and surgery) and 'waiting in' (e.g. in emergency departments and outpatient clinics) public and private hospitals. Whilst 'waiting for' public hospitals was longer than private hospitals, this was often justified and accepted by public patients (e.g. due to reduced government funding), therefore it did not lead to distrust of public hospitals. Private patients had shorter 'waiting for' hospital services, increasing their trust in private hospitals and distrust of public hospitals. Public patients also recounted many experiences of longer 'waiting in' public hospitals, leading to frustration and anxiety, although they rarely blamed or distrusted the doctors or nurses, instead blaming an underfunded system and over-worked staff. Doctors and nurses were seen to be doing their best, and therefore trustworthy. Although public patients experienced longer 'waiting for' and 'waiting in' public hospitals, it did not lead to widespread distrust

  8. The Profile Of Congenital Malformation Among Newborn Infants In ...

    African Journals Online (AJOL)

    Objective: The study pattern of congenital malformations (CM) among newborn infants in Calabar, South-south Nigeria. Patients and Methods: Medical records of all inborn and out-born neonates who were admitted and treated for CM in University of Calabar teaching Hospital (UCTH) from 1997 to 2006 (10 years) were ...

  9. Peripartum hysterectomy: two years experience at Nelson Mandela Academic hospital, Mthatha, Eastern Cape South Africa.

    Science.gov (United States)

    Wandabwa, J N; Businge, C; Longo-Mbenza, B; Mdaka, M L; Kiondo, P

    2013-06-01

    Obstetric haemorrhage is the leading direct cause of maternal mortality in South Africa. To determine the incidence, indications, associations and maternal outcomes of emergency peripartum hysterectomies. A descriptive and retrospective analysis of patients who had peripartum hysterectomy between 1(st) February 2007 and 31(st) January 2009 in Nelson Mandela Academic Hospital at Mthatha city. The incidence of 0.95% of peripartum hysterectomies (n=63 or 9.5/1000 births) increased with the increasing maternal age from 0.121% at age of less than 20 years to 0.5% at age more or equal to 30 years. Similarly the incidence increased with parity from 0.332% for Primiparity to 0.468% at parity of four or more. The indications for the operation were uterine atony 19/63 (30.2%), secondary haemorrhage/puerperal sepsis 17/63 (27%) and ruptured uterus 16/63 (23.4%). The main intra operative complication was haemorrhage 13/63 (20.6%). Repeat laparotomy was done in 10/63 (15%) of patients due to haemorrhage. Admission to intensive care unit was 25/63 (39.7%). The case specific mortality rate was of 19 % (n=12). The main causes of death were hypovolaemic shock and septicemia. The incidence of peripartum hysterectomies was high and was associated with ruptured uterus and puerperal sepsis which are preventable.

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

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    Klapalova Alena

    2013-06-01

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

  11. Causes of gastrointestinal colic at an equine referral hospital in South Africa (1998 - 2007

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    A. Voigt

    2009-05-01

    Full Text Available The most common causes of gastrointestinal colic at an equine referral hospital in South Africa were determined following retrieval of the medical records of horses admitted during a 10-year study period. The study included 935 horses of which 28 % were admitted after hours. Most horses were Thoroughbreds (54 %, male (57 %, with a mean age of 8.2 years and originated from the Gauteng Province (81 %. Heart rate (98 %, mucous membrane colour (95 % and auscultation of the abdomen (91 % were the clinical data commonly obtained at admission. Packed cell volume, total serum protein and white cell count were recorded in 78 %, 75 % and 44 % of horses respectively. Transrectal palpation (93 %, nasogastric intubation (84 %, intravenous catheterisation (74 % and abdominocentesis (53 % were the most frequently performed procedures. Medical intervention was performed in 558 horses (60 %. The common causes of medical colic were impactions (39 %, tympany (7 % and displacement of the large colon (6 %. An exploratory laparotomy was performed in 331 horses (36 %. The common causes of surgical colic were displacement (29 %, impaction (22 % and small intestinal strangulating lesions (18 %. Death occurred in 3 % of horses, while euthanasia before medical intervention was performed in 4 %. Overall, medical intervention was successful in 93 % of horses and 67 % in horses managed surgically. In conclusion, 55 % of all the equine admissions responded to medical intervention and the recovery rate for horses receiving both medical and surgical intervention was comparable to that reported in other studies.

  12. Risk factors associated with postpartum haemorrhage at Juba Teaching Hospital, South Sudan, 2011

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    Thomas Tako Akim Ujjiga

    2014-08-01

    Full Text Available Objective: To study risk factors associated with post partum haemorrhage (PPH in Juba Teaching Hospital, South Sudan. Method: An unmatched case control study was conducted in which 44 cases and 88 Controls were involved, from September to December 2011. Data was collected using a structured questionnaire in face to face interviews, and analyzed using Epi-info 3.5.3 statistical programme to determine if there was a correlation. Results: Maternal demographic and obstetric characteristics were found to be associated with the risk of bleeding during Bivariate analysis. However, age was found to confound emergency admission, uterotonic use (Oxytocin and Misoprostol use and delivery type, the latter being modified, in the development of post partum haemorrhage. Conclusion: These results indicate that active management of the third stage of labour (AMTSL and prompt intervention reduced the risk of developing PPH. Understanding the factors that cause PPH will allow us to better strengthen and effect pre delivery and emergency obstetric care which may help us reduce maternal mortality due to post partum haemorrhage.

  13. Infection Rate in 1033 Elective Neurosurgical Procedures at a University Hospital in South China.

    Science.gov (United States)

    Zhu, Hongwei; Liu, Xiyao; Wang, Zhanxiang

    2017-09-01

    Objective  Infection following surgery is a serious complication, especially in neurosurgery. The aim of the study is to report the change of incidence rates of infection in patients undergoing elective neurosurgical procedures at a university hospital in South China as well as the risk factors. Material and Methods  The medical records and postoperative courses for patients undergoing 1,033 neurosurgical procedures from 2008 to 2014 were reviewed retrospectively to determine the incidence of neurosurgical infection, the identity of the offending organisms, and the factors associated with infection. Results  A total of 33 patients (40 cases) experienced postoperative infection representing 3.19% of the study population. Twenty cases were incision infections (1.94%), and 20 were cranial/spinal infections (1.94%) including 15 intracranial infections and 5 intraspinal infections. The 2.4-fold greater incidence of postoperative infection in 2008 to 2010 was compared with that in 2011 to 2014 with perioperative antibiotic prophylaxis ( p neurosurgery (1.08%). The most common offending organism was Staphylococcus aureus (27.5%). Foreign body implantation, operative time > 4 hours, and cerebrospinal fluid (CSF) leak (13 infections in 158 patients; p <0.001) were risk factors for infections ( p <0.05). Conclusion  The neurosurgical infection rate is usually low with perioperative antibiotic prophylaxis even in developing countries. Less foreign body implantation, shorter operative times, and controlling CSF leak could reduce infection rates. Georg Thieme Verlag KG Stuttgart · New York.

  14. Why do some hospitals achieve better care of severely malnourished children than others? Five-year follow-up of rural hospitals in Eastern Cape, South Africa.

    Science.gov (United States)

    Puoane, Thandi; Cuming, Katie; Sanders, David; Ashworth, Ann

    2008-11-01

    Staff at 11 rural hospitals in an under-resourced region of Eastern Cape Province, South Africa, participated in an intervention to improve the quality of care of severely malnourished children through training and support aimed at implementing the WHO case-management guidelines. Despite similar intervention inputs, some hospitals reduced their case-fatality rates by at least half, whereas others did not. The aim of this study was to investigate reasons for this disparity. Two successful and two poorly performing hospitals were purposively selected based on their case-fatality rates, which were 30% in those performing poorly. Comparative data were collected during June to October 2004 through structured observations of ward procedures, compilation of hospital data on case-loads and resources, and staff interviews and discussions related to attitudes, teamwork, training, supervision, managerial support and leadership. The four study hospitals had broadly similar resources, infrastructure and child:nurse ratios, and all had made changes to their clinical and dietary management following training. Case-management was broadly in line with WHO guidelines but the study revealed clear differences in institutional culture which influenced quality of care. Staff in the successful hospitals were more attentive and assiduous than staff in the poorly performing hospitals, especially in relation to rehydration procedures, feeding and the recording of vital signs. There was a strong emphasis on in-service training and induction of incoming staff in the successful hospitals and better supervision of junior staff and carers. Nurses had more positive attitudes towards malnourished children and their carers, and were less judgmental. Underlying factors were differences in leadership, teamwork, and managerial supervision and support. We conclude that unless there are supportive structures at managerial level, the potential benefits of efficacious interventions and related training

  15. Managerial competencies of hospital managers in South Africa: a survey of managers in the public and private sectors

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    Pillay Rubin

    2008-02-01

    Full Text Available Abstract Background South Africa has large public and private sectors and there is a common perception that public sector hospitals are inefficient and ineffective while the privately owned and managed hospitals provide superior care and are more sustainable. The underlying assumption is that there is a potential gap in management capacity between the two sectors. This study aims to ascertain the skills and competency levels of hospital managers in South Africa and to determine whether there are any significant differences in competency levels between managers in the different sectors. Methods A survey using a self administered questionnaire was conducted among hospital managers in South Africa. Respondents were asked to rate their proficiency with seven key functions that they perform. These included delivery of health care, planning, organizing, leading, controlling, legal and ethical, and self-management. Ratings were based on a five point Likert scale ranging from very low skill level to very high skill level. Results The results show that managers in the private sector perceived themselves to be significantly more competent than their public sector colleagues in most of the management facets. Public sector managers were also more likely than their private sector colleagues to report that they required further development and training. Conclusion The findings confirm our supposition that there is a lack of management capacity within the public sector in South Africa and that there is a significant gap between private and public sectors. It provides evidence that there is a great need for further development of managers, especially those in the public sector. The onus is therefore on administrators and those responsible for management education and training to identify managers in need of development and to make available training that is contextually relevant in terms of design and delivery.

  16. Characteristics and Factors Associated with Death among Patients Hospitalized for Severe Fever with Thrombocytopenia Syndrome, South Korea, 2013.

    Science.gov (United States)

    Shin, Jaeseung; Kwon, Donghyok; Youn, Seung-Ki; Park, Ji-Hyuk

    2015-10-01

    In South Korea, nationwide surveillance for severe fever with thrombocytopenia syndrome (SFTS) began during 2013. Among 301 surveillance cases, 35 hospitalized case-patients in 25 areas were confirmed by using virologic testing, and 16 (46%) case-patients subsequently died. The SFTS cases occurred during May-November and peaked during June (9 cases, 26%). The incidence of SFTS was higher in the southern regions of South Korea. Age and neurologic symptoms, including decreased level of consciousness and slurred speech, were heavily associated with death; neurologic symptoms during the first week after disease onset were also associated with death. Although melena was common among patients who died, no other hemorrhagic manifestations were substantively more common among those who died. No effective treatments, including ribavirin, were identified. Expansion of SFTS surveillance to include the outpatient sector and development of an antibody test would enhance completeness of SFTS detection in South Korea.

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

    Science.gov (United States)

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

    2017-09-01

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

  18. CORRELATION BETWEEN SERVICE QUALITY AND PATIENT LOYALTY AT OUTPATIENT DEPARTMENT IN SPECIALITY EYE HOSPITAL OF SOUTH SUMATERA PROVINCE

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    Adelina Fitri

    2016-03-01

    Full Text Available Background: The increasing number of hospitals in Indonesia, which is managed by the government and private demand to provide giving the level of care, professionalism and the maximum of competence to reflect the best quality of service. Quality gives special encouragement for company to understand customer expectations which in turn can increase customer satisfaction and create customer loyalty. The objective of the study is analyse correlation between service quality and patient loyalty Method: This study used a survey of analytical methods, with the cross-sectional approach. The samples in this study were patients who were treated in outpatient installation specialty eye hospital South Sumatera Province with total 102 people based on inclusion criteria. The Sampling was taken by proportions random sampling. The data analysis was performed in univariate and bivariate statistical fisher-exact test. The data were presented in p-value, prevalence ratio(PR and 95% confidence intervals (CI. Results: Generally 46.2% respondent who are loyal aged 41-64 years, 32.3% graduate from primary school and 80.6% have distance >5 KM from hospital. From the bivariate analyzes relating to patients loyalty in specialty eye hospital South Sumatera Province are access to services (95% CI 4.3 PR (1.293-14.300 and officer interaction with patients (95% CI 6.786 PR (2.140-21.515, whereas safety (95% CI PR 1.248(0.281-5.540, convenience (95% CI PR 4.136 (1.201-14.246 and waiting times (95% CI PR 1.951 (0.259-14.717 does not have a correlation with patient loyalty. Conclusion: The loyalty of patients in Specialty Eyes Hospital South Sumatera Province have been affected by access to services and officer interaction with the patient.

  19. Hospitals

    Data.gov (United States)

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

  20. Species composition of grasshoppers (Orthoptera) in open plots and farmlands in calabar metropolis, southern Nigeria.

    Science.gov (United States)

    Oku, E E; Arong, G A; Bassey, D A

    2011-04-15

    The grasshoppers are strategic in the welfare of man and may constitute a major threat when its population is not checked. A study on the distribution of grasshoppers in open plots and farmlands was carried out within Calabar Metropolis between August to November, 2010. A total of 295 grasshoppers belonging to 11 species grouped under 3 families (Tettigoniidae, Acrididae and Pyrgomorphidae) were collected from 8 study locations. Grasshoppers were collected weekly from all study sites using sweep nets between 11 a.m. to 4 p.m. The collection was done using sweep nets between 11 a.m. to 4 p.m. when grasshoppers baked themselves under the sun. The percentage abundance of these species were Spathosterrium pygmaeum (16.27%), Tettigonia viridissima (11.86%), Catantops spissus (11.19%) Acridaturita sp. (10.17%), Gastrimargus acrididae (9.83%), Schistocerca nitens (9.49%), Tylopsis sp. (7.46%), Zonocerus variegatus (6.78%), Omocestus viridulus (6.10%), Scudderia mexicana (5.76%) and Zonocerus elegans (5.08%). Tettigonia viridissima and Acridaturita sp. were largely distributed as it occurred in 7 of 8 study sites while Scudderia mexicana was the least distributed, as it was reported in 3 sites only. The dominant grasshopper species in open plot was Spathosterrium pygmaeum (19%) in relative abundance and the least was Zonocerus variegatus (0.64%). Zonocerus variegatus was the dominant species in farmland (14%) in relative abundance and the least was Schistocerca nitens (4%). Chi-square test showed a high significant difference between the distribution of grasshoppers in open plots and farmlands (p grasshopper species composition were attributed to lizard predation and management practices such as grass cutting, fertilizer and pesticide applications. It was therefore concluded that species abundance and population of grasshoppers could be enhanced by minimizing human activities that interfere with land use.

  1. Element Content of Surface and Underground Water Sources around a Cement Factory Site in Calabar, Nigeria

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    Edmund Richard Egbe

    2017-01-01

    Full Text Available Background: Cement production is associated with heavy metal emissions and environmental pollution by cement dust. The degree of contamination of drinking water sources by major and trace elements present in cement dust generated by united cement factory (UNICEM is still uncertain. This study estimated the element content of ground and surface water samples (hand-dug wells, boreholes and streams around the factory site to determine the impact of cement dust exposure on the water levels of these elements. Methods: This study was conducted at UNICEM at Mfamosing, Akamkpa local government area, Cross River State, Nigeria. Drinking water samples (5 from each location were collected from the cement factory quarry site camp, 3 surrounding communities and Calabar metropolis (45 km away from factory serving as control. The lead (Pb, copper (Cu, manganes (Mn, iron (Fe, cadmium (Cd, selenium (Se, chromium (Cr, zinc (Zn and arsenic (As levels of samples were determined using Atomic Absorption Spectrometry (AAS. Data were analyzed using ANOVA and LSD post hoc at P = 0.05. Results: As and Pb content of samples from camp were above the WHO recommendations of 0.01mg/l and 0.01mg/l respectively. Chromium and cadmium content of all water samples were above and others below WHO recommendations. Water levels of Mn, Fe, Zn, As, Se, Cd, Ca and Si were significantly elevated (though below WHO recommendations in camp than other locations (P<0.05. Conclusion: Production of cement results in As, Pb, Cr and cd contamination of drinking water sources near the factory. Treatment of all drinking water sources is recommended before public use to avert deleterious health consequences.

  2. Incidence of myocardial injury after noncardiac surgery: Experience at Groote Schuur Hospital Cape Town South Africa

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    R Dyer

    2018-04-01

    Full Text Available Background. Myocardial injury after non-cardiac surgery (MINS is a newly recognised entity identified as an independent risk factor associated with increased 30-day all-cause mortality. MINS increases the risk of death in the perioperative period by ~10-fold. More than 80% of patients with MINS are asymptomatic, so the majority of diagnoses are missed. Awareness of MINS is therefore important for perioperative physicians.Objectives. To investigate the incidence of MINS after elective elevated-risk non-cardiac surgery at Groote Schuur Hospital, Cape Town, South Africa (SA.Methods. Patients aged ≥45 years undergoing elective elevated-risk non-cardiac surgery were enrolled via convenience sampling. The new fifth-generation high-sensitivity cardiac troponin T blood test was used postoperatively to identify MINS. Preoperative troponin levels were not measured.Results. Among 244 patients included in the study, the incidence of MINS was 4.9% (95% confidence interval (CI 2.8 - 8.5, which was not significantly different from that in a major international prospective observational study (VISION (8.0% (95% CI 7.5 - 8.4; p=0.080.Conclusions. Our SA cohort had a lower cardiovascular risk profile but a similar incidence of MINS to that described in international literature. The impact of MINS on morbidity and mortality is therefore likely to be proportionally higher in SA than in published international studies. The limited sample size and lower event rate weaken our conclusions. Larger studies are required to establish patient and surgical risk factors for MINS, allowing for revision of cardiovascular risk prediction models in SA. 

  3. The politics of black patients' identity: ward-rounds on the 'black side' of a South African psychiatric hospital.

    Science.gov (United States)

    Swartz, L

    1991-06-01

    There are many macrosocial studies of the political organisation of health and mental health care in South Africa, and the maldistribution of resources by race is well known. Little attention, however, has been given to the minutiae of the negotiation of power in the clinical setting. This article, which reports on part of a larger study of aspects of culture in South African psychiatry, focuses on interactions in ward-rounds on the 'Black side' of a South African psychiatric hospital. Through analysis of cases, the complexity of interpreting what transpires in such a setting and the central role that the concept of culture has in debates amongst staff members are demonstrated. Close analysis demonstrates the inadequacy of models which seek to locate the institutional racism of apartheid psychiatry in the motives of individual clinicians. Clinicians may simultaneously reproduce and subvert aspects of apartheid practice. A consideration of the social positioning of the clinician both as a South African and as a practitioner of psychiatry is central to the development of psychiatry in a post-apartheid South Africa.

  4. Management of severe acute malnutrition in children under 5 years through the lens of health care workers in two rural South African hospitals

    OpenAIRE

    Muzigaba, Moise; van Wyk, Brian; Puoane, Thandi

    2018-01-01

    Background Despite the widespread implementation of the World Health Organization (WHO) guidelines for the management of severe malnutrition in South Africa, poor treatment outcomes for children under 5 years are still observed in some hospitals, particularly in rural areas. Objective To explore health care workers’ perceptions about upstream and proximal factors contributing to poor treatment outcomes for severe acute malnutrition in two district hospitals in South Africa. Methods An explora...

  5. Management of severe acute malnutrition in children under 5 years through the lens of health care workers in two rural South African hospitals

    OpenAIRE

    Moise Muzigaba; Brian van Wyk; Thandi Puoane

    2018-01-01

    Background: Despite the widespread implementation of the World Health Organization (WHO) guidelines for the management of severe malnutrition in South Africa, poor treatment outcomes for children under 5 years are still observed in some hospitals, particularly in rural areas.Objective: To explore health care workers’ perceptions about upstream and proximal factors contributing to poor treatment outcomes for severe acute malnutrition in two district hospitals in South Africa.Methods: An explor...

  6. The Tools, Approaches and Applications of Visual Literacy in the Visual Arts Department of Cross River University of Technology, Calabar, Nigeria

    Science.gov (United States)

    Ecoma, Victor

    2016-01-01

    The paper reflects upon the tools, approaches and applications of visual literacy in the Visual Arts Department of Cross River University of Technology, Calabar, Nigeria. The objective of the discourse is to examine how the visual arts training and practice equip students with skills in visual literacy through methods of production, materials and…

  7. Counselling Implications of Teachers' Digital Competencies in the Use of Social Networking Sites (SNSs) in the Teaching-Learning Process in Calabar, Nigeria

    Science.gov (United States)

    Eyo, Mfon

    2016-01-01

    The study investigated teachers' digital competencies in the use of Social Networking Sites (SNSs) in the teaching-learning process. It had five research questions and two hypotheses. Adopting a survey design, it used a sample of 250 teachers from 10 out of 16 secondary schools in Calabar Municipal Local Government. A researcher-developed…

  8. 'VllA'l'ER WELLS m CALABAR fifi1§.A,_.§q1tri-isAsr

    African Journals Online (AJOL)

    2007-07-01

    Jul 1, 2007 ... COPYRIGHTQ BACHUDO SCIENCE CO. LTD PRINTED IN ... Acidic water causes corrosion of pumps, pipes and screens made of iron and steel. On the other ... Calabar River in the west and the Great Kwa River in the east ...

  9. Utilization of Information and Communication Technology (ICT) Resources and Job Effectiveness among Library Staff in the University of Calabar and Cross River University of Technology, Nigeria

    Science.gov (United States)

    Ntui, Aniebiet Inyang; Inyang, Comfort Linus

    2015-01-01

    This study investigated utilization of Information and Communication Technology (ICT) resources and job effectiveness among library staff in the University of Calabar and Cross River University of Technology, Nigeria. To achieve the purpose of this study, four hypotheses were formulated to guide the study. Ex-post facto research design was adopted…

  10. Environmental Variables and Ecological Distribution of Ichthyofauna Assemblages in the Calabar River, Nigeria: Present and Future Prospects

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    Andem Andem Bassey

    2016-12-01

    Full Text Available Studies on environmental variables and ecological distribution of ichthyofauna assemblages were conducted in the Calabar River. Surface water and ichthyofauna were sampled in order to provide baseline or reference data on the Calabar River at present as regard its future prospects. Seasonal variation shows significant differences in surface water temperature, pH, DO, BOD, conductivity, TDS and TSS between sampling stations and insignificant differences in heavy metals such as cadmium, chromium, iron and copper between sampling stations. Twenty six species of fish fauna were identified belonging to twenty two families. Mugilidae, Clariidae, Cichlidae, Gobiidae and Sciaenidae were the most abundant for both wet and dry season, while Clupeidae, Bathyclupeidae, Carangidae and Sphyraenidae were low in the wet season but high in the dry season. Chromium, copper, surface water temperature, DO correlate significantly with the presence of E. fimbriata, B. soporator, M. sebae, C. gariepinus, M. loennbergii, C. guentheri and P. babarus. The overall values of biotic diversity indices ranged from 0.0504-0.0745 for Simpson’s Index, 2.770-3.095 for Shannon Index, 2.821-3.105 for Margalef’s Index and 0.8606-0.9498 for equitability. However, the presence of certain fish fauna in polluted and non-polluted parts of the river indicates that they could be used as potential bioindicators in assessment and biomonitoring of the river. The methods used in identifying fish diversity proved their applicability for future studies.

  11. Perceptions of health care professionals on the safety and security at Odi District Hospital, Gauteng, South Africa.

    Science.gov (United States)

    Okeke, Sunday O; Mabuza, Langalibalele H

    2017-10-27

    For optimum delivery of service, an establishment needs to ensure a safe and secure environment. In 2011, the South African government promulgated the National Core Standards for Health Establishments for safety and security for all employees in all establishments. Little is known about whether these standards are being complied to.Aim and setting: To assess the perceptions of health care professionals (HCPs) on safety and security at Odi District Hospital. A sample of 181 out of a total of 341 HCPs was drawn through a systematic sampling method from each HCP category. Data were collected through a self-administered questionnaire. The SPSS® statistical software version 22 was used for data analysis. The level of statistical significance was set at < 0.05. There were more female respondents than male respondents (136; 75.10%). The dominant age group was 28-47 years (114; 57.46%). Perceptions on security personnel, their efficiency and the security system were significantly affirmed (p = 0.0001). The hospital infrastructure, surroundings and plan in emergencies were perceived to be safe (p < 0.0001). The hospital lighting system was perceived as inadequate (p = 0.0041). Only 36 (20.2%) HCPs perceived that hospital authorities were concerned about employees' safety (p < 0.0001). HCPs had positive perceptions regarding the hospital's security system. Except for the negative perceptions of the lighting system and the perceived lack of hospital authorities' concern for staff safety, perceptions of the HCPs on the hospital working environment were positive. The hospital authorities need to establish the basis of negative perceptions and enforce remedial measures to redress them.

  12. Acinetobacter baumannii: Epidemiological and Beta-Lactamase Data From Two Tertiary Academic Hospitals in Tshwane, South Africa

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    Michelle Lowe

    2018-06-01

    Full Text Available Acinetobacter baumannii is an opportunistic pathogen that is increasingly responsible for hospital-acquired infections. The increasing prevalence of carbapenem resistant A. baumannii has left clinicians with limited treatment options. Last line antimicrobials (i.e., polymyxins and glycylcyclines are often used as treatment options. The aim of this study was to determine the prevalence of selected β-lactamase genes from A. baumannii isolates obtained from patients with hospital-acquired infections and to determine the genetic relationship and epidemiological profiles among clinical A. baumannii isolates collected from two tertiary academic hospitals in the Tshwane region, South Africa (SA. Multiplex-PCR (M-PCR assays were performed to detect selected resistance genes. The collected isolates’ genetic relatedness was determined by using pulsed field gel electrophoresis (PFGE and multilocus sequence typing (MLST. The acquired oxacillinase (OXA genes, notably blaOXA-23-like were prevalent in the A. baumannii isolates. The M-PCR assays showed that the isolates collected from hospital A contained the OXA-23-like (96%; n = 69/72 genes and the isolates collected from hospital B contained the OXA-23-like (91%; n = 63/69 and OXA-58-like (4%; n = 3/69 genes. Colistin resistance was found in 1% of the isolates (n = 2/141 and tigecycline intermediate resistance was found in 6% of the isolates (n = 8/141. The A. baumannii isolates were genetically diverse. Molecular epidemiological data showed that specific sequence types (STs (ST106, ST229, ST258 and ST208 were established in both hospitals, while ST848 was established in hospital A and ST502, ST339 and the novel ST1552 were established in hospital B. ST848 (established in hospital A was predominately detected in ICU wards whereas ST208, ST339 and the novel ST1552 (established in hospital B were detected in ICUs and the general wards. The origin of the A. baumannii isolates in the hospitals may be due to

  13. Profile of acne vulgaris-A hospital-based study from South India

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    Adityan Balaji

    2009-01-01

    androgenicity ( P = 0.108. Seborrheic dermatitis (21.35% was the most common disease associated. Seasonal variation was observed only in 80 patients (25.9%; 71 patients (23% exacerbated in summer and 9 patients (2.9% in winter. Smokers had more severe grade of acne vulgaris compared to nonsmokers ( P = 0.001. Conclusion: This study brings out the clinical profile of acne vulgaris in a tertiary care hospital in South India.

  14. Factors associated with recidivism at a South African forensic psychiatric hospital

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    Nirvana Morgan

    2018-04-01

    Full Text Available Aims: This study examines common factors associated with recidivism among state patients at a South African forensic psychiatric hospital. More specifically, demographic, clinical and criminological factors of a recidivist group are compared to a non-recidivist group with the intention of understanding to what extent these factors might determine the likelihood of re-offending. Method: A retrospective case file review of 293 inpatients and a random selection of 120 outpatients was conducted. For the purpose of the study, a patient was classified as a recidivist if an additional charge or act of violence was added to the file while the patient was on leave of absence in the community. Of the inpatients, only those who met the criteria for recidivism were included in the study. All 120 randomly selected outpatients were included. Demographic, clinical and criminological data were captured for all patients. Results: Eighty recidivists were compared with 100 non-recidivists. Using the × 2 and Fischer’s exact test, substance-use disorder, antisocial personality disorder, an index offence of assault and in-ward adverse events were found to be associated with recidivism (p < 0.05. Using logistic regression analysis, the odds of recidivism in a patient with an index offence of assault was 8.4 times of those who did not commit assault as an index offence (95.0% CI 1.6–43.1. The odds of recidivism for patients with cannabis use was 2.8 (95.0% CI 1.3–6.0 and for patients with in-ward adverse sexual behaviour was 17.2 (95.0% CI 2.0–150. Conclusion: Substance-use disorder and antisocial personality disorder are associated with higher risk for recidivism. This study also highlights that a less serious offence such as assault had a higher association with recidivism. Patients noted to display adverse sexual behaviour in the ward pose a potentially high risk for re-offence. Important criminal history factors and certain clinical factors could not

  15. Chart review of acute myocardial infarction at a district hospital in KwaZulu-Natal, South Africa

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    Roland Chetty

    2016-03-01

    Full Text Available Background: Incidence and prevalence of non-communicable diseases, including ischaemic heart disease (IHD and associated acute myocardial infarction (AMI, are increasing in South Africa. Local studies are needed as contextual factors, such as healthcare systems, gender and ethnicity, may affect presentation and management. In AMI, reviews on time between onset of chest pain and initiation of urgent treatment are useful, as delays in initiation of thrombolytic treatment significantly increase morbidity and mortality. Aim: The aim of the study was to determine the profile and management of patients admitted with ischaemic chest pain.Setting: The study was carried out in a busy urban-based district hospital in KwaZulu-Natal, South Africa. The population served is poor, and patients are mainly Indian with associated high risk of IHD. Methods: A chart review of all patients seen at the hospital with acute ischaemic chest pain between 01 March and 31 August 2014 was undertaken. Results: More male than female patients were admitted, with a wide variation in age. Most eligible patients received required thrombolytic intervention within an acceptable time period after arrival at hospital. Conclusion: Chest pain and AMI were a relatively common presentation at the study site, and urgent diagnosis and initiation of fibrinolytic therapy are essential. The encouraging door-toneedle time may have been influenced by the availability of specialist family physicians, trained as ‘expert generalists’ to provide appropriate care in a variety of settings and consultant support to junior staff. The role of the family physician and primary healthcare doctor in primary prevention are re-emphasised through the study findings. Keywords: Acute myocardial infarction; KwaZulu-Natal; district hospital; Asian population; hospital chart review; door-to-needle-time

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

    Science.gov (United States)

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

    2018-01-01

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

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

    Science.gov (United States)

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

    2018-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Liliwe L Shuping

    Full Text Available Hospital-associated methicillin-resistant S. aureus (HA-MRSA remains a significant cause of morbidity and mortality worldwide. We conducted a study to determine risk factors for HA-MRSA in order to inform control strategies in South Africa.We used surveillance data collected from five tertiary hospitals in Gauteng and Western Cape provinces during 2014 for analysis. A case of HA-MRSA was defined as isolation of MRSA from a blood culture 48 hours after admission and/or if the patient was hospitalised in the six months prior to the current culture. Multivariable logistic regression modelling was used to determine risk factors for HA-MRSA.Of the 9971 patients with positive blood cultures, 7.7% (772 had S. aureus bacteraemia (SAB. The overall prevalence of MRSA among those with SAB was 30.9% (231/747; 95% confidence interval [CI] 27.6%- 34.3%. HA-MRSA infections accounted for 28.3% of patients with SAB (207/731; 95% CI 25.1%- 31.7%. Burns (adjusted odds ratio [aOR] 12.7; 95% CI 4.7-34.4, age ≤1 month (aOR 8.7; 95% CI 3.0-24.6, residency at a long-term care facility (aOR 5.2; 95% CI, 1.5-17.4, antibiotic use within two months of the current SAB episode (aOR 5.1; 95% CI 2.8-9.1, hospital stay of 13 days or more (aOR 2.8; 95% CI 1.3-5.6 and mechanical ventilation (aOR 2.2; 95% CI 1.07-4.6, were independent risk factors for HA-MRSA infection.The prevalence of MRSA remains high in South African tertiary public hospitals. Several identified risk factors of HA-MRSA infections should be considered when instituting infection and prevention strategies in public-sector hospitals, including intensifying the implementation of antimicrobial stewardship programmes. There is an urgent need to strengthen infection prevention and control in burn wards, neonatal wards, and intensive care units which house mechanically ventilated patients.

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

    Science.gov (United States)

    Kuonza, Lazarus; Musekiwa, Alfred; Iyaloo, Samantha; Perovic, Olga

    2017-01-01

    Introduction Hospital-associated methicillin-resistant S. aureus (HA-MRSA) remains a significant cause of morbidity and mortality worldwide. We conducted a study to determine risk factors for HA-MRSA in order to inform control strategies in South Africa. Methods We used surveillance data collected from five tertiary hospitals in Gauteng and Western Cape provinces during 2014 for analysis. A case of HA-MRSA was defined as isolation of MRSA from a blood culture 48 hours after admission and/or if the patient was hospitalised in the six months prior to the current culture. Multivariable logistic regression modelling was used to determine risk factors for HA-MRSA. Results Of the 9971 patients with positive blood cultures, 7.7% (772) had S. aureus bacteraemia (SAB). The overall prevalence of MRSA among those with SAB was 30.9% (231/747; 95% confidence interval [CI] 27.6%– 34.3%). HA-MRSA infections accounted for 28.3% of patients with SAB (207/731; 95% CI 25.1%– 31.7%). Burns (adjusted odds ratio [aOR] 12.7; 95% CI 4.7–34.4), age ≤1 month (aOR 8.7; 95% CI 3.0–24.6), residency at a long-term care facility (aOR 5.2; 95% CI, 1.5–17.4), antibiotic use within two months of the current SAB episode (aOR 5.1; 95% CI 2.8–9.1), hospital stay of 13 days or more (aOR 2.8; 95% CI 1.3–5.6) and mechanical ventilation (aOR 2.2; 95% CI 1.07–4.6), were independent risk factors for HA-MRSA infection. Conclusion The prevalence of MRSA remains high in South African tertiary public hospitals. Several identified risk factors of HA-MRSA infections should be considered when instituting infection and prevention strategies in public-sector hospitals, including intensifying the implementation of antimicrobial stewardship programmes. There is an urgent need to strengthen infection prevention and control in burn wards, neonatal wards, and intensive care units which house mechanically ventilated patients. PMID:29145465

  20. What are key determinants of hospital admissions, readmission rate and day case rate within the South African medical schemes population?

    Directory of Open Access Journals (Sweden)

    Nondumiso Gugu Khumalo

    2012-06-01

    Full Text Available  BACKGROUND: In South Africa, private hospitals absorb a high proportion of the total health expenditure on private health care. Between 2008-2010 private hospital expenditure which includes ward fees, theatre fees, consumables, medicines and per diem arrangements consumed between 40.5% and 40.9% of the total benefits paid by medical schemes from the risk pool, whilst in-hospital managed care fees ranged between 1.8% and 2.8% for the equivalent years.OBJECTIVE: The aim of this paper is to highlight key factors contributing to utilisation of hospital services within the medical schemes population and to recommend “appropriate” and cost effective strategies on hospital utilisation management.METHODS: A cross sectional survey informed by retrospective analysis of quantitative data was used. Researchers also triangulated quantitative data with systematic review of literature.RESULTS: The results show that demographic indicators such as age profile, dependency ratio, pensioner ratio and prevalence of chronic conditions are not the only key factors influencing hospital admissions, but rather the effectiveness of each medical scheme in containing hospital admissions is also influenced by available technical capacity on utilisation review and audit as well as the managed care methodology including the philosophy underpinning benefit option design.CONCLUSION: This study highlights the importance of “value based” managed care programs linked to benefit option design in health care utilisation management. The choice of one managed care program over the other often leads to tradeoffs whereby unintended consequences emanate. Medical schemes are therefore encouraged to continuously review their managed care programs to ensure value for money as well as better access and health outcomes.http://dx.doi.org/10.7175/fe.v13i2.207

  1. 'Practice what you preach': Nurses' perspectives on the Code of Ethics and Service Pledge in five South African hospitals.

    Science.gov (United States)

    White, Janine; Phakoe, Maureen; Rispel, Laetitia C

    2015-01-01

    A recent focus of the global discourse on the health workforce has been on its quality, including the existence of codes of ethics. In South Africa, the importance of ethics and value systems in nursing was emphasised in the 2011 National Nursing Summit. The study explored hospital nurses' perceptions of the International Code of Ethics for Nurses; their perceptions of the South African Nurses' Pledge of Service; and their views on contemporary ethical practice. Following university ethics approval, the study was done at a convenience sample of five hospitals in two South African provinces. In each hospital, all day duty nurses in paediatric, maternity, adult medical, and adult surgical units were requested to complete a self-administered questionnaire. The questionnaire focused on their perceptions of the Code of Ethics and the Pledge, using a seven-point Likert scale. STATA(®) 13 and NVIVO 10 were used to analyse survey data and open-ended responses, respectively. The mean age of survey participants (n=69) was 39 years (SD=9.2), and the majority were female (96%). The majority agreed with a statement that they will promote the human rights of individuals (98%) and that they have a duty to meet the health and social needs of the public (96%). More nuanced responses were obtained for some questions, with 60% agreeing with a statement that too much emphasis is placed on patients' rights as opposed to nurses' rights and 32% agreeing with a statement that they would take part in strike action to improve nurses' salaries and working conditions. The dilemmas of nurses to uphold the Code of Ethics and the Pledge in face of workplace constraints or poor working conditions were revealed in nurses' responses to open-ended questions. Continuing education in ethics and addressing health system deficiencies will enhance nurses' professional development and their ethical decision-making and practice.

  2. Hospital reform and staff morale in South Africa: a case study of Dr ...

    African Journals Online (AJOL)

    2012-02-16

    Feb 16, 2012 ... in South Africa, can affect budget, equipment, the work ..... There is insufficient appreciation by management and an insufficient reward .... literature review of selected theories dealing with job satisfaction and motivation.

  3. The development of a national surveillance system for monitoring blood use and inventory levels at sentinel hospitals in South Korea.

    Science.gov (United States)

    Lim, Y A; Kim, H H; Joung, U S; Kim, C Y; Shin, Y H; Lee, S W; Kim, H J

    2010-04-01

    We developed a web-based program for a national surveillance system to determine baseline data regarding the supply and demand of blood products at sentinel hospitals in South Korea. Sentinel hospitals were invited to participate in a 1-month pilot-test. The data for receipts and exports of blood from each hospital information system were converted into comma-separated value files according to a specific conversion rule. The daily data from the sites could be transferred to the web-based program server using a semi-automated submission procedure: pressing a key allowed the program to automatically compute the blood inventory level as well as other indices including the minimal inventory ratio (MIR), ideal inventory ratio (IIR), supply index (SI) and utilisation index (UI). The national surveillance system was referred to as the Korean Blood Inventory Monitoring System (KBIMS) and the web-based program for KBIMS was referred to as the Blood Inventory Monitoring System (BMS). A total of 30 256 red blood cell (RBC) units were submitted as receipt data, however, only 83% of the receipt data were submitted to the BMS server as export data (25 093 RBC units). Median values were 2.67 for MIR, 1.08 for IIR, 1.00 for SI, 0.88 for UI and 5.33 for the ideal inventory day. The BMS program was easy to use and is expected to provide a useful tool for monitoring hospital inventory levels. This information will provide baseline data regarding the supply and demand of blood products in South Korea.

  4. Anesthesia-related and perioperative mortality: An audit of 8493 cases at a tertiary pediatric teaching hospital in South Africa.

    Science.gov (United States)

    Meyer, Heidi M; Thomas, Jenny; Wilson, Graeme S; de Kock, Marianna

    2017-10-01

    This study aimed to quantify the incidence of anesthesia-related and perioperative mortality at a large tertiary pediatric hospital in South Africa. This study included all children aged anesthesia caused the death; (ii) anesthesia may have contributed to or influenced the timing of death; or (iii) anesthesia was entirely unrelated to the death. There were 47 deaths within 30 days of anesthesia prior to discharge from hospital during this 12-month period. The in-hospital mortality within 24 h of administration of anesthesia was 16.5 per 10 000 cases (95% confidence intervals [CI]=7.8-25.1) and within 30 days of administration of anesthesia was 55.3 per 10 000 cases (95% CI=39.5-71.2). Age under 1 year (OR 4.5; 95% CI=2.5-8.0, P=.012) and cardiac surgery and interventional cardiology procedures (OR 2.5; 95% CI=1.2-5.2, Prisk of perioperative mortality. The overall 24-h and 30-day anesthesia-related and in-hospital perioperative mortality rates in our study are comparable with other similar studies from tertiary pediatric centers. © 2017 John Wiley & Sons Ltd.

  5. Geographical distribution and profile of medical doctors in public sector hospitals of the Limpopo Province, South Africa.

    Science.gov (United States)

    Ntuli, Samuel T; Maboya, Edwin

    2017-09-27

    The shortage and unequal distribution of medical doctors in low- and middle-income countries continues to be a public health concern. To establish the geographical distribution and demographic profile of medical doctors in public sector hospitals of the Limpopo Province, South Africa. The PERSAL system was used to obtain information on the number of medical doctors employed in public sector hospitals of the Limpopo Province. Data were exported from PERSAL's database and then analysed using STATA version 9.0. The mean age of the 887 medical doctors was 40.1 ± 11.2 years (range 24-79 years). Sixty per cent of the doctors were male, 66% were aged ≤ 45 years and 84% were African. Most of the doctors (86%) were medical officers, of which 55% had < 5 years working experience. Overall, the doctor-to-population ratio for the five districts in the province was 16.4/100 000, with Capricorn (33.7/100 000) and Waterberg (20.2/100 000) recording the highest ratios. A large proportion (43%) of medical officers are employed in the Capricorn District, of which 71% were practising at the tertiary hospital. This study demonstrated a shortage and maldistribution of medical doctors in the public sector hospitals of the Limpopo Province. This has a potentially negative effect on the delivery of an appropriate and efficient healthcare service to the population and requires urgent attention.

  6. From Slang to Acceptability: Style-Shifting Variation in English Language Usage by Students of CRUTECH, Calabar, Nigeria

    Directory of Open Access Journals (Sweden)

    Mercy Ugot

    2014-01-01

    Full Text Available This paper focuses on informal language usage by students of Cross River University of Technology, Calabar, Nigeria. This includes the use of slang words from primarily the substrate and superstrate language of the mother tongue (MT and Nigerian Pidgin (NP respectively. Participant observation was used for this work including lectures and other forums. Focus is on the speech discourse of students. The NP in particular is a contact language which has grown in stature due to factors of relevance as a common language in a pluralistic society like the Cross River State in particular, and Nigeria in general. Its use has also expanded due to urbanization. The MT has been observed to be influential through direct translation of certain expressions. Findings have shown that the informal use of language by the students has inadvertently affected their competence in standard and formal language use.

  7. The effect of social capital on job satisfaction and quality of care among hospital nurses in South Korea.

    Science.gov (United States)

    Shin, Ji In; Lee, Eunjoo

    2016-10-01

    To identify the level of social capital and its effect on job satisfaction and self-reported quality of care of nurses working in hospital settings in South Korea. There are few studies on social capital and its relationship to workplace outcomes in the nursing profession internationally. A cross-sectional, correlational design was adopted with a convenience sample of 432 nurses from two university-affiliated teaching hospitals in South Korea. Nurses' social capital was positively related to job satisfaction and self-reported quality of care. Social capital explained 50% and 24%, respectively, of the variance in job satisfaction and reported quality of care. By improving social capital, nurses' job satisfaction could be enhanced and result in better quality of care for patients. Strategies to improve social capital in nursing organisations are necessary to improve job satisfaction and the quality of care provided by nurses. Nurse managers and administrators should encourage nurse participation in organisational affairs and decision-making processes to improve social capital by developing a trusting work environment with shared values and support nurses who work with peers, superiors, and subordinates. © 2016 John Wiley & Sons Ltd.

  8. Hospitals

    DEFF Research Database (Denmark)

    Mullins, Michael

    2013-01-01

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

  9. Challenges of information systems strategy implementation in public hospitals: a South African experience

    CSIR Research Space (South Africa)

    Hwabamungu, B

    2015-05-01

    Full Text Available on this phenomenon in the healthcare sector. Building on previous IS strategizing research we explored the challenges of Information Systems strategy implementation. We then explored the challenges of IS strategy implementation in public hospitals in developing...

  10. Hospital reform and staff morale in South Africa: a case study of Dr ...

    African Journals Online (AJOL)

    2012-02-16

    Feb 16, 2012 ... Settings and subjects: This study included all medical and nursing staff working at ... Keywords: hospital reform, staff morale, quality of care, healthcare resources ..... of healthcare workers' goals to cure patients.3 This differs.

  11. The profile of meningitis in a tertiary paediatric hospital in South Africa

    African Journals Online (AJOL)

    Methods. This study describes all patients treated for suspected meningitis at our hospital from 2010 to 2012. Data were .... Weight loss, neck stiffness, altered level of consciousness and lethargy were ..... Direct application of MALDI-TOF mass.

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

    African Journals Online (AJOL)

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

  13. The role of skeletal scintigraphy in nuclear oncology at a medium-sized hospital in South Korea

    International Nuclear Information System (INIS)

    Choe, W.

    2004-01-01

    Full text: Skeletal scintigraphy (SS) has been a workhorse in nuclear medicine departments, whether the department is in a developed country or in a developing country. It also plays an essential role in nuclear oncology in staging or diagnosing cancers or monitoring management of cancer patients. With the availability of improved imaging modalities like positron emission tomography, the role of skeletal scintigraphy is changing accordingly. This study was performed to evaluate the role of SS in nuclear oncology at a medium-sized (900-bed) university hospital in South Korea, by reviewing hospital cases along with the statistics of recently published papers in the journal of Clinical Nuclear Medicine. The hospital does not have a PET. The study period was three years (from 2000 to 2002). The SS is requested from many specialties for various reasons. Only cancer-related cases were selected. Using PubMed database, relevant articles in the Clinical Nuclear Medicine were assessed. To retrieve the articles, the keywords 'skeletal scintigraphy' and 'bone scan' were combined by using Boolean operation. There were a total of 9707 SS out of 16429 nuclear medicine imaging cases at the hospital during the study period. The hospital had 49% of SS contributed to cancer patients, while 52% percent of the SS in the CNM dealt with cancers. During the same period, articles regarding PET were 273 of which 171 were cancer-related PET studies (62%, more often than SS). 59% of the total nuclear medicine studies performed at the hospital were SS, whereas only 9% of the total articles were SS and 5% dealt with cancer-related cases. The cases of SS and cancer-related SS at the hospital increased during the period, whereas the articles in the CNM decreased. Analytic statistics were not considered necessary. In conclusion, there is an increasing demand of SS in nuclear oncology at a medium-sized hospital with non-availability of PET and the proportions of SS and cancer-related SS to the

  14. Stakeholder influence in public sector information systems strategy implementation-The case of public hospitals in South Africa.

    Science.gov (United States)

    Hwabamungu, Boroto; Brown, Irwin; Williams, Quentin

    2018-01-01

    Recent literature on organisational strategy has called for greater emphasis on individuals (stakeholders) and what they do in the process of strategizing. Public sector organisations have to engage with an array of heterogeneous stakeholders in fulfilling their mandate. The public health sector in particular needs to engage with a diversity of stakeholders at local, regional and national levels when strategising. The purpose of this study is to investigate the influence of stakeholder relations on the implementation of Information Systems (IS) strategy in public hospitals in South Africa. An interpretive approach using two provinces was employed. The Activity Analysis and Development (ActAD) framework, an enhanced form of activity theory, was used as the theoretical framework. Data was collected using semi-structured interviews, meetings, documents analysis, physical artefacts and observation. The collected data was analysed using thematic analysis. Findings reveal that IS strategy implementation in public hospitals involves a large and complex network of stakeholder groups at different levels, and over different time periods. These stakeholder groups act in accordance with formal and informal roles, rules and modalities. Various contextual conditions together with the actions of, and interactions between stakeholder groups give rise to the situationality of stakeholder relations dynamics and strategy implementation. The multiple actions and interactions over time lead to the realisation of some aspects of the IS strategy in public hospitals. Given the complexity and dynamism of the context there are also certain unplanned implementations as well. These relationships are captured in a Stakeholder Relations Influence (SRI) framework. The SRI framework can be assistive in the assessment and mapping of stakeholders and stakeholder relations, and the assessment of the implications of these relations for effective IS strategy implementation in public hospitals. The

  15. Management of physical child abuse in South Africa:Literature review and children's hospital data analysis

    NARCIS (Netherlands)

    Janssen, T.L. (T. L.); M. van Dijk (Monique); Al Malki, I. (I.); A.B. van As (Àrjan Bastiaan)

    2013-01-01

    textabstractBackground: The reason for this review is the lack of data on the management of physical abused children in Africa. The primary goal of the first part is to outline the management of physical child abuse in (South) Africa and provide suggestions for other governments in Africa on which

  16. The effects of a language barrier in a South African district hospital

    African Journals Online (AJOL)

    2006-08-11

    Aug 11, 2006 ... Levin M. Language as a barrier to care for Xhosa-speaking patients at a South African paediatric ... of the Western Cape where staff mainly speak Afrikaans or. English and a large .... the other day a child died, and the mom stands there, and we literally sit .... But what other options do you have? (Afrikaans-.

  17. 59 months at Al-Sabah Children Hospital, Juba, South Sudan

    African Journals Online (AJOL)

    Background: Malnutrition is a critical public health concern in South Sudan where an estimated 200,000 children aged under five years are at risk of being malnourished. Studies have shown that adequate and timely treatment of these children leads to reduced mortality. Objective: To determine the proportion of children ...

  18. Genotypic characterisation of Staphylococcus aureus isolates causing bacteraemia at Tygerberg hospital, western cape province, South Africa

    NARCIS (Netherlands)

    Orth, H.; Salaam-Dreyer, Z.; Makgotlho, E.; Sinha, B.; Wasserman, E.

    2011-01-01

    Objectives: There is a paucity of studies on the genotypic characterisation of invasive S. aureus strains and the incidence of communityacquired methicillin resistant S. aureus (CA-MRSA) infections in South Africa. In this study we characterized S. aureus isolates from bacteraemia episodes using

  19. Treatment Outcomes and Costs of Providing Antiretroviral Therapy at a Primary Health Clinic versus a Hospital-Based HIV Clinic in South Africa

    OpenAIRE

    Long, Lawrence C.; Rosen, Sydney B.; Brennan, Alana; Moyo, Faith; Sauls, Celeste; Evans, Denise; Modi, Shookdev L.; Sanne, Ian; Fox, Matthew P.

    2016-01-01

    Background In 2010 South Africa revised its HIV treatment guidelines to allow the initiation and management of patients on antiretroviral therapy (ART) by nurses, rather than solely doctors, under a program called NIMART (Nurse Initiated and Managed Antiretroviral Therapy). We compared the outcomes and costs of NIMART between the two major public sector HIV treatment delivery models in use in South Africa today, primary health clinics and hospital-based HIV clinics. Methods and findings The s...

  20. Healthiness of Food and Beverages for Sale at Two Public Hospitals in New South Wales, Australia

    Directory of Open Access Journals (Sweden)

    Carrie Tsai

    2018-02-01

    Full Text Available (1 Background: Our aim was to conduct objective, baseline food environment audits of two major western Sydney public hospitals and compare them to recently revised state nutritional guidelines. (2 Methods: A cross-sectional assessment was conducted (June–July2017 across 14 fixed food outlets and 70 vending machines in two hospitals using an audit tool designed to assess the guideline’s key food environment parameters of availability, placement, and promotion of ‘Everyday’ (healthy and ‘Occasional’ (less healthy products. (3 Results: Availability: Overall, Everyday products made up 51% and 44% of all products available at the two hospitals. Only 1/14 (7% fixed outlets and 16/70 (23% vending machines met the guideline’s availability benchmarks of ≥75% Everyday food and beverages. Proportion of Everyday products differed among different types of food outlets (café, cafeteria, convenience stores. Placement: On average, food outlets did not meet recommendations of limiting Occasional products in prominent positions, with checkout areas and countertops displaying over 60% Occasional items. Promotion: Over two-thirds of meal deals at both hospitals included Occasional products. (4 Conclusion: Baseline audit results show that substantial improvements in availability, placement, and promotion can be made at these public hospitals to meet the nutrition guidelines. Audits of other NSW hospitals using the developed tool are needed to investigate similarities and differences in food environment between sites. These findings highlight the need for ongoing tracking to inform whether the revised guidelines are leading to improved food environments in health facilities.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2002-01-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2002-01-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Vizuet G, J

    2001-09-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2001-12-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2001-12-15

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

  6. Fresh-frozen plasma use in a South African tertiary hospital | Visser ...

    African Journals Online (AJOL)

    Despite available guidelines on indications for fresh-frozen plasma (FFP) transfusion, inappropriate use is increasing worldwide. We evaluated FFP administration to patients admitted to the Steve Biko Academic Hospital over 4 months, including indications for use and completeness of requisition forms. Transfusions were ...

  7. Disease patterns in the medical wards of a rural South African hospital

    African Journals Online (AJOL)

    Hypertension dominated the disease pattern followed by pulmonary tuberculosis, gastro-enteritis, pneumonia, diabetes, and asthma. The findings of this study suggest that diseases prominent in the affluent urban population affect patients seen at this rural hospital. The focus of primary care physicians should be to manage ...

  8. Same Day Surgery at the 121st General Hospital Seoul, South Korea

    Science.gov (United States)

    2006-06-01

    s ................................................................................. 42 A ppendices ...diagnosed condition of a patient. If the patient is more acutely ill than average and requires extra care, the hospital must pay any cost beyond the DRG...Integration of "well" patients with acutely ill Staff less experienced to meet outpatient health Minimal construction care needs Physician can work

  9. Common geriatric emergencies in a rural hospital in South-Eastern ...

    African Journals Online (AJOL)

    2011-11-02

    Nov 2, 2011 ... epidemiologically recognized as constitutional risk factor ... Materials and Methods: This was a descriptive hospital-based study of 216 geriatric patients who .... (hypertension and hypertension-related heart failure) the ... [7,8] This finding has ... measured with sphygmomanometer, majority of geriatric.

  10. Intracranial suppuration: Review of an 8-year experience at Umtata General Hospital and Nelson Mandela Academic Hospital, Eastern Cape, South Africa.

    Science.gov (United States)

    Anwary, M A

    2015-09-21

    Intracranial suppuration (ICS) is a life-threatening condition caused by various disease processes and consisting of brain abscess and extradural and subdural empyema. The major causes have changed over the decades. To the author's knowledge, the incidence of ICS in South Africa (SA) has not been established. To determine the incidence of ICS, overall and according to age and gender, and to identify the source and distribution of ICS. The archive of the radiology departments at Umtata General Hospital and Nelson Mandela Academic Hospital in the Transkei region, Eastern Cape Province, SA, was searched retrospectively for computed tomography (CT) reports of patients diagnosed with ICS. Cases in which the CT images, patients' clinical information and CT reports were available for an uninterrupted period of at least 1 year were included. Five time frames were established, encompassing 8 years of data. The first time frame established an incidence of ICS of 1/100,000/year for the Transkei region. All the time frames were utilised to determine the incidence according to gender and age, and the source and distribution of ICS. The incidence of ICS was higher among males than females, and highest in the age groups 0-10 and 11-20 years. A seasonal variation in the incidence of sinusitis- and meningitis-related ICS was noted. Numbers of cases declined during the last 3 years of the study period. Sinusitis, head trauma, ear infection and meningitis were the major sources of ICS. A pulmonary source was not a major feature. In the last 4 years, trauma became the commonest source of ICS. A steady decline in ear infection- and meningitis-related ICS was noted.

  11. Typical occupational accidents with employees of a university hospital in the south of Brazil: epidemiology and prevention.

    Science.gov (United States)

    Sêcco, Iara Aparecida de Oliveira; Robazzi, Maria Lúcia do Carmo Cruz; Shimizu, Denise Sayuri; Rúbio, Márcia Maria da Silva

    2008-01-01

    Descriptive epidemiologic study that aimed to analyze the typical occupational accidents notified by employees of a university hospital in the South of Brazil from 1997 to 2002, and to estimate their risk indicators. A total of 717 accidents were registered; 86% of them (616) were typical and presented an annual average risk coefficient of 6.0 per 100 employees. The groups that presented more risks for accidents were cooks, woodworkers and nursing auxiliaries, while hands were the most affected area. Regarding the accidents nature, the greatest risks involved biological material. Hence, it is necessary to orient personnel about the legal aspects of occupational accidents and review work processes, especially those related to employees who perform activities at greater risk of transmissible diseases like AIDS and hepatitis B and C.

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

    International Nuclear Information System (INIS)

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

    2002-01-01

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

  13. Awareness and Practice of Cervical Smear as A Screening Procedure for Cervical Cancer among Female Nurses in A Tertiary Hospital in South-South Nigeria

    Directory of Open Access Journals (Sweden)

    Imoh Unang

    2011-12-01

    Full Text Available AIM: Carcinoma of the cervix, the second most common cancer among women remains a public health problem. Though this preventable cancer occurs more commonly in the developing world, it is almost non-existent in developed countries where there are well established screening programs. The aim of this study is to determine the degree of awareness and practice of cervical smear as a screening procedure for cervical cancer among female nurses in a tertiary health facility in south-south Nigeria. METHOD: Semi-structured questionnaires were distributed to all the female nurses at the University of Uyo Teaching Hospital. RESULTS: The ages of the respondents were between 21 - 60 years with the modal age group being 31- 40 years (48.9%. Majority of the respondents were married (59.7% and 36.4% of them had practiced nursing for over 10 years. Majority of the respondents (94.3% had heard of the cervical smear and 79.5% of the nurses knew that cervical smears were used to detect premalignant diseases of the cervix. Only 7.4% of the nurses had undergone screening for cervical cancer. Common reasons given by the respondents who had not screened were not being a candidate for cervical cancer (31.9% and ignorance as to where screening is done (28.8%. The most common sources of information about cervical smear were the hospital (87.5% and textbooks (13.6%. CONCLUSION: The level of awareness of the cervical smear as a preventive tool for cervical cancer was high but utilization of the test was disappointingly low. Modern concepts of cancer prevention and control should be included in the curriculum of the school of nursing and nurses should be involved in the organisation of health talks to members of the community on cervical cancer and its prevention. The print and electronic media should be made to participate in the dissemination of information on the prevention of cervical cancer in our environment. [TAF Prev Med Bull 2011; 10(6.000: 675-680

  14. The accuracy of nurse performance of the triage process in a tertiary hospital emergency department in Gauteng Province, South Africa

    Directory of Open Access Journals (Sweden)

    L N Goldstein

    2017-03-01

    Full Text Available Background. Triage in the emergency department (ED is necessary to prioritise management according to the severity of a patient’s condition.The South African Triage Scale (SATS is a hospital-based triage tool that has been adopted by numerous EDs countrywide.Many factors can influence the outcome of a patient’s triage result, and evaluation of performance is therefore pivotal. Objectives. To determine how often patients were allocated to the correct triage category and the extent to which they were incorrectly promoted or demoted, and to determine the main reasons for errors in a nurse-led triage system. Methods. Triage forms from a tertiary hospital ED in Gauteng Province, South Africa, were collected over a 1-week period and reviewed retrospectively. Results. A total of 1 091 triage forms were reviewed. Triage category allocations were correct 68.3% of the time. Of the incorrect category assignments, 44.4% of patients were promoted and 55.6% demoted. Patients in the green category were most commonly promoted (29.4% and patients who should have been in orange were most commonly demoted (35.0%. Trauma patients were more likely to be incorrectly promoted and non-trauma patients to be incorrectly demoted. Mistakes were mainly due to discriminator errors (57.8%, followed by numerical miscalculations (21.5%. The leading omitted discriminators were ‘abdominal pain’, ‘chest pain’ and ‘shortness of breath’. Conclusions. Mis-triaging using the SATS can be attributed to incorrect or lack of discriminator use, numerical miscalculations and other human errors. Quality control and quality assurance measures must target training in these areas to minimise mis-triage in the ED.

  15. Laboratory surveillance of influenza-like illness in seven teaching hospitals, South Korea: 2011-2012 season.

    Directory of Open Access Journals (Sweden)

    Ji Yun Noh

    Full Text Available BACKGROUND: A well-constructed and properly operating influenza surveillance scheme is essential for public health. This study was conducted to evaluate the distribution of respiratory viruses in patients with influenza-like illness (ILI through the first teaching hospital-based surveillance scheme for ILI in South Korea. METHODS: Respiratory specimens were obtained from adult patients (≥18 years who visited the emergency department (ED with ILI from week 40, 2011 to week 22, 2012. Multiplex PCR was performed to detect respiratory viruses: influenza virus, adenovirus, coronavirus, respiratory syncytial virus, rhinovirus, human metapneumovirus, parainfluenza virus, bocavirus, and enterovirus. RESULTS: Among 1,983 patients who visited the ED with ILI, 811 (40.9% were male. The median age of patients was 43 years. Influenza vaccination rate was 21.7% (430/1,983 during the 2011-2012 season. At least one comorbidity was found in 18% of patients. The positive rate of respiratory viruses was 52.1% (1,033/1,983 and the total number of detected viruses was 1,100. Influenza A virus was the dominant agent (677, 61.5% in all age groups. The prevalence of human metapneumovirus was higher in patients more than 50 years old, while adenovirus was detected only in younger adults. In 58 (5.6% cases, two or more respiratory viruses were detected. The co-incidence case was identified more frequently in patients with hematologic malignancy or organ transplantation recipients, however it was not related to clinical outcomes. CONCLUSION: This study is valuable as the first extensive laboratory surveillance of the epidemiology of respiratory viruses in ILI patients through a teaching hospital-based influenza surveillance system in South Korea.

  16. An investigation of diverticular disease among black patients undergoing colonoscopy at Dr George Mukhari Academic Hospital, Pretoria, South Africa.

    Science.gov (United States)

    Vally, M; Koto, M Z; Govender, M

    2017-01-30

    Diverticular disease was previously thought to be non-existent in the black African population. Studies over the past four decades, however, have shown a steady increase in the prevalence of the disease. To report on the profile and current prevalence of diverticular disease in the black South African (SA) population at Dr George Mukhari Academic Hospital, Pretoria, SA. A retrospective descriptive study was performed in black SA patients who were diagnosed with diverticular disease by colonoscopy between 1 January and 31 December 2015. Of 348 patients who had undergone colonoscopies and who were eligible for inclusion in this study, 47 were diagnosed with diverticular disease - a prevalence of 13.50% (95% confidence interval 10.30 - 17.50). The greatest number of patients diagnosed were in their 7th and 8th decades, with an age range of 46 - 86 (mean 67) years. There was a female predominance of 57.45%. Lower gastrointestinal bleeding was the most common (65.96%) indication for colonoscopy. The left colon was most commonly involved (72.34%), followed by the right colon (55.31%). A substantial number of patients had pancolonic involvement (27.65%). This retrospective study suggests that there has been a considerable increase in the prevalence of diverticular disease among black South Africans, possibly owing to changes in dietary habits and socioeconomic status.

  17. An investigation of diverticular disease among black patients undergoing colonoscopy at Dr George Mukhari Academic Hospital, Pretoria, South Africa

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    M Vally

    2017-02-01

    Full Text Available Background. Diverticular disease was previously thought to be non-existent in the black African population. Studies over the past four decades, however, have shown a steady increase in the prevalence of the disease. Objective. To report on the profile and current prevalence of diverticular disease in the black South African (SA population at Dr George Mukhari Academic Hospital, Pretoria, SA. Methods. A retrospective descriptive study was performed in black SA patients who were diagnosed with diverticular disease by colonoscopy between 1 January and 31 December 2015. Results. Of 348 patients who had undergone colonoscopies and who were eligible for inclusion in this study, 47 were diagnosed with diverticular disease – a prevalence of 13.50% (95% confidence interval 10.30 - 17.50. The greatest number of patients diagnosed were in their 7th and 8th decades, with an age range of 46 - 86 (mean 67 years. There was a female predominance of 57.45%. Lower gastrointestinal bleeding was the most common (65.96% indication for colonoscopy. The left colon was most commonly involved (72.34%, followed by the right colon (55.31%. A substantial number of patients had pancolonic involvement (27.65%. Conclusion. This retrospective study suggests that there has been a considerable increase in the prevalence of diverticular disease among black South Africans, possibly owing to changes in dietary habits and socioeconomic status.

  18. Factors Related to Healthcare Service Quality in Long-term Care Hospitals in South Korea: A Mixed-methods Study.

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    Sohn, Minsung; Choi, Mankyu

    2017-10-01

    The environment of long-term care hospitals (LTCHs) is critical to the management of the quality of their services and to patient safety, as highlighted by international studies. However, there is a lack of evidence on this topic in South Korea. This study aimed to examine the factors affecting healthcare quality in LTCHs and to explore the effectiveness of their quality management. This study used a mixed methods approach with quantitative data collected in a national survey and qualitative data from semi-structured interviews with practice-based managers. The samples included 725 nationally representative LTCHs in South Korea for the quantitative analysis and 15 administrators for the in-depth interviews. A higher installation rate of patient-safety and hygiene-related facilities and staff with longer-tenures, especially nurses, were more likely to have better healthcare quality and education for both employees and patients. The need for patient-safety- and hygiene-related facilities in LTCHs that serve older adults reflects their vulnerability to certain adverse events (e.g., infections). Consistent and skillful nursing care to improve the quality of LTCHs can be achieved by developing relevant educational programs for staff and patients, thereby strengthening the relationships between them.

  19. Satisfaction and adherence of patients with amputations to physiotherapy service at public hospitals in KwaZulu-Natal, South Africa.

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    Verusia, Chetty; Tanuja, Dunpath; Simira, Meghnath; Sarisha, Mothalal; Varuna, Sewmungal; Ursula, Kunene; Thalente, Ntshakala

    2015-06-01

    Individuals who have undergone a lower limb amputation require comprehensive rehabilitation from the multidisciplinary team to ensure optimal treatment outcomes and social integration. Physiotherapists play a pivotal role within the multidisciplinary team and offer patients physical and psychosocial rehabilitative care. Determining patients' satisfaction levels and exploring factors affecting adherence to physiotherapy interventions can inform practice and improve service delivery of rehabilitation within resource poor settings such as South Africa. To determine the level of satisfaction with physiotherapy services rendered to acute and sub-acute in-patients with lower limb amputations and to explore factors affecting adherence to physiotherapy intervention. A prospective survey of 35 patients with lower limb amputations from four public hospitals in South Africa was undertaken. A modified version of the Hampstead rehabilitation centre patient satisfaction questionnaire was utilised. Majority of participants were satisfied with the physiotherapy services whilst a few reported dissatisfaction. Three themes emerged whilst exploring the patients' experience relating to adherence to physiotherapy programmes. Themes included service delivery, patient-therapist interaction and participation barriers and facilitators. Recommendations aimed to improve quality of care and healthcare outcomes thereby enhancing the participants' adherence to the physiotherapy programme.

  20. Clinical, immunologic and insulin secretory characteristics of young black South African patients with diabetes: Hospital based single centre study.

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    Ekpebegh, C O; Longo-Mbenza, B

    2013-03-01

    To classify and characterize the clinical features of various diabetes classes among young black South Africans. Cross sectional study of 60 black patients with diabetes, all less than 30 years of age and attending Nelson Mandela Academic Hospital, Mthatha, South Africa. Diabetes was classified as Types 1A, 1B and 2 based on the anti-glutamic acid decarboxylase status and serum C-peptide response to intravenous injection of glucagon. Mean age was 19.6±4.8 years (n=60) with similar gender distribution. The mean duration of diabetes was 24.2±45.1 months. Type 1A was the class of diabetes in 55% (n=33/60) of patients. Type 1B and 2 accounted for 30% (n=18/60) and 15% (n=9/60) of patients respectively. Patients classified as Type 2 had higher waist circumference and higher prevalence of acanthosis nigricans than Types 1A and 1B groups. History of diabetes in a first degree relative and hypertension were found in similar proportions of patients with Types 1A, 1B and 2 diabetes. Five Type 1A diabetes patients had body mass index of 26.2-41kg/m(2) and this included two newly diagnosed patients with body mass index of 26.7kg/m(2) and 33.2kg/m(2). The majority of our young black South Africans with diabetes are of the Type 1A class. Acanthosis nigricans was not found in any patient with Type 1 A diabetes. A minority of Type 1 A diabetes patients were obese at initial diagnosis. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  1. Infant feeding practices among HIV-positive mothers at Tembisa hospital, South Africa

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    Armelia Chaponda

    2017-07-01

    Conclusion: In the postnatal hospital setting of this study, the feeding choices of mothers were influenced by nursing personnel. Nursing personnel could marry the influential ‘authority’ they have with correct and consistent information, in order to change feeding behaviour. Significant ‘others’ like grandmothers and other relatives also influenced decisions on infant feeding. As such, family dynamics need to be considered when encouraging breastfeeding.

  2. Newborn transport in South Australia, 1978-80: experience of the Queen Victoria Hospital, Adelaide.

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    Davies, A G; Fitzgerald, A M; Dahlenburg, G W

    1982-01-23

    389 infants were transported to the Queen Victoria Hospital, Adelaide between 1978 and 1980. Twenty-three percent (99) of the infants were ventilated, and 49% (189) received intravenous or intra-arterial therapy. Fifty-six percent (217) of the infants required transport because of prematurity; 11% (46) because of perinatal asphyxia in babies weighing more than 2,500 g. Only one baby died during transport, while 14% of the babies died subsequently. A core temperature of less than 36 degrees C in either hospital is important; a cold baby is 3.5 times more likely to die (X2=25.46, P less than 0.001). The transport of babies over distances greater than 300 kilometres is peculiar to Australia. Significantly more of these babies were cold than those retrieved from hospitals near Adelaide (X2=4.7, P less than 0.05), and significantly more died. Difficulty in transferring mothers in preterm labour may be another reason these babies did relatively badly. Better education and facilities will be important if we are to improve their survival chances.

  3. STANDARD PRECAUTIONS: AN ASSESSMENT OF AWARENESS AMONG HEALTH CARE PERSONNEL IN A TEACHING HOSPITAL, SOUTH INDIA.

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    Sangeetha

    2015-02-01

    Full Text Available BACKGROUND : Standard precautions ar e crucial in the prevention and transmission of Healthcare associated infections ( HAI and transmission of blood - borne pathogens like Hepatitis B, Human Immunodeficiency Virus & Hepatitis C. They are not well u nderstood or implemented by health care practitioners. Hence this study was taken up to determine and compare knowledge, attitude of standard precautions among health care personnel at a teaching hospital, Bangalore. OBJECTIVE : To assess knowledge, attitud e, practices and compliance of Standard precautions among health care workers at a teaching hospital. METHODOLOGY : One hundred and fifty seven health care personnel participated in this study. A pretest and post test was administered to the study group. A pre - structured questionnaire on standard precautions was prepared which included knowledge, attitude and practices. RESULTS : 116 ( 73.88% nurses had knowledge about hand hygiene, but only 82 ( 52.2% nurses practiced hand hygiene before and after patient care. Knowledge about PPE measures like gloves, face mask & goggles, gowns were known to 101(64.33%, 56 ( 35.66% & 69 ( 43.94% nurses respectively. 117 ( 74.52% nurses discarded needles & sharps in correct puncture proof containers, but their correct knowled ge regarding colour coding of hospital waste segregation was comparatively less i.e. 104 ( 66.24%. 119 ( 75.79% of the nurses had practice of recapping the needles after use. CONCLUSION : There was significant improvement in the knowledge and practice of stan dard precautions in the present study after incorporating good training practices

  4. Antimicrobial resistance patterns of Staphylococcus species isolated from cats presented at a veterinary academic hospital in South Africa.

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    Qekwana, Daniel Nenene; Sebola, Dikeledi; Oguttu, James Wabwire; Odoi, Agricola

    2017-09-15

    Antimicrobial resistance is becoming increasingly important in both human and veterinary medicine. This study investigated the proportion of antimicrobial resistant samples and resistance patterns of Staphylococcus isolates from cats presented at a veterinary teaching hospital in South Africa. Records of 216 samples from cats that were submitted to the bacteriology laboratory of the University of Pretoria academic veterinary hospital between 2007 and 2012 were evaluated. Isolates were subjected to antimicrobial susceptibility testing against a panel of 15 drugs using the disc diffusion method. Chi square and Fisher's exact tests were used to assess simple associations between antimicrobial resistance and age group, sex, breed and specimen type. Additionally, associations between Staphylococcus infection and age group, breed, sex and specimen type were assessed using logistic regression. Staphylococcus spp. isolates were identified in 17.6% (38/216) of the samples submitted and 4.6% (10/216) of these were unspeciated. The majority (61.1%,11/18) of the isolates were from skin samples, followed by otitis media (34.5%, 10/29). Coagulase Positive Staphylococcus (CoPS) comprised 11.1% (24/216) of the samples of which 7.9% (17/216) were S. intermedius group and 3.2% (7/216) were S. aureus. Among the Coagulase Negative Staphylococcus (CoNS) (1.9%, 4/216), S. felis and S. simulans each constituted 0.9% (2/216). There was a significant association between Staphylococcus spp. infection and specimen type with odds of infection being higher for ear canal and skin compared to urine specimens. There were higher proportions of samples resistant to clindamycin 34.2% (13/25), ampicillin 32.4% (2/26), lincospectin 31.6% (12/26) and penicillin-G 29.0% (11/27). Sixty three percent (24/38) of Staphylococcus spp. were resistant to one antimicrobial agent and 15.8% were multidrug resistant (MDR). MDR was more common among S. aureus 28.6% (2/7) than S. intermedius group isolates 11.8% (2

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

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

    2017-03-30

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

  6. The impact of patient demographics and comorbidities upon burns admitted to Tygerberg Hospital Burns Unit, Western Cape, South Africa.

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    Cloake, T; Haigh, T; Cheshire, J; Walker, D

    2017-03-01

    In South Africa, burns are a major public health problem responsible for significant morbidity and long-term physical disability. This is, in part, due to a significant proportion of the urban population living in poorly constructed, combustible accommodation. The presence of co-morbid diseases such as diabetes and malignancy in patients with burns has been associated with a poorer outcome. The impact of other diseases such as HIV has yet to be defined. A retrospective data collection study analysed the 221 patients admitted to Tygerberg Hospital Burns Unit in 2011 and the first six months of 2013. Using hospital records, patient demographic data was collected alongside burn agent, ICU admission, complications, and patient outcome in terms of length of stay and mortality. The most common burn agent was hot liquid (45.7%). A significant proportion of patients were subject to intentional attacks (34.3%). Shack fires and flame accounted cumulatively for 85% of total inhalational burns, the highest rates of admission to ICU (85.5%), the highest rate of complications, as well as 92.3% of all total fatalities. HIV+ patients had a higher mortality (13.3% vs 5%, p=0.22) and a higher complication rate (46.7% vs 30%, p=0.21). There was no difference in length of stay between the HIV+ and HIV- cohort (12days vs. 15.5 days, p=0.916). Burns are a significant yet preventable cause of mortality and morbidity. The rising number of shack fires, responsible for extensive burns and resultant mortality is concerning and indicates urgent attention and action. HIV complicates the recovery from burn and is responsible for an increased rate of in hospital mortality. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  7. Causes of deaths in children under-five years old at a tertiary hospital in Limpopo province of South Africa.

    Science.gov (United States)

    Ntuli, Sam Thembelihle; Malangu, Ntambwe; Alberts, Marianne

    2013-02-15

    Accurate and timely information on the causes of child deaths is essential in guiding efforts to improve child survival, by providing data from which health profiles can be constructed and relevant health policies formulated. The purpose of this study was to identify causes of death in children younger than 5 years-old in a tertiary hospital in South Africa. Death certificates from the Pietersburg/Mankweng hospital complex, for the period of January 1, 2008 through December 31, 2010, were obtained for all patients younger than 5 years and were retrospectively reviewed. Data were collected using a data collection form designed for the study. Information abstracted included: date of death, age, sex, and cause of death. A total of 1266 deaths were recorded, the sex ratio was 1.26 boys per girl. About 611 (48%) of deaths were listed as neonatal deaths (0-28 days), 387 (31%) were listed as infant deaths (29 days-11 months), and 268 (21%) as children's death (1-4 years). For neonates the leading causes of death were: prematurity/low birth weight, birth asphyxia and pneumonia. For the infant death group, the leading causes of death were pneumonia, diarrhea, and HIV/AIDS; and in the children's group, the leading causes were injuries, diarrhea and pneumonia. There was no statistical significant difference in the proportions of causes of death based on the sex of children. The top 10 leading causes of death in children under-5 years old treated at Pietersburg/Mankweng Hospital Complex were in descending order: prematurity/low birth weight, pneumonia, diarrheal diseases, birth asphyxia, and severe malnutrition, HIV/AIDS, hydrocephalus, unintentional injuries, meningitis and other infections. These ten conditions represent 73.9% of causes of death at this facility. A mix of multi-faceted interventions is needed to address these causes of death in children.

  8. A survey of digital radiography practice in four South African teaching hospitals: an illuminative study.

    Science.gov (United States)

    Nyathi, T; Chirwa, Tf; van der Merwe, Dg

    2010-01-01

    The purpose of this study was to assess radiographer familiarity and preferences with digital radiography in four teaching hospitals and thereafter make recommendations in line with the migration from screen film to digital radiography. A questionnaire was designed to collect data from either qualified or student radiographers from four teaching hospitals. From the four teaching hospitals, there were a total of 205 potential respondents. Among other things, responses regarding experiences and preferences with digital radiography, quality control procedures, patient dose, advantages and disadvantages of digital radiography were sought. The information collected was based on self-reporting by the participants. The study is exploratory in nature and descriptive statistics were generated from the collected data using Microsoft Excel 2007 and StatsDirect software. Sixty-three out of 205 (31%) radiographers from all the four radiology centers responded to the circulated questionnaire. Only 15% (8) of the qualified radiographers had 4 or more years of experience with digital radiography compared to 68% (36) for the same amount of experience with screen-film radiography. Sixty-one percent (38) of the participants had been exposed to digital radiography during their lectures while at university. A small proportion, 16% (10) of the respondents underwent formal training in quality control procedures on the digital X-ray units they were using. Slightly more than half (55%) of the participants felt it was easier for them to retake an image in digital radiography than in screen film radiography. The results of this survey showed that the participants are familiar with digital radiography and have embraced this relatively new technology as shown by the fact that they can identify both its advantages and disadvantages as applied to clinical practice. However, there are minimal quality control procedures specific to digital radiography being undertaken as such there is need for

  9. Assessment of cost of illness for diabetic patients in South Indian tertiary care hospital

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    Leelavathi D Acharya

    2016-01-01

    Full Text Available Background: The impact of diabetes on health-care expenditures has been increasingly recognized. To formulate an effective health planning and resource allocation, it is important to determine economic burden. Objective: The objective of this study is to assess the cost of illness (COI for diabetic inpatients with or without complications. Methodology: The study was conducted in the medicine wards of tertiary care hospital after ethical approval by the Institutional Ethical Committee. A total of 116 each diabetic with or without complications were selected and relevant data were collected using COI questionnaire and data were analyzed using SPSS version 20. Mann–Whitney U test is used to assess the statistical significant difference in the cost of treatment of diabetes alone and with complications'. P ≤ 0.05 was considered statistically significant. Results: Total COI includes the cost of treatment, investigation, consultation fee, intervention cost, transportation, days lost due to work, and hospitalization. The median of total COI for diabetic care without any complication was Rs. 22,456.97/- per patient per annum and with complication was Rs. 30,634.45/-. Patients on dialysis had to spend 7.3 times higher, and patients with cardiac intervention had to spend 7.4 times higher than diabetic patients without any complication. Conclusion: Treatment costs were many times higher in patients with complications and with cardiac and renal interventions. Complications in diabetic patients will increase the economic burden to family and also to the society.

  10. Job stress, satisfaction, and coping strategies among medical interns in a South Indian tertiary hospital.

    Science.gov (United States)

    Chandramouleeswaran, Susmita; Edwin, Natasha C; Braganza, Deepa

    2014-07-01

    It has previously been demonstrated that there is a significant drop in all domains of quality of life among interns during internship. A modified version of the health consultant's job stress and satisfaction questionnaire (HCJSSQ) was used to assess and quantify aspects of internship that were perceived as stressful and satisfying. Methods used to cope with work place stress were explored. A prospective cohort study was undertaken among 93 medical interns doing a rotating internship at the Christian Medical College and Hospital, a tertiary-care hospital in southern India. After completion of 6 months of internship, the modified version of the HCJSSQ was administered to all participants. The data were entered into Statistical Package for the Social Sciences (SPSS) Version 9 by double data entry technique. Percentages of interns reporting high levels of stress, satisfaction were calculated. While 63.4% of interns reported high levels of satisfaction, 45.2% of the interns experienced high levels of stress, 17.6% coped with work stress by using alcohol and nicotine, and 37% coped through unhealthy eating habits. More people found internship satisfying than stressful. However, a high proportion found it stressful, and many reported unhealthy coping mechanisms.

  11. Leadership in nursing: An experience of hospital nurses in the south of Santa Catarina/SC.

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    Dalila Felipe Bitencourt

    2013-01-01

    Full Text Available Qualitative research using the case study, it’s order to understand the vision of nurses in a hospital in the southern of Santa Catarina/SC about their experience as leaders of nursing team. Participants were ten nurses working in this role. Data collection was performed in the hospital, between the months of May and June 2012, using the technique of semi-structured interview, based on the guiding question of the study. The analysis of data was performed qualitative and comprised the organization, classification and final analysis. The results show that most nurses do not feel prepared to exercise a leading role, which derives, in most cases, the lack of academic preparation, institutional issues and the reasons inherent in early stage, especially insecurity. The professionals working in other categories of nursing at the same institution need to learn to position themselves against the new post, especially in dealing with colleagues who are now under his leadership. While most have expressed difficulties in the process of transition between academia and professional life were identified that professionals are clear about the roles, skills and abilities necessary for leadership. It is also noted that nurses feel that in some situations they cannot exercise their leadership in the way they consider most appropriate.

  12. LEADERSHIP IN NURSING: AN EXPERIENCE OF HOSPITAL NURSES IN THE SOUTH OF SANTA CATARINA/SC

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    Dalila Felipe Bitencourt

    2013-01-01

    Full Text Available Qualitative research using the case study, it’s order to understand the vision of nurses in a hospital in the southern of Santa Catarina/SC about their experience as leaders of nursing team. Participants were ten nurses working in this role. Data collection was performed in the hospital, between the months of May and June 2012, using the technique of semi-structured interview, based on the guiding question of the study. The analysis of data was performed qualitative and comprised the organization, classification and final analysis. The results show that most nurses do not feel prepared to exercise a leading role, which derives, in most cases, the lack of academic preparation, institutional issues and the reasons inherent in early stage, especially insecurity. The professionals working in other categories of nursing at the same institution need to learn to position themselves against the new post, especially in dealing with colleagues who are now under his leadership. While most have expressed difficulties in the process of transition between academia and professional life were identified that professionals are clear about the roles, skills and abilities necessary for leadership. It is also noted that nurses feel that in some situations they cannot exercise their leadership in the way they consider most appropriate.

  13. Determinants of maternal mortality: a hospital based study from south India.

    Science.gov (United States)

    Rajaram, P; Agrawal, A; Swain, S

    1995-01-01

    During 1981-1986, 86 maternal deaths transpired at the obstetrics department of the Jawaharlal Institute of Postgraduate Medical Education and Research in Pondicherry, India. The maternal mortality rate stood at 5.8/1000 births. 31.4% were primigravidae. The percentage of maternal deaths characterized as gravidae 2-4, 5, and multigravidae was 42.9%, 9.3%, and 16.4%, respectively. The leading causes of death were sepsis (41.9%), especially septic abortion (30.2%); eclampsia-severe preeclampsia (10.5%); ruptured uterus (9.3%); and hemorrhage and prolonged labor (8.1% each). Direct obstetric causes of death accounted for 81.4% of all maternal deaths. Indirect obstetric causes of death were hepatitis (5.8%), heart disease (4.7%), and severe anemia (2.3%). Most of the women who died were illiterate (97.6%), poor (98.8%), and had received no prenatal care (94.2%). 47.7% traveled more than 60 km to the hospital. Quacks or untrained traditional birth attendants had excessively interfered with about 33% before they reached the hospital, especially the septic induced abortion, obstructed labor, and ruptured uterus cases. Among the 48 women who delivered before dying, there were 24 live births (5 of whom died during the early neonatal period) and 24 still births. These findings indicate a need for a cooperative effort to improve and expand maternal and child health care in the community.

  14. Metabolic syndrome and associated factors among psychiatric patients in Jimma University Specialized Hospital, South West Ethiopia.

    Science.gov (United States)

    Asaye, Sintayehu; Bekele, Shiferaw; Tolessa, Daniel; Cheneke, Waqtola

    2018-04-24

    Metabolic syndrome is a multisystem disorder which coined to describe the recognized clustering of metabolic and cardiovascular abnormalities including obesity, hypertension, dyslipidemia, and abnormalities of glucose homeostasis. To assess the prevalence and associated factors of metabolic syndrome among psychiatric patients in Jimma University Specialized Hospital. This study was conducted at Jimma University Specialized hospital psychiatric ward from May 15 to July 16, 2015. A cross-sectional study design and consecutive sampling technique were used. A single population proportion formula was used to include a total of 360 psychiatric patients. An interview administered structured questionnaire was used to collect socio-demographic and some clinical data. Anthropometric data were collected based on standard guild line for anthropometric measurement. Five milliliter of venous blood was collected from ante-cubital fossa after overnight fasting for 8 h. Semi-automated clinical chemistry analyzer (Temis Linear) was used for biochemical laboratory analysis. Data analysis was performed by using SPSS version-20 software. Binary and multiple logistic regressions were used to identify the association between dependent and independent variables. P value less than 0.05 was taken as statistically significant association. The prevalence of metabolic syndrome among psychiatric patients was 28.9%. Age greater than 30 years old (AOR: 5.2, CI: 2.3, 11.8, P. value metabolic syndrome among diabetic patients in the study area. The other independent variables such as family history of hypertension, chewing chat, Psychotropic drugs, duration of treatment, regularly eating fruits and vegetables had no statistically significant association with metabolic syndrome (P. value > 0.05). There was high prevalence of metabolic syndrome among the psychiatric patients. Therefore; close assessment, management and treatment of metabolic syndrome among patients with psychiatry problem is

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

    Science.gov (United States)

    Dagget, Tadesse; Molla, Ashagre; Belachew, Tefera

    2016-01-01

    Occupational stress exists in every profession, nevertheless, the nursing profession appears to experience more stress at work compared to other health care workers. Unmanaged stress leads to high levels of employee dissatisfaction, illness, absenteeism, high turnover, and decreased productivity that compromise provision of quality service to clients. However, there is a scarcity of information about nurses' job stress in Jimma zone public hospital nurses. The aim of the present study was to assess job related stress and its predictors among nurses working in Jimma Zone public hospitals, South-West Ethiopia in 2014. An institution based cross sectional study was conducted from March 10 to April 10, 2014 through a census of nurses who are working in Jimma Zone public hospitals using a structured self-administered questionnaire. SPSS Statistics Version 20 used. For the outcome variable: overall job related stress, the participant's responses on each item score summed: a stress score ranging from a minimum of 26 and maximum score of 116. The higher the sum the more the stressed the nurse. The level of stress calculated through tertial the lower to low stress, the middle to moderate & the higher to high stress. Moreover, bivariate and multivariable linear regressions done to see the association between the predictor (sex, age, mutual understanding at work, Job satisfaction and working unit/department) and the outcome variable (Job related stress). A total of 341 nurses working in Jimma Zone public hospitals were given the questionnaire, and the response rate was 92.3 % (315). This study indicated an average overall job related stress level of 58.46 ± 12.62. The highest level of job related stress was on the sub scale of dealing with death & dying mean score of 62.94 % followed by uncertainty regarding patient treatment 57.72 % and workload 57.6 %. While job related stress from sexual harassment had the lowest mean score of 46.19 %. Overall job related stress varies

  16. Nurses and care workers’ perceptions of their nurse-patient therapeutic relationship in private general hospitals, Gauteng, South Africa

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    Anna E. van den Heever

    2013-09-01

    Full Text Available Facilitation of a therapeutic relationship is an essential skill in nursing, particularly in mental-health care. Nurses and care workers in private general hospitals are exposed to the emotional effects of physical illness as well as the increase in admission of patients with mental-health needs. Poor nurse-patient relationships have been reported by patients and in the media. The researchers experienced incidents of apparent misunderstandings during nurse-patient interactions whilst working in private general hospitals. No studies have been done regarding how nurses and care workers perceive a therapeutic relationship with patients in terms of the patients’ emotional and mental-health needs. A quantitative, contextual and deductive study was conducted in three private general hospitals in Gauteng, South Africa with a purposive sample of 154 nurses and 30 care workers. Based on the concepts of a therapeutic relationship, empathy, positive regard, genuineness, concreteness and self-exploration, nurses and care workers’ perceptions of facilitating a therapeutic relationship were self-assessed using five-point scales in a questionnaire. Data were analysed using descriptive statistics and non-parametric statistical techniques. Specific hypotheses were tested to identify whether statistically-significant differences existed between the perceptions of two or more groups of nurses and care workers. Results showed a general insensitivity and lack of awareness and reflection on the part of nurses and care workers with regard to the patients’ emotional needs. When categories of nurses were compared, no statistically-significant differences were found between the perceptions of the various groups tested. There is a need for self-awareness, continued interpersonal skills training and supervision of nurses and care workers. A large percentage of the participants were younger than 40 years, subprofessional, with less than 10 years’ experience as

  17. To relieve the sufferings of humanity, irrespective of party, politics or creed?: conflict, consensus and voluntary hospital provision in Edwardian South Wales.

    Science.gov (United States)

    Thompson, Steven

    2003-08-01

    This article examines the provision of voluntary hospital facilities for injured workers in the mining valleys of Edwardian South Wales. It considers the co-operation and conflict that characterized efforts to establish hospitals, and examines the attitudes and activities of workers, employers, and other interested groups. Despite certain instances of disagreement and conflict, this article demonstrates the significant levels of co-operation and consensus that characterized the efforts of employers and workers to provide communities with hospital facilities. This co-operation was perhaps surprising considering the bitter industrial conflict and social unrest of that period. The article uses this material to question assertions that hospitals reflect the social and political milieus of the communities in which they were situated and argues that the social relations produced by hospital provision sometimes coincided with wider social and industrial relations, but at other times differed from them or transcended them. Furthermore, the article demonstrates that the co-operation between employers and workers in the provision of hospitals in Edwardian South Wales did not stabilize social and industrial relations in the way that historians of associational voluntarism in other contexts have found.

  18. Adverse Drug Reactions Causing Admission to Medical Wards: A Cross-Sectional Survey at 4 Hospitals in South Africa.

    Science.gov (United States)

    Mouton, Johannes P; Njuguna, Christine; Kramer, Nicole; Stewart, Annemie; Mehta, Ushma; Blockman, Marc; Fortuin-De Smidt, Melony; De Waal, Reneé; Parrish, Andy G; Wilson, Douglas P K; Igumbor, Ehimario U; Aynalem, Getahun; Dheda, Mukesh; Maartens, Gary; Cohen, Karen

    2016-05-01

    Limited data exist on the burden of serious adverse drug reactions (ADRs) in sub-Saharan Africa, which has high HIV and tuberculosis prevalence. We determined the proportion of adult admissions attributable to ADRs at 4 hospitals in South Africa. We characterized drugs implicated in, risk factors for, and the preventability of ADR-related admissions.We prospectively followed patients admitted to 4 hospitals' medical wards over sequential 30-day periods in 2013 and identified suspected ADRs with the aid of a trigger tool. A multidisciplinary team performed causality, preventability, and severity assessment using published criteria. We categorized an admission as ADR-related if the ADR was the primary reason for admission.There were 1951 admissions involving 1904 patients: median age was 50 years (interquartile range 34-65), 1057 of 1904 (56%) were female, 559 of 1904 (29%) were HIV-infected, and 183 of 1904 (10%) were on antituberculosis therapy (ATT). There were 164 of 1951 (8.4%) ADR-related admissions. After adjustment for age and ATT, ADR-related admission was independently associated (P ≤ 0.02) with female sex (adjusted odds ratio [aOR] 1.51, 95% confidence interval [95% CI] 1.06-2.14), increasing drug count (aOR 1.14 per additional drug, 95% CI 1.09-1.20), increasing comorbidity score (aOR 1.23 per additional point, 95% CI 1.07-1.41), and use of antiretroviral therapy (ART) if HIV-infected (aOR 1.92 compared with HIV-negative/unknown, 95% CI 1.17-3.14). The most common ADRs were renal impairment, hypoglycemia, liver injury, and hemorrhage. Tenofovir disoproxil fumarate, insulin, rifampicin, and warfarin were most commonly implicated, respectively, in these 4 ADRs. ART, ATT, and/or co-trimoxazole were implicated in 56 of 164 (34%) ADR-related admissions. Seventy-three of 164 (45%) ADRs were assessed as preventable.In our survey, approximately 1 in 12 admissions was because of an ADR. The range of ADRs and implicated drugs reflect South Africa's high HIV

  19. What keeps health professionals working in rural district hospitals in South Africa?

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    Louis S. Jenkins

    2015-06-01

    Full Text Available Background: The theme of the 2014 Southern African Rural Health Conference was ‘Building resilience in facing rural realities’. Retaining health professionals in South Africa is critical for sustainable health services. Only 12% of doctors and 19% of nurses have been retained in the rural areas. The aim of the workshop was to understand from health practitioners why they continued working in their rural settings. Conference workshop: The workshop consisted of 29 doctors, managers, academic family physicians, nurses and clinical associates from Southern Africa, with work experience from three weeks to 13 years, often in deep rural districts. Using the nominal group technique, the following question was explored, ‘What is it that keeps you going to work every day?’ Participants reflected on their work situation and listed and rated the important reasons for continuing to work. Results: Five main themes emerged. A shared purpose, emanating from a deep sense of meaning, was the strongest reason for staying and working in a rural setting. Working in a team was second most important, with teamwork being related to attitudes and relationships, support from visiting specialists and opportunities to implement individual clinical skills. A culture of support was third, followed by opportunities for growth and continuing professional development, including teaching by outreaching specialists. The fifth theme was a healthy work-life balance. Conclusion: Health practitioners continue to work in rural settings for often deeper reasons relating to a sense of meaning, being part of a team that closely relate to each other and feeling supported.

  20. Birth preparedness and complication readiness among prenatal attendees in a teaching hospital in South West Nigeria.

    Science.gov (United States)

    Aduloju, Olusola P; Akintayo, Akinyemi A; Aduloju, Tolulope; Akin-Akintayo, Oladunni O

    2017-11-01

    To assess birth preparedness and complication readiness (BPCR) as well as knowledge of danger signs during pregnancy, labor/delivery, and the postpartum period. A cross-sectional study was undertaken of pregnant women attending the prenatal clinic at a tertiary hospital in Nigeria between October and December 2016. A pretested and structured questionnaire was used to collect data on BPCR, and logistic regression was performed to determine factors affecting BPCR. Of 325 participants, 274 (84.3%) had knowledge of BPCR components, and 265 (81.5%) were well prepared for birth and its complications. However, only 89 (27.4%) knew key danger signs during labor/delivery and 81 (24.9%) knew those in the first 2 days after delivery. Older age, higher parity, tertiary education of women, paid employment of women and their spouses, higher social class, frequent prenatal visits, and knowledge of danger signs were significantly associated with BPCR (Pteaching pregnant women to recognize key danger signs. © 2017 International Federation of Gynecology and Obstetrics.

  1. Causes and pattern of death in a tertiary hospital in south eastern Nigeria

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    C C Nwafor Chukwuemeka Charles

    2014-01-01

    Full Text Available Background: Morbidity and mortality pattern is a reflection of disease burden. The aim of this study is to provide a comprehensive report of the causes of death in a tertiary hospital in Nigeria, a developing tropical nation. Methods and Material: We carried out a retrospective descriptive cross-sectional study of all records of deaths from January 2004 to December 2008 in Federal Medical Centre Umuahia, Abia, State in Southeast Nigeria. Results: Of a total of 18,107 patients were admitted during the study period, 2;172 deaths representing 12% mortality rate and comprising 1;230 (56.6% males and 942 (43.4% females were recorded. The age of patients ranged from birth to 100 years with a mean of 41.41 ± 26.30 years and 25-44 years age group being the most affected (n = 587, 27.1%. The overall leading cause of death was the infections group, which accounted for 837 (37.6% deaths. Other major causes were cardiovascular system -related deaths 534 (24.7%, neonatal causes 173 (8.0%, trauma 155 (7.1%, diabetes mellitus complications 144 (6.6% and neoplasia 76 (3.5%. Conclusion: Majority of the leading causes of mortality in this study are preventable. Our data reflects the effects of double disease burden of infections and non- communicable communicable diseases in a developing nation.

  2. Profile of injury cases admitted to a tertiary level hospital in south India.

    Science.gov (United States)

    Uthkarsh, Pallavi Sarji; Suryanarayana, S P; Gautham, M S; Shivraj, N S; Murthy, N S; Pruthvish, S

    2012-01-01

    Injuries now rank among the leading causes of morbidity and mortality the world over. Injuries are steadily increasing in developing countries like India. Systematic and scientific efforts in injury prevention and control are yet to begin in India. Data on injuries are very essential to plan preventive and control measures. The objective of this study is to know the profile of the injury cases admitted to M S Ramaiah hospital, Bangalore, India, using a cross-sectional study design for six months, i.e. from Oct 2008 to April 2009. The mean age of the study population was 35.3 years (SD = 15.38), 69.1% were injured in road traffic accidents (RTA), 28.7% due to falls and 2.2% due to burns. Nearly 14.4% were under the influence of alcohol. Nearly 73.6% of RTA cases were two-wheeler users, 48.5% had not followed sign boards and 56.5% had not obeyed the one-way rules, 63.5% of the two-wheeler users did not use helmets. Also, 38% of two wheelers had two pillion riders, whereas 57% of four-wheeler users had not used a seat belt. Among falls, 58% occurred at home, 49% occurred due to slippery surface. Road traffic accidents were the most common cause for injuries, in which two wheelers were most commonly involved. Strict enforcement of traffic rules and education on road safety are very essential to prevent injuries.

  3. Factors influencing nurse absenteeism in a general hospital in Durban, South Africa.

    Science.gov (United States)

    Mudaly, P; Nkosi, Z Z

    2015-07-01

    To establish reasons for absenteeism amongst professional nurses, enrolled nurses and enrolled nurse auxiliaries in a general hospital in Durban, in order to recommend strategies that could decrease absenteeism. Nurses endure increased workload, resulting in burnout and absenteeism in workplace environments that already suffer staff shortages. This study was a quantitative, non-experimental survey. The study population consisted of 60 nurses, including professional and enrolled nurses and enrolled nurse auxiliaries. The survey consisted of closed-ended questions to options of 'agree' and 'disagree' and an open-ended section. Family matters, lack of motivation to attend work, illness, finance, favouritism, unfriendly nurse managers, long work hours, increased workload, unsatisfactory work conditions, lack of equipment, unfair promotions and selection of nurses for training, staff shortages, lack of a reward system and incoherent decision-making caused nurse absenteeism. Personal, professional and organisational factors may cause nurse absenteeism, crippling the health sector further against the backdrop of human and mechanical resource shortage. Nurse managers have an important role in reducing absenteeism by addressing the employees' concerns, which can lead to productivity, increased staff morale, decreased medical hazards and satisfied patients. © 2013 John Wiley & Sons Ltd.

  4. Microbiological Spectrum of Brain Abscess at a Tertiary Care Hospital in South India: 24-Year Data and Review

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    V. Lakshmi

    2011-01-01

    Full Text Available Intracranial abscesses are life-threatening infections that pose a diagnostic challenge not only to the neurosurgeon but also to the microbiologists. Detailed studies documenting the spectrum of infecting agents involved in brain abscesses are limited from India. Materials and Methods. This is a retrospective analysis of 352 samples from 1987 to 2010 analyzed at a tertiary care hospital in South India from 1987 to 2010, to document the changing trends with time. Results. The age of the patients ranged from 2 to 80 years, a larger number of males being affected. Otogenic infections were the most common cause while cryptogenic abscesses were 20%. Gram stain and culture positivity were 78% each. Gram-positive and negative facultative aerobes and obligate anaerobes were also on the rise. Unusual organisms, like Burkholderia pseudomallei, Salmonella typhi, Nocardia species, Cladosporium bantiana, Fonsecaea pedrosoi, Entamoeba histolytica, and Acanthamoeba were also isolated and/or detected from the brain abscesses aspirate or resected tissue. Summary. New and emerging pathogens associated with brain abscess, especially in immunosuppressed individuals, have renewed the necessity of an early detection, and it will be of great value in appropriate management of patients with brain abscess.

  5. Immediate post-partum haemorrhage: Epidemiological aspects and maternal prognosis at South N’djamena District Hospital (Chad

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    Gabkika Bray Madoue

    2015-05-01

    Full Text Available Background: Post-partum haemorrhage defined as blood loss after delivery over 500mls, affects all countries and is the commonest cause of maternal mortality. It is a frequent obstetric emergency in developing countries. Objective: To identify the causes of post-partum haemorrhage and identify adequate management of immediate post-partum haemorrhage and thus reduce maternal mortality. Patients and methods: This was a prospective and descriptive study of one year from 1st January 2014 to 31stDecember 2014 conducted at South N’Djamena district hospital. Before including a patient in our survey her consent was obtained after explaining to her the need for the survey. All consenting patients with post-partum haemorrhage were included. Data were analyzed using SPSS17.0. Results: We recorded 100 cases of post-partum haemorrhage among 6815 deliveries giving an incidence of 1.47%. The average age of the women was 25.0 years. The majority of deliveries (90% were vaginal. The main cause of immediate post-partum haemorrhage was a third stage of labour bleeding (66% followed by genital lesions (32%. The management was medical (uterotonic drug, fluid replacement and blood transfusion, obstetric (manual removal of placenta or clot, and surgical (suture of lesions, vascular ligature and hysterectomy. There were two maternal deaths (2%. Conclusion: Post-partum haemorrhage is often fatal in our region. Preventive measures and efficient management can help to improve maternal prognosis.

  6. A Retrospective Analysis of Thyroid Disease in Pregnancy at Chris Hani Baragwanath Academic Hospital Soweto South Africa

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    V Nicolaou

    2017-12-01

    Full Text Available BackgroundThyroid diseases in pregnancy are associated with adverse outcomes for mother and fetus.No studies have been reported examining the spectrum and nature of such disorders in the Black population of South Africa.AimsTo examine thyroid disorders in pregnancy at Chris Hani Baragwanath Academic Hospital in Soweto, by assessing the causes, management and outcomes.MethodsA retrospective review of thyroid disorders was undertaken in 88 patients, attending the Antenatal Endocrine Clinic over a four-year period. All underwent initial and follow-up clinical and biochemical assessments.Maternal delivery records and thyroid function tests of the neonates 48 hours or later following delivery were reviewed.ResultsFifty-eight (66% were hyperthyroid, 23(26% hypothyroid, and 7(8% had euthyroid colloid goiters. Forty-eight (83% hyperthyroid patients had Graves’ disease, whilst had gestational hyperthyroidism. Regarding the hypothyroid patients, more than half followed I131 ablation for Graves’ disease. Eighty-seven percent of the hyperthyroid and 83% of the hypothyroid patients were euthyroid prior to delivery. One fatal maternal outcome, due to uterine rupture and six intra-partum fetal losses occurred. Amongst neonates, there was one case of a tracheo-esophageal fistula and one of neonatal thyrotoxicosis.ConclusionThis is the first report in sub-Saharan Africa detailing thyroid diseases in pregnancy.

  7. Detection of Urinary Tract Infection (UTI Among Pregnant Women in Oluyoro Catholic Hospital, Ibadan, South-Western Nigeria

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    Okonko, I. O.

    2010-01-01

    Full Text Available This study reports the detection of urinary tract infections among 80 pregnant women in Oluyoro Catholic Hospital Ibadan, South-Western, Nigeria for a period of 6 months. It was carried out to detect the presence of urinary tract infection in pregnant women, and to isolate and to identify the pathogens responsible for the infection. A total of 80 clean voided mid-stream urine samples were collected from pregnant women between the ages of 21-40 years. The results showed 38 bacterial isolates with an incidence of 47.5% in this population. The isolates were identified based on colonial morphology, microscopic characteristics, and biochemical tests using Bergey’s Manual of Determinative Bacteriology. Escherichia coli 16(42.1% was the most predominant organism. This was followed by Staphylococcus aureus 11(28.9%, Klebsiella aerogenes 7(18.4%, Pseudomonas aeruginosa 2(5.3%, and a mixed culture of Klebisella aerogenes and Staphylococcus aureus 2(5.3%. Urine microscopy revealed the presence of Pus cells in the urine samples collected. Two samples, representing 2.5% of the samples contained yeast cells, suggesting that Candidiasis was also predominant. The high incidence rate of 47.5% reported in this study should be of great concern, as not only do UTIs pose a threat to health, but they also impose an economic and social burden due to the stigma associated with these infections.

  8. Clinical characteristics, angiographic profile and in hospital mortality in acute coronary syndrome patients in south indian population

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    Rajni Sharma

    2014-01-01

    Full Text Available Aims: The aim was to study the clinical profile, risk factors prevalence, angiographic distribution, and severity of coronary artery stenosis in acute coronary syndrome (ACS patients of South Indian population. Materials and Methods: A total of 1562 patients of ACS were analyzed for various risk factors, angiographic pattern and severity of coronary heart disease, complications and in hospital mortality at Sri Jayadeva Institute of Cardiovascular Research and Sciences, Bengaluru, Karnataka, India. Results: Mean age of presentation was 54.71 ± 19.90 years. Majority were male 1242 (79.5% and rest were females. Most patients had ST elevation myocardial infarction (STEMI 995 (63.7% followed by unstable angina (UA 390 (25% and non-STEMI (NSTEMI 177 (11.3%. Risk factors; smoking was present in 770 (49.3%, hypertension in 628 (40.2%, diabetes in 578 (37%, and obesity in (29.64% patients. Angiography was done in 1443 (92.38% patients. left anterior descending was most commonly involved, left main (LM coronary artery was least common with near similar frequency of right coronary artery and left circumflex involvement among all three groups of ACS patients. Single-vessel disease was present in 168 (45.28% UA, 94 (56.29% NSTEMI and 468 (51.71% STEMI patients. Double-vessel disease was present in 67 (18.08% UA, 25 (14.97% NSTEMI and 172 (19.01% STEMI patients. Triple vessel disease was present in 28 (7.55% UA, 16 (9.58% NSTEMI, 72 (7.95% STEMI patients. LM disease was present in 12 (3.23% UA, 2 (1.19% NSTEMI and 9 (0.99% STEMI patients. Complications; ventricular septal rupture occurred in 3 (0.2%, free wall rupture in 2 (0.1%, cardiogenic shock in 45 (2.9%, severe mitral regurgitation in 3 (0.2%, complete heart block in 11 (0.7% patients. Total 124 (7.9% patients died in hospital after 2.1 ± 1.85 days of admission. Conclusion: STEMI was most common presentation. ACS occurred a decade earlier in comparison to Western population. Smoking was most prevalent

  9. Working towards implementation of a nuclear medicine accreditation program in a South African teaching hospital

    International Nuclear Information System (INIS)

    Eiselen, T.; Ellmann, A.

    2004-01-01

    Full text: Introduction: Quality assurance in Nuclear Medicine is of utmost importance in order to ensure optimal scintigraphic results and correct patient management and care. The implementation of a good quality assurance program should address all factors that playa role in the optimal functioning of a department. It should be developed by scientific findings as well as national and international guidelines. Aim: To develop a tailor made program that can be managed according to the individual needs and requirements of a Nuclear Medicine department in a teaching hospital. This program is aimed at international accreditation of the department. Materials and methods: Auditing of the following aspects was conducted: organizational, clinical and technical, personnel satisfaction, patient experience and satisfaction, referring physicians experience and satisfaction. Information was collected by means of questionnaires to groups and individuals for opinion polls; one-to-one interviews with personnel and patients; technical evaluation of equipment according to manufacturer's specifications and international standards; laboratory equipment evaluation according to precompiled guidelines and investigation of laboratory procedures for standardization and radiation safety. Existing procedure protocols were measured against international guidelines and evaluated for possible shortcomings of technical as well as cosmetic details, and data storage facilities were evaluated in terms of user friendliness, viability and cost effectiveness. A number of international accreditation experts were also visited to establish the validity of our results. Results: Patient questionnaires indicated overall satisfaction with personal service providing, but provision of written and understandable information, long waiting periods and equipment must receive attention. Staff questionnaires indicated a general lack of communication between different professional groups and the need for

  10. Acute perforated peptic ulcer: on clinical experience in an urban tertiary hospital in south east Nigeria.

    Science.gov (United States)

    Ugochukwu, A I; Amu, O C; Nzegwu, M A; Dilibe, U C

    2013-01-01

    Acute perforated peptic ulcer is a leading cause of generalized peritonitis and its management has continued to be a challenging task in our environment. There is a paucity of published reports on acute perforated peptic ulcers in our environment. This study was conducted to evaluate the different pattern of risk factors clinical presentations, management and clinical outcome of patients with acute perforated peptic ulcer in our setting and to highlight the factors that continue to account for the high mortality and morbidity as seen here. A retrospective study where data of seventy-six (76) patients managed for generalized peritonitis due to acute peptic ulcer perforation over a five year period (January 2006-December 2010) were retrieved from medical records of Enugu State University of Science and Technology Hospital (ESUTH). The patients' biodata, clinical and operative findings and treatment outcome were extracted and analysed, after institutional ethical approval was secured. All other cases of generalized peritonitis not traceable to acute peptic ulcer perforation were excluded from the study. There were76 patients; 58 males and 18 females (M:F = 3.2:1) Their ages ranged from 20 to 80years with a mean of 39.5yr and SD ± 13.10years. Majority of the patients 49(64.4%) were 40years of age and below and only 24 (31.6%) had a previous history suggestive of chronic peptic ulcer disease. Twenty five (32.9%) patients presented within 24 h of onset of symptoms of perforation with a mortality of 8.0%. Slightly more than half of our patients 39(51.3%) presented between 24 and 48 h with mortality of 17.9%. Twelve patients (15.8%) presented between 48 and 72 h and the mortality in this group was 58.3%. The latter two groups accounted for most of the mortality in our series. All perforations were anterior perforations within the first 2.5 cm of the duodenum and all had simple closure with pedicled omental patch and peritoneal toilet with copious volumes of warm

  11. The accuracy of radiology speech recognition reports in a multilingual South African teaching hospital

    International Nuclear Information System (INIS)

    Toit, Jacqueline du; Hattingh, Retha; Pitcher, Richard

    2015-01-01

    had no bearing. SR technology consistently increased inaccuracies in Tygerberg Hospital (TBH) radiology reports, thereby potentially compromising patient care. Awareness of increased error rates in SR reports, particularly amongst those transcribing in a second-language, is important for effective implementation of SR in a multilingual healthcare environment

  12. Increasing Recovery of Nontuberculous Mycobacteria from Respiratory Specimens over a 10-Year Period in a Tertiary Referral Hospital in South Korea

    OpenAIRE

    Koh, Won-Jung; Chang, Boksoon; Jeong, Byeong-Ho; Jeon, Kyeongman; Kim, Su-Young; Lee, Nam Yong; Ki, Chang-Seok; Kwon, O Jung

    2013-01-01

    Background The number of patients with pulmonary disease caused by nontuberculous mycobacteria (NTM) has been increasing worldwide. The aim of this study was to evaluate long-term trends in the NTM recovery rate from respiratory specimens over a 10-year period in a tertiary referral hospital in South Korea. Methods We retrospectively reviewed the records of mycobacterial cultures of respiratory specimens at Samsung Medical Center from January 2001 to December 2011. Results During the study pe...

  13. KNOWLEDGE AND ATTITUDE TOWARDS HUMAN PAPILLOMA VIRUS AND ITS VACCINE AMONG PHARMACY STUDENTS OF TERTIARY TEACHING UNIVERSITY HOSPITAL IN SOUTH INDIA

    OpenAIRE

    Raghupathi Mahitha; T. S. Arunprasath

    2016-01-01

    BACKGROUND Cervical cancer in women can be effectively prevented by HPV vaccine. Healthcare professionals including pharmacists have a role in creating awareness about this vaccine to public. In this context, it was decided to study awareness level about HPV among pharmacy students. The aim of the study is to study the knowledge and attitude towards human papilloma virus and it’s vaccine among pharmacy students of tertiary teaching university hospital in South India. MATERIA...

  14. Acute undifferentiated febrile illness in patients presenting to a Tertiary Care Hospital in South India: clinical spectrum and outcome

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    Kundavaram Paul Prabhakar Abhilash

    2016-01-01

    Full Text Available Background: Acute undifferentiated febrile illness (AUFI may have similar clinical presentation, and the etiology is varied and region specific. Materials and Methods: This prospective observational study was conducted in a tertiary hospital in South India. All adult patients presenting with AUFI of 3-14 days duration were evaluated for etiology, and the differences in presentation and outcome were analyzed. Results: The study cohort included 1258 patients. A microbiological cause was identified in 82.5% of our patients. Scrub typhus was the most common cause of AUFI (35.9% followed by dengue (30.6%, malaria (10.4%, enteric fever (3.7%, and leptospirosis (0.6%. Both scrub typhus and dengue fever peaked during the monsoon season and the cooler months, whereas no seasonality was observed with enteric fever and malaria. The mean time to presentation was longer in enteric fever (9.9 [4.7] days and scrub typhus (8.2 [3.2] days. Bleeding manifestations were seen in 7.7% of patients, mostly associated with dengue (14%, scrub typhus (4.2%, and malaria (4.6%. The requirement of supplemental oxygen, invasive ventilation, and inotropes was higher in scrub typhus, leptospirosis, and malaria. The overall mortality rate was 3.3% and was highest with scrub typhus (4.6% followed by dengue fever (2.3%. Significant clinical predictors of scrub typhus were breathlessness (odds ratio [OR]: 4.96; 95% confidence interval [CI]: 3.38-7.3, total whole blood cell count >10,000 cells/mm 3 (OR: 2.31; 95% CI: 1.64-3.24, serum albumin <3.5 g % (OR: 2.32; 95% CI: 1.68-3.2. Overt bleeding manifestations (OR: 2.98; 95% CI: 1.84-4.84, and a platelet count of <150,000 cells/mm 3 (OR: 2.09; 95% CI: 1.47-2.98 were independent predictors of dengue fever. Conclusion: The similarity in clinical presentation and diversity of etiological agents demonstrates the complexity of diagnosis and treatment of AUFI in South India. The etiological profile will be of use in the development of

  15. Three-Frames Approach to Cardiovascular Disease Prevention: A Quasi-Experimental Educational Intervention among Civil Servants in Calabar, Nigeria

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    Ogban E. Omoronyia

    2017-08-01

    Full Text Available Cardiovascular diseases (CVDs have continued to be a leading cause of death among adults. Civil servants constitute vital workforce, and high CVD burden in this group has implications for national productivity. Unfortunately, guided cardiovascular health education interventions are uncommon. This study assessed the effect of an educational intervention on knowledge and practice of CVD prevention among Nigerian civil servants. Quasi-experimental study design was employed among subjects in distant communities in Cross River State. Multistage technique was used to recruit 172 subjects into one control group (Ogoja and two intervention groups (Calabar and Ikom. The first intervention group received 4-h daily, 5-day cardiovascular health education, with emphasis on burden, risk factors, and preventive measures including nutrition, stress, alcohol, medicals, exercise, and smoking. The second intervention group received the same content of education, but with the use of Food, Rest for stress management, Alcohol, Medicals, Exercise, and Smoking (FRAMES as guide for delivery. Questionnaires were used to assess knowledge and practice at baseline and post-intervention. Data were analyzed using SPSS version 20.0. Knowledge scores and practice of CVD prevention were compared between study groups using inferential statistics. Mean age was 46.3 ± 7.4 years, and no significant difference in sociodemographic characteristics was observed by comparing the study groups (p > 0.05. Baseline knowledge and practice of preventive measures were generally poor, and no significant difference was observed by comparing the groups (p > 0.05. At 12 weeks post-intervention, knowledge of CVD was higher in the intervention groups compared with the control group (p 0.05. For effective delivery of cardiovascular health education, the use of “FRAMES” is as effective as its nonuse. Further studies in other settings are recommended.

  16. Organisational culture and trust as influences over the implementation of equity-oriented policy in two South African case study hospitals.

    Science.gov (United States)

    Erasmus, Ermin; Gilson, Lucy; Govender, Veloshnee; Nkosi, Moremi

    2017-09-15

    This paper uses the concepts of organisational culture and organisational trust to explore the implementation of equity-oriented policies - the Uniform Patient Fee Schedule (UPFS) and Patients' Rights Charter (PRC) - in two South African district hospitals. It contributes to the small literatures on organisational culture and trust in low- and middle-income country health systems, and broader work on health systems' people-centeredness and "software". The research entailed semi-structured interviews (Hospital A n = 115, Hospital B n = 80) with provincial, regional, district and hospital managers, as well as clinical and non-clinical hospital staff, hospital board members, and patients; observations of policy implementation, organisational functioning, staff interactions and patient-provider interactions; and structured surveys operationalising the Competing Values Framework for measuring organisational culture (Hospital A n = 155, Hospital B n = 77) and Organisational Trust Inventory (Hospital A n = 185, Hospital B n = 92) for assessing staff-manager trust. Regarding the UPFS, the hospitals' implementation approaches were similar in that both primarily understood it to be about revenue generation, granting fee exemptions was not a major focus, and considerable activity, facility management support, and provincial support was mobilised behind the UPFS. The hospitals' PRC paths diverged quite significantly, as Hospital A was more explicit in communicating and implementing the PRC, while the policy also enjoyed stronger managerial support in Hospital A than Hospital B. Beneath these experiences lie differences in how people's values, decisions and relationships influence health system functioning and in how the nature of policies, culture, trust and power dynamics can combine to create enabling or disabling micro-level implementation environments. Achieving equity in practice requires managers to take account of "unseen" but important factors such as

  17. Predictors of Treatment Failure among Adult Antiretroviral Treatment (ART) Clients in Bale Zone Hospitals, South Eastern Ethiopia.

    Science.gov (United States)

    Haile, Demewoz; Takele, Abulie; Gashaw, Ketema; Demelash, Habtamu; Nigatu, Dabere

    2016-01-01

    Treatment failure defined as progression of disease after initiation of ART or when the anti-HIV medications can't control the infection. One of the major concerns over the rapid scaling up of ART is the emergence and transmission of HIV drug resistant strains at the population level due to treatment failure. This could lead to the failure of basic ART programs. Thus this study aimed to investigate the predictors of treatment failure among adult ART clients in Bale Zone Hospitals, South east Ethiopia. Retrospective cohort study was employed in four hospitals of Bale zone named Goba, Robe, Ginir and Delomena. A total of 4,809 adult ART clients were included in the analysis from these four hospitals. Adherence was measured by pill count method. The Kaplan Meier (KM) curve was used to describe the survival time of ART patients without treatment failure. Bivariate and multivariable Cox proportional hazards regression models were used for identifying associated factors of treatment failure. The incidence rate of treatment failure was found 9.38 (95% CI 7.79-11.30) per 1000 person years. Male ART clients were more likely to experience treatment failure as compared to females [AHR = 4.49; 95% CI: (2.61-7.73)].Similarly, lower CD4 count (ART was found significantly associated with higher odds of treatment failure [AHR = 3.79; 95% CI: (2.46-5.84).Bedridden [AHR = 5.02; 95% CI: (1.98-12.73)] and ambulatory [AHR = 2.12; 95% CI: (1.08-4.07)] patients were more likely to experience treatment failure as compared to patients with working functional status. TB co-infected clients had also higher odds to experience treatment failure [AHR = 3.06; 95% CI: (1.72-5.44)]. Those patients who had developed TB after ART initiation had higher odds to experience treatment failure as compared to their counter parts [AHR = 4.35; 95% CI: (1.99-9.54]. Having other opportunistic infection during ART initiation was also associated with higher odds of experiencing treatment failure [AHR = 7.0, 95

  18. Predictors of Treatment Failure among Adult Antiretroviral Treatment (ART Clients in Bale Zone Hospitals, South Eastern Ethiopia.

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    Demewoz Haile

    Full Text Available Treatment failure defined as progression of disease after initiation of ART or when the anti-HIV medications can't control the infection. One of the major concerns over the rapid scaling up of ART is the emergence and transmission of HIV drug resistant strains at the population level due to treatment failure. This could lead to the failure of basic ART programs. Thus this study aimed to investigate the predictors of treatment failure among adult ART clients in Bale Zone Hospitals, South east Ethiopia.Retrospective cohort study was employed in four hospitals of Bale zone named Goba, Robe, Ginir and Delomena. A total of 4,809 adult ART clients were included in the analysis from these four hospitals. Adherence was measured by pill count method. The Kaplan Meier (KM curve was used to describe the survival time of ART patients without treatment failure. Bivariate and multivariable Cox proportional hazards regression models were used for identifying associated factors of treatment failure.The incidence rate of treatment failure was found 9.38 (95% CI 7.79-11.30 per 1000 person years. Male ART clients were more likely to experience treatment failure as compared to females [AHR = 4.49; 95% CI: (2.61-7.73].Similarly, lower CD4 count (<100 m3/dl at initiation of ART was found significantly associated with higher odds of treatment failure [AHR = 3.79; 95% CI: (2.46-5.84.Bedridden [AHR = 5.02; 95% CI: (1.98-12.73] and ambulatory [AHR = 2.12; 95% CI: (1.08-4.07] patients were more likely to experience treatment failure as compared to patients with working functional status. TB co-infected clients had also higher odds to experience treatment failure [AHR = 3.06; 95% CI: (1.72-5.44]. Those patients who had developed TB after ART initiation had higher odds to experience treatment failure as compared to their counter parts [AHR = 4.35; 95% CI: (1.99-9.54]. Having other opportunistic infection during ART initiation was also associated with higher odds of

  19. Etiology and outcome determinants of intracerebral hemorrhage in a south Indian population, A hospital-based study

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    Sunil K Narayan

    2012-01-01

    Full Text Available Background: There is paucity of methodologically sound published studies on intracerebral hemorrhage (ICH from India, on pub med/embase search. Aims: To explore etiology of ICH and correlate the causes, location, and size of hemorrhage to clinical outcome. Materials and Methods: A hospital-based descriptive study from South Indian eastern coastal town of Puducherry; 60 consecutive subjects aged > 12 years, predominantly of inbred Tamil population, with head CT evidence of intracerebral hemorrhage not associated with trauma and brain tumors, were recruited. Outcome at three months was measured using Glasgow Outcome scale, NIHSS and mortality. SPSS v 19 was used for statistical analysis. Results: Commonest etiological factor was hypertension, followed by bleeding diathesis, thrombolysis for myocardial infarction, and cortical vein thrombosis. Most frequent locations of hematoma were basal ganglia, thalamus, internal capsule, and cerebral and cerebellar parenchyma. Hematoma volume correlated significantly with systolic and mean arterial pressure but not with diastolic blood pressure. Poor outcome was correlated to size (P < 0.05 and intraventricular extension of hematoma (P < 0.05, and to systolic, diastolic and mean arterial pressure, but not to age, gender, smoking, alcoholism, ischemic heart disease, and blood sugar level. Among diabetic patients with ICH, the size of hematoma (P = 0.04 and severity of coma (P = 0.01 at admission were significantly worse compared to the non-diabetic, but not the outcome at three months [Glasgow outcome scale or mortality (P = 0.94 and 0.14]. Conclusions: The location of hemorrhage and correlation with outcome agreed with the patterns described for the non-white races in prior reports. Independence of outcome to diabetic status despite a more severe initial presentation may indicate importance of good care, even in high risk groups.

  20. Lived experiences of parents of premature babies in the intensive care unit in a private hospital in Johannesburg, South Africa

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    Erika Steyn

    2017-02-01

    Full Text Available Background: Many of the 15 million premature babies born worldwide every year survive because of advanced medical interventions. Their parents have intense experiences when their babies are in the intensive care unit (ICU, and these have an impact on their thoughts, feelings and relationships, including their relationships with their premature babies. Objectives: The aim of the study was to explore and describe the lived experiences of parents of premature babies in an ICU. Method: Research design was qualitative, exploratory, descriptive and contextual. A purposive sample of parents with premature babies in an ICU in a private hospital in Johannesburg Gauteng in South Africa was used. Eight parents, four mothers and four fathers, married and either Afrikaans or English-speaking, were included in the study. Data were collected by conducting in-depth phenomenological interviews with them and making use of field notes. Trustworthiness was ensured by implementing the strategies of credibility, transferability, dependability and confirmability. Ethical principles such as autonomy, beneficence, nonmaleficence and justice were adhered to throughout the research process. Results: Thematic analyses were utilised to analyse the data. Two themes in the experiences of parents with premature babies in ICU became apparent. Parents experienced thoughts, emotions and hope while their premature babies were in the ICU as well as challenges in their relationships and these challenges influenced their experiences. Recommendations: Mindfulness of intensive care nurses should be facilitated so that intensive care nurses can promote the mental health of parents with premature babies in the ICU. Conclusion: Parents with premature babies in the ICU have thoughts and emotional experiences which include hope and they affect parents’ relationships.

  1. Lived experiences of parents of premature babies in the intensive care unit in a private hospital in Johannesburg, South Africa.

    Science.gov (United States)

    Steyn, Erika; Poggenpoel, Marie; Myburgh, Chris

    2017-02-28

    Many of the 15 million premature babies born worldwide every year survive because of advanced medical interventions. Their parents have intense experiences when their babies are in the intensive care unit (ICU), and these have an impact on their thoughts, feelings and relationships, including their relationships with their premature babies. The aim of the study was to explore and describe the lived experiences of parents of premature babies in an ICU. Research design was qualitative, exploratory, descriptive and contextual. A purposive sample of parents with premature babies in an ICU in a private hospital in Johannesburg Gauteng in South Africa was used. Eight parents, four mothers and four fathers, married and either Afrikaans or English-speaking, were included in the study. Data were collected by conducting in-depth phenomenological interviews with them and making use of field notes. Trustworthiness was ensured by implementing the strategies of credibility, transferability, dependability and confirmability. Ethical principles such as autonomy, beneficence, nonmaleficence and justice were adhered to throughout the research process. Thematic analyses were utilised to analyse the data. Two themes in the experiences of parents with premature babies in ICU became apparent. Parents experienced thoughts, emotions and hope while their premature babies were in the ICU as well as challenges in their relationships and these challenges influenced their experiences. Mindfulness of intensive care nurses should be facilitated so that intensive care nurses can promote the mental health of parents with premature babies in the ICU. Parents with premature babies in the ICU have thoughts and emotional experiences which include hope and they affect parents' relationships.

  2. Pathogenic factors associated with development of disseminated intravascular coagulopathy (DIC) in a tertiary academic hospital in South Africa.

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    Mayne, Elizabeth S; Mayne, Anthony L H; Louw, Susan J

    2018-01-01

    Disseminated intravascular coagulopathy (DIC) is a thrombotic microangiopathy arising from consumption of both coagulation factors and platelets. DIC is triggered by a number of clinical conditions including severe infection, trauma and obstetric complications. Early diagnosis and treatment of the underlying condition is paramount. A high clinical index of suspicion is needed to ensure that patients at risk of developing DIC are appropriately investigated. In order to establish the clinical conditions most frequently associated with DIC, we reviewed all DIC screens received at a tertiary hospital in Johannesburg, South Africa over a 1 year period. The commonest clinical condition associated with DIC in our population was infection with 84% of patients infected with an identified pathogen. The most frequently diagnosed pathogen was HIV followed by Mycobacterium tuberculosis and other bacterial infections. In the majority of cases, bacteria were isolated from blood cultures. In 47 patients, HIV was the only pathogen which could be isolated. A relative risk ratio of 2.73 and an odds ratio of 29.97 was attributed to HIV for development of a DIC. A malignancy was present in 51 of the patients of which approximately 60% had co-existing infection. No cause could be attributed in 30 patients. Infection was identified in the majority of the patients diagnosed with DIC in this study. HIV showed the highest relative risk ratio of all pathogens although previous studies have not suggested that HIV was strongly associated with DIC. In almost half of the HIV infected patients, there was no other pathogen isolated despite extensive investigation. This suggests that HIV has a strong association with the development of DIC, warranting further research into the relationship between HIV and disseminated microvascular thrombosis.

  3. Knowledge and attitude toward interdisciplinary team working among obstetricians and gynecologists in teaching hospitals in South East Nigeria.

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    Iyoke, Chukwuemeka Anthony; Lawani, Lucky Osaheni; Ugwu, George Onyemaechi; Ajah, Leonard Ogbonna; Ezugwu, Euzebus Chinonye; Onah, Paul; Onwuka, Chidinma Ifechi

    2015-01-01

    Interdisciplinary team working could facilitate the efficient provision and coordination of increasingly diverse health services, thereby improving the quality of patient care. The purpose of this study was to describe knowledge of interdisciplinary team working among obstetricians and gynecologists in two teaching hospitals in South East Nigeria and to determine their attitude toward an interdisciplinary collaborative approach to patient care in these institutions. This was a questionnaire-based cross-sectional study. Data analysis involved descriptive statistics and was carried out using Statistical Package for the Social Sciences software version 17.0 for Windows. In total, 116 doctors participated in the study. The mean age of the respondents was 31.9±7.0 (range 22-51) years. Approximately 74% of respondents were aware of the concept of interdisciplinary team working. Approximately 15% of respondents who were aware of the concept of interdisciplinary team working had very good knowledge of it; 52% had good knowledge and 33% had poor knowledge. Twenty-nine percent of knowledgeable respondents reported ever receiving formal teaching/training on interdisciplinary team working in the course of their professional development. About 78% of those aware of team working believed that interdisciplinary teams would be useful in obstetrics and gynecology practice in Nigeria, with 89% stating that it would be very useful. Approximately 77% of those aware of team working would support establishment and implementation of interdisciplinary teams at their centers. There was a high degree of knowledge of the concept and a positive attitude toward interdisciplinary team working among obstetricians and gynecologists in the study centers. This suggests that the attitude of physicians may not be an impediment to implementation of a collaborative interdisciplinary approach to clinical care in the study centers.

  4. The effectiveness of the South African Triage Toll use in Mahalapye District Hospital – Emergency Department, Botswana

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    Stephane T. Tshitenge

    2016-07-01

    Full Text Available Background: The study aimed to determine the proportion of each priority level of patients, time of performance in each priority level, and the reliability of the South African Triage Scale (SATS tool at the Mahalapye District Hospital - Emergency Department (MDH-ED, a setting where the majority of the nurses were not formally trained on the use of the SATS. Methods: This was a cross-sectional study using case records in MDH-ED from 1 January 2014 to 31 December 2014. A panel of experts from the Mahalapye site of the Family Medicine Department, University of Botswana, reviewed and scored each selected case record that was compared with the scores previously attributed to the nurse triage. Results: From the 315 case records, both the nurse triage and the panel of expert triage assigned the majority of cases in the routine category (green, 146 (46% and 125 (40%, respectively, or in the urgent category (yellow, they assigned 140 (44% and 111 (35% cases, respectively.Overall, there was an adequate agreement between the nurse triage and the panel of expert triage (k = 0.4, 95% confidence interval: 0.3–0.5, although the level of agreement was satisfactory. Conclusion: Findings of the study reported that the profile of the priority-level categories in MDH-ED was made in the majority of routine and urgent patients, only the routine and the emergency patients were seen within the targeted time and they had a satisfactory level of reliability (between 0.4 and 0.6.

  5. Management of severe acute malnutrition in children under 5 years through the lens of health care workers in two rural South African hospitals.

    Science.gov (United States)

    Muzigaba, Moise; Van Wyk, Brian; Puoane, Thandi

    2018-01-30

    Despite the widespread implementation of the World Health Organization (WHO) guidelines for the management of severe malnutrition in South Africa, poor treatment outcomes for children under 5 years are still observed in some hospitals, particularly in rural areas. To explore health care workers' perceptions about upstream and proximal factors contributing to poor treatment outcomes for severe acute malnutrition in two district hospitals in South Africa. An explorative descriptive qualitative study was conducted. Four focus group discussions were held with 33 hospital staff (senior clinical and management staff, and junior clinical staff) using interview guide questions developed based on the findings from an epidemiological study that was conducted in the same hospitals. Qualitative data were analysed using the framework analysis. Most respondents believed that critical illness, which was related to early and high case fatality rates on admission, was linked to a web of factors including preference for traditional medicine over conventional care, gross negligence of the child at household level, misdiagnosis of severe malnutrition at the first point of care, lack of specialised skills to deal with complex presentations, shortage of patient beds in the hospital and policies to discharge patients before optimal recovery. The majority believed that the WHO guidelines were effective and relatively simple to implement, but that they do not make much difference among severe acute malnutrition cases that are admitted in a critical condition. Poor management of cases was linked to the lack of continuity in training of rotating clinicians, sporadic shortages of therapeutic resources, inadequate staffing levels after normal working hours and some organisational and system-wide challenges beyond the immediate control of clinicians. Findings from this study suggest that effective management of paediatric severe acute malnutrition in the study setting is affected by a

  6. Epidemiology of respiratory syncytial virus-associated acute lower respiratory tract infection hospitalizations among HIV-infected and HIV-uninfected South African children, 2010-2011.

    Science.gov (United States)

    Moyes, Jocelyn; Cohen, Cheryl; Pretorius, Marthi; Groome, Michelle; von Gottberg, Anne; Wolter, Nicole; Walaza, Sibongile; Haffejee, Sumayya; Chhagan, Meera; Naby, Fathima; Cohen, Adam L; Tempia, Stefano; Kahn, Kathleen; Dawood, Halima; Venter, Marietjie; Madhi, Shabir A

    2013-12-15

    There are limited data on respiratory syncytial virus (RSV) infection among children in settings with a high prevalence of human immunodeficiency virus (HIV). We studied the epidemiology of RSV-associated acute lower respiratory tract infection (ALRTI) hospitalizations among HIV-infected and HIV-uninfected children in South Africa. Children aged infection among HIV-infected and uninfected children were examined. The relative risk of hospitalization in HIV-infected and HIV-uninfected children was calculated in 1 site with population denominators. Of 4489 participants, 4293 (96%) were tested for RSV, of whom 1157 (27%) tested positive. With adjustment for age, HIV-infected children had a 3-5-fold increased risk of hospitalization with RSV-associated ALRTI (2010 relative risk, 5.6; [95% confidence interval (CI), 4.5-6.4]; 2011 relative risk, 3.1 [95% CI, 2.6-3.6]). On multivariable analysis, HIV-infected children with RSV-associated ALRTI had higher odds of death (adjusted odds ratio. 31.1; 95% CI, 5.4-179.8) and hospitalization for >5 days (adjusted odds ratio, 4.0; 95% CI, 1.5-10.6) than HIV-uninfected children. HIV-infected children have a higher risk of hospitalization with RSV-associated ALRTI and a poorer outcome than HIV-uninfected children. These children should be targeted for interventions aimed at preventing severe RSV disease.

  7. Nurses and care workers’ perceptions of their nurse-patient therapeutic relationship in private general hospitals, Gauteng, South Africa

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    Anna E. van den Heever

    2013-09-01

    Full Text Available Facilitation of a therapeutic relationship is an essential skill in nursing, particularly in mental-health care. Nurses and care workers in private general hospitals are exposed to the emotional effects of physical illness as well as the increase in admission of patients with mental-health needs. Poor nurse-patient relationships have been reported by patients and in the media. The researchers experienced incidents of apparent misunderstandings during nurse-patient interactions whilst working in private general hospitals. No studies have been done regarding how nurses and care workers perceive a therapeutic relationship with patients in terms of the patients’ emotional and mental-health needs. A quantitative, contextual and deductive study was conducted in three private general hospitals in Gauteng, South Africa with a purposive sample of 154 nurses and 30 care workers. Based on the concepts of a therapeutic relationship, empathy, positive regard, genuineness, concreteness and self-exploration, nurses and care workers’ perceptions of facilitating a therapeutic relationship were self-assessed using five-point scales in a questionnaire. Data were analysed using descriptive statistics and non-parametric statistical techniques. Specific hypotheses were tested to identify whether statistically-significant differences existed between the perceptions of two or more groups of nurses and care workers. Results showed a general insensitivity and lack of awareness and reflection on the part of nurses and care workers with regard to the patients’ emotional needs. When categories of nurses were compared, no statistically-significant differences were found between the perceptions of the various groups tested. There is a need for self-awareness, continued interpersonal skills training and supervision of nurses and care workers. A large percentage of the participants were younger than 40 years, subprofessional, with less than 10 years’ experience as

  8. Right care, right place, right time: improving the timeliness of health care in New South Wales through a public-private hospital partnership.

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    Saunders, Carla; Carter, David J

    2017-10-01

    Objective The overall aim of the study was to investigate and assess the feasibility of improving the timeliness of public hospital care through a New South Wales (NSW)-wide public-private hospital partnership. Methods The study reviewed the academic and professional grey literature, and undertook exploratory analyses of secondary data acquired from two national health data repositories informing in-patient access and utilisation across NSW public and private hospitals. Results In 2014-15, the NSW public hospital system was unable to deliver care within the medically recommended time frame for over 27400 people who were awaiting elective surgery. Available information indicates that the annual commissioning of 15% of public in-patient rehabilitation bed days to the private hospital system would potentially free up enough capacity in the NSW public hospital system to enable elective surgery for all public patients within recommended time frames. Conclusions The findings of the study justify a strategic whole-of-health system approach to reducing public patient wait times in NSW and highlight the need for research efforts aimed at securing a better understanding of available hospital capacity across the public and private hospital systems, and identifying and testing workable models that improve the timeliness of public hospital care. What is known about the topic? There are very few studies available to inform public-private hospital service partnerships and the opportunities available to improve timely health care access through such partnerships. What does this paper add? This paper has the potential to open and prompt timely discussion and debate, and generate further fundamental investigation, on public-private hospital service partnerships in Australia where opportunity is available to address elective surgery wait times in a reliable and effective manner. What are the implications for practitioners? The NSW Ministry of Health and its Local Health Districts

  9. ‘Practice what you preach’: Nurses’ perspectives on the Code of Ethics and Service Pledge in five South African hospitals

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    Janine White

    2015-05-01

    Full Text Available Background: A recent focus of the global discourse on the health workforce has been on its quality, including the existence of codes of ethics. In South Africa, the importance of ethics and value systems in nursing was emphasised in the 2011 National Nursing Summit. Objective: The study explored hospital nurses’ perceptions of the International Code of Ethics for Nurses; their perceptions of the South African Nurses’ Pledge of Service; and their views on contemporary ethical practice. Methods: Following university ethics approval, the study was done at a convenience sample of five hospitals in two South African provinces. In each hospital, all day duty nurses in paediatric, maternity, adult medical, and adult surgical units were requested to complete a self-administered questionnaire. The questionnaire focused on their perceptions of the Code of Ethics and the Pledge, using a seven-point Likert scale. STATA® 13 and NVIVO 10 were used to analyse survey data and open-ended responses, respectively. Results: The mean age of survey participants (n=69 was 39 years (SD=9.2, and the majority were female (96%. The majority agreed with a statement that they will promote the human rights of individuals (98% and that they have a duty to meet the health and social needs of the public (96%. More nuanced responses were obtained for some questions, with 60% agreeing with a statement that too much emphasis is placed on patients’ rights as opposed to nurses’ rights and 32% agreeing with a statement that they would take part in strike action to improve nurses’ salaries and working conditions. The dilemmas of nurses to uphold the Code of Ethics and the Pledge in face of workplace constraints or poor working conditions were revealed in nurses’ responses to open-ended questions. Conclusion: Continuing education in ethics and addressing health system deficiencies will enhance nurses’ professional development and their ethical decision-making and

  10. ‘Practice what you preach’: Nurses’ perspectives on the Code of Ethics and Service Pledge in five South African hospitals

    Science.gov (United States)

    White, Janine; Phakoe, Maureen; Rispel, Laetitia C.

    2015-01-01

    Background A recent focus of the global discourse on the health workforce has been on its quality, including the existence of codes of ethics. In South Africa, the importance of ethics and value systems in nursing was emphasised in the 2011 National Nursing Summit. Objective The study explored hospital nurses’ perceptions of the International Code of Ethics for Nurses; their perceptions of the South African Nurses’ Pledge of Service; and their views on contemporary ethical practice. Methods Following university ethics approval, the study was done at a convenience sample of five hospitals in two South African provinces. In each hospital, all day duty nurses in paediatric, maternity, adult medical, and adult surgical units were requested to complete a self-administered questionnaire. The questionnaire focused on their perceptions of the Code of Ethics and the Pledge, using a seven-point Likert scale. STATA® 13 and NVIVO 10 were used to analyse survey data and open-ended responses, respectively. Results The mean age of survey participants (n=69) was 39 years (SD=9.2), and the majority were female (96%). The majority agreed with a statement that they will promote the human rights of individuals (98%) and that they have a duty to meet the health and social needs of the public (96%). More nuanced responses were obtained for some questions, with 60% agreeing with a statement that too much emphasis is placed on patients’ rights as opposed to nurses’ rights and 32% agreeing with a statement that they would take part in strike action to improve nurses’ salaries and working conditions. The dilemmas of nurses to uphold the Code of Ethics and the Pledge in face of workplace constraints or poor working conditions were revealed in nurses’ responses to open-ended questions. Conclusion Continuing education in ethics and addressing health system deficiencies will enhance nurses’ professional development and their ethical decision-making and practice. PMID:25971398

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

    Science.gov (United States)

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

    2017-01-01

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

  12. Overturning refusal of a hospital to terminate life support for a brain-dead mother until the fetus was born: What is the law in South Africa?

    Science.gov (United States)

    McQuoid-Mason, David Jan

    2014-06-19

    In a Texas case the court granted a husband an order for the removal of life support from his brain-dead pregnant wife after a hospital tried to keep her on it until the fetus was born. In South Africa the court would have issued a similar order, but for different reasons. Here, unlawfully and intentionally subjecting a pregnant corpse to life-support measures to keep a fetus alive against the wishes of the family would amount to the crime of violating a corpse.

  13. Validation of administrative hospital data for identifying incident pancreatic and periampullary cancer cases: a population-based study using linked cancer registry and administrative hospital data in New South Wales, Australia.

    Science.gov (United States)

    Creighton, Nicola; Walton, Richard; Roder, David; Aranda, Sanchia; Currow, David

    2016-07-01

    Informing cancer service delivery with timely and accurate data is essential to cancer control activities and health system monitoring. This study aimed to assess the validity of ascertaining incident cases and resection use for pancreatic and periampullary cancers from linked administrative hospital data, compared with data from a cancer registry (the 'gold standard'). Analysis of linked statutory population-based cancer registry data and administrative hospital data for adults (aged ≥18 years) with a pancreatic or periampullary cancer case diagnosed during 2005-2009 or a hospital admission for these cancers between 2005 and 2013 in New South Wales, Australia. The sensitivity and positive predictive value (PPV) of pancreatic and periampullary cancer case ascertainment from hospital admission data were calculated for the 2005-2009 period through comparison with registry data. We examined the effect of the look-back period to distinguish incident cancer cases from prevalent cancer cases from hospital admission data using 2009 and 2013 as index years. Sensitivity of case ascertainment from the hospital data was 87.5% (4322/4939), with higher sensitivity when the cancer was resected (97.9%, 715/730) and for pancreatic cancers (88.6%, 3733/4211). Sensitivity was lower in regional (83.3%) and remote (85.7%) areas, particularly in areas with interstate outflow of patients for treatment, and for cases notified to the registry by death certificate only (9.6%). The PPV for the identification of incident cases was 82.0% (4322/5272). A 2-year look-back period distinguished the majority (98%) of incident cases from prevalent cases in linked hospital data. Pancreatic and periampullary cancer cases and resection use can be ascertained from linked hospital admission data with sufficient validity for informing aspects of health service delivery and system-level monitoring. Limited tumour clinical information and variation in case ascertainment across population subgroups are

  14. The household costs of health care in rural South Africa with free public primary care and hospital exemptions for the poor.

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    Goudge, Jane; Gilson, Lucy; Russell, Steve; Gumede, Tebogo; Mills, Anne

    2009-04-01

    To measure the direct cost burdens (health care expenditure as a percent of total household expenditure) for households in rural South Africa, and examine the expenditure and use patterns driving those burdens, in a setting with free public primary health care and hospital exemptions for the poor. Data on illness events, treatment patterns and health expenditure in the previous month were assessed from a cross-sectional survey of 280 households conducted in the Agincourt Health and Demographic Surveillance site, South Africa. On average, a household experiencing illness incurred a direct cost burden of 4.5% of total household expenditure. A visit to a public clinic generated a mean burden of 1.3%. Complex sequences of treatments led 20% of households to incur a burden over 10%, with transport costs generating 42% of this burden. An outpatient public hospital visit generated a burden of 8.2%, as only 58% of those eligible obtained an exemption; inpatient stays incurred a burden of 45%. Consultations with private providers incurred a mean burden of 9.5%. About 38% of individuals who reported illness did not take any treatment action, 55% of whom identified financial and perceived supply-side barriers as reasons. The low overall mean cost burden of 4.5% suggests that free primary care and hospital exemptions provided financial protection. However, transport costs, the difficulty of obtaining hospital exemptions, use of private providers, and complex treatment patterns meant state-provided protection had limitations. The significant non-use of care shows the need for other measures such as more outreach services and more exemptions in rural areas. The findings also imply that fee removal anywhere must be accompanied by wider measures to ensure improved access.

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

    Science.gov (United States)

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

    2018-01-01

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

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

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    Laurence Pascal

    2013-01-01

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

  17. Exploring spatial planning and functional program impact on microbial diversity and distribution in two South African hospital microbiomes

    CSIR Research Space (South Africa)

    Nice, Jaco A

    2015-07-01

    Full Text Available This paper presents a theoretical and experimental research approach on the impact of spatial planning and functional program on the microbial load, distribution and organism diversity in hospital environments. The investigation aims to identify...

  18. Accreditation status of hospital pharmacies and their challenges of medication management: A case of south Iranian largest university.

    Science.gov (United States)

    Barati, Omid; Dorosti, Hesam; Talebzadeh, Alireza; Bastani, Peivand

    2016-01-01

    Considering the importance of accreditation for hospital pharmacies, this study was to determine the challenges of medication management in hospital pharmacies affiliated with Shiraz University of Medical Sciences, Iran. The study was a mix-method research conducted in two qualitative and quantitative phases during the years 2014-2015 in Shiraz, Iran. National Accreditation Standard checklist for hospitals was used for data collection in the first phase, and Delphi method was applied in three rounds to achieve the most challenges of medication management and the related solutions. Results indicated a medium status of accreditation for all three dimensions in the above hospital pharmacies (3.53, 42.15 and 7, respectively). Lack of clinical pharmacists, nonparticipation of the pharmacy director in annual budgeting, lack of access to patient information, discontinuity of pharmaceutical care for patients discharged, defects in pharmacy staff training, lack of legislation in support of pharmacists and lack of adequate access to physicians' prescriptions, shortages in reporting medication errors, and lack of evidence related to microbial contamination are the most challenges extracted from the second phase. It seems that the studied hospital pharmacies encounter numerous problems regarding accreditation, pharmaceutical care as well as appropriate medication management and supply chain. Attempts to solve these problems can play an important role in improving the efficiency and effectiveness of pharmacies in Iran.

  19. Accreditation status of hospital pharmacies and their challenges of medication management: A case of south Iranian largest university

    Directory of Open Access Journals (Sweden)

    Omid Barati

    2016-01-01

    Full Text Available Considering the importance of accreditation for hospital pharmacies, this study was to determine the challenges of medication management in hospital pharmacies affiliated with Shiraz University of Medical Sciences, Iran. The study was a mix-method research conducted in two qualitative and quantitative phases during the years 2014–2015 in Shiraz, Iran. National Accreditation Standard checklist for hospitals was used for data collection in the first phase, and Delphi method was applied in three rounds to achieve the most challenges of medication management and the related solutions. Results indicated a medium status of accreditation for all three dimensions in the above hospital pharmacies (3.53, 42.15 and 7, respectively. Lack of clinical pharmacists, nonparticipation of the pharmacy director in annual budgeting, lack of access to patient information, discontinuity of pharmaceutical care for patients discharged, defects in pharmacy staff training, lack of legislation in support of pharmacists and lack of adequate access to physicians' prescriptions, shortages in reporting medication errors, and lack of evidence related to microbial contamination are the most challenges extracted from the second phase. It seems that the studied hospital pharmacies encounter numerous problems regarding accreditation, pharmaceutical care as well as appropriate medication management and supply chain. Attempts to solve these problems can play an important role in improving the efficiency and effectiveness of pharmacies in Iran.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2002-01-15

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

  1. Optimal medical therapy for secondary prevention after an acute coronary syndrome: 18-month follow-up results at a tertiary teaching hospital in South Korea

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    Byeon HJ

    2016-02-01

    Full Text Available Hee Ja Byeon,1,* Young-Mo Yang,2,* Eun Joo Choi21Department of Pharmacy, Chosun University Hospital, 2Department of Pharmacy, College of Pharmacy, Chosun University, Gwangju, South Korea*These authors contributed equally to this workBackground: Acute coronary syndrome (ACS is a fatal cardiovascular disease caused by atherosclerotic plaque erosion or rupture and formation of coronary thrombus. The latest guidelines for ACS recommend the combined drug regimen, comprising aspirin, P2Y12 inhibitor, angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker, β-blocker, and statin, at discharge after ACS treatment to reduce recurrent ischemic cardiovascular events. This study aimed to examine prescription patterns of secondary prevention drugs in Korean patients with ACS after hospital discharge, to access the appropriateness of secondary prevention drug therapy for ACS, and to evaluate whether to persistently use discharge medications for 18 months.Methods: This study was retrospectively conducted with the patients who were discharged from the tertiary hospital, located in South Korea, after ACS treatment between September 2009 and August 2013. Data were collected through electronic medical record.Results: Among 3,676 patients during the study period, 494 were selected based on inclusion and exclusion criteria. The regimen of aspirin + clopidogrel + β-blocker + angiotensin-converting enzyme inhibitor/angiotensin II receptor blocker + statin was prescribed to 374 (75.71% patients with ACS at discharge. Specifically, this regimen was used in 177 (69.69% unstable angina patients, 44 (70.97% non-ST-segment elevation myocardial infarction patients, and 153 (85.96% ST-segment elevation myocardial infarction patients. Compared with the number of ACS patients with all five guideline-recommended drugs at discharge, the number of ACS patients using them 12 (n=169, 34.21% and 18 (n=105, 21.26% months after discharge tended to be gradually

  2. Predictors of loss to follow-up among patients on ART at a rural hospital in KwaZulu-Natal, South Africa.

    Science.gov (United States)

    Arnesen, Rachel; Moll, Anthony P; Shenoi, Sheela V

    2017-01-01

    Improved HIV outcomes as a result of expanded antiretroviral therapy (ART) access is threatened by increasing rates of loss to follow up (LTFU) among those on ART, largely reported in urban populations. Some reports suggest that LTFU rates are overestimated due to patient movement to other facilities and inadequate medical records. To define the proportion disengaging from HIV care as well as the characteristics of those LTFU in order to design and implement appropriate interventions to increase retention. We performed a retrospective review of patients who discontinued ART at a central hospital ART clinic in rural South Africa and compared with patients receiving care at the 15 primary health clinics (PHCs) to determine the true proportion of those who were LTFU. We also compared those who discontinued ART with those who did not at the central hospital ART clinic to determine predictors of loss to follow up. Among 3242 patients on ART, 820 were originally marked as LTFU. Among all patients, 272 (8.4%) were found at a clinic on treatment, 56 (1.7%) were found at a clinic from which they had since discontinued treatment, and 10 (0.3%) returned to care between June and July 2016, leaving 475 (14.7%) unaccounted for and thus categorized as 'true' LTFU. Factors found to be associated with discontinuation include being male, age 18-35, having a CD4 count under 200 cells/μL, and being on ART for under six months. Young men with low CD4 counts early after ART initiation are at highest risk of ART disengagement in this rural South African HIV clinic. Novel interventions targeting this group are needed to improve retention in care.

  3. Increasing Recovery of Nontuberculous Mycobacteria from Respiratory Specimens over a 10-Year Period in a Tertiary Referral Hospital in South Korea.

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    Koh, Won-Jung; Chang, Boksoon; Jeong, Byeong-Ho; Jeon, Kyeongman; Kim, Su-Young; Lee, Nam Yong; Ki, Chang-Seok; Kwon, O Jung

    2013-11-01

    The number of patients with pulmonary disease caused by nontuberculous mycobacteria (NTM) has been increasing worldwide. The aim of this study was to evaluate long-term trends in the NTM recovery rate from respiratory specimens over a 10-year period in a tertiary referral hospital in South Korea. We retrospectively reviewed the records of mycobacterial cultures of respiratory specimens at Samsung Medical Center from January 2001 to December 2011. During the study period, 32,841 respiratory specimens from 10,563 patients were found to be culture-positive for mycobacteria. These included 12,619 (38%) Mycobacterium tuberculosis and 20,222 (62%) NTM isolates. The proportion of NTM among all positive mycobacterial cultures increased from 43% (548/1,283) in 2001 to 70% (3,341/4,800) in 2011 (ptrend). The recovery rate of NTM isolates from acid-fast bacilli smear-positive specimens increased from 9% (38/417) in 2001 to 64% (1,284/1,997) in 2011 (ptrend). The proportion of positive liquid cultures was higher for NTM than for M. tuberculosis (p<0.001). The most frequently isolated NTM were Mycobacterium avium-intracellulare complex (53%) and Mycobacterium abscessus-massiliense complex (25%). The recovery rate of NTM from respiratory specimens in South Korea has increased steadily.

  4. Compliance to Occupational Safety Measures among the Paramedical Workers in a Tertiary Hospital in Karnataka, South India

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    P Phukan

    2014-01-01

    Full Text Available Background: The guidelines for minimizing occupational health risk from exposure to highly infectious diseases is already established but little information exists on the compliance of these measures among paramedical workers in India. Objective: To study the awareness of occupational safety measures such as universal precautions, biomedical waste handling, disposal and its compliance in their daily practice. Methods: A hospital-based cross-sectional study was undertaken in a tertiary private hospital in Karnataka, Bangalore, India. Data was collected using a pretested and predesigned proforma from 120 respondents: 85 nurses and 35 laboratory technicians. Results: 27 (32% nurses and 20 (57% laboratory technicians could relate universal precautions to infection prevention. Only 6 (7% nurses and 2 (6% technicians had knowledge about proper hospital waste segregation. 45 (52.9% nurses and 15 (42.8% technicians had knowledge about post-exposure prophylaxis. 3 (4% nurses and 9 (26% technicians were formally trained in following universal precautions. Adequate hand washing was practiced among 17 (20% nurses and none of the technicians. Faulty practice such as recapping of needle was prevalent among 57 (67% nurses and 29 (83% technicians. 32 (38% nurses and 10 (29% technicians received hepatitis B vaccine. Conclusion: As knowledge and practice regarding different aspects of universal precautions was not satisfactory, training was warranted urgently in the study population. Also, suggestions were made to develop and implement institutional policies on the universal precautions and ensuring supply of personal protection equipment.

  5. Major surgery in south India: a retrospective audit of hospital claim data from a large community health insurance programme.

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    Shaikh, Maaz; Woodward, Mark; Rahimi, Kazem; Patel, Anushka; Rath, Santosh; MacMahon, Stephen; Jha, Vivekanand

    2015-04-27

    Information about use of major surgery in India is scarce. This study aims to bridge this gap by auditing hospital claims from the Rajiv Aarogyasri Community Health Insurance Scheme (RACHIS) that provides access to free tertiary care for major surgery through state-funded insurance to 68 million beneficiaries with limited household incomes-81% of population in states of Telangana and Andhra Pradesh (combined Human Development Index 0·485). Beneficiary households receive an annual coverage of INR 200 000 (US$3333) for admissions to any empanelled public or private hospital. Publicly available deidentified hospital claim data for all surgical procedures conducted between mid-2008 and mid-2012 were compiled across all 23 districts in Telangana and Andhra Pradesh. 677 332 surgical admissions (80% at private hospitals) were recorded at a mean annual rate of 259 per 100 000 beneficiaries (95% CI 235-283), excluding cataract and caesarean sections as these were not covered under the insurance programme. Men accounted for 56% of admissions. Injury was the most common cause for surgical admission (185 733; 27%) with surgical correction of long bone fractures being the most common procedure (144 997; 20%) identified in the audit. Diseases of digestive (110 922; 16%), genitourinary (82 505; 12%), and musculoskeletal system (70 053; 10%) were other leading causes for surgical admissions. Most hospital bed-days were used for injuries (584 days per 100 000 person years; 31%), digestive diseases (314 days; 17%), and musculoskeletal system (207 days; 11%), costing 19% (INR 4·4 billion), 13% (3·03 billion), and 11% (2·5 billion) of claims, respectively. Cardiovascular surgeries (53 023; 8%) alone accounted for 21% (INR 4·9 billion) of cost. Annual per capita cost of surgical claims was US$1·49 (95% CI 1·32-1·65). Our findings are limited to a population socioeconomically representative of India and other countries with low-income and middle

  6. A survey of blood conservation methods in clinical practice in some urban south-eastern government hospitals in Nigeria.

    Science.gov (United States)

    Amucheazi, A O; Ajuzeiogu, V O; Ezike, H A; Odiakosa, M C; Nwoke, O M; Onyia, E

    2011-01-01

    GENERAL OBJECTIVE: To assess the practice of blood conservation. To determine the methods of blood conservation in use, to assess the lower limit for hemoglobin for elective procedures, to determine transfusion trigger point in practice, to find out limitations in practice and ways to improve clinical practice. This was conducted in February 2009. Self-administered questionnaires were distributed among the surgeons and anesthetists in practice at the University of Nigeria Teaching Hospital, Enugu State University Teaching Hospital, Ebonyi State University Teaching Hospital and National Orthopaedic Hospital, Enugu. The data gathered was analyzed using the SPSS software. : Of participants who agreed to fill the questionnaires, more than 50% were males. The most prevalent specialty was general surgery (24.2%), followed by orthopedics (22.6%), obstetrics and gynecology (20.7%), and anesthesia (17.7%). The lowest hemoglobin limit before the patient was allowed into the theatre for elective procedures was 10 g/dl while individual transfusion trigger points ranged from hemoglobin of 6 to 10 g/dl. Majority of the doctors would avoid homologous blood transfusion in order to avoid transfusion-related diseases and reaction. Regarding knowledge of blood conservation methods and means of avoiding homologous blood, the use of diathermy was highest (12.33%), followed by preoperative blood donation (11.87%), use of hematinics (10.96%), and tourniquet 10.5%. Also, in practice, diathermy was the most frequently used (18.69%), followed by preoperative blood donation (16.16%), use of tourniquet (15.15%), while the Ovadje cell saver was least with 0.01%. Suggestions from respondents on the ways of limiting transfusion-related problems included optimization of patients (24.5%), improvement of standard of living (17.7%), and personnel training (13.3%). There is an agreement with the global trend geared toward minimizing the use of homologous blood by doctors in these hospitals. However

  7. A survey of blood conservation methods in clinical practice in some urban south-eastern government hospitals in Nigeria

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    Amucheazi A

    2011-01-01

    Full Text Available General Objective: To assess the practice of blood conservation. Specific Objectives: To determine the methods of blood conservation in use, to assess the lower limit for hemoglobin for elective procedures, to determine transfusion trigger point in practice, to find out limitations in practice and ways to improve clinical practice. Materials and Methods: This was conducted in February 2009. Self-administered questionnaires were distributed among the surgeons and anesthetists in practice at the University of Nigeria Teaching Hospital, Enugu State University Teaching Hospital, Ebonyi State University Teaching Hospital and National Orthopaedic Hospital, Enugu. The data gathered was analyzed using the SPSS software. Results : Of participants who agreed to fill the questionnaires, more than 50% were males. The most prevalent specialty was general surgery (24.2%, followed by orthopedics (22.6%, obstetrics and gynecology (20.7%, and anesthesia (17.7%. The lowest hemoglobin limit before the patient was allowed into the theatre for elective procedures was 10 g/dl while individual transfusion trigger points ranged from hemoglobin of 6 to 10 g/dl. Majority of the doctors would avoid homologous blood transfusion in order to avoid transfusion-related diseases and reaction. Regarding knowledge of blood conservation methods and means of avoiding homologous blood, the use of diathermy was highest (12.33%, followed by preoperative blood donation (11.87%, use of hematinics (10.96%, and tourniquet 10.5%. Also, in practice, diathermy was the most frequently used (18.69%, followed by preoperative blood donation (16.16%, use of tourniquet (15.15%, while the Ovadje cell saver was least with 0.01%. Suggestions from respondents on the ways of limiting transfusion-related problems included optimization of patients (24.5%, improvement of standard of living (17.7%, and personnel training (13.3%. Conclusion: There is an agreement with the global trend geared toward

  8. Antibiotic Susceptibilities of Enterococcus Species Isolated from Hospital and Domestic Wastewater Effluents in Alice, Eastern Cape Province of South Africa

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    Benson Chuks Iweriebor

    2015-04-01

    Full Text Available Background: Antimicrobial resistance in microorganisms are on the increase worldwide and are responsible for substantial cases of therapeutic failures. Resistance of species of Enterococcus to antibiotics is linked to their ability to acquire and disseminate antimicrobial resistance determinants in nature, and wastewater treatment plants (WWTPs are considered to be one of the main reservoirs of such antibiotic resistant bacteria. We therefore determined the antimicrobial resistance and virulence profiles of some common Enterococcus spp that are known to be associated with human infections that were recovered from hospital wastewater and final effluent of the receiving wastewater treatment plant in Alice, Eastern Cape. Methods: Wastewater samples were simultaneously collected from two sites (Victoria hospital and final effluents of a municipal WWTP in Alice at about one to two weeks interval during the months of July and August 2014. Samples were screened for the isolation of enterococci using standard microbiological methods. The isolates were profiled molecularly after targeted generic identification and speciation for the presence of virulence and antibiotic resistance genes. Results: Out of 66 presumptive isolates, 62 were confirmed to belong to the Enterococcus genusof which 30 were identified to be E. faecalis and 15 E. durans. The remaining isolates were not identified by the primers used in the screening procedure. Out of the six virulence genes that were targeted only three of them; ace, efaA, and gelE were detected. There was a very high phenotypic multiple resistance among the isolates and these were confirmed by genetic analyses. Conclusions: Analyses of the results obtained indicated that hospital wastewater may be one of the sources of antibiotic resistant bacteria to the receiving WWTP. Also, findings revealed that the final effluent discharged into the environment was contaminated with multi-resistant enterococci species thus

  9. Effect of personal and work stress on burnout, job satisfaction and general health of hospital nurses in South Africa

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    Natasha Khamisa

    2017-10-01

    Full Text Available The majority of studies to date have focused on the effects of work stress in the nursing environment, with the effect of personal stress in nursing being less explored. This study sought to determine whether personal stress is a more significant predictor of burnout, job satisfaction and general health than work stress. Of the 1200 nurses randomly selected to participate in the study, 895 agreed to complete six questionnaires over 3 weeks. Data was analysed using hierarchical multiple linear regression. Findings revealed that personal stress is a better predictor of burnout and general health than job satisfaction, which is better predicted by work stress. The findings of this study could inform potential solutions to reduce the impact of personal and work stress on burnout, job satisfaction and general health. Coping strategies and staffing strategies need to be evaluated within developing contexts such as South Africa to as certain their effectiveness.

  10. Deviation Value for Conventional X-ray in Hospitals in South Sulawesi Province from 2014 to 2016

    Science.gov (United States)

    Bachtiar, Ilham; Abdullah, Bualkar; Tahir, Dahlan

    2018-03-01

    This paper describes the conventional X-ray machine parameters tested in the region of South Sulawesi from 2014 to 2016. The objective of this research is to know deviation of every parameter of conventional X-ray machine. The testing parameters were analyzed by using quantitative methods with participatory observational approach. Data collection was performed by testing the output of conventional X-ray plane using non-invasive x-ray multimeter. The test parameters include tube voltage (kV) accuracy, radiation output linearity, reproducibility and radiation beam value (HVL) quality. The results of the analysis show four conventional X-ray test parameters have varying deviation spans, where the tube voltage (kV) accuracy has an average value of 4.12%, the average radiation output linearity is 4.47% of the average reproducibility of 0.62% and the averaged of the radiation beam (HVL) is 3.00 mm.

  11. Utilization of Spirituality and Spiritual Care in Nursing Practice in Public Hospitals in KwaZulu-Natal, South Africa

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    Sandhya Chandramohan

    2016-03-01

    Full Text Available This study explored the views of professional nurses in KwaZulu-Natal, South Africa regarding the role of spirituality and spiritual care in nursing practice and investigated whether professional nurses utilize spiritually based care in nursing practice. A cross-sectional descriptive design using multistage random sampling was utilized. Five hundred and fifty questionnaires were distributed to professional nurses between December 2012 and February 2013. A total of 385 participants completed the survey questionnaire, resulting in a 77% response rate. Data was analyzed using SSPS 0.20. The data revealed that nurses see spirituality and spiritual care as an important dimension of nursing practice but need greater preparedness. Nurses need to be effectively prepared to deal with the complexity of providing ethically based personalized spiritual care in an increasingly diverse society.

  12. Turnover of professional nurses at Mokopane Hospital in the Limpopo Province, South Africa: Experiences of nursing unit managers.

    Science.gov (United States)

    Mmamma, Mogale L; Mothiba, Tebogo M; Nancy, Malema R

    2015-12-17

    Staff turnover of professional nurses remains a concern for public and private hospitals management because it has an impact on the morale of nurses and it may also lead to poor patient care. The objectives of this study were to explore and describe the experiences of nursing unit managers with regard to the turnover of professional nurses who were under their supervision. A qualitative, explorative, descriptive research design was used to determine the experiences of nursing unit managers related to the turnover of professional nurses. Data collection was done by using semi-structured one-to-one interviews with professional nurses .Two groups of participants were interviewed: Those working day duty (n = 9) and those working night duty (n = 3) who were at work on the anticipated days for data collection. The findings revealed that every unit was experiencing a shortage of professional nurses, which caused other nurses to work overtime with an inevitable increase in workload. That led to tiredness, conflict amongst professional nurses, job dissatisfaction, and absenteeism which compromised nursing care. This resulted in patient dissatisfaction and sometimes led to deaths that could have been prevented. It is recommended that staff turnover should be addressed by the hospital top management implementing several strategies. For example, top management could ensure that staff members work in a healthy environment with resources that they need during the provision of care, address the effects of the staff turnover, support the staff members and refrain from putting pressure on nursing unit managers whilst they are attending to problems.

  13. Toxicoepidemiology of acute poisoning cases in a secondary care hospital in rural South India: A five-year analysis

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    T H Indu

    2015-01-01

    Full Text Available Objective: To ascertain the trend of poisoning cases admitted to the Government District Headquarters Hospital, a secondary care center in Udhagamandalam, Nilgiris District, Tamil Nadu, India, over a five-year period. Materials and Methods: The number of cases that presented to the hospital annually (incidence, mortality, and case fatality rates, socio-demographic pattern, and the nature of the poison were noted. Results: A total of 1860 poisoning cases (80 deaths were reported during the period from October 2008 to September 2013. The incidence of poisoning was found to increase every year. The average incidence was 1.60 per 1000 population, while the average case fatality rate and mortality rates were 40.51 and 0.07, respectively. A total of 1148 (62% were males. The majority of cases were seen in the 21-30 age group (41.24%. The poisonings were largely deliberate self-harm (n = 1,755; 94.35%, followed by accidental (n = 85; 4.57%. Agrochemicals were the main choice of poisoning agents and among these, organophosphates were the major cause. Conclusion: The data generated can help policy makers take decisions on the sale and availability of pesticides in this region.

  14. Occupational Exposure to Infection: A study on Healthcare Waste Handlers of a Tertiary Care Hospital in South India.

    Science.gov (United States)

    Shivalli, Siddharudha; Sowmyashree, H

    2015-11-01

    Occupational exposure to infection is an important public health concern. Such accidents are associated with a few, but pose significant risk to worker's health, family and the community. 1) To assess the knowledge and attitude of waste handlers regarding healthcare waste management in tertiary care hospital of Mangalore. 2) To assess the occupational risk of exposure to infection in their work setting. A cross-sectional study was conducted among healthcare waste handlers (involved in collection, storage and safe disposal) in a tertiary care hospital of Mangalore, India. A semi-structured and pre-tested proforma was used to assess respondents' knowledge and percentage score was calculated based on a scoring system. Chi square and independent sample t tests were applied to judge the association of study variables with knowledge and occupational risk of infection. A total of 43 healthcare waste handlers participated in the study and all were females. Almost half of them had poor knowledge (healthcare waste management. As much as 41.8% of them had exposure to healthcare waste and 'needle stick injury' was the most common type. Age, literacy and experience did not significantly (p>0.05) influence the knowledge and occupational risk of infection. Respondents' knowledge regarding healthcare waste management was unsatisfactory. They were at high risk of occupational exposure to infection. It emphasizes the need of refresher training and reinforcement of personal protection measures in their work setting. © Journal of the Association of Physicians of India 2011.

  15. Nurses experiences regarding staffing patterns in the surgical wards of a private hospital in Gauteng South Africa

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    Moloko Malatji

    2017-12-01

    Purpose: The purpose of this study was to explore and describe nurses' experiences regarding staffing patterns in the surgical wards of a private hospital in Gauteng in order to develop recommendations for staffing patterns in these wards. Methodology: A qualitative, exploratory, descriptive and contextual research design was used. Data was collected by means of in-depth semi structured individual interviews from a purposive sample of professional nurses working in the surgical wards of this hospital. Data was analysed using Tesch's method of qualitative thematic analysis. Principles of trustworthiness and ethical principles to ensure the protection of human rights were applied throughout the study. Results: The findings of the study revealed one central theme which reflected that participants experienced the staffing patterns of the surgical wards negatively. Two main themes emerged as, nurses had negative experiences in the surgical wards as well as negative emotional experiences related to the staffing patterns. Conclusion: It is evident from the findings of the study that nurses are experiencing staffing patterns negatively.

  16. Counselling implications of teachers’ digital competencies in the use of Social Networking Sites (SNSs in the teaching-learning process in Calabar, Nigeria

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    Mfon Eyo

    2016-12-01

    Full Text Available The study investigated teachers’ digital competencies in the use of Social Networking Sites (SNSs in the teaching-learning process. It had five research questions and two hypotheses. Adopting a survey design, it used a sample of 250 teachers from 10 out of 16 secondary schools in Calabar Municipal Local Government. A researcher-developed instrument called Digital Competency Questionnaire (DCQ was used in data gathering. The DCQ was validated by three experts, and its reliability was established to be 0.86. Findings of the study indicated that the levels of digital competencies of teachers in the use of SNSs and general usage of SNSs by teachers are moderate. It also revealed that the level of application of SNSs in the teaching-learning process is low. Results of the study also indicated significant differences in the level of digital competencies in the use of SNSs based on gender; and in the level of application of SNSs in the teaching-learning process based on age category of teachers. Recommendations were made to the guidance counsellor to improve these levels and bridge the established gaps based on gender and age category of the teachers.

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

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    Melese Belayneh

    2017-01-01

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

  18. Turnover of professional nurses at Mokopane Hospital in the Limpopo Province, South Africa: Experiences of nursing unit managers

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    Mogale L. Mmamma

    2015-12-01

    Full Text Available Background: Staff turnover of professional nurses remains a concern for public and private hospitals management because it has an impact on the morale of nurses and it may also lead to poor patient care. Objectives: The objectives of this study were to explore and describe the experiences of nursing unit managers with regard to the turnover of professional nurses who were under their supervision. Method: A qualitative, explorative, descriptive research design was used to determine the experiences of nursing unit managers related to the turnover of professional nurses. Data collection was done by using semi-structured one-to-one interviews with professional nurses .Two groups of participants were interviewed: Those working day duty (n = 9 and those working night duty (n = 3 who were at work on the anticipated days for data collection. Results: The findings revealed that every unit was experiencing a shortage of professional nurses, which caused other nurses to work overtime with an inevitable increase in workload. That led to tiredness, conflict amongst professional nurses, job dissatisfaction, and absenteeism which compromised nursing care. This resulted in patient dissatisfaction and sometimes led to deaths that could have been prevented. Conclusion: It is recommended that staff turnover should be addressed by the hospital top management implementing several strategies. For example, top management could ensure that staff members work in a healthy environment with resources that they need during the provision of care, address the effects of the staff turnover, support the staff members and refrain from putting pressure on nursing unit managers whilst they are attending to problems.

  19. Pattern of surgical procedures performed in the orthopaedic units of a tertiary hospital in South West Nigeria

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    Thomas O Adekoya-Cole

    2016-01-01

    Full Text Available Background: Lagos University Teaching Hospital (LUTH is one of the foremost teaching institutions in Nigeria. It is a recognized training institution for residency training in Nigeria. However, a thorough evaluation of the procedures being undertaken by the orthopaedic teams in this centre and the impact on the type of training being passed on to the resident doctors in training is the focus of this paper. Objectives: To determine the pattern of procedures performed by the orthopaedic units of the Department of Surgery, LUTH with a view to import the findings in re-organizing its structure based on service requirement, manpower allocation and to make recommendation. Methods: We retrospectively reviewed data including age, sex, procedures and leading surgeons retrieved from all our operating theatres over a period from 1st January 2010 to 31st December 2011. The data retrieved was analyzed. Results: A total 741 procedures were performed over the 2 year period. More male patients (58.5% had procedures performed on them than the female patients. The mean age of patients treated was 37.2±15.5 years. Trauma related procedures accounted for 68.8% of the total procedures. Open reduction and internal fixation surgical operations were the most common trauma related procedure while ablative surgical operations following Diabetic Mellitus foot syndrome were the most common non-trauma related procedure performed. Conclusion: Trauma related surgery remains the most common procedures in our teaching hospital. Efforts should be made to increase the number of elective operations like Arthroplasties, Arthroscopic operations and Spinal axis correction operations being performed.

  20. Utilization Study of Antihypertensives in a South Indian Tertiary Care Teaching Hospital and Adherence to Standard Treatment Guidelines.

    Science.gov (United States)

    Datta, Supratim

    2016-12-01

    Hypertension represents a major health problem primarily because of its role in contributing to the initiation and progression of major cardiovascular diseases. Concerns pertaining to hypertension and its sequelae can be substantially addressed and consequent burden of disease reduced by early detection and appropriate therapy of elevated blood pressure. This cross-sectional observational study aims at analyzing the utilization pattern of antihypertensives used for the treatment of hypertension at a tertiary care hospital in perspective of standard treatment guidelines. Prescriptions were screened for antihypertensives at the medicine outpatient department of a tertiary care teaching hospital. Medical records of the patients were scrutinized after which 286 prescriptions of patients suffering from hypertension were included. The collected data were sorted and analyzed on the basis of demographic characteristics and comorbidities. The calcium channel blockers were the most frequently used antihypertensive class of drugs (72.3%). Amlodipine (55.6%) was the single most frequently prescribed antihypertensive agent. The utilization of thiazide diuretics was 9%. Adherence to the National List of Essential Medicines (NLEMs) was 65%. The combination therapy was used more frequently (51.5%) than monotherapy (48.8%). The use of angiotensin-converting enzyme inhibitors/angiotensin 2 receptor blockers (ACE-I/ARB) was 41.4% in diabetes. The treatment pattern, in general, conformed to standard treatment guidelines. Few areas, however, need to be addressed such as the underutilization of thiazide diuretics, need for more awareness of drugs from the NLEMs and enhanced use of ACE-I/ARB in diabetic hypertensives.

  1. Factors influencing the recommendation of the Human Papillomavirus vaccine by South African doctors working in a tertiary hospital.

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    Hoque, Muhammad Ehsanul

    2016-06-01

    In South Africa, HPV vaccination programme has been incorporated recently in the school health system. Since doctors are the most trusted people regarding health issues in general, their knowledge and attitudes regarding HPV infections and vaccination are very important for HPV vaccine program nationally. The objective of this study was to investigate factors contributing to recommendation of HPV vaccines to the patients. This was a quantitative cross-sectional study conducted among 320 doctors, using a self-administered anonymous questionnaire. All the doctors were aware of HPV and knew that HPV is transmitted sexually. Their overall level of knowledge regarding HPV infections and HPV vaccine was poor. But the majority intended to prescribe the vaccine to their patients. It was found that doctors who knew that HPV 6 and 11 are responsible for >90% of anogenital warts, their patients would comply with the counselling regarding HPV vaccination, and received sufficient information about HPV vaccination were 5.68, 4.91 and 4.46 times respectively more likely to recommend HPV vaccination to their patients, compared to their counterparts (p<0.05). There was a knowledge gap regarding HPV infection and HPV vaccine among the doctors.

  2. Accepting telemedicine in a circulatory medicine ward in major hospitals in South Korea: patients' and health professionals' perception of real-time electrocardiogram monitoring.

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    Lee, Seo-Joon; Jung, Tae-Young; Lee, Tae-Ro; Han, Jae-Hoon

    2018-04-20

    South Korean government is currently in progress of expanding the coverage of telemedicine projects as part of an attempt to vitalize service industry, but is facing fierce opposition from KMA. Practice of telemedicine requires sufficient discussions among related parties. Although the participation of medical specialists is important, agreement from the public is essential. Three main tertiary care centers in Seoul were selected for data collection. A total of 224 patients (patients n = 180, patient guardian n = 44) and medical professionals (n = 41) were selected using simple random sampling. Mixed method of quantitative survey and qualitative semi-interview was used. This study analyzed patients' and medical professionals' perception about the application of telemedicine in cardiology ward in tertiary care centers to provide baseline data when developing and applying telemedicine services. Results implied high need for encouraging telemedicine projects in order to appeal needs among population by providing experience (p < 0.001) and knowledge (p < 0.001). Other results showed that the need for electrocardiography monitoring was high among not only in remote areas but also in areas close to the capital. 64.52% of all participants thought that telemedicine was needed, and 73.21% of participants were willing to use telemedicine service if provided. Semi-interviews revealed that participants expected more cost and time saving services through remote treatment, by not having to visit long distance hospitals frequently. Research results oppose Korean Medical Association's opinion that the population is against enforcing telemedicine related laws. The findings in this study reflect an up-to-date perception of telemedicine among patients and medical professionals in a tertiary care centers' cardiology ward. Moreover, the study provides a baseline that is needed in order to overcome past failures and to successfully implement telemedicine in South

  3. Species distribution and antifungal susceptibility patterns of Candida isolates from a public tertiary teaching hospital in the Eastern Cape Province, South Africa.

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    Mnge, P; Okeleye, B I; Vasaikar, S D; Apalata, T

    2017-05-15

    Candida species are the leading cause of invasive fungal infections, and over the past decade there has been an increased isolation of drug resistant Candida species. This study aimed to identify the species distribution of Candida isolates and to determine their unique antifungal susceptibility and resistance patterns. During a cross-sectional study, 209 Candida isolates (recovered from 206 clinical samples) were collected and their species distribution was determined using ChromAgar Candida. The Vitek-2 system (Biomerieux, South Africa) was used to determine minimum inhibitory concentrations (MICs) to azoles (fluconazole, voriconazole), echinocandins (caspofungin, micafungin), polyenes (amphotericin B) and flucytosine. Four species of Candida were isolated, of which C. albicans was the most frequent, isolated in 45.4% (95/209) of the isolates, followed by C. glabrata: 31.1% (65/209). The MICs of the different antifungal drugs varied amongst the species of Candida. From the 130 isolates tested for MICs, 90.77% (112/130) were susceptible to all antifungal drugs and 6.9% (9/130) of the isolates were multi-drug resistant. C. dubliniensis (n=2) isolates were susceptible to all the above mentioned antifungal drugs. There was no significant difference in species distribution amongst clinical specimens and between patients' genders (P>0.05). An increase in MIC values for fluconazole and flucytosine towards the resistance range was observed. To our knowledge, this is the first report on surveillance of Candida species distribution and antifungal susceptibility at a public tertiary teaching hospital in Eastern Cape, South Africa.

  4. The International Classification of Function Disability and Health (ICF) in adults visiting the HIV outpatient clinic at a regional hospital in Johannesburg, South Africa.

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    Van As, Melissa; Myezwa, Hellen; Stewart, Aimee; Maleka, Douglas; Musenge, Eustasius

    2009-01-01

    In 2005, 16.6% of South Africans between 15 and 49 years of age were HIV positive. The advent of anti-retroviral therapy has led to improved longevity, CD4 counts and clinical well-being of people living with HIV/AIDS (PLWHA). Physical impairments, activity limitations and participation restrictions of PLWHA have profound effects on the Health-related Quality of Life and functional abilities of those with the disease, and understanding thereof may assist in the formulation of rehabilitation protocols, health care interventions as well as vocational and legislative policies. The International Classification of Function, Disability and Health (ICF) is a standardised tool, endorsed by the World Health Assembly for international use, which aims to classify functioning and disability. It is structured to assess body functions and structure, functional activities and associated personal and environmental factors.This study aimed to develop a profile of the level of functional activity, using the ICF Checklist, of an urban cohort of 45 South African individuals who are HIV positive attending an outpatient clinic at the Helen Joseph Memorial Hospital, Gauteng, South Africa. The results showed a high prevalence of physical impairments, participation restrictions and selective activity limitations and that environmental factors influence their level of ability. Specific impairments where patients had problems were mental functions (69% (n=31), sensory and pain -- 71% (n=32), digestive and metabolic functions 45% (n=20) and neuromuscular 27% (n=12). Activity limitations included major life areas' 58% (n=26), interpersonal relationships 56% (n=25), mobility 40% (n=18) and general tasks and demands 38% (n=17). Limitations in mobility were significantly associated with problems of sensory functions (p=0.05), pain (p=0.006), neuromusculoskeletal and movement-related functions (p=0.006), muscle power (p=0.006) as well as energy and drive functions (p=0.001). The study identifies

  5. A review of the management of perforated duodenal ulcers at a tertiary hospital in south western Nigeria.

    Science.gov (United States)

    Etonyeaku, A C; Agbakwuru, E A; Akinkuolie, A A; Omotola, C A; Talabi, A O; Onyia, C U; Kolawole, O A; Aladesuru, O A

    2013-12-01

    Gastro-duodenal perforations are common and may complicate peptic ulcer disease. Management is often by surgical closure. To determine the patterns of presentation and mode of management of duodenal ulcer perforations. Retrospective review of patients with duodenal ulcer perforations seen at the Obafemi Awolowo University Teaching Hospital between June 2001 and July 2011. Patients' records were reviewed for demography, duration of disease, probable risk factors, type of surgery and complications. Data obtained was analyzed using SPSS 15.0. Forty- five patients were reviewed. There were 37 males (82.2%). Mean age was 39.7years (range 15-78years). There were 10 (22.6%) students and 8(17.8%) farmers. NSAIDs abuse (11), previous peptic ulcer disease (2), and no prior dyspeptic symptoms (20) constituted 24.4%, 4.4% and 44.4% respectively of cases. Seven (16%) patients presented less than 24 hours of onset of illness. Forty one perforations (91.1%) involved the first part of duodenum. Twenty two (49%) patients had Graham's omental patch. We had one (2.2%) failed repair and six (13.3%) mortalities. Late presentation of duodenal ulcer perforation is common with high mortality. Pragmatic surgical intervention with Graham's omentopexy with broad spectrum antibiotics is still commonly practiced.

  6. The need for pharmaceutical care in an intensive care unit at a teaching hospital in South Africa

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    N Shellack

    2014-11-01

    Full Text Available Background. The role of the pharmacist has evolved over the last 2 decades beyond traditional functions such as stock control and dispensing. Objectives. To describe the functions performed by a clinical pharmacist while based in a surgical and trauma intensive care unit of a teaching hospital. Methods. An operational research study that included indications of programme success was conducted. Interventions to assess therapy and achieve definite outcomes to satisfy patients’ medicine needs were documented for 51 patients over a study period of 8 weeks.Results. A total of 181 interventions were suggested by the pharmacist, with 127 (70% accepted and implemented by the medical and nursing staff of the unit. The most frequent interventions were related to: untreated medical conditions (15.5%, appropriate therapy or course (13.8%, investigations indicated or outstanding (12.2%, and inappropriate doses and dosing frequency (11%. Interventions were also made regularly to address system errors or non-compliance and factors hindering therapeutic effect. Of the 250 h the pharmacist spent in the ward, most time was used for pharmaceutical care (28% and ward rounds (21% with members of the multidisciplinary team.Conclusions. The study results demonstrated that a clinical pharmacist’s contribution to patient care at ward level resulted in improved monitoring of pharmacotherapy. Medicine-related problems were identified and addressed.

  7. Sero-prevalence for Hepatitis B virus among pregnant women attending antenatal clinic in Juba Teaching Hospital, Republic of South Sudan.

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    Kirbak, Anthony Laku Stephen; Ng'ang'a, Zipporah; Omolo, Jared; Idris, Hakim; Usman, Abdulmumini; Mbabazi, William Baguma

    2017-01-01

    Hepatitis B virus infection is a major public health problem worldwide and in Africa. This would be the first ever documented study on epidemiology of Hepatitis B infections in the newly formed Republic of South Sudan. This study was designed to estimate the sero-prevalence of Hepatitis B virus infection amongst pregnant women attending antenatal services in Juba. A cross-sectional study was conducted among pregnant women attending antenatal clinic services in Juba Teaching Hospital, in the period between December 2012 and March 2013. Any pregnant woman, attending antenatal care services at Juba Teaching Hospital, was included if she was a resident of Juba County for at least 1 year before pregnancy. A Hepatitis B case was defined as any women participating in the study and was found to be positive for HbsAg and confirmed by ELISA. This study documented that the prevalence of Hepatitis B surface antigen (HBsAg) among pregnant women attending ANC in Juba was 11% (31 out of the 280 samples). Other samples tested were indeterminate (36%), naturally immune (27.1%), susceptible (23%) and the remaining 1.8% was immune due to vaccination. Significant risk factors for Hepatitis B infection were loss of partner (OR 4.4 and CI of 1.4-13.9) and history of Jaundice (OR 1.7 and CI of 1.2-2.1). These study findings show that only 29% of infants in Juba county are born to immune mothers (naturally or vaccine induced). The remaining 70% of babies would be at risk of infection, if a birth dose of Hepatitis B is not provided. We therefore recommended introduction of Hepatitis B Vaccine birth dose into routine infants' vaccination series to eliminate this risk.

  8. Proportion of depression and its determinants among type 2 diabetes mellitus patients in various tertiary care hospitals in Mangalore city of South India

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    Nitin Joseph

    2013-01-01

    Full Text Available Background: Depression is found to be common among patients with diabetes and it is associated with poor outcomes in disease control. This study was carried out to find out the proportion and determinants associated with depression among patients with established type 2 diabetes mellitus (T2DM in various tertiary care hospitals in Mangalore city of south India. Materials and Methods: This study was conducted in one government and three private tertiary care hospitals in Mangalore in December 2010. All consenting patients with confirmed diagnosis of T2DM were interviewed and screened for depression by administering the 9-item PRIME-MD Patient Health Questionnaire (PHQ-9. Results: Of the 230 T2DM patients, 119 (51.7% were males. The mean age of all participants was 53.61 ± 10.7 years. The median duration of T2DM was found to be 12.1 ± 7.35 years. Among the participants, 71 (30.9% met the criteria for moderate depression, 33 (14.3% for severe depression, and the remaining 126 (54.8% had no clinically significant depression. Only 26 (11.3% patients were already aware that they were depressed, of whom just 3 had taken medical consultation. Among the risk factors, depression was found to be significantly associated with older age, female gender, low socioeconomic status, unskilled and retired employment status, having complications due to T2DM or comorbidities like hypertension and coronary artery disease, being overweight and being on insulin syringe injections. Conclusion: This study found a high proportion of depression among patients with T2DM. Therefore the care of individuals with diabetes mellitus (DM should include the screening and possible treatment of depression in order to achieve and sustain treatment goals.

  9. Awareness about basic life support and emergency medical services and its associated factors among students in a tertiary care hospital in South India

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    Akshatha Rao Aroor

    2014-01-01

    Full Text Available Background: The knowledge and skills about the basic life support (BLS and the advanced life support are the most important determining factors of the cardiopulmonary resuscitation (CPR success rates. Objectives: To determine the level of awareness on BLS and skills among undergraduate and postgraduate students of medical and dental profession, as well as nursing students and interns in a tertiary care hospital. Materials and Methods: This descriptive cross-sectional study was conducted in a tertiary care hospital in South India. The awareness level on BLS and factors associated which include age, sex, level of training (undergraduate, internship, and postgraduate groups, course of study (nursing, dental, and medical groups, and previous exposure to BLS were assessed by using a structured questionnaire. The association of these variables with awareness level was assessed by independent t test, analysis of variance, and linear regression analysis. Results: Among 520 study subjects, 229 were students, 171 were interns, and 120 were postgraduate students. The overall mean score of awareness was 4.16 ± 1.40 (score range: 0-10. Age, sex, level of training, course of study, and previous exposure to BLS were significantly associated with awareness level in univariate analysis (P < 0.05. Linear regression model also showed that all the above variables were significantly associated with awareness level (P < 0.05. About 322 (61.9% subjects attributed lack of awareness about BLS to lack of available professional training. About 479 (92.1% responded that BLS training should be a part of medical curriculum. Conclusion: Awareness level on BLS is below average indicating the importance of professional training at all levels in a tertiary care health institution.

  10. Awareness about basic life support and emergency medical services and its associated factors among students in a tertiary care hospital in South India.

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    Aroor, Akshatha Rao; Saya, Rama Prakash; Attar, Nazir Rahim; Saya, Ganesh Kumar; Ravinanthanan, Manikandan

    2014-07-01

    The knowledge and skills about the basic life support (BLS) and the advanced life support are the most important determining factors of the cardiopulmonary resuscitation (CPR) success rates. To determine the level of awareness on BLS and skills among undergraduate and postgraduate students of medical and dental profession, as well as nursing students and interns in a tertiary care hospital. This descriptive cross-sectional study was conducted in a tertiary care hospital in South India. The awareness level on BLS and factors associated which include age, sex, level of training (undergraduate, internship, and postgraduate groups), course of study (nursing, dental, and medical groups), and previous exposure to BLS were assessed by using a structured questionnaire. The association of these variables with awareness level was assessed by independent t test, analysis of variance, and linear regression analysis. Among 520 study subjects, 229 were students, 171 were interns, and 120 were postgraduate students. The overall mean score of awareness was 4.16 ± 1.40 (score range: 0-10). Age, sex, level of training, course of study, and previous exposure to BLS were significantly associated with awareness level in univariate analysis (P < 0.05). Linear regression model also showed that all the above variables were significantly associated with awareness level (P < 0.05). About 322 (61.9%) subjects attributed lack of awareness about BLS to lack of available professional training. About 479 (92.1%) responded that BLS training should be a part of medical curriculum. Awareness level on BLS is below average indicating the importance of professional training at all levels in a tertiary care health institution.

  11. PREVALENCE AND SUSCEPTIBILITY OF EXTENDED SPECTRUM BETA-LACTAMASES IN URINARY ISOLATES OF ESCHERICHIA COLI IN A TERTIARY CARE HOSPITAL, CHENNAI-SOUTH INDIA

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    Dr. Anbumani Narayanaswamy MD PhD

    2011-01-01

    Full Text Available Extended spectrum beta – lactamases (ESBLs are on the rise in hospital settings across the globe. The presence of ESBLs significantly affects the outcome of an infection and poses a challenge to the management of infection worldwide. Therefore, the aim of the present study is to determine the prevalence and susceptibility of extended spectrum beta – lactamase in urinary isolates of Escherichia coli (E.coli in a tertiary care hospital, Chennai-South India. A total of 450 urinary isolates of E.coli were collected over a period of six months from April 2008 to September 2008. Antimicrobial susceptibility testing was determined to commonly used antibiotics using the modified Kirby-Bauer’s disc diffusion method. ESBL detection was done by the screening method of double disc synergy test and then confirmed by the phenotypic confirmatory test with combination disc as recommended by the Clinical Laboratory Standards Institute (CLSI and the minimum inhibitory concentration (MIC method using the E test strips (AB Biodisk,Sweden - as per manufacturer’s instructions. The prevalence of E.coli ESBL was 60%. The ESBL producing isolates were significantly resistant (p < 0.01 to ampicillin, trimethoprim / sulfamethoxazole, norfloxacin and nalidixic acid as compared to non-ESBL producers. Multidrug resistance was significantly (p < 0.01 higher (69% in ESBL positive isolates than non-ESBL isolates (21%. Knowledge of the prevalence of ESBL and resistance pattern of bacterial isolates in a geographical area will help the clinicians to formulate the guidelines for antibiotic therapy to avoid inappropriate use of extended spectrum cephalosporins.

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

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

    2017-09-01

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

  13. Change-readiness of the blind: a hospital based study in a coastal town of South India.

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    Shetty, Ramya; Kulkarni, Uma D

    2014-01-01

    Blindness is a devastating condition with psychosocial and economic effects. The shortcomings result in a burden to the blind person, the family and society. Rehabilitation of the blind can transform their lives. The aim of this study was to assess the "change-readiness" of the blind to undergo a "change-management". The study was a semi-structured pre-tested questionnaire-based study of 50 blind subjects in a medical college hospital. The blind participants were assessed for depression using the Beck Depression Inventory II, for the perceived effect of blindness on family, social life and occupation. The participants were counseled to undergo psychiatric management, vocational training, use blind aids and learn Braille. The willingness of the participants with reasons was assessed using a verbal analogue scale. Pearson Chi-square test, ANOVA and the t-test were used for statistical analysis. Over two-thirds of the subjects were depressed. Family life, social life and occupation were perceived to be affected by 44%, 66% and 74%, respectively. Change-readiness scores were low for low vision and blind aids, vocational training, psychiatric management, change of job and learning Braille. The low score was due to the associated taboo, dependence, lack of skills, embarrassment, etc., The most valuable feature was the family cohesiveness. The results suggest that there is a need to modify health policy to include blind rehabilitation, to improve visibility of blind rehabilitation centers, to include family members and co-professionals while managing the blind so that we treat the "blind person" and not a "pair of blind eyes".

  14. Antimicrobial Susceptibility Pattern and Age Dependent Etiology of Urinary Tract Infections in Nemazee Hospital, Shiraz, South-West of Iran

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    Mohammad Motamedifar

    2015-08-01

    Full Text Available Background: Urinary tract infections (UTIs are one of the most common bacterial diseases. The etiological agents and emergence of antimicrobial resistance UTIs vary according to time and geographical region. Objectives: The present study aimed to determine the prevalence of etiological agents of UTIs and determine their antimicrobial susceptibility pattern to locally available antibiotics. Patients and Methods: This descriptive cross-sectional study was conducted within six months on all patients with clinical symptoms of UTI who referred to Nemazee Teaching hospital, Shiraz, Iran. Clean catch midstream urine samples were collected and cultured on appropriate media in a short time as possible. Conventional bacteriological methods were followed for the isolation and identification of the bacteria. Antimicrobial susceptibility profiles were determined by locally available antibiotics by using disk diffusion method in accordance with CLSI recommendation. Results: In this study, from overall 9991 specimens analyzed 848 (8.5% culture had significant bacterial growth. Of the total positive cultures, 500 (59% cases were female. Escherichia coli (50.6% was the predominant gram-negative isolated pathogen followed by Klebsiella spp. and Enterobacter spp., respectively. Enterococcus isolates (11.2% was the most isolated gram-positive cocci. Nitrofurantoin (80.9%, gentamycin (77.9% and amikacin (65.3% had the most in-vitro antibacterial effect on E. coli isolates as the predominant cause of UTIs. Conclusions: The results of regional assessments, such as our study, provide not only useful information for prescription of more effective empirical therapy, but also good epidemiological background for comparison of our situation with other regions.

  15. Are healthcare workers ready for Ebola? An assessment of their knowledge and attitude in a referral hospital in South India.

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    Ahmad, Akram; Khan, Muhammad Umair; Jamshed, Shazia Qasim; Kumar, Bandari Deepak; Kumar, Gogikar Sudhir; Reddy, Puchchakayala Goverdhan; Ajmera, Sudhakar

    2016-08-02

    The World Health Organization (WHO) declared the Ebola virus disease (EVD) epidemic to be a public health emergency of international concern. Healthcare workers (HCWs) are at the highest risk of infection, as they may come into contact with patients' blood or fluids. This study was conducted to assess knowledge and attitudes of HCWs towards EVD in India. A descriptive, cross-sectional study was conducted in a multispecialty public sector referral hospital of Telangana, India. Knowledge and attitude of HCWs were evaluated using a pre-validated questionnaire. A sample of 278 participants was selected to participate in this study. The Chi-squared test was used to assess the relationship between attitudes and demographic characteristics. Logistic regression was used examine the association between knowledge and study variables. Of 257 participants who responded (92.4% response rate), 157 (61.1%) were females. The majority of the respondents were physicians (n = 117, 45.5%). Radio and television were the major sources of information about EVD reported by participants (89%). Overall knowledge of HCWs was poor (mean knowledge score: 6.57 ± 2.57). Knowledge of physicians and experienced workers (≥ 10 years) was significantly higher than their respective groups. The overall attitude of the participants was positive (mean attitude score: 1.62 ± 0.57). Significant positive correlations between knowledge and attitude were observed. The findings indicate that participants lack basic understanding of EVD. We recommend future studies be conducted across India to identify and subsequently bridge the knowledge gaps among HCWs.

  16. Epidemiology, disease burden and outcomes of cirrhosis in a large secondary care hospital in South Auckland, New Zealand.

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    Hsiang, J C; Bai, W W; Raos, Z; Stableforth, W; Upton, A; Selvaratnam, S; Gane, E J; Gerred, S J

    2015-02-01

    Liver cirrhosis is an important cause of morbidity and mortality; however, little is known about its impact in New Zealand. We aim to determine the disease burden, epidemiology and outcomes of cirrhotic patients. This is a retrospective study of cirrhosis patients under secondary public hospital care in a geographically defined region, between the years 2000 and 2011. Cirrhosis complications and mortality was recorded. Poisson log-linear regression analysis was performed for incidence rate ratio (IRR) and Cox regression analysis was used to analyse time-related events. Seven hundred and forty-six cirrhotic patients were analysed; most were European/Other (39.9%), Pacific islanders (21.6%), Southeast Asian/Chinese (17.8%) and Maori (12.3%). 68.4% were male. The common primary aetiologies for cirrhosis were chronic hepatitis B (CHB) cirrhosis (37.3%), alcoholic liver disease (ALD) cirrhosis (24.1%), chronic hepatitis C (CHC) cirrhosis (22.3%) and non-alcoholic fatty liver disease (NAFLD) cirrhosis (16.4%). The hepatocellular carcinoma (HCC) mortality rates were highest in NAFLD and CHB cirrhosis groups (3.0 and 3.1 per 100 patient-year respectively), compared with ALD and CHC groups (2.2 and 1.4 per 100 patient-year, all P < 0.05 respectively). Patients with ALD and NAFLD cirrhosis had the highest all-cause and non-HCC mortality rate compared with viral hepatitis cirrhosis groups. The IRR for HCC incidence, liver-related mortality and HCC mortality were 1.087, 1.098 and 1.114, respectively (all P < 0.001), suggesting increasing incidence and disease burden over the study period. The number of cirrhotic patients in secondary care is increasing steadily. Cirrhosis complications and mortality rates are also rising, particularly the incidence and mortality of HCC. © 2014 Royal Australasian College of Physicians.

  17. Foot Kinetics and Kinematics Profile in Type 2 Diabetes Mellitus with Peripheral Neuropathy: A Hospital Based Study from South India.

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    Hazari, Animesh; Maiya, Arun G; N, Shivashankara K

    2018-02-01

    A kinetic change in thefoot like altered plantar pressure is the most common etiological risk factor for causing foot ulcers among people with diabetes mellitus. Kinematic alterations in joint angle and spatiotemporal parameters of the gait have also been frequently observed in participants with diabetes peripheral neuropathy. Diabetes peripheral neuropathy is the most common long-term standing complication of type 2 diabetes mellitus. It leads to various micro and macrovascular related complication of the foot. There is a gap in theliteraturefor biomechanical evaluation and assessment in type 2 diabetes mellitus with peripheral neuropathy in Indian population. The aim of the study was to assess and determine the biomechanical changes including kinetics and kinematics of foot among diabetic peripheral neuropathy. The cross-sectional study was conducted at Diabetic Foot Clinic, Kasturba Hospital, Manipal University, Manipal, Karnataka, India. A total of 120 participants with type 2 diabetes mellitus and peripheral neuropathywere recruited under the purposive sampling method. Participants with any active ulceration or amputation were excluded from the study. The mean age, height, weight, body mass index, duration of diabetes was 57±14 year, 164±11cm, 61±18kg, 24± 3, 12±7 year respectively. There were significant changes in overall biomechanical profile along with clinical manifestations of diabetes peripheral neuropathy.The regression analysis showed statistical significance for dynamic maximum plantar pressure at forefoot with age, weight, height, duration of diabetes, body mass index, knee & ankle joint angle at toe-off phase of gait cycle,pinprick sensation and ankle reflex (R=.71,R =.55, F (12, 108)=521.9 kPa, p=.002) Conclusions: From the present study, we conclude that people with type 2 diabetes mellitus and peripheral neuropathy have significant changes in their foot kinetics and kinematicsparameters. Therefore, they could be at higher risk of foot

  18. A retrospective quality assessment of pre-hospital emergency medical documentation in motor vehicle accidents in south-eastern Norway

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    Staff Trine

    2011-03-01

    Full Text Available Abstract Background Few studies have evaluated pre-hospital documentation quality. We retrospectively assessed emergency medical service (EMS documentation of key logistic, physiologic, and mechanistic variables in motor vehicle accidents (MVAs. Methods Records from police, Emergency Medical Communication Centers (EMCC, ground and air ambulances were retrospectively collected for 189 MVAs involving 392 patients. Documentation of Glasgow Coma Scale (GCS, respiratory rate (RR, and systolic blood pressure (SBP was classified as exact values, RTS categories, clinical descriptions enabling post-hoc inference of RTS categories, or missing. The distribution of values of exact versus inferred RTS categories were compared (Chi-square test for trend. Results 25% of ground and 11% of air ambulance records were unretrieveable. Patient name, birth date, and transport destination was documented in >96% of ambulance records and 81% of EMCC reports. Only 54% of patient encounter times were transmitted to the EMCC, but 77% were documented in ground and 96% in air ambulance records. Ground ambulance records documented exact values of GCS in 48% and SBP in 53% of cases, exact RR in 10%, and RR RTS categories in 54%. Clinical descriptions made post-hoc inference of RTS categories possible in another 49% of cases for GCS, 26% for RR, and 20% for SBP. Air ambulance records documented exact values of GCS in 89% and SBP in 84% of cases, exact RR in 7% and RR RTS categories in 80%. Overall, for lower RTS categories of GCS, RR and SBP the proportion of actual documented values to inferred values increased (All: p Conclusion EMS documentation of logistic and mechanistic variables was adequate. Patient physiology was frequently documented only as descriptive text. Our finding indicates a need for improved procedures, training, and tools for EMS documentation. Documentation is in itself a quality criterion for appropriate care and is crucial to trauma research.

  19. Pattern and outcome of postneonatal pediatric emergencies in Nnamdi Azikiwe University Teaching Hospital, Nnewi, South East Nigeria.

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    Ndukwu, C I; Onah, S K

    2015-01-01

    Nigeria is still battling with preventable childhood deaths, being one of the six countries in which 50% of all global child deaths occur. Regular community and health facility audits are needed to determine morbidity and mortality patterns in children which will guide preventive and therapeutic interventions. The objective was to determine morbidity and mortality patterns, and identify factors influencing poor outcome of the disease in children seen in the emergency room of Nnamdi Azikiwe University Teaching Hospital, Nnewi. This was a 2-year retrospective study (March 2012 to February 2014) involving all children admitted into the children emergency room (CHER). Information on the patients' biodata, diagnosis, and outcome were retrieved from the CHER doctors' log. Analysis was done using Microsoft Office Excel 2007 and Statistical Package for Social Sciences version 20. The total of 1964 patients were seen (1088 males, 845 females, 31 unspecified) with a male to female ratio of 1.3:1. Under-fives constituted 78.8% of the study population. Mean duration of illness before presentation was 18.71 ± 71.94 days. Malaria, diarrheal disease, and respiratory tract infections were the most common morbidities. Sepsis had the highest case fatality rate (CFR) and was the most common cause of death among the 247 patients that died - mortality rate of 12.6%. Most deaths were in under-fives (CFR = 13.9, χ2 = 25.553, P = 0.000), with 74.1% of the mortalities occurring within 24 h of presentation. Patients who presented within a day and those that presented in the 2 nd and 3 rd weeks of onset of symptoms had CFR of 6.4-15.2%, respectively. Infectious diseases remain a menace in our environment with the eventual outcome worsened by late presentation to an appropriate health facility. There is an urgent need to create public awareness on the need to seek prompt medical attention for sick children.

  20. Using a structured morbidity and mortality meeting to understand the contribution of human error to adverse surgical events in a South African regional hospital.

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    Clarke, Damian L; Furlong, Heidi; Laing, Grant L; Aldous, Colleen; Thomson, Sandie Rutherford

    2013-10-22

    Several authors have suggested that the traditional surgical morbidity and mortality meeting be developed as a tool to identify surgical errors and turn them into learning opportunities for staff. We report our experience with these meetings. A structured template was developed for each morbidity and mortality meeting. We used a grid to analyse mortality and classify the death as: (i) death expected/death unexpected; and (ii) death unpreventable/death preventable. Individual cases were then analysed using a combination of error taxonomies. During the period June - December 2011, a total of 400 acute admissions (195 trauma and 205 non-trauma) were managed at Edendale Hospital, Pietermaritzburg, South Africa. During this period, 20 morbidity and mortality meetings were held, at which 30 patients were discussed. There were 10 deaths, of which 5 were unexpected and potentially avoidable. A total of 43 errors were recognised, all in the domain of the acute admissions ward. There were 33 assessment failures, 5 logistical failures, 5 resuscitation failures, 16 errors of execution and 27 errors of planning. Seven patients experienced a number of errors, of whom 5 died. Error theory successfully dissected out the contribution of error to adverse events in our institution. Translating this insight into effective strategies to reduce the incidence of error remains a challenge. Using the examples of error identified at the meetings as educational cases may help with initiatives that directly target human error in trauma care.

  1. Adolescent Linkage to Care After a Large-scale Transfer From a Hospital-based HIV Clinic to the Public Sector in South Africa.

    Science.gov (United States)

    Ramirez-Avila, Lynn; Regan, Susan; Cloete, Christie; Crankshaw, Tamaryn; Rabideau, Dustin J; Freedberg, Kenneth A; Parker, Robert A; Walensky, Rochelle P; Losina, Elena; Bassett, Ingrid V

    2017-03-01

    HIV clinics formerly supported by the President's Emergency Plan for AIDS Relief are transferring patients to public-sector clinics. We evaluated adolescent linkage to care after a large-scale transfer from a President's Emergency Plan for AIDS Relief-subsidized pediatric HIV clinic in Durban, South Africa. All adolescents (11-18 years) in care at a pediatric state-subsidized, hospital-based clinic (HBC) were transferred, from May to June 2012, to government sites [primary health care (PHC) clinic; community health center (CHC); and HBCs] or private clinics. Caregivers were surveyed 7-8 months after transfer to assess their adolescents' linkage to care and their reports were validated by clinic record audits in a subset of randomly selected clinics. Of the 309 (91%) caregivers reached, only 5 (2%) reported that their adolescent did not link. Of the 304 adolescents who linked, 105 (35%) were referred to a PHC, 73 (24%) to a CHC and 106 (35%) to a HBC. A total of 146 (48%) linked adolescents attended a different clinic than that assigned. Thirty-five (20%) of the 178 who linked and were assigned to a PHC or CHC ultimately attended a HBC. Based on clinic validation, the estimated transfer success was 88% (95% confidence interval: 77%-97%). The large majority of adolescents successfully transferred to a new HIV clinic, although nearly half attended a clinic other than that assigned.

  2. KNOWLEDGE AND ATTITUDE TOWARDS HUMAN PAPILLOMA VIRUS AND ITS VACCINE AMONG PHARMACY STUDENTS OF TERTIARY TEACHING UNIVERSITY HOSPITAL IN SOUTH INDIA

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    Raghupathi Mahitha

    2016-10-01

    Full Text Available BACKGROUND Cervical cancer in women can be effectively prevented by HPV vaccine. Healthcare professionals including pharmacists have a role in creating awareness about this vaccine to public. In this context, it was decided to study awareness level about HPV among pharmacy students. The aim of the study is to study the knowledge and attitude towards human papilloma virus and it’s vaccine among pharmacy students of tertiary teaching university hospital in South India. MATERIALS AND METHODS Cross sectional, questionnaire-based study among pharmacy students. RESULTS 229 pharmacy students participated in the study. The mean total knowledge score among participants was 2.69 (SD=2.260 out of the possible maximum of 11 and the mean total attitude score was 2.67 (SD=2.437 out of the possible maximum of 10. Lack of knowledge about vaccine was the main reason for not taking the vaccine. Knowledge about the vaccines improves the attitude towards it (p<0.0001. CONCLUSION There is a need to design education program for pharmacy students to increase awareness about HPV, which in turn will increase the awareness among public positively.

  3. Alcohol, hospital discharge, and socioeconomic risk factors for default from multidrug resistant tuberculosis treatment in rural South Africa: a retrospective cohort study.

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    Kendall, Emily A; Theron, Danie; Franke, Molly F; van Helden, Paul; Victor, Thomas C; Murray, Megan B; Warren, Robin M; Jacobson, Karen R

    2013-01-01

    Default from multidrug-resistant tuberculosis (MDR-TB) treatment remains a major barrier to cure and epidemic control. We sought to identify patient risk factors for default from MDR-TB treatment and high-risk time periods for default in relation to hospitalization and transition to outpatient care. We retrospectively analyzed a cohort of 225 patients who initiated MDR-TB treatment between 2007 through 2010 at a rural TB hospital in the Western Cape Province, South Africa. Fifty percent of patients were cured or completed treatment, 27% defaulted, 14% died, 4% failed treatment, and 5% transferred out. Recent alcohol use was common (63% of patients). In multivariable proportional hazards regression, older age (hazard ratio [HR]= 0.97 [95% confidence interval 0.94-0.99] per year of greater age), formal housing (HR=0.38 [0.19-0.78]), and steady employment (HR=0.41 [0.19-0.90]) were associated with decreased risk of default, while recent alcohol use (HR=2.1 [1.1-4.0]), recent drug use (HR=2.0 [1.0-3.6]), and Coloured (mixed ancestry) ethnicity (HR=2.3 [1.1-5.0]) were associated with increased risk of default (PDefaults occurred throughout the first 18 months of the two-year treatment course but were especially frequent among alcohol users after discharge from the initial four-to-five-month in-hospital phase of treatment, with the highest default rates occurring among alcohol users within two months of discharge. Default rates during the first two months after discharge were also elevated for patients who received care from mobile clinics. Among patients who were not cured or did not complete MDR-TB treatment, the majority defaulted from treatment. Younger, economically-unstable patients and alcohol and drug users were particularly at risk. For alcohol users as well as mobile-clinic patients, the early outpatient treatment phase is a high-risk period for default that could be targeted in efforts to increase treatment completion rates.

  4. A comparative study of pregnancy complications and outcomes for the years 1999 and 2004 at a rural hospital in South Africa: Implications for antenatal care

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    Monjurul Hoque

    2010-10-01

    Objectives: This study reviewed the demographic variables, pregnancy and obstetric complications and perinatal outcomes for the years 1999 and 2004 in a rural hospital in KwaZulu-Natal Province, South Africa, with the aim of evaluating trends and gaps that may enhance appropriate strategies for improvement of antenatal care. Method: A retrospective comparative study, with representative samples of pregnant women, were randomly selected for the respective years 1999 and 2004. Descriptive statistics were calculated depending on measurement scale. A Z-test was carried out to assess the significant difference (p < 0.05 in proportions between pregnancy complications and outcomes of the groups. Multivariate logistic regression analysis was undertaken to determine the significant predictors for outcome variables. Results: The numbers of pregnancies among young women (< 25 years increased significantly by 8% (p < 0.05 in the year 2004. Compared with 1999, the reduction in the numbers of pregnancies (1% among higher parity (parity 5 or more women in 2004 was remarkable. There were significant reductions of eclampsia, anaemia and post partum haemorrhage. Women with breech presentation were 3.75 times more likely to deliver preterm, and 5.45 times more likely to deliver low birth-weight babies. Similarly, women with pregnancy-induced hypertension were more likely to have preterm (OR = 3.50, 95% CI 2.83; 4.35 and low birth-weight babies (OR = 2.09, 95% CI 1.62; 2.71. Eclampsia was also a risk factor associated with preterm deliveries (OR = 6.14, 95% CI 3.74; 10.09 and low birth-weight babies (OR = 3.40, 95% CI 1.83; 6.28. Conclusion: This study suggests that further research is needed to find the causes of higher rate of teenage pregnancies and an increase in quality of antenatal care is more important in improving maternal and perinatal health. Training of staff to standard protocol and guidelines on antenatal care and care during delivery, and adherence to it, should be

  5. Birth Settings and the Validation of Neonatal Seizures Recorded in Birth Certificates Compared to Medicaid Claims and Hospital Discharge Abstracts Among Live Births in South Carolina, 1996-2013.

    Science.gov (United States)

    Li, Qing; Jenkins, Dorothea D; Kinsman, Stephen L

    2017-05-01

    Objective Neonatal seizures in the first 28 days of life often reflect underlying brain injury or abnormalities, and measure the quality of perinatal care in out-of-hospital births. Using the 2003 revision of birth certificates only, three studies reported more neonatal seizures recorded among home births ​or planned out-of-hospital births compared to hospital births. However, the validity of recording neonatal seizures or serious neurologic dysfunction across birth settings in birth certificates has not been evaluated. We aimed to validate seizure recording in birth certificates across birth settings using multiple datasets. Methods We examined checkbox items "seizures" and "seizure or serious neurologic dysfunction" in the 1989 and 2003 revisions of birth certificates in South Carolina from 1996 to 2013. Gold standards were ICD-9-CM codes 779.0, 345.X, and 780.3 in either hospital discharge abstracts or Medicaid encounters jointly. Results Sensitivity, positive predictive value, false positive rate, and the kappa statistic of neonatal seizures recording were 7%, 66%, 34%, and 0.12 for the 2003 revision of birth certificates in 547,177 hospital births from 2004 to 2013 and 5%, 33%, 67%, and 0.09 for the 1998 revision in 396,776 hospital births from 1996 to 2003, and 0, 0, 100%, -0.002 among 660 intended home births from 2004 to 2013 and 920 home births from 1996 to 2003, respectively. Conclusions for Practice Despite slight improvement across revisions, South Carolina birth certificates under-reported or falsely reported seizures among hospital births and especially home births. Birth certificates alone should not be used to measure neonatal seizures or serious neurologic dysfunction.

  6. Clinical characteristics and causes of heart failure adherence to treatment guidelines and mortality of patients with acute heart failure: Experience at Groote Schuur Hospital Cape Town South Africa

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    P Szymanski

    2018-02-01

    Full Text Available Background. There is limited information on acute heart failure (AHF and its treatment in sub-Saharan Africa.Objective. To describe the clinical characteristics and causes of heart failure (HF, adherence to HF treatment guidelines, and mortality of patients with AHF presenting to Groote Schuur Hospital (GSH, Cape Town, South Africa.Methods. This sub-study of The Sub-Saharan Africa Survey of Heart Failure (THESUS-HF was a prospective and observational survey that focused on the enrolment and follow-up of additional patients with AHF presenting to GSH and entered into the existing registry after publication of the primary THESUS-HF article in 2012. The patients were classified into prevalent (existing or incident (new cases of HF.Results. Of the 119 patients included, 69 (58.0% were female and the mean (standard deviation age was 49.9 (16.3 years. The majority of prevalent cases were patients of mixed ancestry (63.3%, and prevalent cases had more hypertension (70.0%, diabetes mellitus (36.7%, hyperlipidaemia (33.3% and ischaemic heart disease (IHD (36.7% than incident cases. The top five causes of HF were cardiomyopathy (20.2%, IHD (19.3%, rheumatic valvular heart disease (RHD (18.5%, cor pulmonale (11.8% and hypertension (10.1%, with the remaining 20.1% consisting of miscellaneous causes including pericarditis, toxins and congenital heart disease. Most patients received renin-angiotensin system blockers and loop diuretics on discharge. There was a low rate of beta-blocker, aldosterone antagonist and digoxin use. Rehospitalisation within 180 days occurred in 25.2% of cases. In-hospital mortality was 8.4% and the case fatality rate at 6 months was 26.1%.Conclusion. In Cape Town, the main causes of AHF are cardiomyopathy, IHD and RHD. AHF affects a young population and is associated with a high rate of rehospitalisation and mortality. There is serious under-use of beta-blockers, aldosterone antagonists and digoxin. Emphasis on the rigorous

  7. P02.05 Peripheral Nerve Sheath Tumor Epidemiology in the South Central Hospital of High Specialty from PEMEX in Mexico

    Science.gov (United States)

    Guerra Mora, J.; Cordoba Mosqueda, M.; Hernandez Resendiz, R.; Loya Aguilar, I.; Vicuña Gonzalez, R.; Garcia Gonzalez, U.

    2016-01-01

    Abstract Introduction: The peripheral sheath tumors are part of a large group of neoplasms that range from biologically benign with minimal disorders in life quality to highly malign with life quality deterioration and high mortality. There are subtypes with high prevalence like Schwannomas and some much rarer like the intracranial peripheral nerve sheath tumor which happen to have very bad prognosis. The aim of this study is to describe the epidemiologic and clinical characteristics of patients with peripheral nerve sheat tumors in a hospital of high specialty. Method and materials: Observational study with patients from March 1999 to March 2016 with confirmed diagnosis of peripheral nerve sheath tumor in the electronic files of the South Central Hospital of High Specialty PEMEX. A statistical analysis is made through the SPSS Statistics of the disease in this Institution program. Results: There were 84 patients with the diagnosis of peripheral nerve sheath tumor with a median age of 48.04 years, 65.5% were males, the most common histological type found was the Schwannoma with a 72.6%, followed by senescent Schwannoma 13.1%, neurofibroma 8.3%, and malign peripheral nerve sheath tumor 2.4%. The most frequent location was at the site of cranial nerves, followed by cervical level 27.4%, lumbar 16.7% and thoracic 9.5%. The most common initial symptom was pain in 23.8% of the patients, and the time of the onset of symptoms to the diagnosis was 31.6 months. From the total of patients 8.3% had neurofibromatosis type 1, 6.0% neurofibromatosis type 2. Conclusions: We realized in our series of reported cases that the frequency is similar to those reported in worldwide population; nevertheless the time between the onset of symptoms and the diagnosis is much higher in our cases as well as the population of patients with neurofibromatosis. This study justifies the need of attention quality improvement and the knowledge of this information the medical doctor of first

  8. Survival and predictors of mortality among human immunodeficiency virus patients on anti-retroviral treatment at Jinka Hospital, South Omo, Ethiopia: a six years retrospective cohort study

    Science.gov (United States)

    Ameni, Gobena

    2016-01-01

    OBJECTIVES The survival rate of human immunodeficiency virus (HIV)-infected patients receiving treatment in Ethiopia is poorly understood. This study aimed to determine the survival rate and predictors of mortality among HIV-infected adults on antiretroviral therapy (ART) at Jinka Hospital, South Omo, Ethiopia. METHODS A 6-year retrospective cohort study was conducted using 350 patient records drawn from 1,899 patients on ART at Jinka Hospital from September 2010 to August 2015. The data were analyzed using Kaplan-Meier statistics and Cox regression models. RESULTS Of the 350 study participants, 315 (90.0%) were censored and 35 (10.0%) died. Twenty-two (62.9%) of the deaths occurred during the first year of treatment. The total follow-up encompassed 1,995 person-years, with an incidence rate of 1.75 deaths per 100 person-years. The mean survival time of patients on highly active antiretroviral therapy (HAART) was 30.84±19.57 months. The overall survival of patients on HAART was 64.00% (95% confidence interval [CI], 61.85 to 66.21%) at 72 months of follow-up. The significant predictors of mortality included non-disclosure of HIV status (adjusted hazard ratio [aHR], 5.82; 95% CI, 1.91 to 17.72), a history of tuberculosis (aHR, 1.82; 95% CI, 1.41 to 3.51), and ambulatory (aHR, 2.97; 95% CI, 1.20 to 8.86) or bedridden (aHR, 4.67; 95% CI, 1.30 to 17.27) functional status, World Health Organization (WHO) clinical stage IV illness (aHR, 24.97; 95% CI, 2.75 to 26.45), and substance abusers (aHR, 3.72; 95% CI, 1.39 to 9.97). CONCLUSIONS Patients with a history of tuberculosis treatment, ambulatory or bedridden functional status, or advanced WHO clinical stage disease, as well substance abusers, should be carefully monitored, particularly in the first few months after initiating antiretroviral therapy. Patients should also be encouraged to disclose their status to their relatives. PMID:27820957

  9. Survival and predictors of mortality among human immunodeficiency virus patients on anti-retroviral treatment at Jinka Hospital, South Omo, Ethiopia: a six years retrospective cohort study

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    Erdaw Tachbele

    2016-11-01

    Full Text Available OBJECTIVES The survival rate of human immunodeficiency virus (HIV-infected patients receiving treatment in Ethiopia is poorly understood. This study aimed to determine the survival rate and predictors of mortality among HIV-infected adults on antiretroviral therapy (ART at Jinka Hospital, South Omo, Ethiopia. METHODS A 6-year retrospective cohort study was conducted using 350 patient records drawn from 1,899 patients on ART at Jinka Hospital from September 2010 to August 2015. The data were analyzed using Kaplan-Meier statistics and Cox regression models. RESULTS Of the 350 study participants, 315 (90.0% were censored and 35 (10.0% died. Twenty-two (62.9% of the deaths occurred during the first year of treatment. The total follow-up encompassed 1,995 person-years, with an incidence rate of 1.75 deaths per 100 person-years. The mean survival time of patients on highly active antiretroviral therapy (HAART was 30.84±19.57 months. The overall survival of patients on HAART was 64.00% (95% confidence interval [CI], 61.85 to 66.21% at 72 months of follow-up. The significant predictors of mortality included non-disclosure of HIV status (adjusted hazard ratio [aHR], 5.82; 95% CI, 1.91 to 17.72, a history of tuberculosis (aHR, 1.82; 95% CI, 1.41 to 3.51, and ambulatory (aHR, 2.97; 95% CI, 1.20 to 8.86 or bedridden (aHR, 4.67; 95% CI, 1.30 to 17.27 functional status, World Health Organization (WHO clinical stage IV illness (aHR, 24.97; 95% CI, 2.75 to 26.45, and substance abusers (aHR, 3.72; 95% CI, 1.39 to 9.97. CONCLUSIONS Patients with a history of tuberculosis treatment, ambulatory or bedridden functional status, or advanced WHO clinical stage disease, as well substance abusers, should be carefully monitored, particularly in the first few months after initiating antiretroviral therapy. Patients should also be encouraged to disclose their status to their relatives.

  10. Exploring the role of the ICU nurse in the antimicrobial stewardship team at a private hospital in KwaZuluNatal South Africa

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    J Rout

    2017-10-01

    Full Text Available Background. Care of the critically ill patient has become increasingly challenging, with a rising incidence of resistant pathogens resulting in the ineffectiveness of many antibiotics. Severe infection is associated with prolonged intensive care unit (ICU length of stay, and increased morbidity, mortality, and healthcare costs. Antimicrobial stewardship (AMS aims to prevent resistance and protect patients and the wider community by promoting correct antimicrobial use. The current AMS literature has failed to describe the role of the ICU nurse in this important initiative.Objective. To explore the perceptions of AMS team members regarding the role of the ICU nurse in the AMS team.Methods. Using a qualitative research approach, purposive sampling was used to identify participants in an ICU. Semi-structured interviews were conducted with 15 participants, including ICU shift-leader nurses, nursing management, surgeons, anaesthetists, physicians, microbiologists and pharmacists. Data were analysed and categorised using content analysis. The study was conducted in a general ICU in the private healthcare sector in KwaZulu-Natal, South Africa.Results. Participants representing various disciplines of the AMS team felt that the role of the ICU nurse within the team was an important part of the AMS programme. Four categories that emerged from the data are discussed: organisational, advocacy, clinical and collaborative roles.Conclusion. The role of the ICU nurse was found to be essential to the success of AMS in the ICU. These findings provide implications for practice, which, if recognised and supported by all healthcare stakeholders from ICU and hospital management, could improve AMS in this acute care area.

  11. P12.01 Epidemiology in spinal tumors treated surgically at the South Central Hospital of High Specialty from PEMEX in Mexico

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    Hernandez Resendiz, R.; Cordoba Mosqueda, M.; Guerra Mora, J.; Loya Aguilar, I.; Garcia Gonzalez, U.

    2016-01-01

    Abstract Introduction: The spinal tumors are rare neoplasms, they can be primary or metastatic; in the literature they are divided in extradural and intradural, extramedullary and intramedullary, from which extradural tumors are the most frequent and are usually metastatic, the intramedullary are generally gliomas. From the primary tumors up to 78% are benign and 22% malign, the histological stripe and the involvement to the spinal compartments are of great importance for the results and the treatment which is mainly surgical, individualized and meticulously planned with the support of technological resources such as the electrophysiological monitoring during the surgery. Methods and Materials: Observational study with a range of patients from March 1999- March 2016 to whom surgical resection of the spinal tumor was performed and reported on the Electronic Files of the South Central Hospital of High Specialty PEMEX. A Statistical analysis is made with the SPSS Statistic of disease of the Institution program. Results: 23 patients with spinal tumor surgical resection were found. The median age was 53 ± 10 years. The most common clinical manifestation was radiculopathy (65%). The Karnofsky scale was used for initial evaluation where a 43% of patients had a 90 score at the moment of the diagnosis, while 65% had an ECOG 1. The most frequent tumor was the Spinal Shwannoma (39%), followed in prevalence by the Condroid Cordoma (17%), where the intradural extramedullary location was the most prevalent (78%). The medium rate of survival after the surgical procedure was from 11 months. Conclusions: Our cases and the international statistics coincide. Radiculopathy as high prevalence initial manifestation conceals us to dismiss in the sixth decade of life any possibility for spinal tumor presentation. Most of spinal tumor patients do not have any clinical deterioration in their basal state, which indicates that performing a successful surgical procedure and the right

  12. Nurses’ knowledge about and attitudes toward organ donation in state and private hospitals in Johannesburg South Africa

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    H Etheredge

    2017-10-01

    Full Text Available Background. Nurses are intricately involved in organ donation; however, the referral of donors appears to be declining in Johannesburg, South Africa (SA. This may be due to barriers in the referral process.Objectives. The objectives of this study were to explore nurses’ knowledge of the organ donation process and to explore personal beliefs and attitudes around organ donation.Methods. A quantitative, self-administered questionnaire was completed by nurses in Johannesburg, SA.Results. A total of 273 nurses participated, of whom most were female and <50 years old. The majority of participants (64.2% reported positive attitudes, and 63.2% stated that their personal beliefs about organ donation did not influence the advice they gave to patients. However, only 36.8% felt confident referring potential donors and 35.8% felt that referral was within their scope of practice. Most participants (84.5% felt that it was the doctor’s responsibility to refer donors, but 80.3% noted that they would refer donors themselves if there was a mandatory referral protocol. Only 61% of nurses were aware that there was access to a transplant procurement coordinator through their hospitals; however, there was uncertainty regarding the role of the coordinator.Conclusion. There is an urgent need to clarify the role of nurses in the process of organ donor referral in SA. Although nurses felt positive about organ donation, they expressed uncertainties about referring potential donors. However, if a clear protocol for referral was introduced, the majority of nurses noted that they would willingly follow it. We advocate for the development and implementation of a nationally endorsed protocol for donor referral and for the training of nurses in organ donation in SA.

  13. Obesity and its cardio-metabolic co-morbidities among adult Nigerians in a primary care clinic of a tertiary hospital in South-Eastern, Nigeria

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    Gabriel Uche Pascal Iloh

    2013-01-01

    Full Text Available Background: Obesity once thought the medical problem of affluent countries now exist in Nigeria and has been described as a time bomb for the future explosion in the frequency of cardio-metabolic diseases. The most deleterious health consequences of obesity are on the cardiovascular system and associated disorder of lipid and glucose homeostasis. Aim: This study was designed to determine the magnitude of obesity and its cardio-metabolic co-morbidities among adult Nigerians in a primary care clinic of a tertiary hospital South-Eastern, Nigeria. Materials and Methods: A cross-sectional study carried out on 2391 adult Nigerians who were assessed for obesity using body mass index (BMI criterion. 206 patients who had BMI ΃30kg/m 2 were screened for cardio-metabolic co-morbidities. The data collected included basic demographic variables, weight, height, blood pressure; fasting plasma glucose and lipid profile. Results: The prevalence of obesity was 8.6%. Grade I obesity (67.5% was the most common pattern; others included grade II obesity (23.3% and grade III obesity (9.2%. Hypertension (42.7% was the most common cardio-metabolic morbidity. Others included low HDL-cholesterol (22.8%, diabetes mellitus (15.1%, high triglyceride (12.6%, high total cholesterol (9.2%, and high LDL-cholesterol (6.8%. Conclusion: Obesity and its cardio-metabolic morbidities exist among the study population. Anthropometric determination of obesity and screening for its associated cardio-metabolic co-morbidities should constitute clinical targets for intervention in primary care clinics.

  14. Prevalence of Charcot Arthropathy in Type 2 Diabetes Patients Aged over 50 Years with Severe Peripheral Neuropathy: A Retrospective Study in a Tertiary Care South Indian Hospital.

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    Salini, Dharmadas; Harish, Kumar; Minnie, Pillay; Sundaram, Karimassery R; Arun, Bal; Sandya, Chirukandath J; Mangalanandan, Thacho S; Vivek, Lakshmanan; Praveen, Valiyaparambil P

    2018-01-01

    Available literature on the prevalence of Charcot arthropathy (CA) represents mainly Western population. No study has been reported from India so far. Hence we attempted to study the prevalence of CA in patients with type 2 diabetes mellitus and severe peripheral neuropathy (T2DMPN), belonging to Indian population amongst whom type 2 diabetes is on the rise in alarming proportions. Medical records of 3387 patients who performed an objective vibration perception threshold test during the year 2015 were screened for T2DMPN. Out of these, 1475 T2DMPN patients above 50 years were selected and analyzed in detail for CA. CA was diagnosed based on clinical features and/or radiological investigations. The anatomical localization of the disease distribution of the affected foot was done according to Brodsky's classification. The prevalence of CA in T2DMPN patients was found to be 9.8%. The mean age of patients diagnosed with CA was 63 ± 8.36 years, and mean duration of DM for CA to develop was 18.01 ± 8.23 years. About 62.5% of the patients were male and 37.5% female. Bilateral presentation of CA was observed in 20.8% of patients. Multiple sites of the foot were affected in 48.6% of patients and belonged to type 4 classification of Brodsky. A high prevalence of CA (9.8%) was observed in the present study conducted on T2DMPN patients who presented to the endocrinology department of a tertiary care South Indian hospital. In the majority of patients, the area of foot affected belonged to type 4 classification of Brodsky.

  15. Cross-cultural comparison of workplace stressors, ways of coping and demographic characteristics as predictors of physical and mental health among hospital nurses in Japan, Thailand, South Korea and the USA (Hawaii).

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    Lambert, Vickie A; Lambert, Clinton E; Itano, Joanne; Inouye, Jillian; Kim, Susie; Kuniviktikul, Wipada; Sitthimongkol, Yajai; Pongthavornkamol, Kanuangnit; Gasemgitvattana, Saipin; Ito, Misae

    2004-08-01

    In an attempt to cross-culturally compare factors that may contribute to the nursing shortage within countries that have produced a limited number of research findings on role stress in nurses, this research examined work stressors, ways of coping and demographic characteristics as predictors of physical and mental health among hospital nurses from Japan, South Korea, Thailand and the USA (Hawaii). Subjects (n = 1554 hospital-based nurses) were administered four self-report questionnaires: Demographic Questionnaire, "Nursing Stress Scale", "Ways of Coping Questionnaire" and "SF-36 Health Survey". Findings suggested that nurses indicated similar workplace stressors, ways of coping, and levels of physical and mental health. While subjects, across countries, demonstrated a variety of predictors of physical and mental health, several predictors were found to be the same. Cross-culturally the role of nurses may vary; however, certain factors are predictive of the status of hospital nurses' physical health and mental health. Copyright 2004 Elsevier Ltd.

  16. Burden and predictors of Staphylococcus aureus and S. pseudintermedius infections among dogs presented at an academic veterinary hospital in South Africa (2007–2012

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    Daniel N. Qekwana

    2017-04-01

    Full Text Available Background Staphylococci are commensals of the mucosal surface and skin of humans and animals, but have been implicated in infections such as otitis externa, pyoderma, urinary tract infections and post-surgical complications. Laboratory records provide useful information to help investigate these infections. Therefore, the objective of this study was to investigate the burdens of these infections and use multinomial regression to examine the associations between various Staphylococcus infections and demographic and temporal factors among dogs admitted to an academic veterinary hospital in South Africa. Methods Records of 1,497 clinical canine samples submitted to the bacteriology laboratory at a veterinary academic hospital between 2007 and 2012 were included in this study. Proportions of staphylococcal positive samples were calculated, and a multinomial logistic regression model was used to identify predictors of staphylococcal infections. Results Twenty-seven percent of the samples tested positive for Staphylococcus spp. The species of Staphylococcus identified were S. pseudintermedius (19.0%, S. aureus (3.8%, S. epidermidis (0.7% and S. felis (0.1%. The remaining 2.87% consisted of unspeciated Staphylococcus. Distribution of the species by age of dog showed that S. pseudintermedius was the most common (25.6% in dogs aged 2–4 years while S. aureus was most frequent (6.3% in dogs aged 5–6 years. S. pseudintermedius (34.1% and S. aureus (35.1% were the most frequently isolated species from skin samples. The results of the multivariable multinomial logistic regression model identified specimen, year and age of the dog as significant predictors of the risk of infection with Staphylococcus. There was a significant temporal increase (RRR = 1.17; 95% CI [1.06–1.29] in the likelihood of a dog testing positive for S. pseudintermedius compared to testing negative. Dogs ≤ 8 years of age were significantly more likely to test positive for S

  17. GENERAL PRACTITIONERS AND HOSPITALS

    African Journals Online (AJOL)

    In recent years in South Africa the position of the general practi- tioner in hospitals has ... ments, and it is in these hospitals that difficulties have arisen. On the other hand, ... great extent deprived of contact with his colleagues. He comes to ... eventually lose interest in the results of treatment and advances in medicine. In fact ...

  18. Traditional eye medicine use by newly presenting ophthalmic patients to a teaching hospital in south-eastern Nigeria: socio-demographic and clinical correlates

    Directory of Open Access Journals (Sweden)

    Uche Judith

    2009-10-01

    Full Text Available Abstract Background This study set out to determine the incidence, socio-demographic, and clinical correlates of Traditional Eye Medicine (TEM use in a population of newly presenting ophthalmic outpatients attending a tertiary eye care centre in south-eastern Nigeria. Methods In a comparative cross-sectional survey at the eye clinic of the University of Nigeria Teaching Hospital (UNTH, Enugu, between August 2004 - July 2006, all newly presenting ophthalmic outpatients were recruited. Participants' socio-demographic and clinical data and profile of TEM use were obtained from history and examination of each participant and entered into a pretested questionnaire and proforma. Participants were subsequently categorized into TEM- users and non-users; intra-group analysis yielded proportions, frequencies, and percentages while chi-square test was used for inter-group comparisons at P = 0.01, df = 1. Results Of the 2,542 (males, 48.1%; females, 51.9% participants, 149 (5.9% (males, 45%; females, 55% used TEM for their current eye disease. The TEMs used were chemical substances (57.7%, plant products (37.7%, and animal products (4.7%. They were more often prescribed by non-traditional (66.4% than traditional (36.9% medicine practitioners. TEMs were used on account of vision loss (58.5%, ocular itching (25.4% and eye discharge (3.8%. Reported efficacy from previous users (67.1% and belief in potency (28.2% were the main reasons for using TEM. Civil servants (20.1%, farmers (17.7%, and traders (14.1% were the leading users of TEM. TEM use was significantly associated with younger age (p Conclusion The incidence of TEM use among new ophthalmic outpatients at UNTH is low. The reasons for TEM use are amenable to positive change through enhanced delivery of promotive, preventive, and curative public eye care services. This has implications for eye care planners and implementers. To reverse the trend, we suggest strengthening of eye care programmes, even

  19. A cost analysis of a hospital-based palliative care outreach program: implications for expanding public sector palliative care in South Africa.

    Science.gov (United States)

    Hongoro, Charles; Dinat, Natalya

    2011-06-01

    Increasing access to palliative care services in low- and middle-income countries is often perceived as unaffordable despite the growing need for such services because of the increasing burden of chronic diseases including HIV and AIDS. The aim of the study was to establish the costs and cost drivers for a hospital outreach palliative care service in a low-resource setting, and to elucidate possible consequential quality-of-life improvements and potential cost savings. The study used a cost accounting procedure to cost the hospital outreach services--using a step-down costing method to measure unit (average) costs. The African Palliative Care Association Palliative Outcome Score (APCA POS) was applied at five intervals to a cohort of 72 consecutive and consenting patients, enrolled in a two-month period. The study found that of the 481 and 1902 patients registered for outreach and in-hospital visits, respectively, 4493 outreach hospital visits and 3412 in-hospital visits were done per year. The costs per hospital outreach visit and in-hospital visit were US$71 and US$80, respectively. The cost per outreach visit was 50% less than the average cost of a patient day equivalent for district hospitals of $142. Some of the POS of a subsample (n=72) showed statistically significant improvements. Hospital outreach services have the potential to avert hospital admissions in generally overcrowded services in low-resource settings and may improve the quality of life of patients in their home environments. Copyright © 2011 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

  20. CONTEMPORARY URBAN DEVELOPMENT IN CALABAR ...

    African Journals Online (AJOL)

    The result showed that the existing urban development spread could be reduced by more than 150% if the current trend of ... density at the core, people tend to seek for building lands at the .... of Wuhan, China, Yun (2011), showed that the.

  1. Tabagismo entre pacientes internados em um hospital universitário no sul do Brasil: prevalência, grau de dependência e estágio motivacional Smoking among patients hospitalized at a university hospital in the south of Brazil: prevalence, degree of nicotine dependence, and motivational stage of change

    Directory of Open Access Journals (Sweden)

    Rafael Balsini Barreto

    2012-02-01

    Full Text Available OBJETIVO: Avaliar a prevalência e o perfil do tabagismo em pacientes internados em um hospital universitário no sul do Brasil. MÉTODOS: Estudo descritivo transversal com pacientes maiores de 18 anos hospitalizados há mais de 24 h no Hospital Universitário da Universidade de Santa Catarina em Florianópolis. Os pacientes foram entrevistados em duas ocasiões distintas. Dados demográficos, socioeconômicos e ligados ao tabagismo foram coletados. RESULTADOS: Foram entrevistados 235 pacientes: 44 (18,7% eram tabagistas; 77 (32,8% eram ex-tabagistas; 114 (48,5% eram não tabagistas e 109 (46,7% eram tabagistas passivos. A média de idade dos fumantes foi de 45,7 ± 15,2 anos, e 29 (65,9% eram do sexo masculino. Entre os fumantes, a mediana da idade de início do tabagismo foi de 15 anos; a carga tabágica média foi de 32 ± 30,2 anos-maço; 36 (81,9% tinham consumo diário de até 20 cigarros; 20 (45,4% tinham grau de dependência à nicotina elevada ou muito elevada; 32 (72,7% já haviam tentado cessar, 39 (88,6% gostariam de cessar, 32 (72,7% aceitariam receber tratamento, 13 (29,5% fumaram durante a internação, e 13 (29,5% apresentaram síndrome de abstinência. Houve um aumento no número de pacientes nos estágios motivacionais de preparação e ação durante a internação (de 31,8% para 54,8%. CONCLUSÕES: A prevalência de tabagismo no estudo foi semelhante à encontrada em outros estudos no Brasil. Os resultados sugerem que nossa amostra foi significativa em relação à população de fumantes hospitalizados, que se encontra motivada à cessação do hábito tabágico durante a hospitalização, necessitando de uma abordagem sistematizada para a cessação.OBJECTIVE: To determine the prevalence and profile of smoking among hospitalized patients at a university hospital in the south of Brazil. METHODS: This was a descriptive cross-sectional study involving patients over 18 years of age hospitalized for over 24 h at the Federal

  2. Effects of untreated hospital effluents on the accumulation of toxic metals in sediments of receiving system under tropical conditions: case of South India and Democratic Republic of Congo.

    Science.gov (United States)

    Mubedi, Josué Ilunga; Devarajan, Naresh; Le Faucheur, Séverine; Mputu, John Kayembe; Atibu, Emmanuel K; Sivalingam, Periyasamy; Prabakar, Kandasamy; Mpiana, Pius T; Wildi, Walter; Poté, John

    2013-10-01

    Physicochemical and ecotoxicological analyses have been performed to assess the quality of sediments receiving untreated hospital effluents from Indian and Democratic Republic of Congo (DRC) hospitals. The sediments were collected monthly and characterized for grain size, organic matter, total organic carbon, total carbon, nitrogen, phosphorus, toxic metals and ecotoxicity. The results highlight the high concentration of toxic metals from the Indian hospital effluent receiving systems, especially for Cr, Cu, As, Zn and Hg. On the other hand, the metal concentrations in the sediment receiving system from DRC are low (e.g. maximum Hg and Zn concentration were 0.46 and 48.84 mg kg(-1) respectively). Ostracods exposed to sediment samples H2 (September month sample) and H3 (June and September month samples) were found dead after 6d of exposure whereas the higher mortality rate for Congo sediments was 23% but was accompanied with 33 ± 7% of growth inhibition. The results of this study show the variation of sediment composition on toxic metal levels as well as toxicity related to both, the type of hospitals and the sampling period. Additionally, hospital effluent disposal practices at the study sites can lead to the pollution of water resources and may generate risks for aquatic organisms and human health. Copyright © 2013 Elsevier Ltd. All rights reserved.

  3. Quality of acute asthma care in two tertiary hospitals in a state in South Western Nigeria: A report of clinical audit.

    Science.gov (United States)

    Desalu, Olufemi Olumuyiwa; Adeoti, Adekunle Olatayo; Ogunmola, Olarinde Jeffrey; Fadare, Joseph Olusesan; Kolawole, Tolutope Fasanmi

    2016-01-01

    To audit the quality of acute asthma care in two tertiary hospitals in a state in the southwestern region of Nigeria and to compare the clinical practice against the recommendations of the Global Initiative for Asthma (GINA) guideline. We carried out a retrospective analysis of 101 patients who presented with acute exacerbation of asthma to the hospital between November 2010 and October 2015. Majority of the cases were females (66.3%), audit has implicated the need to address the non-performing areas and organizational issues to improve the quality of care.

  4. Knowledge, perceptions and practices of pharmacovigilance amongst community and hospital pharmacists in a selected district of North West Province, South Africa

    Directory of Open Access Journals (Sweden)

    M.C. Joubert

    2016-12-01

    Conclusion: The majority of pharmacists are familiar with the concept of PV, but less than half reported any ADR. They are willing to participate in PV processes but are unsure what their exact role playing should be. More than half indicated that they would like to see improvements to the current PV system in South Africa. The majority are prepared to undergo further education to improve their PV knowledge.

  5. Knowledge and attitude of donating and using cord blood for transfusion among patients attending Nnamdi Azikiwe University Teaching Hospital, Nnewi, South East Nigeria

    OpenAIRE

    Chide E Okocha; Nkiru N Ezeama; John C Aneke; Chinyere U Onubogu; Charles I Okafor; Chijioke G Egbunike

    2017-01-01

    Background: Allogeneic blood for transfusion is in short supply in most parts of the developing world. Cord blood for transfusion can be a significant source of blood supply to our health institutions. Aims: This study aims to investigate the knowledge and attitude to the donation and use of umbilical cord blood (UCB) for transfusion among the patients receiving services in a tertiary health institution in South-East Nigeria. Materials and Methods: This was a cross-sectional study; an a...

  6. Patient and social work factors related to successful placement of long-term psychiatric in-patients from a specialist psychiatric hospital in South Africa.

    Science.gov (United States)

    Krüger, C; Lewis, C

    2011-05-01

    The slow discharge of long-term psychiatry patients from Weskoppies Hospital into the community has not matched the national and international drive towards deinstitutionalisation. This article investigates patient and social work factors related to successful community placement, in the context of limited community care facilities. Thirty-six long-term patients who were successfully placed outside of the hospital during a seven month period were compared to 235 unplaced long-term patients in terms of demographic and clinical variables. Social work services were analysed in terms of which patients received the most interventions, and the most common type of interventions. The most significant patient factors associated with successful placement were: female patients; medium-to-high level of functioning; having involved relatives living far away; a low frequency of behavioural problems (especially of cannabis abuse, verbal or physical aggression, uncontrolled sexual activity), and agitation or restlessness. These patient factors were mirrored in the social work services rendered to the long-term patients during the study period: The recipients were mostly female, in open wards (higher-functioning); and the social services utilised were mostly related to planning for placement and patient support. The lack of community care facilities in the Pretoria area that are able to care for the more difficult long-term psychiatry patients, limits successful placement and increases the burden of hospital based social workers. The problem cannot be resolved at a hospital level and needs to be addressed in the context of provincial and national health departments.

  7. Reasons given by hypertensive patients for concurrently using traditional and Western medicine at Natalspruit Hospital in the Gauteng Province, South Africa

    Science.gov (United States)

    Mabuza, Langalibalele H.; Okonta, Henry I.

    2013-01-01

    Abstract Background In 2007, a large number of hypertensive patients seen at Natalspruit Hospital had poor adherent to their anti-hypertension treatment which manifested itself through poor blood pressure control. On enquiry, they revealed that they were also taking traditional medicines. Objectives To explore the reasons given by hypertensive patients for concurrently using traditional and Western medicine. Methods A qualitative study was conducted amongst nine purposefully selected participants attending treatment at the hospital. Interviews were conducted in the Southern Sotho and IsiZulu languages and were audio-taped. The exploratory question was: ‘Would you tell us why you are taking traditional medicine together with the antihypertensive medicine your are receiving at this hospital?’ The transcribed and translated transcriptions were analysed using the ‘cut and paste’ method to identify themes. Results Themes that emerged were that traditional medicine was readily accessible; traditional healers displayed knowledge and confidence in their medicine; traditional medicine was perceived to counteract the side-effects of western medicine; the two streams were perceived to complement each other and both streams could lead to a ‘cure’. Patients were disappointed at the perceived bad attitude of the hospital staff. Conclusion The reasons given by hypertensive patients for their concurrent use of traditional and Western medicine centred around patients’ relatively favourable perception of traditional medicine and its practitioners. Western medicine health care practitioners should continue health education on antihypertensive medication in a manner acceptable to patients.

  8. Early urinary diversion with ileal conduit and vesicovaginostomy in the treatment of radiation cystitis due to carcinoma cervix: a study from a tertiary care hospital in South India.

    Science.gov (United States)

    Banerji, John Samuel; Devasia, Antony; Kekre, Nitin Sudhakar; Chacko, Ninan

    2015-10-01

    To study the magnitude of radiation cystitis following radiation therapy for carcinoma cervix, and propose an algorithm to decide on early diversion, with or without vesicovaginostomy. Women who developed radiation cystitis following radiotherapy for carcinoma cervix from January 1998 to December 2011 were included in this retrospective study. Electronic hospital records were analysed to document the presence of radiation cystitis. All women who developed evidence of radiation-induced cystitis, according to the common toxicity and Radiation Therapy Oncology Group criteria, were included in the study. We looked at transfusion requirements, number of hospital admissions, quality of life and cost involved. Chi-square tests were done where applicable. SPSS version 16 was used for analysis. Of the 902 patients who received radiation for carcinoma cervix in the 13-year period, 62 (6.87%) developed grade 3/4 cystitis. Twenty-eight of them underwent ileal conduit diversion, with 18 undergoing concomitant vesicovaginostomy. When compared with the patients who did not have diversion, the transfusion requirements, number of hospital admissions and quality of life had a statistically significant difference. Cost analysis of early diversion too showed a marginal benefit with early diversion. The limitation of the study was that it was retrospective in nature. In radiation cystitis, multiple hospital admissions and consequential increase in cost is the norm. In severe disease, early diversion is a prudent, cost-effective approach with good quality of life and early return to normal activity. © 2014 Royal Australasian College of Surgeons.

  9. Use of major surgery in south India: A retrospective audit of hospital claim data from a large, community health insurance program.

    Science.gov (United States)

    Shaikh, Maaz; Woodward, Mark; Rahimi, Kazem; Patel, Anushka; Rath, Santosh; MacMahon, Stephen; Jha, Vivekanand

    2015-05-01

    Information on the use of major surgery in India is scarce. In this study we aimed to bridge this gap by auditing hospital claims from Rajiv Aarogyasri Community Health Insurance Scheme, which provides access to free hospital care through state-funded insurance to 68 million beneficiaries, an estimated 81% of population in the states of Telangana and Andhra Pradesh. Publicly available deidentified hospital claim data for all surgery procedures conducted between mid-2008 and mid-2012 were compiled across all 23 districts in Telangana and Andhra Pradesh. A total of 677,332 operative admissions (80% at private hospitals) were recorded at an annual rate of 259 per 100,000 beneficiaries, with male subjects accounting for 56% of admissions. Injury was the most common cause for operative admission (27%) with operative correction of long bone fractures being the most common procedure (20%) identified in the audit. Diseases of the digestive (16%), genitourinary (12%), and musculoskeletal (10%) systems were other leading causes for operative admissions. Most hospital bed-days were used by admissions for injuries (31%) and diseases of the digestive (17%) and musculoskeletal system (11%) costing 19%, 13%, and 11% of reimbursement. Operations on the circulatory system (8%) accounted for 21% of reimbursements. Annual per capita cost of operative claims was US$1.48. The use of surgery by an insured population in India continued to be low despite access to financing comparable with greater spending countries, highlighting need for strategies, beyond traditional health financing, that prioritize improvement in access, delivery, and use of operative care. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Review of the Aetiology and Complications of Primary Postpartum ...

    African Journals Online (AJOL)

    Review of the Aetiology and Complications of Primary Postpartum Haemorrhage following vaginal delivery at University of Calabar Teaching Hospital (UCTH), Calabar, Nigeria: A 5-year Review. CI Emechebe, CO Njoku, AN Njoku, JT Ukaga, EM Eyong ...

  11. Use of Oral Mucoperiosteal and Pterygo‑Masseteric Muscle Flaps as ...

    African Journals Online (AJOL)

    stress.[1-4] Surgical treatment are aimed at improving esthetics, functional, and ... Department of Dental Surgery, University of Calabar Teaching Hospital, Calabar, Nigeria. Abstract ... which include its autogenous nature, resilience, adequate.

  12. Do loss to follow-up and death rates from ART care vary across primary health care facilities and hospitals in south Ethiopia? A retrospective follow-up study.

    Science.gov (United States)

    Teshome, Wondu; Belayneh, Mehretu; Moges, Mathewos; Mekonnen, Emebet; Endrias, Misganu; Ayele, Sinafiksh; Misganaw, Tebeje; Shiferaw, Mekonnen; Tesema, Tigist

    2015-01-01

    Decentralization and task shifting has significantly improved access to antiretroviral therapy (ART). Many studies conducted to determine the attrition rate in Ethiopia have not compared attrition rates between hospitals and health centers in a relatively recent cohort of patients. This study compared death and loss to follow-up (LTFU) rates among ART patients in hospitals and health centers in south Ethiopia. Data routinely collected from patients aged older than 15 years who started ART between July 2011 and August 2012 in 20 selected health facilities (12 being hospitals) were analyzed. The outcomes of interest were LTFU and death. The data were entered, cleaned, and analyzed using Statistical Package for the Social Sciences version 20.0 and Stata version 12.0. Competing-risk regression models were used. The service years of the facilities were similar (median 8 and 7.5 for hospitals and health centers, respectively). The mean patient age was 33.7±9.6 years. The median baseline CD4 count was 179 (interquartile range 93-263) cells/mm(3). A total of 2,356 person-years of observation were made with a median follow-up duration of 28 (interquartile range 22-31) months; 24.6% were either dead or LTFU, resulting in a retention rate of 75.4%. The death rates were 3.0 and 1.5 and the LTFU rate were 9.0 and 10.9 per 100 person-years of observation in health centers and hospitals, respectively. The competing-risk regression model showed that the gap between testing and initiation of ART, body mass index, World Health Organization clinical stage, isoniazid prophylaxis, age, facility type, and educational status were independently associated with LTFU. Moreover, baseline tuberculous disease, poor functional status, and follow-up at a health center were associated with an elevated probability of death. We observed a higher death rate and a lower LTFU rate in health centers than in hospitals. Most of the associated variables were also previously documented. Higher LTFU was

  13. Do loss to follow-up and death rates from ART care vary across primary health care facilities and hospitals in south Ethiopia? A retrospective follow-up study

    Directory of Open Access Journals (Sweden)

    Teshome W

    2015-05-01

    Full Text Available Wondu Teshome,1 Mehretu Belayneh,1 Mathewos Moges,1 Emebet Mekonnen,2 Misganu Endrias,2 Sinafiksh Ayele,2 Tebeje Misganaw,2 Mekonnen Shiferaw,2 Tigist Tesema2 1School of Public and Environmental Health, Hawassa University, 2Health Research and Technology Transfer Support Process, Southern Nations Nationalities and Peoples' Regional Health Bureau, Hawassa, Ethiopia Background: Decentralization and task shifting has significantly improved access to antiretroviral therapy (ART. Many studies conducted to determine the attrition rate in Ethiopia have not compared attrition rates between hospitals and health centers in a relatively recent cohort of patients. This study compared death and loss to follow-up (LTFU rates among ART patients in hospitals and health centers in south Ethiopia. Methods: Data routinely collected from patients aged older than 15 years who started ART between July 2011 and August 2012 in 20 selected health facilities (12 being hospitals were analyzed. The outcomes of interest were LTFU and death. The data were entered, cleaned, and analyzed using Statistical Package for the Social Sciences version 20.0 and Stata version 12.0. Competing-risk regression models were used. Results: The service years of the facilities were similar (median 8 and 7.5 for hospitals and health centers, respectively. The mean patient age was 33.7±9.6 years. The median baseline CD4 count was 179 (interquartile range 93–263 cells/mm3. A total of 2,356 person-years of observation were made with a median follow-up duration of 28 (interquartile range 22–31 months; 24.6% were either dead or LTFU, resulting in a retention rate of 75.4%. The death rates were 3.0 and 1.5 and the LTFU rate were 9.0 and 10.9 per 100 person-years of observation in health centers and hospitals, respectively. The competing-risk regression model showed that the gap between testing and initiation of ART, body mass index, World Health Organization clinical stage, isoniazid prophylaxis

  14. An outbreak of Streptococcus dysgalactiae subsp equisimilis in a hospital in the south of Brazil Surto causado por Streptococcus dysgalactiae subsp equisimilis, em um hospital, no Sul do Brasil

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    Rosângela Stadnick Lauth de Almeida Torres

    2007-09-01

    Full Text Available The beta-hemolytic group C streptococci (Lancefield's group has been considered an emergent human pathogen, showing an important role as an opportunist agent, being responsible for nosocomial infections and outbreaks. This study is reporting the first outbreak of nosocomial infection caused by Streptococcus dysgalactiae subsp. equisimilis in Brazil. From January, 2002, to December, 2004, S. equisimilis was isolated in 67/207 (32.37% samples from secretions of patients' infected wounds, interned at the Hospital of Sanitary Dermatology in the State of Paraná (HDSPR. The prevalence of this microorganism increased from 11/42 (26.19% in 2002, 14/65 (21.54% in 2003 to 42/100 (42.00% in 2004. This increase was statistically significant (p=0.024, and this microorganism became the most frequently isolated in these patients, overtaking the rates of isolation of Pseudomonas aeruginosa. The S. equisimilis grew in pure culture, as a unique microorganism, in six samples (2.9% out of 207. Fresh feces of 15 animals (horses and sheep living in the proximities of the hospital were also examined and three of them positive for S. equisimilis. The biochemical profile of the strains isolated from the patients and from the animals was the same. These animals might have been the source of the dissemination of the outbreak in the hospital. New studies will be necessary to confirm the genetic relationship between the strains isolated from patients and animals.O estreptococo beta-hemolítico do grupo C de Lancefield tem sido considerado patógeno humano emergente, mostrando importante papel como agente oportunista, implicado algumas vezes em infecções hospitalares e surtos. Este estudo está relatando o primeiro surto de infecção hospitalar causado pelos Streptococcus dysgalactiae subsp. equisimilis no Brasil. De janeiro de 2002 a dezembro de 2004, isolou-se S. equisimilis em 67/207 (32,37% das amostras de secreções de lesões de feridas coletadas de pacientes

  15. Hospitals; hospitals13

    Data.gov (United States)

    University of Rhode Island Geospatial Extension Program — Hospital Facilities information was compiled from several various sources. Main source was the RI Department of Health Facilities Regulation database, License 2000....

  16. Community-associated methicillin-resistant Staphylococcus aureus infections in Aboriginal children attending hospital emergency departments in a regional area of New South Wales, Australia: a seven-year descriptive study

    Directory of Open Access Journals (Sweden)

    Susan Thomas

    2017-12-01

    Full Text Available Objective: Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA can cause bacterial skin infections that are common problems for Aboriginal children in New South Wales (NSW. MRSA is not notifiable in NSW and surveillance data describing incidence and prevalence are not routinely collected. The study aims to describe the epidemiology of CA-MRSA in Aboriginal children in the Hunter New England Local Health District (HNELHD. Methods: We linked data from Pathology North Laboratory Management System (AUSLAB and the HNELHD patient administration system from 33 hospital emergency departments. Data from 2008–2014 for CA-MRSA isolates were extracted. Demographic characteristics included age, gender, Aboriginality, rurality and seasonality. Results: Of the 1222 individuals in this study, 408 (33.4% were Aboriginal people. Aboriginal people were younger with 45.8% aged less than 10 years compared to 25.9% of non-Aboriginal people. Most isolates came from Aboriginal people who attended the regional Tamworth Hospital (193/511 isolates from 149 people. A larger proportion of Aboriginal people, compared to non-Aboriginal people, resided in outer regional (64.9% vs 37.2% or remote/very remote areas (2.5% vs 0.5%. Most infections occurred in summer and early autumn. For Aboriginal patients, there was a downward trend through autumn, continuing through winter and spring. Discussion: Aboriginal people at HNELHD emergency departments appear to represent a greater proportion of people with skin infections with CA-MRSA than non-Aboriginal people. CA-MRSA is not notifiable in NSW; however, pathology and hospital data are available and can provide valuable indicative data to health districts for planning and policy development.

  17. Evaluation of supportive care management outcomes in cancer chemotherapy: A prospective observational study in a tertiary care teaching hospital in South India

    Directory of Open Access Journals (Sweden)

    Reshma Susan Reji

    2018-01-01

    Full Text Available Aims: Evaluation of supportive care management of cancer patients experiencing drug-related problems (DRPs is a challenge because it might increase the cost due to additional therapy. The main objectives of this study were to estimate chemotherapy-associated drug-related hospital admissions in the department of medical oncology and to estimate the cost of managing chemotherapy-associated DRPs.Settings and Design: This study is a prospective observational study.Subjects and Methods: Patients with chemotherapy-related DRPs were prospectively identified from the patient's medical records. The contribution of DRPs and cost incurred due to each hospitalization was assessed.Statistical Analysis Used: Data were analyzed using SPSS® 20.0 version.Results: Out of 55 patients analyzed for DRPs, 25 (45.5% patients in the age group of 51–60 years experienced DRPs most frequently. Most commonly occurring DRP was adverse drug reactions 42 (76.4%, which were more frequent in females. DRPs were maximum with alkylating agents 15 (27.3% and the least with hormonal agents 1 (1.8%. The mean length of hospitalization was 9.6 ± 6.5 days. The total direct medical cost was Rs. 31,540 ± 42,476, of which medicine cost accounted for Rs. 16,550 ± 25,404, constituting a major share of the total medical costs.Conclusions: Pharmacists can provide better patient care by identifying and preventing DRPs and reducing drug-related morbidity and mortality.

  18. Perceived Nurse-Physician Communication in Patient Care and Associated Factors in Public Hospitals of Jimma Zone, South West Ethiopia: Cross Sectional Study.

    Directory of Open Access Journals (Sweden)

    Fikadu Balcha Hailu

    Full Text Available Nurse-physician communication has been shown to have a significant impact on the job satisfaction and retention of staff. In areas where it has been studied, communication failure between nurses and physicians was found to be one of the leading causes of preventable patient injuries, complications, death and medical malpractice claims.The objective of this study is to determine perception of nurses and physicians towards nurse-physician communication in patient care and associated factors in public hospitals of Jimma zone, southwest Ethiopia.Institution based cross-sectional survey was conducted from March 10 to April 16, 2014 among 341 nurses and 168 physicians working in public hospitals in Jimma zone. Data was collected using a pre-tested self-administered questionnaire; entered into EpiData version 3.1 and exported to Statistical Package for Social Sciences (SPSS version 16.0 for analysis. Factor analysis was carried out. Descriptive statistics, independent sample t-test, linear regression and one way analysis of variance were used. Variables with P-value < 0.05 were considered as statistically significant.The response rate of the study was 91.55%. The mean perceived nurse-physician communication scores were 50.88±19.7% for perceived professional respect and satisfaction, and 48.52±19.7% for perceived openness and sharing of patient information on nurse-physician communication. Age, salary and organizational factors were statistically significant predictors for perceived respect and satisfaction. Whereas sex, working hospital, work attitude individual factors and organizational factors were significant predictors of perceived openness and sharing of patient information in nurse-physician communication during patient care.Perceived level of nurse-physician communication mean score was low among nurses than physicians and it is attention seeking gap. Hence, the finding of our study suggests the need for developing and implementing nurse

  19. IK Brunel's Crimean war hospital.

    Science.gov (United States)

    Merridew, C G

    2014-07-01

    "Those wonderful huts…" (Florence Nightingale). This is the story of the British Civil Hospital, erected in 1855 at Renkioi on the south Dardanelles coast of Turkey. The spectacular hospital was a portable one designed by British engineer IK Brunel. It was his only health-related project, and it was known as a Civil Hospital because its staff were all civilians, despite its patients being military.

  20. Is English Language Really the Appropriate Language for Health ...

    African Journals Online (AJOL)

    This paper explores the impact of the use of the English language for health mobilization in Calabar Town. It also aimed at establishing the effectiveness of the language used in health mobilization in the town. The study was carried out in Calabar Municipality and Calabar South Local Government Areas of Cross River ...

  1. Socio-Demographic Characteristics Of Dog Meat Consumers In ...

    African Journals Online (AJOL)

    The need to understand consumer spread prompted this study, which had the general objective of understanding the socio-demographic characteristics of dog meat consumers Calabar area of Cross River State, Nigeria. Thirty two (32) dog meat joints, 16 in Calabar Municipality, and 16 in Calabar South Local Government ...

  2. Otosclerosis among South African indigenous blacks | Tshifularo ...

    African Journals Online (AJOL)

    Objective: To report cases of clinical otosclerosis histologically confirmed among indigenous South African blacks. Design: A retrospective study. Setting: Referral tertiary center, MEDUNSA, Garankuwa Hospital, South Africa. Subjects: All fifteen indigenous South African blacks diagnosed with clinical otosclerosis at ...

  3. Congenital malformations among newborns admitted in the neonatal unit of a tertiary hospital in Enugu, South-East Nigeria - a retrospective study

    Science.gov (United States)

    2012-01-01

    Background Congenital abnormalities are not uncommon among newborns and contribute to neonatal and infant morbidity and mortality. The prevalence and pattern of presentation vary from place to place. Many a time the exact etiology is unknown but genetic and environmental factors tend to be implicated. Methods The objective of this study was to determine the prevalence of congenital malformations among newborns admitted in a tertiary hospital in Enugu, the nature of these abnormalities and the outcome/prognosis. For purposes of this study, congenital abnormalities are defined as obvious abnormality of structure or form which is present at birth or noticed within a few days after birth. A cross-sectional retrospective study in which a review of the records of all babies admitted in the Newborn Special Care Unit (NBSCU) of the University of Nigeria Teaching Hospital (UNTH), Ituku/Ozalla, Enugu over a four year period (January 2007-April 2011) was undertaken. All babies admitted in the unit with the diagnosis of congenital abnormality were included in the study. Information extracted from the records included characteristics of the baby, maternal characteristics, nature/type of abnormalities and outcome. Data obtained was analyzed using SPSS 13. Rates and proportions were calculated with 95% confidence interval. The proportions were compared using students T-test. Level of significance was set at P congenital abnormalities of various types, giving a prevalence of 2.8%. Common abnormalities seen in these babies were mainly surgical birth defects and included cleft lip/cleft palate, neural tube defects (occurring either singly or in combination with other abnormalities), limb abnormalities (often in combination with neural tube defects of various types), omphalocoele, umbilical herniae, ano-rectal malformations and dysmorphism associated with multiple congenital abnormalities. Conclusions The results of this study show that 2.8% of babies admitted to a Newborn Special

  4. Congenital malformations among newborns admitted in the neonatal unit of a tertiary hospital in Enugu, South-East Nigeria--a retrospective study.

    Science.gov (United States)

    Obu, Herbert A; Chinawa, Josephat M; Uleanya, Nwachinemere D; Adimora, Gilbert N; Obi, Ikechukwu E

    2012-07-10

    Congenital abnormalities are not uncommon among newborns and contribute to neonatal and infant morbidity and mortality. The prevalence and pattern of presentation vary from place to place. Many a time the exact etiology is unknown but genetic and environmental factors tend to be implicated. The objective of this study was to determine the prevalence of congenital malformations among newborns admitted in a tertiary hospital in Enugu, the nature of these abnormalities and the outcome/prognosis. For purposes of this study, congenital abnormalities are defined as obvious abnormality of structure or form which is present at birth or noticed within a few days after birth. A cross-sectional retrospective study in which a review of the records of all babies admitted in the Newborn Special Care Unit (NBSCU) of the University of Nigeria Teaching Hospital (UNTH), Ituku/Ozalla, Enugu over a four year period (January 2007-April 2011) was undertaken.All babies admitted in the unit with the diagnosis of congenital abnormality were included in the study. Information extracted from the records included characteristics of the baby, maternal characteristics, nature/type of abnormalities and outcome.Data obtained was analyzed using SPSS 13. Rates and proportions were calculated with 95% confidence interval. The proportions were compared using students T-test. Level of significance was set at P congenital abnormalities of various types, giving a prevalence of 2.8%. Common abnormalities seen in these babies were mainly surgical birth defects and included cleft lip/cleft palate, neural tube defects (occurring either singly or in combination with other abnormalities), limb abnormalities (often in combination with neural tube defects of various types), omphalocoele, umbilical herniae, ano-rectal malformations and dysmorphism associated with multiple congenital abnormalities. The results of this study show that 2.8% of babies admitted to a Newborn Special Care Unit in a teaching hospital

  5. High prevalence of complementary and alternative medicine use among patients with sickle cell disease in a tertiary hospital in Lagos, South West, Nigeria.

    Science.gov (United States)

    Busari, A A; Mufutau, M A

    2017-06-07

    Attention and interest in the use of complementary and alternative medicine (CAM) has been reignited globally, most especially in patients with chronic diseases. Sickle cell disease (SCD) is one of such chronic diseases associated with devastating clinical and psychosocial consequences, thus leading those affected to seek alternative treatment apart from orthodox medicine. Hence, this study aimed to determine the prevalence, pattern and tolerability of the use of CAM in patients with SCD in the Lagos University Teaching Hospital (LUTH). This was a cross-sectional survey of 200 respondents with SCD attending the hematology clinics of the Lagos University Teaching Hospital over a period of 3 months. Data on socio-demographic characteristic, clinical profile, the types and sources of CAM used were collected using a well structured pretested questionnaire. The data obtained were analyzed using Statistical Package for Social Sciences (SPSS®) version 17. Of the 200 patients who participated in the study, 113; 56.5% were males and 87; 43.5% were females. Majority of the SCD patients were 1-10 years old and their mean age was 18.8 ± 14.39 years. CAM was reportedly used by 88.5% of the respondents. Biological (herbal) products 156; 62.9% were the most commonly used CAM, followed by alternative medical systems 52; 20.9% and mind-body interventions 30; 12.1%. Relations, friends and neighbors influenced 85.2% of CAM users by recommending CAM to them. Tolerability of CAM was perceived to be excellent as only 33 (18.6%) of the respondents abandoned the use of CAM. Comparing CAM users and CAM non-users, there was no statistical significant difference in the proportion of those >18 years (45.76% vs 52.17%; p = 0.658), those who experienced two or more crises (51.41% vs 34.78%; p = 0.183), and those with stable haemoglobin concentration of >7 g/dL (15.81% vs 8.69%; p = 0.539) More patients among CAM non-users (91.30%) significantly spend over 3000 Naira (USD 15) per

  6. Prevalence and phenotypic characterization of Enterococcus species isolated from clinical samples of pediatric patients in Jimma University Specialized Hospital, south west Ethiopia.

    Science.gov (United States)

    Toru, Milkiyas; Beyene, Getnet; Kassa, Tesfaye; Gizachew, Zeleke; Howe, Rawleigh; Yeshitila, Biruk

    2018-05-08

    This study was done to determine the prevalence and phenotypic characterization of Enterococcus species isolated from clinical samples of pediatric patients in Jimma University Specialized Hospital, Southwest Ethiopia. The overall prevalence of Enterococci species was 5.5% (22/403). Five (22.7%) of Enterococci species were vancomycin resistant. Haemolysin, gelatinase and biofilm production was seen among 45.5, 68.2 and 77.3% of isolates respectively. The overall rate of antibiotic resistance was 95.5% (21/22). High resistance was observed against norfloxacin (87.5%), and tetracycline (77.3%). Whereas, low resistance (36.5%) was observed against ciprofloxacin and eighteen (80.8%) of the isolates were multi-drug resistant.

  7. Human immuno-deficiency virus antibody seroprevalence among pregnant women at booking at a university teaching hospital in South-Eastern Nigeria.

    Science.gov (United States)

    Okeudo, C; Ezem, B U; Ojiyi, E C

    2012-01-01

    In Africa, human immuno-deficiency virus (HIV) infection continues to be progressively feminized. This has led to an increase in the number of paediatric HIV infections reported due to increased risk of mother-to-child transmission (MTCT) of HIV during pregnancy, labour and breastfeeding. The objective of the study was to determine the HIV positive sero-prevalence at booking among pregnant women at the Imo State University Teaching Hospital, Orlu. A retrospective analysis of the case records of women who booked and were screened for Human Immune-deficiency Virus at the Imo State University Teaching Hospital (IMSUTH), Orlu from 1st March 2008 to 28th February 2010 was done. Data on age, parity, educational status, gestational age at booking, and retroviral status were collected and analysed using spss version 13. Nine hundred and twenty one pregnant women were screened for the presence of HIV 1 & 2 antibodies in their serum. One hundred and six of them were positive, giving a sero-prevalence rate at booking of 11.5%. The highest sero prevalence rate of 45.2% occurred in the age group of 26-30 years. Petty traders contributed 97 (91.5%) of the HIV positive women, while multiparous (para 2-4) women contributed 50% of the positive pregnant women. Only 32 (30.2%) of the HIV positive women booked within the first trimester for antenatal care. Majority 53 (59.4%) of the HIV positive women had secondary education, while those that had no formal education contributed only 6 (5.7%) of the HIV positive women. There was a high HIV seroprevalence at booking among pregnant women at IMSUTH, Orlu. A lot more needs to be done in order to reduce vertical transmission of HIV in our environment.

  8. Factors predictive of abnormal semen parameters in male partners of couples attending the infertility clinic of a tertiary hospital in south-western Nigeria

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    Peter Olusola Aduloju

    2016-11-01

    Full Text Available Background: Infertility is a common gynaecological problem and male factor contributes significantly in the aetiology of infertility. Semen analysis has remained a useful investigation in the search for male factor infertility. Aim: This study assessed the pattern of semen parameters and predictive factors associated with abnormal parameters in male partners of infertile couples attending a Nigerian tertiary hospital. Methods: A descriptive study of infertile couples presenting at the clinic between January 2012and December 2015 was done at Ekiti State University Teaching Hospital, Ado-Ekiti. Seminal fluid from the male partners were analysed in the laboratory using the WHO 2010 criteria for human semen characteristics. Data was analysed using SPSS 17 and logistic regression analysis was used to determine the predictive factors associated with abnormal semen parameters. Results: A total of 443 men participated in the study and 38.2% had abnormal sperm parameters. Oligozoospermia (34.8% and asthenozoospermia (26.9% are leading single factor abnormality found, astheno-oligozoospermia occurred in 14.2% and oligo-astheno-teratozoospermia in 3.6% of cases. The prevalence of azoospermia was 3.4%. Smoking habit, past infection with mumps and previous groin surgery significantly predicted abnormal semen parameters with p values of 0.025, 0.040 and 0.017 respectively. Positive cultures were recorded in 36.2% of cases and staph aureus was the commonest organism. Conclusion: Male factor abnormalities remain significant contributors to infertility and men should be encouraged through advocacy to participate in investigation of infertility to reduce the level of stigmatization and ostracizing of women with infertility especially in sub-Saharan Africa.

  9. PREVALENCE AND AT EARLY AGE ONSET OF HYPO AND HYPERTHYROIDISM IN POST-IODIZATION ERA: A HOSPITAL BASED STUDY FROM SOUTH INDIA

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    Fathima Nusrath, Baderuzzaman, Anees Syyeda , Siraj M, N Parveen , Ishaq M

    2015-07-01

    Full Text Available Background: Thyroid dysfunction has been considered as one of the most common endocrine disorder in clinical practice throughout the world. Its increasing prevalence had led to the screening of general population in different parts of the world in order to investigate causes for rising incidence. A nationwide survey on epidemiology of thyroid dysfunction in selected cities of India suggested the need for further studies in order to have a more comprehensive analysis of epidemiological aspect for better awareness and control of this endocrine disorder. Aim: The major objective of the present study was to identify the prevalence and early age at onset of hypo and hyperthyroidism in post-iodization era based on a hospital based study. Materials and Methods: A total of 516 subjects visiting department of Medicine, Princess ESRA Hospital, Hyderabad, in age group of 10 to 75 years were included in the study from June 2013 to January 2014. Serum TSH, T3, and T4 assays were assessed by chemiluminescence method. Based on thyroid dysfunction test results, subjects were classified into Hypothyroidism, Subclinical Hypothyroidism and Hyperthyroidism. Results: The prevalence of hypothyroidism was highest in the females 33.52 % (n=173 as compared to males 2.32% (n=12 and hyperthyroidism in females 4.06% (n=21 and 0.19% (n=1 in males. Subclinical hypothyroidism in females was 7.55% (n=39. Conclusions: An inordinately high increase in the prevalence rate in women was observed particularly in the age group 21-30years. Monitoring of thyroid profile is necessary to prevent adverse outcome at clinical and subclinical levels related to infertility, pregnancies and other complications.

  10. Assessment of hepatitis B virus and hepatitis C virus infections and associated risk factors in HIV infected patients at Debretabor hospital, South Gondar, Northwest Ethiopia

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    Melashu Balew

    2014-02-01

    Full Text Available Objective: To assess hepatitis B and hepatitis C virus infections and associated risk factors among HIV infected patients at Debretabor hospital. Methods: A cross-sectional study was conducted among HIV/AIDS patients attending Debretabor hospital from February to April, 201 2. Venous blood samples were collected from study participants for HBsAg and anti HCV antibody tests. Bivariate and multivariate analyses were used to identify associated variables with HBsAg and anti HCV positivity. Variables having P<0.05 was taken as statistically significant association. Results: From a total of 395 HIV infected patients included in this study, 234 (59.2% were females and 161 (40.8% males with mean (依SD age of 36.31 (依9.91 years. The prevalence of HBsAg and anti HCV antibody was 6.1% and 1.3%, respectively. In multivariate analysis, multiple sexual partner (AOR=8.1, 95% CI=1.8-33.97 and history of opportunistic infections (AOR=3.17, 95% CI=1.3-7.7 were statistically associated with HBsAg positivity. History of blood transfusion (AOR=5.61, 95% CI= 1.03-36.59 was associated with presence of anti-HCV antibody. Conclusions: The prevalence of HBsAg and anti HCV antibodies in HIV coinfected patients was intermediate. However, it is relevant for HIV infected patients since viral hepatitis co-infections in HIV patients can cause multiple complications. Therefore, routine HBV and HCV screening with reliable diagnostic markers need to be carried out for close monitoring and better management in HIV patients.

  11. Perinatal outcomes in pregnant women presenting with preterm premature rupture of membranes at a regional hospital in KwaZulu Natal Province South Africa

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    G Msomi

    2017-09-01

    Full Text Available Background. Worldwide, the incidence of preterm premature rupture of membranes (PPROM is between 1% and 4% of all pregnancies.Objectives. The primary objectives of this study were to describe and compare the perinatal outcomes of HIV-positive and HIV-negative women presenting with PPROM to a regional hospital in KwaZulu-Natal.Methods. This was a retrospective analytical cross-sectional study which reviewed files of pregnant women presenting with premature rupture of membranes at gestation between 28 and 36 completed weeks. These were identified from the labour ward birth register and from the neonatal ward admission book. Categorical and numerical variables pertaining to the method of confirmation of diagnoses, clinical profiles, modes of delivery, maternal outcomes and neonatal outcomes were considered.Results. A total of 87 files were analysed. Forty-six women (53% were HIV-negative and 41 (47% were HIV-positive. Fifty-two percent were in the gestational age <34 weeks. Fifty-nine percent (n=51 of women delivered vaginally and 31% (n=27 delivered by caesarean delivery (CD. There was also no statistical significance between the Apgar scores of the HIV-exposed and HIV-unexposed neonates, birth weights and modes of delivery. There was no statistical significance in sepsis rates, the need for ventilation and the duration of hospital stay between the two groups. The odds of developing neonatal jaundice (NNJ in the HIV-positive group was 0.14(95% confidence interval (CI 0 - 0.93, which was statistically significant. There was no reported maternal or neonatal mortality and no maternal morbidity associated with PPROM in either groups.Conclusion. This study suggests that there are no immediate significant differences in neonatal and maternal outcomes in pregnancies complicated by PPROM between HIV-negative and HIV-positive women on ART except that of NNJ.

  12. Knowledge, attitude, and practice toward cervical cancer among women attending Obstetrics and Gynecology Department: A cross-sectional, hospital-based survey in South India.

    Science.gov (United States)

    Narayana, G; Suchitra, M Jyothi; Sunanda, G; Ramaiah, J Dasaratha; Kumar, B Pradeep; Veerabhadrappa, K V

    2017-01-01

    Cervical cancer-related deaths among women in India are often due to late diagnosis of disease. Knowledge about disease and early screening is the most effective measure for cervical cancer prevention. Lack of awareness, negative attitude, and poor practice about cervical cancer and screening are the major causes to increase the incidence of disease. The study is designed to assess knowledge, attitude, and practice (KAP) toward cervical cancer, screening, and prevention. A cross-sectional, hospital-based survey was conducted in women attending Obstetrics and Gynecology Department of a secondary care referral hospital. A total of 403 subjects were enrolled and subjected for interview using prevalidated KAP questionnaire on cervical cancer. Descriptive statistics were used to represent the sociodemographic characteristics and KAP levels. Association of sociodemographic variables with KAP levels is determined using Chi-square test. Most of (301; 74.6%) the respondents had heard about cervical cancer and majority of them are heard from media (168; 41.6%) and friends (83; 20.5%). Most women knew symptoms (259; 64.2%), risk factors (253; 62.7%), screening methods (310; 76.9%), and preventive measures (249; 61.7%) for cervical cancer. More than half of the women (252; 62.5%) having positive attitude toward screening. More than three-fourth of women (349; 86.6%) are not having practice toward cervical cancer screening. Sociodemographic characteristics are strongly associated with KAP levels. Although women are having good knowledge, positive attitude toward cervical cancer screening and prevention still there is a gap to transform it into practice. There is a need for more educational programs to connect identified knowledge slits and uplift of regular practice of cervical cancer screening.

  13. Work-related stress perception and hypertension amongst health workers of a mission hospital in Oyo State, south-western Nigeria

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    Akinwumi O. Owolabi

    2012-04-01

    Objective: This study was a work site cross-sectional descriptive study carried out amongst the health workers at the Baptist Medical Centre Ogbomoso, Oyo State, south-western Nigeria. The aim of the study was to discern the prevalence of perceived work stress and to explore the relationship between perceived work stress and the presence of hypertension. Methods: A total of 324 consenting health workers of the institution were administered the job demand-control questionnaire to assess work stress. A standardised questionnaire was used to collect socio-demographic data and other personal data. Measurements of blood pressure, weight and height were carried out and body mass indices were calculated. Results: More than a quarter (26.2% of the subjects perceived themself as stressed at work. The single largest group of hypertensive subjects was seen amongst subjects with work stress. Conclusion: A significant number of health workers in this study is afflicted by work-related stress and perceived work stress was found to be significantly associated with higher hypertension prevalence.

  14. Impact of a hand hygiene campaign in a tertiary hospital in South Korea on the rate of hospital-onset methicillin-resistant Staphylococcus aureus bacteremia and economic evaluation of the campaign.

    Science.gov (United States)

    Chun, June Young; Seo, Hye Kyung; Kim, Min-Kyung; Shin, Myoung Jin; Kim, Su Young; Kim, Moonsuk; Kim, Chung-Jong; Song, Kyoung-Ho; Kim, Eu Suk; Lee, Heeyoung; Kim, Hong Bin

    2016-12-01

    Hand hygiene (HH) is the most important factor affecting health care-associated infections. We introduced a World Health Organization HH campaign in October 2010. The monthly procurement of hand sanitizers per 1,000 patient days was calculated, and the monthly incidence of methicillin-resistant Staphylococcus aureus bacteremia (MRSAB), classified into community- and hospital-onset (HO), was measured from a microbiologic laboratory database. Trends of MRSAB incidence were assessed using Bayesian structural time series models. A cost-benefit analysis was also performed based on the economic burden of HO MRSAB in Korea. Procurement of hand sanitizers increased 134% after the intervention (95% confidence interval [CI], 120%-149%), compared with the preintervention period (January 2008-September 2010). In the same manner, HH compliance improved from 33.2% in September 2010 to 92.2% after the intervention. The incidence of HO MRSAB per 100,000 patient days decreased 33% (95% CI, -57% to -7.8%) after the intervention. Because there was a calculated reduction of 65 HO MRSAB cases during the intervention period, the benefit outweighed the cost (total benefit [$851,565]/total cost [$167,495] = 5.08). Implementation of the HH campaign led to increased compliance and significantly reduced HO MRSAB incidence; it was also cost saving. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  15. Severity of acute hepatitis and its outcome in patients with dengue fever in a tertiary care hospital Karachi, Pakistan (South Asia

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    Akhtar Jaweed

    2010-05-01

    Full Text Available Abstract Background Liver injury due to dengue viral infection is not uncommon. Acute liver injury is a severe complicating factor in dengue, predisposing to life-threatening hemorrhage, Disseminated Intravascular Coagulation (DIC and encephalopathy. Therefore we sought to determine the frequency of hepatitis in dengue infection and to compare the outcome (length of stay, in hospital mortality, complications between patients of Dengue who have mild/moderate (ALT 23-300 IU/L v/s severe acute hepatitis (ALT > 300 IU/L. Methods A Cohort study of inpatients with dengue viral infection done at Aga Khan University Hospital Karachi. All patients (≥ 14 yrs age admitted with diagnosis of Dengue Fever (DF, Dengue Hemorrhagic Fever (DHF or Dengue Shock Syndrome (DSS were included. Chi square test was used to compare categorical variables and fischer exact test where applicable. Survival analysis (Cox regression and log rank for primary outcome was done. Student t test was used to compare continuous variables. A p value of less than or equal to 0.05 was taken as significant. Results Six hundred and ninety nine patients were enrolled, including 87% (605 patients with DF and 13% (94 patients with DHF or DSS. Liver functions tests showed median ALT of 88.50 IU/L; IQR 43.25-188 IU/L, median AST of 174 IU/L; IQR 87-371.5 IU/L and median T.Bil of 0.8 mg/dl; IQR 0.6-1.3 mg/dl. Seventy one percent (496 had mild to moderate hepatitis and 15% (103 had severe hepatitis. Mean length of stay (LOS in patients with mild/moderate hepatitis was 3.63 days v.s 4.3 days in those with severe hepatitis (P value 0.002. Overall mortality was 33.3% (n = 6 in mild/moderate hepatitis vs 66.7% (n = 12 in severe hepatitis group (p value Conclusion Severe hepatitis (SGPT>300IU in Dengue is associated with prolonged LOS, mortality, bleeding and RF.

  16. Knowledge and attitude of donating and using cord blood for transfusion among patients attending Nnamdi Azikiwe University Teaching Hospital, Nnewi, South East Nigeria.

    Science.gov (United States)

    Okocha, Chide E; Ezeama, Nkiru N; Aneke, John C; Onubogu, Chinyere U; Okafor, Charles I; Egbunike, Chijioke G

    2017-01-01

    Allogeneic blood for transfusion is in short supply in most parts of the developing world. Cord blood for transfusion can be a significant source of blood supply to our health institutions. This study aims to investigate the knowledge and attitude to the donation and use of umbilical cord blood (UCB) for transfusion among the patients receiving services in a tertiary health institution in South-East Nigeria. This was a cross-sectional study; an anonymous structured questionnaire was used. A total of 549 consenting patients randomly selected from the antenatal, postnatal, sickle cell clinics, and wards were the subjects. Statistical analysis of the data was done using SPSS version 20.0. The mean age of the participants was 31.9 ± 9.5 years. The majority were females (77.2%), married (86.4%). About 26.2% of the respondents were willing to accept UCB for transfusion to them or their child. Following counseling, the acceptance rate increased to 71.5%. Most of the respondents (80.0%) were willing to donate the UCB of their baby; or be tested for HIV (93.3%), if necessary. Educational level was significantly associated with knowledge of UCB. After logistic regression, occupation, and gender were significantly associated with acceptance of UCB for transfusion. Up to 52% belonged to low income family background, approximately 150 US dollars monthly family income (50,000 naira). The knowledge and acceptance of UCB for transfusion are low in our environment. However, proper counseling and public enlightenment could change this attitude.

  17. Mortality predictors of HIV-infected patients on antiretroviral therapy in Debre Tabor General Hospital and Woreta Health Center, South Gondar Zone, Northwest Ethiopia

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    Mekonnen Assefa Ahunie

    2017-02-01

    Full Text Available Objective: To investigate the mortality predictors of HIV-infected individuals who were receiving antiretroviral treatment. Methods: Data were extracted from medical records of 698 antiretroviral therapy (ART users enrolled at Debre Tabor General Hospital and Woreta Health Center from January 2005 to June 2014 and sociodemographic, clinical and ART-related data were collected. Mortality was compared by using time-to-event Kaplan-Meier method and log rank test and Cox regression analysis were used to identify the predictors of mortality. Results: The overall mortality rate was 1.5 per 100 persons per year. Ambulatory and bedridden patients had four- and seven-fold higher risk of death [adjusted hazard ratio (HR = 4.2, 95% confidence interval (CI: 1.7–10.7 and adjusted HR = 6.5, 95% CI: 2.0–20.7, respectively] as compared to those patients who had worked functional status. Patients who had poor antiretroviral drug adherence had five times higher risk of death (adjusted HR = 5.1, 95% CI: 1.6–16.3 than patients who had good antiretroviral adherence. Conclusions: Mortality rate was highly observed in the early phase of antiretroviral treatment. Poor ART adherence, being ambulatory and bedridden functional status was independent predictors of mortality.

  18. Knowledge of hypoglycemia and its associated factors among type 2 diabetes mellitus patients in a Tertiary Care Hospital in South India.

    Science.gov (United States)

    Shriraam, Vanishree; Mahadevan, Shriraam; Anitharani, M; Jagadeesh, Nalini Sirala; Kurup, Sreelekha Bhaskara; Vidya, T A; Seshadri, Krishna G

    2015-01-01

    Hypoglycemia being the rate limiting complication in the attainment of strict glycemic control in diabetes management, in this study, we intended to study the knowledge of its symptoms, target blood levels during treatment and ways of prevention among type 2 diabetes patients attending Outpatient Department (OPD) of a medical college hospital. Every fifth patient attending the OPD during the 4 months between March and June 2013 was interviewed using a questionnaire. The study included 366 type 2 diabetic patients, of which 76.5% were females. The target fasting and postprandial blood glucose levels while on treatment was known to 135 (36.9%) and 126 (34.4%) patients, respectively. The common symptoms of hypoglycemia known to the study subjects were dizziness (81.4%), weakness (73.8%), and drowsiness (72.1%). Overall, 242 (66.1%) diabetic patients had good knowledge on hypoglycemia (knowledge of at least three symptoms of hypoglycemia together with at least one precipitating factor and at least one remedial measure). Higher age, illiteracy, low socioeconomic status were associated with poor knowledge whereas treatment with insulin along with oral hypoglycemic agents was associated with good knowledge on hypoglycemia. Sex and duration of disease were not associated with knowledge on hypoglycemia. Although the knowledge on symptoms of hypoglycemia, precipitating factors, remedial measures are high in this study, the target blood levels, complications were known to just a third of them. There is a knowledge gap on important aspects of hypoglycemia among type 2 diabetic patients.

  19. Perceptions of hospital managers regarding the impact of doctors ...

    African Journals Online (AJOL)

    South African Family Practice ... In 1997, the South African government introduced compulsory community service (CS) to ... CS has improved health services delivery, alleviated work pressure, and improved the image of hospital managers.

  20. Hospital Compare

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    U.S. Department of Health & Human Services — Hospital Compare has information about the quality of care at over 4,000 Medicare-certified hospitals across the country. You can use Hospital Compare to find...

  1. HCAHPS - Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of hospital ratings for the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). HCAHPS is a national, standardized survey of hospital...

  2. Duplex ultrasound: Indications and findings in a newly created ...

    African Journals Online (AJOL)

    Duplex ultrasound: Indications and findings in a newly created facility at the University of Calabar Teaching Hospital, Calabar. ... It is recommended that timely referrals be made, and mobile Doppler units be acquired to save more lives and limbs in the developing world. Keywords: Calabar, deep venous thrombosis, duplex ...

  3. Prevalence of non-responsiveness to an indigenous recombinant hepatitis B vaccine: A study among South Indian health care workers in a tertiary hospital

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    R J Thomas

    2015-01-01

    Full Text Available Background and Aim: Health care workers (HCW are at higher risk of contracting HBV infection. Non-response to HBV vaccine is one of the major impediments to prevent healthcare associated HBV infection (HAHI. We estimated the prevalence of non-responsiveness to initial 3-dose regimen of an indigenous recombinant HBV vaccine (GeneVac-B among South Indian HCWs and typed the HLA in non-responders. Study Design and Method: Of the 778 subjects screened over 1 year, 454 completed all three doses of the hepatitis B vaccination. Anti-HBs titers were estimated by microparticle enzyme immunoassay AxSYM AUSAB, (Abbott, Germany. HLA typing was done using SSP-PCR assay AllSet+™ Gold SSP (Invitrogen, USA. Results: The overall seroconversion rate (anti-HBs > 10 mIU/mL was 98.89% wherein 90.8% had titers >1000mIU/mL, 7.6% had titers 100-1000mIU/mL, 0.43% had titers < 100 mIU/mL and 1.1% were non-responsive (<10 mIU/mL to the initial 3-dose regimen. Antibody titers <1000 mIU/mL were significantly associated with the highest quartile of body mass index (BMI (P < 0.001. We found no significant difference in seroprotection rate between gender (P = 0.088. There was no difference in seroprotection rates among various ethnic groups (P = 0.62. Subjects who were non-responsive in our study had at least one HLA allele earlier known to be associated with non-responsiveness to the vaccine. Conclusion: Our findings suggest that non-response to HBV vaccine is not a major impediment to prevent HAHI. Robust seroprotection rates can be achieved using this indigenous HBV vaccine. However, gender and BMI might influence the level of anti-HBs titers. We recommend the use of this cost effective HBV vaccine as well as postvaccination anti-HBs testing to prevent HAHI among HCWs.

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

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    Sandeep Kumar Gupta

    2016-01-01

    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.

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

    Science.gov (United States)

    Gupta, Sandeep Kumar; Nayak, Roopa P; Sivaranjani, R

    2016-01-01

    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. 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. 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. 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). 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.

  6. Knowledge of hypoglycemia and its associated factors among type 2 diabetes mellitus patients in a Tertiary Care Hospital in South India

    Directory of Open Access Journals (Sweden)

    Vanishree Shriraam

    2015-01-01

    Full Text Available Introduction: Hypoglycemia being the rate limiting complication in the attainment of strict glycemic control in diabetes management, in this study, we intended to study the knowledge of its symptoms, target blood levels during treatment and ways of prevention among type 2 diabetes patients attending Outpatient Department (OPD of a medical college hospital. Materials and Methods: Every fifth patient attending the OPD during the 4 months between March and June 2013 was interviewed using a questionnaire. Results: The study included 366 type 2 diabetic patients, of which 76.5% were females. The target fasting and postprandial blood glucose levels while on treatment was known to 135 (36.9% and 126 (34.4% patients, respectively. The common symptoms of hypoglycemia known to the study subjects were dizziness (81.4%, weakness (73.8%, and drowsiness (72.1%. Overall, 242 (66.1% diabetic patients had good knowledge on hypoglycemia (knowledge of at least three symptoms of hypoglycemia together with at least one precipitating factor and at least one remedial measure. Higher age, illiteracy, low socioeconomic status were associated with poor knowledge whereas treatment with insulin along with oral hypoglycemic agents was associated with good knowledge on hypoglycemia. Sex and duration of disease were not associated with knowledge on hypoglycemia. Conclusion: Although the knowledge on symptoms of hypoglycemia, precipitating factors, remedial measures are high in this study, the target blood levels, complications were known to just a third of them. There is a knowledge gap on important aspects of hypoglycemia among type 2 diabetic patients.

  7. The correlation of symptoms, pulmonary function tests and exercise testing with high-resolution computed tomography in patients with idiopathic interstitial pneumonia in a tertiary care hospital in South India.

    Science.gov (United States)

    Isaac, Barney Thomas Jesudason; Thangakunam, Balamugesh; Cherian, Rekha A; Christopher, Devasahayam Jesudas

    2015-01-01

    For the follow-up of patients with idiopathic interstitial pneumonias (IIP), it is unclear which parameters of pulmonary function tests (PFT) and exercise testing would correlate best with high-resolution computed tomography (HRCT).. To find out the correlation of symptom scores, PFTs and exercise testing with HRCT scoring in patients diagnosed as idiopathic interstitial pneumonia. Cross-sectional study done in pulmonary medicine outpatients department of a tertiary care hospital in South India. Consecutive patients who were diagnosed as IIP by a standard algorithm were included into the study. Cough and dyspnea were graded for severity and duration. Pulmonary function tests and exercise testing parameters were noted. HRCT was scored based on an alveolar score, an interstitial score and a total score. The HRCT was correlated with each of the clinical and physiologic parameters. Pearson's/Spearman's correlation coefficient was used for the correlation of symptoms and parameters of ABG, PFT and 6MWT with the HRCT scores. A total of 94 patients were included in the study. Cough and dyspnea severity (r = 0.336 and 0.299), FVC (r = -0.48), TLC (r = -0.439) and DLCO and distance saturation product (DSP) (r = -0.368) and lowest saturation (r = -0.324) had significant correlation with total HRCT score. Among these, DLCO, particularly DLCO corrected % of predicted, correlated best with HRCT score (r = -0.721).. Symptoms, PFT and exercise testing had good correlation with HRCT. DLCO corrected % of predicted correlated best with HRCT.

  8. Insertion/deletion polymorphism of the angiotensin-converting enzyme gene and the risk of hypertension among residents of two cities, South-South Nigeria

    Directory of Open Access Journals (Sweden)

    Mary Esien Kooffreh

    2014-01-01

    Conclusion: The I/D polymorphism of the angiotensin-converting enzyme gene was a risk factor for hypertension in the sample population of Calabar and Uyo. This research will form baseline information for subsequent molecular studies in this population.

  9. Patterns and predictors of antimicrobial resistance among Staphylococcus spp. from canine clinical cases presented at a veterinary academic hospital in South Africa.

    Science.gov (United States)

    Qekwana, Daniel N; Oguttu, James W; Sithole, Fortune; Odoi, Agricola

    2017-04-28

    Antimicrobial resistance in staphylococci, often associated with treatment failure, is increasingly reported in veterinary medicine. The aim of this study was to investigate patterns and predictors of antimicrobial resistance among Staphylococcus spp. isolates from canine samples submitted to the bacteriology laboratory at the University of Pretoria academic veterinary hospital between 2007 and 2012. Retrospective data of 334 Staphylococcus isolates were used to calculate the proportion of samples resistant to 15 antimicrobial agents. The Cochran-Armitage trend test was used to investigate temporal trends and logistic regression models were used to investigate predictors of antimicrobial resistance in Staphylococcus aureus and Staphylococcus pseudintermedius. Results show that 98.2% (55/56) of the S. aureus isolates were resistant to at least one drug while 42.9% were multidrug resistant. Seventy-seven percent (214/278) of the S. pseudintermedius isolates were resistant to at least one drug and 25.9% (72/278) were multidrug resistant. Resistance to lincospectin was more common among S. aureus (64.3%) than S. pseudintermedius (38.9%). Similarly, resistance to clindamycin was higher in S. aureus (51.8%) than S. pseudintermedius (31.7%) isolates. There was a significant (p = 0.005) increase in S. aureus resistance to enrofloxacin over the study period. Similarly, S. pseudintermedius exhibited significant increasing temporal trend in resistance to trimethoprim-sulphamethoxazole (p = 0.004), clindamycin (p = 0.022) and orbifloxacin (p = 0.042). However, there was a significant decreasing temporal trend in the proportion of isolates resistant to doxycycline (p = 0.041), tylosin (p = 0.008), kanamycin (p = 0.017) and amoxicillin/clavulanic acid (p = 0.032). High levels of multidrug resistance and the increasing levels of resistance to sulphonamides, lincosamides and fluoroquinolones among Staphylococcus spp. isolates in this study are concerning. Future

  10. Diagnostic accuracy, incremental yield and prognostic value of Determine TB-LAM for routine diagnostic testing for tuberculosis in HIV-infected patients requiring acute hospital admission in South Africa: a prospective cohort.

    Science.gov (United States)

    Lawn, Stephen D; Kerkhoff, Andrew D; Burton, Rosie; Schutz, Charlotte; Boulle, Andrew; Vogt, Monica; Gupta-Wright, Ankur; Nicol, Mark P; Meintjes, Graeme

    2017-03-21

    We previously reported that one-third of HIV-positive adults requiring medical admission to a South African district hospital had laboratory-confirmed tuberculosis (TB) and that almost two-thirds of cases could be rapidly diagnosed using Xpert MTB/RIF-testing of concentrated urine samples obtained on the first day of admission. Implementation of urine-based, routine, point-of-care TB screening is an attractive intervention that might be facilitated by use of a simple, low-cost diagnostic tool, such as the Determine TB-LAM lateral-flow rapid test for HIV-associated TB. Sputum, urine and blood samples were systematically obtained from unselected HIV-positive adults within 24 hours of admission to a South African township hospital. Additional clinical samples were obtained during hospitalization as clinically indicated. TB was defined by the detection of Mycobacterium tuberculosis in any sample using Xpert MTB/RIF or liquid culture. The diagnostic yield, accuracy and prognostic value of urine-lipoarabinomannan (LAM) testing were determined, but urine-LAM results did not inform treatment decisions. Consecutive HIV-positive adult acute medical admissions not already receiving TB treatment (n = 427) were enrolled regardless of clinical presentation or symptoms. TB was diagnosed in 139 patients (TB prevalence 32.6%; median CD4 count 80 cells/μL). In the first 24 hours of admission, sputum (spot and/or induced) samples were obtained from 37.0% of patients and urine samples from 99.5% of patients (P < 0.001). The diagnostic yields from these specimens were 19.4% (n = 27/139) for sputum-microscopy, 26.6% (n = 37/139) for sputum-Xpert, 38.1% (n = 53/139) for urine-LAM and 52.5% (n = 73/139) for sputum-Xpert/urine-LAM combined (P < 0.01). Corresponding yields among patients with CD4 counts <100 cells/μL were 18.9%, 24.3%, 55.4% and 63.5%, respectively (P < 0.01). The diagnostic yield of urine-LAM was unrelated to respiratory symptoms, and

  11. Antimicrobial susceptibility of gram-negative pathogens isolated from patients with complicated intra-abdominal infections in South African hospitals (SMART Study 2004-2009): impact of the new carbapenem breakpoints.

    Science.gov (United States)

    Brink, Adrian J; Botha, Roelof F; Poswa, Xoliswa; Senekal, Marthinus; Badal, Robert E; Grolman, David C; Richards, Guy A; Feldman, Charles; Boffard, Kenneth D; Veller, Martin; Joubert, Ivan; Pretorius, Jan

    2012-02-01

    The Study for Monitoring Antimicrobial Resistance Trends (SMART) follows trends in resistance among aerobic and facultative anaerobic gram-negative bacilli (GNB) isolated from complicated intra-abdominal infections (cIAIs) in patients around the world. During 2004-2009, three centralized clinical microbiology laboratories serving 59 private hospitals in three large South African cities collected 1,218 GNB from complicated intra-abdominal infections (cIAIs) and tested them for susceptibility to 12 antibiotics according to the 2011 Clinical Laboratory Standards Institute (CLSI) guidelines. Enterobacteriaceae comprised 83.7% of the isolates. Escherichia coli was the species isolated most commonly (46.4%), and 7.6% of these were extended-spectrum β-lactamase (ESBL)-positive. The highest ESBL rate was documented for Klebsiella pneumoniae (41.2%). Overall, ertapenem was the antibiotic most active against susceptible species for which it has breakpoints (94.6%) followed by amikacin (91.9%), piperacillin-tazobactam (89.3%), and imipenem-cilastatin (87.1%), whereas rates of resistance to ceftriaxone, cefotaxime, ciprofloxacin, and levofloxacin were documented to be 29.7%, 28.7%, 22.5%, and 21.1%, respectively. Multi-drug resistance (MDR), defined as resistance to three or more antibiotic classes, was significantly more common in K. pneumoniae (27.9%) than in E. coli (4.9%; p<0.0001) or Proteus mirabilis (4.1%; p<0.05). Applying the new CLSI breakpoints for carbapenems, susceptibility to ertapenem was reduced significantly in ESBL-positive E. coli compared with ESBL-negative isolates (91% vs. 98%; p<0.05), but this did not apply to imipenem-cilastatin (95% vs. 99%; p=0.0928). A large disparity between imipenem-cilastatin and ertapenem susceptibility in P. mirabilis and Morganella morganii was documented (24% vs. 96% and 15% vs. 92%, respectively), as most isolates of these two species had imipenem-cilastatin minimum inhibitory concentrations in the 2-4 mcg/mL range, which

  12. Perfil clínico-epidemiológico dos pacientes em pós-operatório de artroplastia em um hospital do sul de Minas Gerais / Epidemiological clinical profile of patients in arthroplasty postoperative period in a hospital south of Minas Gerais

    Directory of Open Access Journals (Sweden)

    Verônica dos Santos Rezende

    2017-09-01

    Full Text Available Introdução: Conhecer a epidemiologia das artroplastias contribui para uma melhor assistência ao paciente, proporcionando medidas corretivas e preventivas das possíveis complicações. Objetivos: Traçar o perfil clínico-epidemiológico dos pacientes em pós-operatório (PO de artroplastia em um Hospital do Sul de Minas Gerais. Métodos: Foi realizado um estudo observacional, retrospectivo e transversal a partir da análise de prontuários e exames complementares de pacientes submetidos à artroplastia de quadril e joelho no Hospital Escola da Faculdade de Medicina de Itajubá (HE/FMIt. Resultados: Houve prevalência do gênero feminino; a idade média foi de 69,1 anos; 93,6% eram brancos; 49,4% eram casados; 92,0% eram católicos. Em relação à artroplastia de quadril e joelho, respectivamente, 48,4% tiveram fratura de fêmur e 73,3% artrose; 83,4% foram submetidos à artroplastia total de quadril e 100,0% à artroplastia total de joelho; 82,2% e 100,0% utilizaram prótese cimentada; 91,1% internados de 5 a 10 dias e 86,7% internados de 1 a 5 dias; 42,7% negaram comorbidades e 66,7% tinham hipertensão arterial; 46,5% e 60,0% relataram dor, 5,1% apresentaram luxação e 80,0% sem complicações. Destaca-se que 100,0% dos pacientes não foram encaminhados à fisioterapia. Conclusão: Conclui-se que a organização e sistematização de dados são fundamentais para a promoção da segurança do paciente, prevenindo suas complicações e aumentando a sua qualidade de vida. Introduction: To know the epidemiology of arthroplasties is a way to contribute to better patient care, by providing corrective and preventive measures of possible complications. Aims: To describe the clinical-epidemiological profile of patients in the postoperative period (PO of arthroplasty in a Hospital in the South of Minas Gerais State. Methods: An observational, retrospective and cross-sectional study was carried out and it was based on the analysis of charts and

  13. The South African Surgical Outcomes Study: a seven-day ...

    African Journals Online (AJOL)

    LR Mathivha, TR Mokoena, S Monokoane, Rui Moreno, David ... Method: A seven-day national, multicentre, prospective, observational cohort study was conducted in 50 government-funded hospitals in South .... Dr George Mukhari Hospital.

  14. Short-term and sustained effects of a health system strengthening intervention to improve mortality trends for paediatric severe malnutrition in rural South African hospitals: An interrupted time series design

    Directory of Open Access Journals (Sweden)

    M Muzigaba

    2017-04-01

    Full Text Available Background. Case fatality rates for childhood severe acute malnutrition (SAM remain high in some resource-limited facilities in South Africa (SA, despite the widespread availability of the World Health Organization treatment guidelines. There is a need to develop reproducible interventions that reinforce the implementation of these guidelines and assess their effect and sustainability. Objectives. To assess the short-term and sustained effects of a health system strengthening intervention on mortality attributable to SAM in two hospitals located in the Eastern Cape Province of SA. Methods. This was a theory-driven evaluation conducted in two rural hospitals in SA over a 69-month period (2009 - 2014. In both facilities, a health system strengthening intervention was implemented within the first 32 months, and thereafter discontinued. Sixty-nine monthly data series were collected on: (i monthly total SAM case fatality rate (CFR; (ii monthly SAM CFR within 24 hours of admission; and (iii monthly SAM CFR among HIV-positive cases, to determine the intervention’s effect within the first 32 months and sustainability over the remaining 37 months. The data were analysed using Linden’s method for analysing interrupted time series data. Results. The study revealed that the intervention was associated with a statistically significant decrease of up to 0.4% in monthly total SAM CFR, a non-statistically significant decrease of up to 0.09% in monthly SAM CFR within 24 hours of admission and a non-statistically significant decrease of up to 0.11% in monthly SAM CFR among HIV-positive cases. The decrease in mortality trends for both outcomes was only slightly reversed upon the discontinuation of the intervention. No autocorrelation was detected in the regression models generated during data analyses. Conclusion. The study findings suggest that although the intervention was designed to be self-sustaining, this may not have been the case. A qualitative enquiry

  15. Feasibility of Pulse Oximetry Pre-discharge Screening Implementation for detecting Critical Congenital heart Lesions in newborns in a secondary level maternity hospital in the Western Cape, South Africa: The 'POPSICLe' study.

    Science.gov (United States)

    Van Niekerk, A M; Cullis, R M; Linley, L L; Zühlke, L

    2016-07-07

    Early detection of critical congenital heart disease (CCHD) through newborn pulse oximetry (POx) screening is an effective strategy for reducing paediatric morbidity and mortality rates and has been adopted by much of the developed world. To document the feasibility of implementing pre-discharge POx screening in well babies born at Mowbray Maternity Hospital, a busy government hospital in Cape Town, South Africa. Parent and staff acceptance was assessed. We conducted a prospective study of predischarge POx screening in one postnatal ward, following informed parental consent. During the 4-month study period, 1 017 of 2 256 babies discharged (45.1%) were offered POx screening and 1 001 were screened; 94.0% of tests took <3 minutes to perform, 4.3% 3 - 5 minutes and 1.7% >5 minutes. Eighteen patients needed second screens and three required third screens. Only 3.1% protocol errors were made, all without consequence. The vast majority (91.6%) of nursing staff reported insufficient time to perform the study screening in addition to their daily tasks, but ~75% felt that with a full nursing staff complement and if done routinely (not part of a study), pre-discharge POx screening could be successfully instituted at our facility. Over 98% of the mothers had positive comments. Two babies failed screening and required echocardiograms; one was diagnosed with CCHD and the other with neonatal sepsis. The sensitivity and specificity were 50% (95% confidence interval (CI) 1.3 - 98.7%) and 99.9% (95% CI 99.4 - 100%), respectively, with a percentage correct of 99.8%. POx screening was supported and accepted by staff and parents. If there are no nursing staff shortages and if it is done routinely before discharge, not as part of a study, we conclude that POx screening could be implemented successfully without excessive false positives or errors, or any additional burden to cardiology services.

  16. Does outsourcing affect hospital profitability?

    Science.gov (United States)

    Danvers, Kreag; Nikolov, Pavel

    2010-01-01

    Organizations outsource non-core service functions to achieve cost reductions and strategic benefits, both of which can impact profitability performance. This article examines relations between managerial outsourcing decisions and profitability for a multi-state sample of non-profit hospitals, across 16 states and four regions of the United States. Overall regression results indicate that outsourcing does not necessarily improve hospital profitability. In addition, we identify no profitability impact from outsourcing for urban hospitals, but somewhat positive effects for teaching hospitals. Our regional analysis suggests that hospitals located in the Midwest maintain positive profitability effects with outsourcing, but those located in the South realize negative effects. These findings have implications for cost reduction efforts and the financial viability of non-profit hospitals.

  17. Truth telling in a South African tertiary hospital | Vangu | South ...

    African Journals Online (AJOL)

    Introduction. Truth telling forms part of the contemporary debate in clinical bioethics and centres around the right of the patient to receive honest information concerning his or her medical condition/illness and the duty of the doctor to give this information to the patient. Many patients complain that they are not being informed, ...

  18. South Korea

    International Nuclear Information System (INIS)

    Hayes, P.

    1990-01-01

    South Korea aspires to become a major nuclear supplier in the world nuclear market. There is no doubt that South Korea has great potential to fulfill these aspirations. South Korea is well positioned in terms of competitiveness, market relationships, institutional capability, ability to deliver, and commitment to nonproliferation values. As a mercantilist state, South Korea hopes to capitalize on its close relationships with transnational nuclear corporations in this endeavor. It hopes to participate in two- or three-way joint ventures---especially with the American firms that have traditionally predominated in the South Korean domestic nuclear business---to market their nuclear wares abroad. This paper is divided into four parts. The first section describes South Korea's intent to become a nuclear supplier in the 1990s. It delineates the networks of prior transactions and relationships that South Korea may use to penetrate export markets. The second section reviews South Korea's nuclear export potential, particularly its technological acquisitions from the domestic nuclear program. These capabilities will determine the rate at which South Korea can enter specific nuclear markets. The third section describes the institutional framework in South Korea for the review and approval of nuclear exports

  19. South African Gastroenterology Review: Editorial Policies

    African Journals Online (AJOL)

    Auckland Park 2006. South Africa Dr John P Wright Kingsbury Hospital 301 Fairfield Medical Suite Wilderness Road Claremont 7708. South Africa. ISSN: 1812-1659. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and ...

  20. Acromegaly Presenting with Hemiplegia | Saffer | South African ...

    African Journals Online (AJOL)

    A case of acromegaly presenting with hemiplegia is described. The radiological features, including cerebral angiography, are discussed. Acromegaly is uncommon in the Black population of South Africa. Experience at Baragwanath Hospital (2400 beds) confirms the rarity of the disease, and reference to the South African ...

  1. Hospital staffing and hospital costs.

    Science.gov (United States)

    Andrew, R R

    1976-08-07

    A comparative study of costs per bed per day in teaching hospitals affiliated with Monash University compared with large non-teaching metropolitan hospitals (1964 to 1974) shows they are much higher in teaching hospitals. There is no evidence that this is due to the additional costs arising from the clinical schools. Research in the teaching hospitals and the accompanying high professional standards and demands on services are major factors accounting for the difference. Over the decade studied, the resident staff have increased by 77% and other salaried staff by 24%. The index of expenditure for the three teaching hospitals in the decade has increased by 386%.

  2. South-South Migration and Remittances

    OpenAIRE

    Ratha, Dilip; Shaw, William

    2007-01-01

    South-South Migration and Remittances reports on preliminary results from an ongoing effort to improve data on bilateral migration stocks. It sets out some working hypotheses on the determinants and socioeconomic implications of South-South migration. Contrary to popular perception that migration is mostly a South-North phenomenon, South-South migration is large. Available data from nation...

  3. P17.05 Epidemiology and clinical in patients with primary and secondary lymphomas with a nervous system condition in the South Central Hospital of High Specialty from PEMEX in Mexico

    Science.gov (United States)

    Cordoba Mosqueda, M.; Guerra Mora, J.; Hernandez Resendiz, R.; Loya Aguilar, I.; Vicuña Gonzalez, R.; Ibarra de la Torre, A.; Garcia Gonzalez, U.

    2016-01-01

    Abstract Introduction: Primary lymphomas of the central nervous system are a type of Non Hodgkin Lymphoma with high morbidity and mortality. They are frequently associated with HIV infection, nevertheless the prevalence in non HIV patients has been tripled recently without any justified cause. In occasions it is difficult to identify the difference between primary and secondary origin in the central nervous system, this is crucial since the prognosis also changes. Method and Materials: Observational study with a range of patients from March 1999- March 2016 with reported diagnosis of Non Hodgkin Lymphoma with Central Nervous System involvement inside the electronic files of the South Central Hospital of High Specialty PEMEX. A statistical analysis is made through the SPSS Statistics of the Disease in this Institution program. Results: There were a total of 20 patients found with the diagnosis of Non Hodgkin Lymphoma with Central Nervous System involvement with a media of 57.7 ± 16 years of age, 60% males. 45% were classified as primary; multiple variables were analyzed such as the histological subtype from which the most common was Giant B cell types in a 40%. Within the symptoms the most common was headheach and pyramidal syndrome with 25%. At the time of diagnosis we found that with most prevalence ECOG of the population was of 1 reported case of 55 % of patients, nevertheless the survival rate after diagnosis had a global media of 40.3 ± 21 months, being of 56 months in secondary lymphoma and of 16 months in primary lymphoma, there were no significant statistical differences in both groups. Conclusions: The clinical and epidemiological characteristics in both groups were similar to the ones reported in the literature, nonetheless compared with the time of diagnosis based on the ECOG the overall rate of survival in both groups is low, which brings a great challenge for medical and surgical management. It is important to denote that the clinical

  4. Sedating children in South Africa

    African Journals Online (AJOL)

    bRed Cross War Memorial Children's Hospital, Cape Town, South Africa. cSedation and Pain ... As the authors indicate, there is increasing pressure from practitioners, funders and patients or parents for procedures to take place outside the ...

  5. South Africa

    DEFF Research Database (Denmark)

    Brixen, Peter; Tarp, Finn

    1996-01-01

    This paper explores the macroeconomic situation and medium-term perspectives of the South African economy. Three fully quantified and internally consistent scenarios are presented. The projections demonstrate that there is room for increased public spending in real terms to help address South Afr...... macro-economic balance and avoid unsustainable public sector deficits...

  6. South Africa

    DEFF Research Database (Denmark)

    Brixen, Peter; Tarp, Finn

    1996-01-01

    This paper explores the macroeconomic situation and medium-term perspectives of the South African economy. Three fully quantified and internally consistent scenarios are presented. The projections demonstrate that there is room for increased public spending in real terms to help address South Afr...... macro-economic balance and avoid unsustainable public sector deficits....

  7. Typical occupational accidents with employees of a university hospital in the south of Brazil: epidemiology and prevention Accidentes de trabajo típicos de trabajadores de un hospital universitario de la región sur de Brasil: epidemiología y prevención Acidentes de trabalho típicos envolvendo trabalhadores de hospital universitário da região sul do Brasil: epidemiologia e prevenção

    Directory of Open Access Journals (Sweden)

    Iara Aparecida de Oliveira Sêcco

    2008-10-01

    Full Text Available Descriptive epidemiologic study that aimed to analyze the typical occupational accidents notified by employees of a university hospital in the South of Brazil from 1997 to 2002, and to estimate their risk indicators. A total of 717 accidents were registered; 86% of them (616 were typical and presented an annual average risk coefficient of 6.0 per 100 employees. The groups that presented more risks for accidents were cooks, woodworkers and nursing auxiliaries, while hands were the most affected area. Regarding the accidents nature, the greatest risks involved biological material. Hence, it is necessary to orient personnel about the legal aspects of occupational accidents and review work processes, especially those related to employees who perform activities at greater risk of transmissible diseases like AIDS and hepatitis B and C.Se trata de un estudio epidemiológico descriptivo que tuvo como objetivo analizar los accidentes de trabajo típicos notificados por los trabajadores de un hospital universitario de la región sur de Brasil, de 1997 a 2002 y estimar indicadores de riesgo. Fueron notificados 717 accidentes, siendo 86% (616 típicos, cuyo Coeficiente de Riesgo Promedio Anual fue igual a 6,0 accidentes a cada 100 trabajadores. Los equipos que corrieron los mayores riesgos de sufrir tales accidentes fueron los de los cocineros, carpinteros y auxiliares de enfermería, siendo las manos la parte del cuerpo más afectada. En cuanto a la naturaleza de los accidentes, los de mayor riesgo fueron los relacionados a materiales biológicos. Se constató la necesidad de orientar al personal sobre los aspectos legales de los accidentes y revisar los procesos de trabajo desarrollados, especialmente para los que actúan en funciones cuyos riesgos son mayores de contraer enfermedades graves como SIDA y Hepatitis B y C.Estudo epidemiológico descritivo objetivou analisar os acidentes de trabalho típicos notificados pelos trabalhadores de um hospital

  8. South-South medical tourism and the quest for health in Southern Africa.

    Science.gov (United States)

    Crush, Jonathan; Chikanda, Abel

    2015-01-01

    Intra-regional South-South medical tourism is a vastly understudied subject despite its significance in many parts of the Global South. This paper takes issue with the conventional notion of South Africa purely as a high-end "surgeon and safari" destination for medical tourists from the Global North. It argues that South-South movement to South Africa for medical treatment is far more significant, numerically and financially, than North-South movement. The general lack of access to medical diagnosis and treatment in SADC countries has led to a growing temporary movement of people across borders to seek help at South African institutions in border towns and in the major cities. These movements are both formal (institutional) and informal (individual) in nature. In some cases, patients go to South Africa for procedures that are not offered in their own countries. In others, patients are referred by doctors and hospitals to South African facilities. But the majority of the movement is motivated by lack of access to basic healthcare at home. The high demand and large informal flow of patients from countries neighbouring South Africa has prompted the South African government to try and formalise arrangements for medical travel to its public hospitals and clinics through inter-country agreements in order to recover the cost of treating non-residents. The danger, for 'disenfranchised' medical tourists who fall outside these agreements, is that medical xenophobia in South Africa may lead to increasing exclusion and denial of treatment. Medical tourism in this region and South-South medical tourism in general are areas that require much additional research. Copyright © 2014. Published by Elsevier Ltd.

  9. AIDS in South Africa.

    Science.gov (United States)

    Ijsselmuiden, C; Evian, C; Matjilla, J; Steinberg, M; Schneider, H

    1993-01-01

    The National AIDS Convention in South Africa (NACOSA) in October 1992 was the first real attempt to address HIV/AIDS. In Soweto, government, the African National Congress, nongovernmental organizations, and organized industry and labor representatives worked for 2 days to develop a national plan of action, but it did not result in a united effort to fight AIDS. The highest HIV infection rates in South Africa are among the KwaZulu in Natal, yet the Inkatha Freedom Party did not attend NACOSA. This episode exemplifies the key obstacles for South Africa to prevent and control AIDS. Inequality of access to health care may explain why health workers did not diagnose the first AIDS case in blacks until 1985. Migrant labor, Bantu education, and uprooted communities affect the epidemiology of HIV infection. Further, political and social polarization between blacks and whites contributes to a mindset that AIDS is limited to the other race which only diminishes the personal and collective sense of susceptibility and the volition and aptitude to act. The Department of National Health and Population Development's voluntary register of anonymously reported cases of AIDS specifies 1517 cumulative AIDS cases (October 1992), but this number is low. Seroprevalence studies show between 400,000-450,000 HIV positive cases. Public hospitals cannot give AIDS patients AZT and DDI. Few communities provided community-based care. Not all hospitals honor confidentiality and patients' need for autonomy. Even though HIV testing is not mandatory, it is required sometimes, e.g., HIV testing of immigrants. AIDS Training, Information and Counselling Centers are in urban areas, but not in poor areas where the need is most acute. The government just recently developed in AIDS education package for schools, but too many people consider it improper, so it is not being used. The poor quality education provided blacks would make it useless anyhow. Lifting of the academic boycott will allow South African

  10. Telehealth-based model of care redesign to facilitate local fitting and management of patients with a spinal fracture requiring a thoracic lumbar sacral orthosis in rural hospitals in New South Wales.

    Science.gov (United States)

    Gallagher, Ryan; Giles, Michelle; Morison, Jane; Henderson, Judith

    2018-03-23

    To develop and implement a telehealth-based model of care for spinal fractures requiring management with thoracic lumbar sacral orthoses that eliminates the need for transfer to a metropolitan tertiary referral hospital. Pre-post design observational study evaluating model of care implementation. Rural referral hospitals in a large NSW region covering metropolitan, rural and remote hospitals. Patients presenting with a thoracic or lumbar spine fracture requiring thoracic lumbar sacral orthoses management and rural clinicians caring for them. Number of patients managed in rural hospitals without transfer to a metropolitan tertiary referral hospital; length of stay and related cost efficiencies; clinicians' perceived skills, knowledge and confidence levels. Model of care was implemented with clinical and system governance processes; and educational workshops across eight rural hospitals. A total of 81 patients managed in rural hospitals under this model between July 2013 and June 2016 without transfer were included in this study. Mean length of stay reduced from nine to four days. Hospital transfers were eliminated from the patient journey, totalling 24 324 km. Workshops were attended by 71 clinicians from nine rural hospitals and survey findings indicated a significant increase in staff knowledge, skill and confidence post education. Cost efficiencies were gained by eliminating 162 inter-hospital transfers and 405 patient bed days. This model has streamlined patient journeys and reduced transfers and travel, enabling rural clinicians to provide specialised services in local communities and facilitating timely evidence-based care in local communities without any adverse events. © 2018 National Rural Health Alliance Ltd.

  11. South Africa

    International Development Research Centre (IDRC) Digital Library (Canada)

    Cathy Egan

    prompted in part by the growth of the anti-apartheid movement. ... showing a new degree of organizational capacity and power in South Africa and among .... leading institutions in the generation and application of new knowledge to meet.

  12. Hospital Inspections

    Data.gov (United States)

    U.S. Department of Health & Human Services — Welcome to hospitalinspections.org, a website run by the Association of Health Care Journalists (AHCJ) that aims to make federal hospital inspection reports easier...

  13. Hospital marketing.

    Science.gov (United States)

    Carter, Tony

    2003-01-01

    This article looks at a prescribed academic framework for various criteria that serve as a checklist for marketing performance that can be applied to hospital marketing organizations. These guidelines are drawn from some of Dr. Noel Capon of Columbia University's book Marketing Management in the 21st Century and applied to actual practices of hospital marketing organizations. In many ways this checklist can act as a "marketing" balanced scorecard to verify performance effectiveness and develop opportunities for innovation.

  14. South Africa

    International Nuclear Information System (INIS)

    Fischer, D.

    1990-01-01

    This paper reports that South Africa's main reason for entering the international nuclear market is, and always has been, to sell its uranium abroad. From 1939-45 South Africa took part in the war against Nazi Germany, and the South African government of the time sought to help the Allied war effort in all ways that were practical. Later, during the Cold War, it tried to help build up the West's nuclear arsenal. In 1944, the British government secretly asked General Smuts---prime minister of South Africa since 1939 and a member of Churchill's War Cabinet---to survey South Africa's deposits of uranium. The survey, carried out with U.S. and British help, showed that the deposits were large, generally low-grade, but, in most cases, associated with gold and therefore could be profitably mined. In 1951, South Africa became a significant producer, with lucrative contracts for the sale of all its output to the U.S.-U.K.-Canada Joint Development Agency and one of the three main suppliers to the U.S. nuclear weapons program. In time, government controls eased and uranium production and marketing became a purely commercial operation

  15. Population structure analyses of Staphylococcus aureus at Tygerberg Hospital, South Africa, reveals a diverse population, a high prevalence of Panton-Valentine leukocidin genes, and unique local methicillin-resistant S. aureus clones

    NARCIS (Netherlands)

    Oosthuysen, W. F.; Orth, H.; Lombard, C. J.; Sinha, B.; Wasserman, E.

    Studies reporting on the population structure of Staphylococcus aureus in South Africa have focused only on methicillin-resistant S. aureus (MRSA). This study describes the population structure of S. aureus, including methicillin-susceptible S. aureus (MSSA) isolated from patients at Tygerberg

  16. Academic Hospitality

    Science.gov (United States)

    Phipps, Alison; Barnett, Ronald

    2007-01-01

    Academic hospitality is a feature of academic life. It takes many forms. It takes material form in the hosting of academics giving papers. It takes epistemological form in the welcome of new ideas. It takes linguistic form in the translation of academic work into other languages, and it takes touristic form through the welcome and generosity with…

  17. Hospital Presbiteriano Valley

    Directory of Open Access Journals (Sweden)

    Luckman, Charles

    1964-12-01

    Full Text Available This hospital is built on the circular system. This arrangement has economic and functional advantages. The nurses walk 40 % less distance than in a hospital of similar size, of conventional layout. The rooms are situated along the external perimeter and the beds are orientated towards the corridor, rather than towards the window. However, the patients can see out of doors by turning on their side. The hospital is most carefully fitted out, and is very comfortable. There is air conditioning, and patients can control their own TV sets. There are also curtains separating each bed form the rest, thus providing maximum independence. Warm colours have been adopted in the decoration of rooms facing north, whilst those facing south are painted in cooler tones. The circular design arrangement makes the distribution far more flexible, and it will be easier to include further units later on; by adding small adjustments to the central building. To reduce external noise, and to improve the surrounding landscape, small sand hills have been provided in the garden, and the parking site also serves to partially absorb the noise.Presenta esta solución de unidades circulares numerosas ventajas de tipo económico, ahorra espacio y da eficiencia a la circulación— las enfermeras recorren un 40 por 100 menos de camino que en otro hospital de dimensiones similares—. Las habitaciones están distribuidas a lo largo del perímetro exterior y tienen las camas orientadas hacia los corredores, en lugar de hacia las ventanas, pero de tal modo que los pacientes puedan contemplar el exterior al volverse sobre uno de sus costados. Están cuidadosamente diseñadas y dotadas de las máximas comodidades: aire acondicionado y aparatos de televisión controlados por el paciente; así como cortinas divisorias que le proporcionan el grado de aislamiento deseado.

  18. Hospitality and hostility in hospitals

    DEFF Research Database (Denmark)

    Jensen, Tina Blegind; Aanestad, Margunn

    2007-01-01

    The purpose of this paper is to discuss the adoption of healthcare information systems (HIS) from a user perspective. Our case study concerns how a group of orthopaedic surgeons experienced and reacted to the adoption and mandatory use of an Electronic Patient Record system in a Danish hospital. We...... propose to use the concepts of hospitality and hostility to turn our attention to the interaction between the host (the surgeons) and the guest (the information system) and consider how the boundaries between them evolved in the everyday work practices. As an alternative to previous studies on technology...

  19. South Africa

    Science.gov (United States)

    2002-01-01

    This true-color image of South Africa was acquired on May 14, 2000, by NASA's Moderate-resolution Imaging Spectroradiometer, or MODIS. The image was produced using a combination of the sensor's 250-m and 500-m resolution visible wavelength bands. As part of the opening ceremony to begin the joint U.S.-South Africa SAFARI Field Experiment, NASA presented print copies of this image as GIFts to Dr. Ben Ngubane, Minister of Arts, Science and Technology, and Honorable Advocate Ngoaka Ramathlodi, Premier of the Northern Province, South Africa. The area shown in this image encompasses seven capital cities and a number of the region's distinctive geological features can be seen clearly. Toward the northern (top) central part of the image, the browns and tans comprise the Kalahari Desert of southern Botswana. The Tropic of Capricorn runs right through the heart of the Kalahari and the Botswanan capital city of Gaborone sits on the Limpopo River, southeast of the Kalahari. Along the western coastline of the continent is the country of Namibia, where the Namib Desert is framed against the sea by the Kaokoveld Mountains. The Namibian capital of Windhoek is obscured by clouds. Looking closely in the center of the image, the Orange River can be seen running from east to west, demarcating the boundary between Namibia and South Africa. On the southwestern corner of the continent is the hook-like Cape of Good Hope peninsula and Cape Town, the parliamentary capital of South Africa. Running west to east away from Cape Town are the Great Karroo Mountains. The shadow in this image conveys a sense of the very steep grade of the cliffs along the southern coast of South Africa. Port Elizabeth sits on the southeasternmost point of South Africa, and a large phytoplankton bloom can be seen in the water about 100 miles east of there. Moving northward along the east coast, the Drakensberg Mountains are visible. The two small nations of Lesotho and Swaziland are in this region, completely

  20. Hospital Malnutrition

    OpenAIRE

    Asumadu-Sarkodie, Samuel

    2012-01-01

    Malnutrition seen in hospitals usually occurs as some form of protein-energy malnutrition (PEM). Primary PEM results from an acute or chronic deficiency of both protein and calories. Secondary PEM, or cachexia, results from a disease or medical condition such as cancer or gastrointestinal disease that alters requirements or impairs utilization of nutrients. This record was migrated from the OpenDepot repository service in June, 2017 before shutting down.

  1. Twin deliveries in Sacred Heart Catholic Hospital Obudu ...

    African Journals Online (AJOL)

    Background: Twin pregnancy is associated with increased risk of obstetric complications as well as increased perinatal mortality rate. The study aims to determine the incidence and outcome of twin pregnancy in a rural/semi urban hospital which provide secondary level obstetric services in South- south Nigeria. Method: ...

  2. Qualidade da atenção básica mediante internações evitáveis no Sul do Brasil Quality of primary care as measured by preventable hospitalizations in the South of Brazil

    Directory of Open Access Journals (Sweden)

    Juvenal Soares Dias-da-Costa

    2008-07-01

    Full Text Available Realizou-se estudo para avaliar mediante taxa de internações hospitalares evitáveis a qualidade dos cuidados oferecidos pela rede básica de saúde em Pelotas, Rio Grande do Sul, Brasil, no período entre 1995 a 2004. Foram consideradas como internações evitáveis: diabetes mellitus, insuficiência cardíaca, hipertensão arterial sistêmica, doença pulmonar obstrutiva crônica e doenças imunopreveníveis (poliomielite, difteria, tétano, coqueluche, sarampo. Foram incluídos homens e mulheres de 20 a 59 anos. Os percentuais entre as mulheres foram superiores aos encontrados nos homens. Foi observada uma diminuição dos percentuais de internações tanto nos homens como nas mulheres no decorrer do período. Mesmo após a padronização direta revelou-se que as taxas de internação de Pelotas foram inferiores às do Rio Grande do Sul. Os custos das hospitalizações evitáveis acompanharam a queda observada nas taxas de internações. Aparentemente, a diminuição verificada nas taxas de internações evitáveis pode estar relacionada à qualificação dos serviços de atenção básica. Contudo, os resultados podem ser conseqüências do financiamento do sistema de saúde. Os valores de pagamento desses procedimentos são baixos e podem estar direcionando os hospitais a uma diminuição da oferta de leitos.This study assessed the quality of primary care in Pelotas, Rio Grande do Sul, Brazil, through preventable hospitalization rates (1995-2004. Preventable hospitalizations were defined as those related to the following diseases: diabetes mellitus, congestive heart failure, hypertension, chronic obstructive pulmonary disease, and vaccine-preventable diseases (polio, diphtheria, tetanus, whooping cough, and measles. Men and women from 20 to 59 years of age were included in the study. The proportion of preventable causes among hospital admissions was higher for women than for men. From 1995 to 2004 there was a decrease in preventable

  3. Childbirth in South Sudan: Preferences, practice and perceptions in ...

    African Journals Online (AJOL)

    b American Refugee Committee International, Juba, South Sudan ... at birth in the three county catchment areas of Kapoeta Civil Hospital. .... oblige him to offer an animal sacrifice. ... the 140th American Public Health Association Annual.

  4. Forensic telepsychiatry : a possible solution for South Africa?

    African Journals Online (AJOL)

    psychiatrists in South Africa to meet the country's needs. There are even fewer .... criminal justice system to hospital and or community mental health placements ... administrative meetings, other judicial activities and other clinical services4,9 ...

  5. Commitment and the emigration intentions of South African ...

    African Journals Online (AJOL)

    2013-03-11

    Mar 11, 2013 ... 500 South African registered nurses working abroad, whilst 32 000 ... nurses (N= 419), working within public sector tertiary hospitals in the Western Cape, responded ..... Managers do, however, have control over the culture.

  6. Sepsis: Primary indication for peripartum hysterectomies in a South ...

    African Journals Online (AJOL)

    Background. Peripartum hysterectomies are lifesaving procedures but definitions vary. Indications are variable and dependant on resources and geographical factors. Objectives. To evaluate the incidence, aetiology and complications associated with peripartum hysterectomies in a tertiary hospital in South Africa. Methods.

  7. South Africa

    International Nuclear Information System (INIS)

    2002-01-01

    This document provides information on the status of institutional and financial arrangements in South Africa for the long term management of HLW and SNF, It includes the following elements: A consistent set of requirements for the technical and legal infrastructure including: funding, liability, institutional control, records management, and research activities; An organizational structure with clearly defined responsibilities; and Provisions for participation by interested parties in decisions and outcomes

  8. South Africa

    African Journals Online (AJOL)

    Even towards the end of the 19th century, the removal of circulating blood from the body (blood-letting) .... Brooks,8 discussing the situation in the USA, opined that allowing openly homosexual men to donate .... Some private hospitals in the USA have their own blood banks and are well placed to deal directly with patients ...

  9. Tolerability and efficacy of single dose albendazole, diethylcarbamazine citrate (DEC) or co-administration of albendazole with DEC in the clearance of Wuchereria bancrofti in asymptomatic microfilaraemic volunteers in Pondicherry, South India: a hospital-based study

    OpenAIRE

    Pani, SP; Subramanyam Reddy, G; Das, LK; Vanamail, P; Hoti, SL; Ramesh, J; Das, PK

    2002-01-01

    Background The tolerability and efficacy of single dose albendazole (400 mg), diethylcarbamazine citrate (DEC) (6 mg/kg bodyweight) or co-administration of albendazole (400 mg) + DEC (6 mg/kg bodyweight) was studied in 54 asymptomatic Wuchereria bancrofti microfilaraemic volunteers in a double blind hospital-based clinical study. Results There was no significant difference in the overall incidence of adverse reactions between the three drug groups [42.1% (albendazole), 52.9% (DEC) and 61.1% (...

  10. Setting up a child eye care centre: the Mercy Eye Hospital, Abak ...

    African Journals Online (AJOL)

    Aim: To document and share our experience in setting up a Child Eye Care Centre within a rural mission eye hospital and document subsequent development of services. Method: The location of the project was Mercy Eye Hospital (MEH) Abak, Akwa Ibom State in the South South zone of Nigeria). Consent to commence ...

  11. Do South African universities provide the required training platforms ...

    African Journals Online (AJOL)

    Background. Concern exists about the quality of specialist training platforms at South African universities and teaching hospitals. Method. We conducted an audit of the quality of training at South African otolaryngology (ENT) training institutions from the perspective of the registrars. Results. Some institutions were deficient in ...

  12. Maternal and perinatal mortality figures in 249 South African ...

    African Journals Online (AJOL)

    the PMR for the black population is considerably hi9her than for the other ethnic groups. That said, perinatal mortality levels in South African blacks still compare favourably with figures from other African cQuntries.12. In conclusion, the MMRs and PMRs found in our survey of. 249 South African hospitals - though not truly.

  13. Economic analysis of intravenous immunoglobulin and plasma exchange therapies for the treatment of Guillain-Barré Syndrome in a university-based hospital in the South of Brazil

    Directory of Open Access Journals (Sweden)

    Alexandre Paulo Machado de Brito

    2011-10-01

    Full Text Available Introduction: Direct costs for treating Guillain-Barré Syndrome (GBS represent a significant financial burden to public hospitals. Few studies compared the cost of plasma exchange (PE treatment with human intravenous immunoglobulin (IVIg. Objectives: To compare the cost of two therapies for GBS: IVIg and PE. Secondary objective was to evaluate compliance to IVIg prescription guidelines of the Pharmacy and Therapeutics Committee (PTC. Methods: A cross-sectional study included 25 patients with GBS admitted in a university affiliated hospital from June, 2003 through June, 2008. The costs of IVIg (n=20 and PE (n=5 were evaluated through the cost minimization method, considering direct medical costs yield by the management of the institution. Patients receiving treatments other than PE or IVIg were excluded. Data were collected by medical records review. Clinical endpoint was disability on discharge, established by the 7-point scale of Hughes. Compliance to the PTC guidelines was evaluated considering the dose and prescription regime of IVIg. Results: Twenty-five participants, ranging from 2 to 70 years of age, were included. No difference occurred in any medical variables related to the treatment or in the main clinical outcome measured by the Hughes’ scale. The mean direct cost of PE treatment was US$ 6,059± 1,701 per patient, and the same expense for IVIg was US$ 18,344±12,259 (P = 0.035. Total inpatient cost was US$ 25,730± 18,714 in the PE group, and 34,768± 27,766 (p=0.530 in the IVIg group. Conclusions: In a university-based hospital, PE is equally effective and less expensive than IVIg to treat GBS.

  14. The case of Gauteng, South Africa

    African Journals Online (AJOL)

    Adele

    patients and downsizing of hospitals, but also the develop- ment of alternative ... certain minimum number of chronic beds and the resources to adequately care ... pressed despite evidence of extreme deficiencies in the qual- ity of institutional ... health care inherited by the new South African administration in 1994, as well ...

  15. South African Music Studies

    African Journals Online (AJOL)

    SAMUS: South African Music Studies is the official organ for the South African ... Shifty Records in Apartheid South Africa: Innovations in Independent Record ... Experiences of Belonging and Exclusion in the Production and Reception of ...

  16. Toilet training practices in Nigerian children | Solarin | South African ...

    African Journals Online (AJOL)

    Background. This study reports on toilet training with a focus on the effect of age, methods used, and factors that can affect urinary incontinence in Nigerian children. Methods. This was a cross-sectional hospital-based study carried out in public and private hospitals in South-Western Nigeria. A questionnaire was used to ...

  17. System delays in breast cancer | Dalwai | South African Journal of ...

    African Journals Online (AJOL)

    Background: Centralised multidisciplinary management of breast cancer occurs in KwaZulu-Natal, South Africa, and requires a diagnostic and staging pathway at the referring hospital. Delays in this pathway are unknown. This study, conducted at a referring hospital, R K Khan (RKK), quantifies and analyses these delays.

  18. Assessment of the effectiveness of a home-based care program for patients coinfected with tuberculosis and human immunodeficiency virus after discharge from a reference hospital in South-Eastern Brazil

    Directory of Open Access Journals (Sweden)

    Carlos Alessandro Plá Bento

    Full Text Available The effectiveness of tuberculosis treatment delivered by a home-based care program to patients coinfected with HIV was compared with that of a service provided by outpatient departments. A retrospective study was made of a cohort of coinfected patients discharged from hospital between January 1998 and December 2002 who had been followed-up for one year within one of these programs. Two-hundred-and-forty-three patients who met the inclusion criteria were grouped according to their treatment program (group 1 received home-based care; group 2 attended outpatient departments and then paired one-to-one across the groups by gender, age and level of education. Only 48 patients from each group could be paired. Apart from the duration of HIV infection, there were no statistically significant differences (P < 0.05 between patients in the two groups with respect to social-demographic status and clinical or laboratory characteristics. In group 1, 75.0% of patients attained successful tuberculosis treatment compared with 72.9% of those in group 2 (P = 0.816. Treatment was abandoned by 22.9% of patients in group 1 and by 54.2% of those in group 2 (P = 0.008. The death rate within one year after discharge was 20.8% for group 1 compared with 6.3% for group 2 (P = 0.334. Although both programs achieved a similar success rate in the treatment of tuberculosis, patients receiving outpatient care were three to eight-times more likely to abandon the program. The importance of assigning patients at-risk of abandoning treatment to a home-based care program after discharge from hospital is emphasized.

  19. Port Harcourt Medical Journal - Vol 7, No 1 (2013)

    African Journals Online (AJOL)

    Editorial: Quality assurance in health care delivery · EMAIL FULL TEXT EMAIL FULL TEXT ... An audit of acquired external auditory meatal stenosis/atresia: Problems of ... Assessment of school health services in Calabar, South-South Nigeria ...

  20. Hospital Outpatient PPS Partial Hospitalization Program LDS

    Data.gov (United States)

    U.S. Department of Health & Human Services — Hospital Outpatient Prospective Payment System (OPPS) Partial Hospitalization Program LDS This file contains select claim level data and is derived from 2010 claims...

  1. Can hospitals compete on quality? Hospital competition.

    Science.gov (United States)

    Sadat, Somayeh; Abouee-Mehrizi, Hossein; Carter, Michael W

    2015-09-01

    In this paper, we consider two hospitals with different perceived quality of care competing to capture a fraction of the total market demand. Patients select the hospital that provides the highest utility, which is a function of price and the patient's perceived quality of life during their life expectancy. We consider a market with a single class of patients and show that depending on the market demand and perceived quality of care of the hospitals, patients may enjoy a positive utility. Moreover, hospitals share the market demand based on their perceived quality of care and capacity. We also show that in a monopoly market (a market with a single hospital) the optimal demand captured by the hospital is independent of the perceived quality of care. We investigate the effects of different parameters including the market demand, hospitals' capacities, and perceived quality of care on the fraction of the demand that each hospital captures using some numerical examples.

  2. The prevalence and risk factors for Trichomonas vaginalis infection amongst human immunodeficiency virus-infected pregnant women attending the antenatal clinics of a university teaching hospital in Lagos, South-Western, Nigeria.

    Science.gov (United States)

    Ijasan, Olaolopin; Okunade, Kehinde Sharafadeen; Oluwole, Ayodeji Ayotunde

    2018-01-01

    Trichomonas vaginalis infection is the most prevalent non-viral sexually transmitted infection worldwide. Interactions between this infection and human immunodeficiency virus (HIV) may cause adverse pregnancy outcomes such as preterm labour, premature rupture of membranes, chorioamnionitis, low birth weight and post-abortal sepsis. This study was aimed to determine the prevalence and risk factors of T. vaginalis infection amongst HIV-positive pregnant women attending antenatal care at the Lagos University Teaching Hospital (LUTH), Lagos, Nigeria. This was an analytical cross-sectional study in which 320 eligible participants which included 160 HIV-positive (case group) and 160 HIV-negative (control group) pregnant women were recruited at the antenatal clinic of LUTH. A structured pro forma was used to collect data from consenting participants after which high vaginal swabs were collected, processed and examined for T. vaginalis. The association between categorical variables was tested using the Chi-square test and Fisher's exact test where applicable. All significances were reported at P women were 10% and 8.1%, respectively (P = 0.559). Significant risk factors for T. vaginalis infection in the HIV-positive pregnant women were early coitarche (P women for T. vaginalis infection as a tool of reducing HIV acquisition, especially in pregnancy, campaign to create better sexual health awareness should be commenced as a way to contributing to the reduction in T. vaginalis infection during pregnancy and perinatal transmission of HIV.

  3. Help prevent hospital errors

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000618.htm Help prevent hospital errors To use the sharing features ... in the hospital. If You Are Having Surgery, Help Keep Yourself Safe Go to a hospital you ...

  4. Association of microRNA-125a and microRNA-499a polymorphisms in chronic periodontitis in a sample south Indian population: A hospital-based genetic association study.

    Science.gov (United States)

    Venugopal, Priyanka; Lavu, Vamsi; Rao, Suresh Ranga; Venkatesan, Vettriselvi

    2017-10-05

    Periodontitis is a chronic inflammatory disease, caused by interaction between periodontopathic bacteria and the host immune response. MicroRNAs are small, single-stranded molecules, which play a key role in the regulation of diverse biological processes. Dysregulation of microRNAs function can lead to several diseases such as autoimmune and chronic inflammatory diseases. The objective of the study was to determine the association between selected single nucleotide polymorphisms in miR-125a, miR-499 and LIN28 homology A with chronic periodontitis susceptibility in a sample population from south India. Genotyping of the single nucleotide polymorphisms in miR-125a (rs41275794, rs12976445, rs10404453 and rs12975333), miR-499 (rs3746444) and LIN28 homolog A (rs3811463) was performed in DNA from288 controls (individuals with healthy gingiva) and 262 cases (chronic periodontitis patients) by direct dye-terminator sequencing. Disease association analysis revealed a significant association of the variant alleles of the miR-499a polymorphism (rs3746444) in chronic periodontitis [OR=2.07; 95%CI (1.35-3.17)]. The risk associated C-allele frequency was found to be higher in chronic periodontitis subjects as compared to that of healthy individuals. Similar results were also observed in the dominant model [OR=2.42; 95% CI (1.67-3.51)]. The recessive model for miR-125a polymorphism (rs12976445) was also found to be statistically significant with OR=1.54 and 95% CI (1.03-2.30). The haplotype "GCGGCA" was found to be higher in chronic periodontitis subjects than in healthy individuals. Pairwise linkage disequilibrium analysis exhibited that the polymorphisms, rs41275794 and rs12976445 in miR-125a, were in strong linkage equilibrium (D'=0.97). Epistatic interaction by multifactorial dimensionality reduction analysis revealed that the genotypes of the polymorphisms of miR-125a (rs41275794, rs12976445, rs10404453), miR-499a (rs3746444) and LIN28 (rs3811463) were interacting

  5. Factors Influencing Utilization of Modern Family Planning Services ...

    African Journals Online (AJOL)

    Factors Influencing Utilization of Modern Family Planning Services among Women of Child Bearing Age (15 - 49 years) in the University of Calabar Teaching Hospital, Calabar. ... Using accidental sampling technique, 150 women of childbearing age were selected to constitute the sample. Data were collected using a ...

  6. The Problems And Prospects Of Family Planning Services In The ...

    African Journals Online (AJOL)

    The focus of this research was to study the problems and prospects of family planning services in the University of Calabar Teaching Hospital, Calabar. The Levels of poverty, income and health education of the clients were studied. The main source of data and information was a structured questionnaire. A sample of 200 ...

  7. Toothache and Self‑Medication Practices: A Study of Patients ...

    African Journals Online (AJOL)

    Department of Dental Surgery, University of Calabar Teaching Hospital, Calabar, 1Department of Oral and Maxillofacial Surgery,. University of Benin ... Background: There is evidence that self‑medication practices among dental patients with toothache are .... is a local anesthetic agent and Tolu of balsam, 1.25%. Other.

  8. A cross-sectional study of quality of life in a cohort of enteral ostomy patients presenting to a tertiary care hospital in a developing country in South Asia.

    Science.gov (United States)

    Jayarajah, Umesh; Samarasekera, Dharmabandhu N

    2017-01-31

    Enteral ostomy creation affects the quality of life (QOL) of stoma patients significantly. Studying the QOL and its determinants is important as it may help in the early identification of those with poor QOL leading to appropriate intervention. This study was aimed to assess the possible contributory factors of QOL of stoma patients. A cross sectional study was conducted among 43 ostomy patients who presented for follow up at a surgical clinic of a tertiary care hospital in Sri Lanka over a period of 1 year. Relevant demographic and ostomy related data were collected using an interviewer administered questionnaire. Stoma quality of life scale (Stoma-QOL) and stoma care self-efficacy scale (SCSE) which are validated questionnaires were used to assess QOL and self-efficacy in managing stoma respectively. Associations were established using independent samples t test and Spearman's correlation. The median age of the study participants was 47.5 years (range 18-83). The median follow up duration was 38 months (range 6-183). The mean overall QOL score was 53.07 ± SD 12.68. Approximately 70% of the study participants scored less than 60. Higher QOL was associated with female sex, colostomies, comfortable income and satisfactory sexual activity. Significantly lower overall QOL was found in those who reported a significant change in the style of dressing (p < 0.05), those who felt depressed (p < 0.05), and those who had thoughts of self-harm soon after surgery (p < 0.05). There was a significant positive correlation between QOL and self-efficacy (p < 0.01). Those who took longer time to learn to take care of the stoma had lower QOL (p < 0.05). The overall QOL score was considerably low in our study. The QOL was significantly associated with self-efficacy which indicates the importance of patient education and training during follow up visits to maintain a higher QOL. Furthermore integrating with other non-surgical specialities to address multi

  9. Cost-effectiveness analysis of three different combinations of inhalers for severe and very severe chronic obstructive pulmonary disease patients at a tertiary care teaching hospital of South India.

    Science.gov (United States)

    Altaf, Mohammed; Zubedi, Ayesha Mubeen; Nazneen, Fareesa; Kareemulla, Shaik; Ali, Syed Amir; Aleemuddin, N M; Hannan Hazari, Md Abdul

    2015-01-01

    This study aims at simplifying the practical patient management and offers some general indications for pharmacotherapeutic choice by the implementation of (Global Initiative for Chronic Lung Disease) guidelines. This study was designed to evaluate the clinical and economic consequences of salmeterol/fluticasone (SF), formoterol/budesonide (FB), and formoterol/fluticasone (FF) in severe and very severe chronic obstructive pulmonary disease (COPD) patients. The aim was to find out the most cost-effective drug combination between the three combinations (SF/FB/FF) in COPD patients. A prospective observational comparative study (cost-effectiveness analysis), in which 90 severe (30 ≤ forced expiratory volume in 1 s [FEV1] days (SFDs), number of moderate and severe exacerbations, Number of days of hospitalization and direct, indirect, and total cost to assess the cost-effectiveness of SF/FB/FF. Comparison of cost and effects was done during the period of 6 months of using SF/FB/FF. The average FEV1 for Group I, Group II, and Group III subjects at initial visit was 33.47%, 33.73%, and 33.20% and was increased to 36.60%, 35.8%, and 33.4%, respectively. A 3% increment in FEV1 was reported for Group I subjects (SF) and was highly significant statistically (t = -8.833, P = 0.000) at 95% CI. For Group II subjects (FB), a 2% increment in FEV1 was reported and was highly significant statistically (t = -9.001, P = 0.000) at 95% CI. For Group III (FF) subjects 0.2% increment in FEV1. The overall mean total cost for Group I, Group II, and Group III subjects during the 6 months period was found to be Rs. 29,725/-, Rs. 32,602/- and Rs. 37,155/-. Incremental cost-effectiveness of FB versus SF was Rs. 37,781/- per avoided exacerbation and Rs. 661/-per SFD. This study highlights the favorable therapeutic performance of combined inhaled bronchodilators and corticosteroids (SF/FB/FF), thus suggesting that healthcare costs would be also affected positively. Results from our study showed

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

    Science.gov (United States)

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

    2015-06-15

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

  11. Hospital marketing revisited.

    Science.gov (United States)

    Costello, M M

    1987-05-01

    With more hospitals embracing the marketing function in their organizational management over the past decade, hospital marketing can no longer be considered a fad. However, a review of hospital marketing efforts as reported in the professional literature indicates that hospitals must pay greater attention to the marketing mix elements of service, price and distribution channels as their programs mature.

  12. Hospital Library Administration.

    Science.gov (United States)

    Cramer, Anne

    The objectives of a hospital are to improve patient care, while the objectives of a hospital library are to improve services to the staff which will support their efforts. This handbook dealing with hospital administration is designed to aid the librarian in either implementing a hospital library, or improving services in an existing medical…

  13. ELEMENTAL FORMS OF HOSPITALITY

    OpenAIRE

    Maximiliano Emanuel Korstanje

    2010-01-01

    Modern studies emphasized on the needs of researching the hospitality as relevant aspects of tourism and hospitality fields. Anyway, these approaches are inextricably intertwined to the industry of tourism and do not take seriously the anthropological and sociological roots of hospitality. In fact, the hotel seems to be a partial sphere of hospitality at all. Under this context, the present paper explores the issue of hospitality enrooted in the political and economic indo-European principle ...

  14. Patient Satisfaction at America’s Lowest Performing Hospitals

    Science.gov (United States)

    Girotra, Saket; Cram, Peter; Popescu, Ioana

    2012-01-01

    BACKGROUND Previous studies have identified hospitals with poor performance on cardiac process measures. How these hospitals fare in other domains such as patient satisfaction remains unknown. METHODS We used Hospital Compare data to identify hospitals that reported acute myocardial infarction (AMI) and heart failure (HF) process measures for 2006–2008 and calculated respective composite performance scores. Using these scores, we classified hospitals as low-performing (bottom decile for all three years), top-performing (top decile for all three years), and intermediate (all others). We used Hospital Consumer Assessment of Healthcare Providers and Systems 2008 data to compare overall satisfaction between low, intermediate, and top-performing hospitals. RESULTS Low-performing hospitals had fewer beds, fewer nurses per-patient, and were more likely rural, safety-net hospitals located in the South, compared to intermediate and top-performing hospitals (Ppatient satisfaction (kappa statisticpatient satisfaction on average suggesting that these hospitals have overall poor quality of care. However, there is discordance between the two measures in profiling hospital quality. PMID:22496113

  15. South African Medical Journal

    African Journals Online (AJOL)

    The South African Medical Journal is published by the South African Medical Association, which represents ... G Watermeyer, S Thomson, 399-402 ... Assessing the value of Western Cape Provincial Government health administrative data and ...

  16. Infraestrutura de biossegurança para agentes biológicos em hospitais do sul do Estado da Bahia, Brasil Infraesctructura de bioseguridad para los agentes biológicos en hospitales del sur del Estado de Bahia, Brasil Biosecurity infrastructure for biological agents in hospitals from the south of Bahia State, Brazil

    Directory of Open Access Journals (Sweden)

    Maridalva de Souza Penteado

    2010-10-01

    én el cuidado con la vida de sus trabajadores.The purpose of the study was to describe the biosecurity infrastructure in hospitals located in the South Region of Bahia State, Brazil. That was a descriptive-exploratory study carried out in commissions hospital infections control and institutional prevention commission of accidents about the existence of written norms, the accomplishment of training, the existence of concernments institutional registers to the biosecurity, and the existence of practical attention to the health of the professionals and isolated patients. Hospitals are compared according to the presence of each one of the itens under analysis as its classification, legal-financial issues, etc. It was conclude that the general situation is precarious regarding the presence of the items investigated, that impels to consider the necessity that must take into account an analysis of hospital quality, and also the care of the life of its workers.

  17. Electricity in South Africa

    International Nuclear Information System (INIS)

    Davis, Mark; Steyn, Grove

    1998-09-01

    Contains Executive Summary and Chapters on: Introductory background; The South African energy sector; The development and regulation of the South African electricity supply industry; Electricity supply and demand; Eskom: South Africa's public utility; Electricity distribution; Household electrification; Regional integration and environmental issues; Regulation and emerging policies - pointers to the future. (Author)

  18. Potential for cadaveric organ retrieval in New South Wales.

    OpenAIRE

    Hibberd, A. D.; Pearson, I. Y.; McCosker, C. J.; Chapman, J. R.; Macdonald, G. J.; Thompson, J. F.; O'Connell, D. L.; Mohacsi, P. J.; McLoughlin, M. P.; Spratt, P. M.

    1992-01-01

    OBJECTIVES--To measure the potential for cadaver organ retrieval in New South Wales and to determine the reasons for potential donors failing to become actual donors. DESIGN--Prospective audit of all patients dying in five hospitals in New South Wales between 1 December 1989 and 30 November 1990; quality assurance of the data by independent medical specialist and if disagreement by study committee. PATIENTS--2879 patients (100% of all deaths) yielding 364 patients with coma and 181 potential ...

  19. Hospitable Classrooms: Biblical Hospitality and Inclusive Education

    Science.gov (United States)

    Anderson, David W.

    2011-01-01

    This paper contributes to a Christian hermeneutic of special education by suggesting the biblical concept of hospitality as a necessary characteristic of classroom and school environments in which students with disabilities and other marginalized students can be effectively incorporated into the body of the classroom. Christian hospitality, seen…

  20. Hospitality Healthscapes: The New Standard for Making Hospitals More Hospitable

    Directory of Open Access Journals (Sweden)

    Courtney Suess Raeisinafchi

    2017-06-01

    Full Text Available What comes to mind when you think of a hospital room? Stark. Sterile. Bare. Clinical. What might it mean for patients if the association with the environment shifted to something like: Comforting. Bright. Elegant. Personal?

  1. Development of an Orientation Program for Mid-level Managers at a Rural Civilian Community Hospital

    National Research Council Canada - National Science Library

    Mullarkey, David

    1998-01-01

    This study's focus was to identify perceived orientation and management development needs of department directors and middle managers at a mid-size, not-for-profit community hospital in Beaufort. south Carolina...

  2. The application of hospitality elements in hospitals.

    Science.gov (United States)

    Wu, Ziqi; Robson, Stephani; Hollis, Brooke

    2013-01-01

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

  3. Community Hospital Telehealth Consortium

    National Research Council Canada - National Science Library

    Williams, Elton

    2004-01-01

    The Community Hospital Telehealth Consortium is a unique, forward-thinking, community-based healthcare service project organized around 5 not-for-profit community hospitals located throughout Louisiana and Mississippi...

  4. The interstices of hospitality

    African Journals Online (AJOL)

    jane.b

    School of Hospitality and Tourism, Anhembi Morumbi University, São Paulo, Brazil ... aspects of hospitality, and the approach of the social sciences, which study the dynamics of ..... in the virtual media, the ritual always begins with an invitation.

  5. Community Hospital Telehealth Consortium

    National Research Council Canada - National Science Library

    Williams, Elton

    2003-01-01

    The Community Hospital Telehealth Consortium is a unique, forward-thinking, community-based healthcare service project organized around 5 not-for-profit community hospitals located throughout Louisiana and Mississippi...

  6. Unplanned Hospital Visits - National

    Data.gov (United States)

    U.S. Department of Health & Human Services — Unplanned Hospital Visits – national data. This data set includes national-level data for the hospital return days (or excess days in acute care) measures, the...

  7. The Hospitable Meal Model

    DEFF Research Database (Denmark)

    Justesen, Lise; Overgaard, Svend Skafte

    2017-01-01

    This article presents an analytical model that aims to conceptualize how meal experiences are framed when taking into account a dynamic understanding of hospitality: the meal model is named The Hospitable Meal Model. The idea behind The Hospitable Meal Model is to present a conceptual model...... that can serve as a frame for developing hospitable meal competencies among professionals working within the area of institutional foodservices as well as a conceptual model for analysing meal experiences. The Hospitable Meal Model transcends and transforms existing meal models by presenting a more open......-ended approach towards meal experiences. The underlying purpose of The Hospitable Meal Model is to provide the basis for creating value for the individuals involved in institutional meal services. The Hospitable Meal Model was developed on the basis of an empirical study on hospital meal experiences explored...

  8. Structural Measures - Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of hospitals and the structural measures they report. A structural measure reflects the environment in which hospitals care for patients, for example, whether...

  9. Hospital Compare - Archived Data

    Data.gov (United States)

    U.S. Department of Health & Human Services — Hospital Compare is a consumer-oriented website that provides information on how well hospitals provide recommended care to their patients. This information can help...

  10. Research in Hospitality Management

    African Journals Online (AJOL)

    Research in Hospitality Management (RHM) is a peer-reviewed journal ... to the quintessential managerial areas of Finance, Human Resources, Operations, ... competency and career development of hospitality management students · EMAIL ...

  11. Community Hospital Telehealth Consortium

    National Research Council Canada - National Science Library

    Williams, Jr, Elton L

    2007-01-01

    The Community Hospital Telehealth Consortium is a unique, forward-thinking, community-based healthcare service project organized around 5 not-for-profit community hospitals located throughout Louisiana and Mississippi...

  12. Telerehabilitation In South Africa – Is There A Way Forward?

    Directory of Open Access Journals (Sweden)

    Maurice Mars

    2011-05-01

    Full Text Available South Africa, like the rest of sub-Saharan Africa, has a disproportionate burden of disease and a shortage of health professionals. Telemedicine has been identified as a possible way of overcoming part of the problem but telemedicine has not been widely adopted. In the public sector hospitals in South Africa which serve 82% of the population there are 2.5 physiotherapists and 2 occupational therapists per 100,000 people served. The extent of telerehabilitation in South Africa is unknown. A literature review of telerehabilitation found no papers from South Africa. A survey of the heads of university departments of physiotherapy, occupational therapy and speech and language pathology revealed limited knowledge of telerehabilitation. Telerehabilitation services are confined to follow-up of patients at some institutions by telephone, fax or email. There is need to raise awareness among therapists if telerehabilitation is to become a reality in South Africa.  Future actions are outlined.

  13. Telerehabilitation in South Africa - is there a way forward?

    Science.gov (United States)

    Mars, Maurice

    2011-01-01

    South Africa, like the rest of sub-Saharan Africa, has a disproportionate burden of disease and a shortage of health professionals. Telemedicine has been identified as a possible way of overcoming part of the problem but telemedicine has not been widely adopted. In the public sector hospitals in South Africa which serve 82% of the population there are 2.5 physiotherapists and 2 occupational therapists per 100,000 people served. The extent of telerehabilitation in South Africa is unknown. A literature review of telerehabilitation found no papers from South Africa. A survey of the heads of university departments of physiotherapy, occupational therapy and speech and language pathology revealed limited knowledge of telerehabilitation. Telerehabilitation services are confined to follow-up of patients at some institutions by telephone, fax or email. There is need to raise awareness among therapists if telerehabilitation is to become a reality in South Africa. Future actions are outlined.

  14. Avaliação Cognitiva de Pacientes Idosos Pós Acidente Vascular Encefálico Isquêmico de um Hospital do Sul de Minas Gerais/ Cognitive Assessment of Elderly Patients After Ischemic Cerebrovascular Accident in a Hospital in the South of Minas Gerais

    Directory of Open Access Journals (Sweden)

    Flaviane Evelin Dias Fernandes

    2014-12-01

    hypertension, with p = 0.032. Although the overall score did not show a statistically significant difference in relation to the time of occurrence of the ischemic stroke, it was found out that the subscale scores of spatial orientation had a statistically significant improvement, p <0.038. Conclusion: Only the spatial orientation subscale had a significant variation in scoring, while the overall scores were within normal limits. It also showed a decline in the cognitive performance among elderly hypertensive patients, although not characterizing a cognitive impairment status defined as dementia. Consequently, the scale can be useful for brief screening at a hospital and a resource in the exploration of cognitive functioning in patients with recent stroke.

  15. Intracardiac air- the "hospital killer' identified? | Smith | South African ...

    African Journals Online (AJOL)

    Venous access is an essential part of caring for the sick neonate. The primary problem with catheters, whether peripherally or centrally placed, is the difficulty in maintaining them, the development of phlebitis and systemic infection, and fluid extravasation. A lesser known complication is the development of venous air ...

  16. Osteosarcoma outcomes at a South African tertiary hospital

    African Journals Online (AJOL)

    presented with advanced disease, to which the authors attributed their poor outcomes compared .... Province, the other SA provinces and other countries accounting for. 16 (26.2%) and 3 (4.9%), .... Author contributions. LL, ZAL, RDK and ML ...

  17. Psychosocial rehabilitation in a chronic care hospital in South Africa ...

    African Journals Online (AJOL)

    prevalent in many parts of the world and guidelines for the use of translators or interpreters has been documented.27 Of course, language should not be .... training and job satisfaction.32 It is also very positive to note this association in this ...

  18. Management of incomplete abortions at South African public hospitals

    African Journals Online (AJOL)

    incomplete abortion can be more effectively and safely managed using ..... rational prescribing of antibiotics, use of blood transfusion and shortening ... emotional volcano. ... Sal FT, NaSS1m J. The need lOT a replOOuctrve health approach.

  19. Breech presentation at a district level hospital in South Africa

    African Journals Online (AJOL)

    2009-03-05

    Mar 5, 2009 ... The results of the Term Breech Trial led the researchers to conclude that the combined ... and methodology of the Term Breech Trial6 and suggestions made that .... gestation), giving an incidence of 2.4%. Three hundred and ...

  20. Uterovaginal prolapse at a University Teaching Hospital in South ...

    African Journals Online (AJOL)

    The mean age of presentation was 51.4± 3.3 years. The mean parity was 4.2± 1.6. Grandmultiparity accounted for 81% of the cases. The most common symptom at presentation was the sensation of a protrusion down the vagina in 32 (76.2%) of the patients. Difficult labour was found to be the most common associated ...

  1. Splenic Operations In A Teaching Hospital, South-Western Nigeria ...

    African Journals Online (AJOL)

    %. Conclusion: As trauma is the most common indication for operations on the spleen, spleen conservation should be practiced more often where open procedures are indicated. Keywords: Splenic operations, Spleen conservation surgery, ...

  2. Utilization of PMTCT services at Juba Teaching Hospital, South Sudan

    African Journals Online (AJOL)

    Six mothers were not using any mode of family planning, one used condoms, one had an IUCD and one used dates. (natural) .... associated with increase in CD4 cell count of 15.1 cells/ .... 2652-14-61http://www.ncbi.nlm.nih.gov/pmc/articles/.

  3. Management of snakebites at a rural South African hospital

    African Journals Online (AJOL)

    Different species have differing proportions of most if not all of .... therapeutic cut wounds, 32 (45.7%) had swelling and 31 (44.3%) had tenderness over .... who I supervised and assisted in converting his MFamMed dissertation into this article.

  4. Chronic active hepatitis at Baragwanath Hospital | Asvat | South ...

    African Journals Online (AJOL)

    Systemic features such as skin rashes (acne, urticaria), bacterial infections and congestive cardiac failure were prominent in the auto-immune type of CAH. The liver was enlarged in the majority of cases. Hepatitis B virus-related CAH showed an absence of tissue nonspecific auto-antibodies. Cirrhosis was present in ...

  5. The role of print advertising in clinical trial recruitment: Lessons from a South African site

    OpenAIRE

    Burgess, Lesley J

    2010-01-01

    Lesley J Burgess, Nicky U SulzerTREAD Research/Cardiology Unit, Department of Internal Medicine, Tygerberg Hospital and Stellenbosch University, Parow, South AfricaObjective: To evaluate the effectiveness of print advertising in our setting in enrolling patients into a study and whether the associated costs are justified.Methods: This study was carried out by TREAD Research, based within an academic hospital in the Western Cape, South Africa, between January 2006 and June 2007. Newspaper adve...

  6. Medicare Hospital Spending Per Patient - Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — The "Medicare hospital spending per patient (Medicare Spending per Beneficiary)" measure shows whether Medicare spends more, less or about the same per Medicare...

  7. Hospitality and prosumption | Ritzer | Research in Hospitality ...

    African Journals Online (AJOL)

    Research in Hospitality Management. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 5, No 1 (2015) >. Log in or Register to get access to full text downloads.

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

    African Journals Online (AJOL)

    Mitchell's Plain District Hospital, Western Cape Department of Health, Cape Town, South Africa. Corresponding author: E de .... group as a whole, 6.3% of patients had mental illness. .... be investigated, research can also be focused specifically on reducing .... strongly affected by social stigma, particularly in the case of illicit.

  9. Hospitality & Tourism--Linking Industry to the Classroom

    Science.gov (United States)

    Kirkley, Darron

    2013-01-01

    This article provides information on the requirement of career and technical education (CTE) in the hospitality and tourism industry of South Carolina. It focuses on educating future employees during high school to fill the gap between industry and education. It also mentions career opportunities available for students in such positions as hotel…

  10. Care of HIV-infected adults at Baragwanath Hospital, Soweto

    African Journals Online (AJOL)

    and associated costs, in order to inform clinical practice, health service ... Setting. The outpatient department of a public sector, academic hospital in Soweto, South Africa. Design. ... primary care leveL The average cost per consultation was. R112.03. ... HIV-related illness, care strategies and costs of HIVlAJDS care is ...

  11. Service Robots for Hospitals

    DEFF Research Database (Denmark)

    Özkil, Ali Gürcan

    services to maintain the quality of healthcare provided. This thesis and the Industrial PhD project aim to address logistics, which is the most resource demanding service in a hospital. The scale of the transportation tasks is huge and the material flow in a hospital is comparable to that of a factory. We......Hospitals are complex and dynamic organisms that are vital to the well-being of societies. Providing good quality healthcare is the ultimate goal of a hospital, and it is what most of us are only concerned with. A hospital, on the other hand, has to orchestrate a great deal of supplementary...... believe that these transportation tasks, to a great extent, can be and will be automated using mobile robots. This thesis consequently addresses the key technical issues of implementing service robots in hospitals. In simple terms, a robotic system for automating hospital logistics has to be reliable...

  12. Hospitality and Institutional Meals

    DEFF Research Database (Denmark)

    Justesen, Lise; Strøjer, Anna-Lise

    2017-01-01

    Abstract: There is a growing interest in articulating institutional meal serving practices as a hospitality activity involving host and guest interactions. This study aims to qualify institutional hospitality and meal activities by exploring private hospitality events. The study is based......-structured interview, students reflected on their hospitality experiences. The interviews were transcribed and analyzed using a thematic analysis method. The emerging themes on hospitality activities were identified. It was found that hospitality activities could be characterized as a process where the individual...... was transformed into a guest. Information on purpose of the event and other information given in the invitation were part of this process. Furthermore, hospitality activities could be characterized by blurred host-guest relations and by being able to embrace unexpected events as well. The activities were...

  13. Hospital turnaround strategies.

    Science.gov (United States)

    Langabeer, James

    2008-01-01

    Despite reports of higher profitability in recent years, hospitals are failing at a faster rate than ever before. Although many hospitals leave decisions regarding revenues and costs to chief financial officers and their staff, this is a recipe for disaster. From research conducted over the last 4 years on hospital bankruptcies and turnarounds, the author found that a common series of actions will help organizations evade collapse. The author explored these turnaround strategies through research and analysis of a variety of hospitals and health systems that had a high probability of immediate financial crisis or collapse. His continued observation and analysis of these hospitals in subsequent years showed that most hospitals never emerge from their bleak financial conditions. However, a few hospital administrations have successfully turned around their organizations.

  14. ELEMENTAL FORMS OF HOSPITALITY

    Directory of Open Access Journals (Sweden)

    Maximiliano Emanuel Korstanje

    2010-11-01

    Full Text Available Modern studies emphasized on the needs of researching the hospitality as relevant aspects of tourism and hospitality fields. Anyway, these approaches are inextricably intertwined to the industry of tourism and do not take seriously the anthropological and sociological roots of hospitality. In fact, the hotel seems to be a partial sphere of hospitality at all. Under this context, the present paper explores the issue of hospitality enrooted in the political and economic indo-European principle of free-transit which is associated to a much broader origin.  Starting from the premise etymologically hostel and hospital share similar origins, we follow the contributions of J Derrida to determine the elements that formed the hospitality up to date.

  15. An evaluation of the use of the South African Triage Scale in an ...

    African Journals Online (AJOL)

    Background: Emergency centres in South Africa are among the busiest in the world and serve as entry points for hospital care for most of the population. The South African Triage Scale (SATS) is a validated tool introduced nationally in 2006 and intended to increase the efficiency of emergency centres through a process of ...

  16. pre-hypertension and hypertension in apparently healthy ...

    African Journals Online (AJOL)

    user

    hypertension among urban adolescents in Calabar, south eastern Nigeria. This was a ... disease later in life but also to significantly increase .... beam balance is not available (Paynter and ..... keeping with work done among Nigerian School.

  17. Terrorism in South Korea.

    Science.gov (United States)

    Wang, Soon Joo; Choi, Jin Tae; Arnold, Jeffrey

    2003-01-01

    South Korea has experienced > 30 suspected terrorism-related events since 1958, including attacks against South Korean citizens in foreign countries. The most common types of terrorism used have included bombings, shootings, hijackings, and kidnappings. Prior to 1990, North Korea was responsible for almost all terrorism-related events inside of South Korea, including multiple assassination attempts on its presidents, regular kidnappings of South Korean fisherman, and several high-profile bombings. Since 1990, most of the terrorist attacks against South Korean citizens have occurred abroad and have been related to the emerging worldwide pattern of terrorism by international terrorist organizations or deranged individuals. The 1988 Seoul Olympic Games provided a major stimulus for South Korea to develop a national emergency response system for terrorism-related events based on the participation of multiple ministries. The 11 September 2001 World Trade Center and Pentagon attacks and the 2001 United States of America (US) anthrax letter attacks prompted South Korea to organize a new national system of emergency response for terrorism-related events. The system is based on five divisions for the response to specific types of terrorist events, involving conventional terrorism, bioterrorism, chemical terrorism, radiological terrorism, and cyber-terrorism. No terrorism-related events occurred during the 2002 World Cup and Asian Games held in South Korea. The emergency management of terrorism-related events in South Korea is adapting to the changing risk of terrorism in the new century.

  18. Hospital diversification strategy.

    Science.gov (United States)

    Eastaugh, Steven R

    2014-01-01

    To determine the impact of health system restructuring on the levels of hospital diversification and operating ratio this article analyzed 94 teaching hospitals and 94 community hospitals during the period 2008-2013. The 47 teaching hospitals are matched with 47 other teaching hospitals experiencing the same financial market position in 2008, but with different levels of preference for risk and diversification in their strategic plan. Covariates in the analysis included levels of hospital competition and the degree of local government planning (for example, highly regulated in New York, in contrast to Texas). Moreover, 47 nonteaching community hospitals are matched with 47 other community hospitals in 2008, having varying manager preferences for service-line diversification and risk. Diversification and operating ratio are modeled in a two-stage least squares (TSLS) framework as jointly dependent. Institutional diversification is found to yield better financial position, and the better operating profits provide the firm the wherewithal to diversify. Some services are in a growth phase, like bariatric weight-loss surgery and sleep disorder clinics. Hospital managers' preferences for risk/return potential were considered. An institution life cycle hypothesis is advanced to explain hospital behavior: boom and bust, diversification, and divestiture, occasionally leading to closure or merger.

  19. Education in geriatric medicine for community hospital staff.

    LENUS (Irish Health Repository)

    O'Hanlon, Shane

    2010-12-01

    Community hospitals provide many services for older people. They are mainly managed by nursing staff, with some specialist input. Little is known about education provided in these facilities. Most education in geriatric medicine is provided in hospitals, despite most elderly care being provided in the community. The authors surveyed senior nursing staff in Irish community hospitals to examine this area in more detail. Staff in all 18hospitals in the Health Service Executive (South) area were invited to participate. The response rate was 100%. Sixteen of the 18 respondents (89%) felt staff did not have enough education in geriatric medicine. Just over half of hospitals had regular staff education sessions in the area, with a minority of sessions led by a geriatrician, and none by GPs. Geriatrician visits were valued, but were requested only every 1-3 months. Staff identified challenging behaviour and dementia care as the areas that posed most difficulty.

  20. Medicare charge-receipt data: results for South Dakota.

    Science.gov (United States)

    Lamfers, Randall; Miller, Nathan; Nettleman, Mary D

    2013-10-01

    The 2013 release of 2011 financial information by the Centers for Medicare and Medicaid Services (CMS) caused concern because some hospitals had charges that appeared to be exorbitantly high compared to reimbursement rates. Charges and receipts for South Dakota were compared to national data. The study was restricted to nine discharge codes likely to be seen by an adult hospitalist service. South Dakota hospitals had a lower charge-to-receipt ratio than the national average (p Dakota was 2.74 compared to 3.75 nationally. South Dakota charged 29 percent less for these discharge codes and received 3 percent lower reimbursement than the national average. The relatively low charge-to-receipt ratio and low charges in South Dakota are encouraging. Unfortunately, the only South Dakotans likely to be asked to pay full charges are the uninsured, who thus face bills that are much higher than insurance companies pay for the insured population. This leaves uninsured patients and hospitals with trying to negotiate discounts or waivers on an individual basis, which is an inefficient and problematic approach for both parties.