Ergonomic Assessment and Design of Electronic Ticket Booths in Mashhad City

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H. Razavi

2015-04-01

.Conclusion: Vendors of electronic ticket booths are exposed to musculoskeletal and environmental health threats, in Mashhad. Relocating the booths, adjustingcounterand desk height can significantly reduce the risk of mentioned hazards

Studying the factors affecting urban dispersion in mashhad metropolis

African Journals Online (AJOL)

solutions to control this problem. The tools used in this research were GIS software for mapping, quantitative methods of Holdren Model, urban primacy index, and area to population growth rate for review and analysis, and at first by examining area to population growth rate, Mashhad- developmental process map, Holdren ...

Adherence to a Standardized Order Form for Gastric Cancer in a Referral Chemotherapy Teaching Hospital, Mashhad, Iran

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Mitra Asgarian

2017-09-01

Full Text Available Background: Standardized forms for prescription and medication administration are one solution to reduce medication errors in the chemotherapy process. Gastric cancer is the most common cancer in Iran. In this study, we have attempted to design and validate a standard printed chemotherapy form and evaluate adherence by oncologists and nurses to this form. Methods: We performed this cross-sectional study in a Mashhad, Iran teaching hospital from August 2015 until January 2016. A clinical pharmacist designed the chemotherapy form that included various demographic and clinical parameters and approved chemotherapy regimens for gastric cancer. Clinical oncologists that worked in this center validated the form. We included all eligible patients. A pharmacy student identified adherence by the oncologists and nurses to this form and probable medication errors. Results are mean ± standard deviation or number (percentages for nominal variables. Data analysis was performed using the SPSS 16.0 statistical package. Results:We evaluated 54 patients and a total of 249 chemotherapy courses. In 146 (58.63% chemotherapy sessions, the administered regimens lacked compatibility with the standard form. Approximately 66% of recorded errors occurred in the prescription phase and the remainder during the administration phase. The most common errors included improper dose (61% and wrong infusion time (34%. We observed that 37 dose calculation errors occurred in 32 chemotherapy sessions. Conclusions: In general, adherence by oncologists and nurses with the developed form for chemotherapy treatment of gastric cancer was not acceptable. These findings indicated the necessity for a standardized order sheet to simplify the chemotherapy process for the clinicians, and reduce prescription and administration errors.

The Causes for Lack of Interest to Blood Donation in Eligible Individuals, Mashhad, Northeastern Iran

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Shakeri, M T; Vafaee, A; Esmaeily, H; Shafiei, N; Bazargani, R; Khayamy, ME

2012-01-01

Background Donor recruitment and retention are significant problems in blood collection agencies around the world. The Aim of this study was to determine the causes of lack of interest to blood donation in eligible individu­als in Mashhad, Northeast of Iran. Methods This was a descriptive study. Cases were 1130 non-donor individuals. Participants were selected from eligible individuals in different regions of Mashhad. In this study, surveys included information about age groups, gender, resid...

Attitudes of Mashhad Public Hospital's Nurses and Midwives toward the Causes and Rates of Medical Errors Reporting.

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Mobarakabadi, Sedigheh Sedigh; Ebrahimipour, Hosein; Najar, Ali Vafaie; Janghorban, Roksana; Azarkish, Fatemeh

2017-03-01

Patient's safety is one of the main objective in healthcare services; however medical errors are a prevalent potential occurrence for the patients in treatment systems. Medical errors lead to an increase in mortality rate of the patients and challenges such as prolonging of the inpatient period in the hospitals and increased cost. Controlling the medical errors is very important, because these errors besides being costly, threaten the patient's safety. To evaluate the attitudes of nurses and midwives toward the causes and rates of medical errors reporting. It was a cross-sectional observational study. The study population was 140 midwives and nurses employed in Mashhad Public Hospitals. The data collection was done through Goldstone 2001 revised questionnaire. SPSS 11.5 software was used for data analysis. To analyze data, descriptive and inferential analytic statistics were used. Standard deviation and relative frequency distribution, descriptive statistics were used for calculation of the mean and the results were adjusted as tables and charts. Chi-square test was used for the inferential analysis of the data. Most of midwives and nurses (39.4%) were in age range of 25 to 34 years and the lowest percentage (2.2%) were in age range of 55-59 years. The highest average of medical errors was related to employees with three-four years of work experience, while the lowest average was related to those with one-two years of work experience. The highest average of medical errors was during the evening shift, while the lowest were during the night shift. Three main causes of medical errors were considered: illegibile physician prescription orders, similarity of names in different drugs and nurse fatigueness. The most important causes for medical errors from the viewpoints of nurses and midwives are illegible physician's order, drug name similarity with other drugs, nurse's fatigueness and damaged label or packaging of the drug, respectively. Head nurse feedback, peer

Seroepidemiological Study of Toxocariasis in the Owners of Domestic Cats and Dogs in Mashhad, Northeastern Iran

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Fariba BERENJI

2016-10-01

Full Text Available Background: Toxocariasis is the clinical terms applied to infection of human with Ascarid nematodes in the order Ascaridida, named Toxocara canis and T. cati. Because in recent years in Iran many people desire to keep pets (cats and dogs, and lacking of seroepidemiological study of toxocariasis in Mashhad, we decided to determine the seroprevalence of toxocariasis among people who own cats and dogs in comparison with control group.Methods: A serological study for detection antibodies to Toxocara in two groups (93 cat and dog owners and 93 healthy people as control group was conducted from Feb 2013 to Dec 2013. An ELISA method was employed using determination of IgG antibodies against Toxocara. The serum samples were evaluated for anti-Toxocara antibody, using ELISA technique at Parasitology and Immunology Lab of Imam Reza Hospital of Mashhad. Using a questionnaire, epidemiological factors associated with infection were examined. Data were analyzed using Chi-square test.Results: The seroprevalence of Toxocara antibodies in the pet owners and control group was respectively 20.43% and 1.07%.  47.3% of pet owners were female. Conclusion: Presented data showed the significant difference between seroprevalence of toxocariasis among pet owners and control group. Education of society and in particular pet owners consisting of preventing contamination of the environment with Toxocara eggs is advised. 

Evaluation of quality of urban life with emphasis on health; A case study in Mashhad city

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Khalilullah Kazemi Khabiri

2018-05-01

Full Text Available Background: The quality of life of the citizens is one of the most important issues studied in different countries and used in the planning and monitoring of public policies. The present study measured and evaluated the indicators of quality of urban life among citizens of Mashhad city. Methods: This analytical study was conducted on 375 citizens of various regions in Mashhad city. The random sampling method using population distribution and short-form questionnaires for data collection were applied. The validity of the questionnaires was verified by experts and the points given each question based on a 5-point Likert scale, and the Cronbach αcoefficient was used to measure the reliability of the questionnaire; the questionnaire rated 0.853%. To analyze the variables under study, SPSS and other statistical methods such as average answers and t test for independent variables were used. Results: Findings of this research showed that the average health-sanitation dimension and environmental quality dimension are lower than 50% in Mashhad city. Sanitation and health, with a standard deviation of 5.838, are situated below the median level. The most common weakness is related to the dietary intake of protein. Environmental quality with a standard deviation of 5.857 is lower than the median level which is related to garbage separation and landfill sites. This result indicates that the quality of health and the environment in Mashhad is undesirable. Conclusion: Citizens’ satisfaction with quality of life index is lower than average in Mashhad city. Plans for improving the quality of life and developing services are highly necessary for increasing the quality of life.

Hospital Medicine and Fellowship Program in Rural North Dakota - A Multifaceted Success Story.

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Hyder, S S; Amundson, Mary

2017-11-01

Recruitment of hospitalists and primary care physicians for Critical Access Hospitals and tertiary care hospitals in North Dakota is difficult. To address this challenge, 2 programs were implemented in Bismarck, North Dakota. St. Alexius Medical Center created a hospitalist fellowship training program in collaboration with the University of North Dakota School of Medicine and Health Sciences and physicians willing to work in Critical Access Hospitals were offered a joint appointment to teach hospitalist fellows and obtain a clinical academic appointment at the university. Since it was created in 2012, 84 physicians have applied for 13 fellowships. Of the 11 fellows who have completed the program, 64% (7/11) remained in North Dakota to practice. Physicians are more likely to work in a rural Critical Access Hospital if they spend time working at a tertiary care center and have clinical academic appointments. Where recruitment is challenging, hospitalist fellowship programs are helpful in meeting the health care workforce demand.

Evaluation of dry solid waste recycling from municipal solid waste: case of Mashhad city, Iran.

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Farzadkia, Mahdi; Jorfi, Sahand; Akbari, Hamideh; Ghasemi, Mehdi

2012-01-01

The recycling for recovery and reuse of material and energy resources undoubtedly provides a substantial alternative supply of raw materials and reduces the dependence on virgin feedstock. The main objective of this study was to assess the potential of dry municipal solid waste recycling in Mashhad city, Iran. Several questionnaires were prepared and distributed among various branches of the municipality, related organizations and people. The total amount of solid waste generated in Mashhad in 2008 was 594, 800  tons with per capita solid waste generation rate of 0.609  kg  person(-1) day(-1). Environmental educational programmes via mass media and direct education of civilians were implemented to publicize the advantages and necessity of recycling. The amount of recycled dry solid waste was increased from 2.42% of total dry solid waste (2588.36  ton  year(-1)) in 1999 to 7.22% (10, 165  ton  year(-1)) in 2008. The most important fractions of recycled dry solid waste in Mashhad included paper and board (51.33%), stale bread (14.59%), glass (9.73%), ferrous metals (9.73%), plastic (9.73%), polyethylene terephthalate (2.62%) and non-ferrous metals (0.97%). It can be concluded that unfortunately the potential of dry solid waste recycling in Mashhad has not been considered properly and there is a great effort to be made in order to achieve the desired conditions of recycling.

Antibiotic resistance of Helicobacter pylori in Mashhad, Iran

International Nuclear Information System (INIS)

Zendedel, A.; Almasi, V.; Moradimoghadam, F.; Zivarifar, H.

2013-01-01

Objective: To evaluate Helicobacter pylori resistance to amoxicillin, clarithromycin, metronidazole and tetracycline in Mashhad, Iran. Methods: The cross-sectional study was done from January to May 2008 in Mashhad, involving 185 patients who had been indicated for endoscopy and lesions had been found. Biopsy samples were assessed with histological evaluation, rapid urease test, and culture. Antibiotic resistance was assessed by the disc diffusion method. Data was analysed with SPSS 11.5 using chi-square and Fisher exact test. P values of < 0.05 were regarded as statistically significant. Results: Of the total patients, histological evaluations were positive in 124 (67%). Compared with histology, sensitivity and specificity of rapid urease test were 96.7% and 100%, respectively. In 82 (66.1%) patients with positive cultures, antibiotic resistance was found in 14 (17.1%) for clarithromycin; 53 (64.6%) for metronidazole; and 8 (9.8%) for amoxicillin. No resistance was observed for tetracycline. Moreover, 9 (64%) patients with resistance to clarithromycin had co-resistance to metronidazole. Conclusion: Metronidazole is not recommended for treatment of Helicobacter pylori as a first-line drug. Also, considering the sensitivity and specificity of rapid urease test, we suggest this method as a suitable alternative for histology. (author)

Molecular and phylogenetic analysis of HIV-1 variants circulating among injecting drug users in Mashhad-Iran

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Buonaguro FM

2006-09-01

Full Text Available Abstract Genetic and phylogenetic information on the HIV-1 epidemic in Middle-East Countries, and in particular in Iran, are extremely limited. By March 2004, the Iranian Ministry of Health officially reported a cumulative number of 6'532 HIV positive individuals and 214 AIDS cases in the Iranian HIV-1 epidemic. The intra-venous drug users (IDUs represent the group at highest risk for HIV-1 infection in Iran, accounting for almost 63% of all HIV-infected population. In this regards, a molecular phylogenetic study has been performed on a sentinel cohort of HIV-1 seropositive IDUs enrolled at the end of 2005 at the University of Mashhad, the largest city North East of Tehran. The study has been performed on both gag and env subgenomic regions amplified by Polymerase Chain Reaction (PCR from peripheral blood mononuclear cells (PBMCs and characterized by direct DNA sequence analysis. The results reported here show that the HIV-1 subtype A is circulating in this IDUs sentinel cohort. Moreover, the single phylogenetic cluster as well as the intra-group low nucleotide divergence is indicative of a recent outbreak. Unexpectedly, the Iranian samples appear to be phylogenetically derived from African Sub-Saharan subtype A viruses, raising stirring speculations on HIV-1 introduction into the IDUs epidemic in Mashhad. This sentinel study could represent the starting point for a wider molecular survey of the HIV-1 epidemics in Iran to evaluate in detail the distribution of genetic subtypes and possible natural drug-resistant variants, which are extremely helpful information to design diagnostic and therapeutic strategies.

Barriers to collaboration among tourism industry stakeholders. Case study: Mashhad Metropolis

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Farhad Azizpour

2016-07-01

Full Text Available In a tourist destination there are usually various stakeholders with different goals. Achieving cooperation and integration among them is a major concern for policy makers and urban managers. In this regard, the role of tourist destination management becomes important more than ever. Therefore, cooperation between organizations can be an effective model but very little researches have been done about this topic. To fill the gap, this study tends to analyze the collaboration between tourism-related public and private institutions in the city of Mashhad.This study applies qualitative case study methodology approach. Data are collected using semi-structured interview. The results showed that the main factors affecting the non-collaboration between related-tourism organizations in Mashhad city include: lack of a systematic approach, weak legal structure, poor planning, lack of integrated tourism management, and the weakness of the policy-making system.

A Study on Emotional Valence of the Relation between Tourists and Host in Mashhad

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Hamed Bakhshi

Full Text Available The research is conducted to “describe the emotional valence of the relation between tourists and host in Mashhad”. Using the secondary analysis method, the researchers have used data from “assessment of pilgrims’ attitudes about Mashhad residents and service providers” survey. During the survey interviewees described Mashhad residents with specific words (attributions. In this research the attributions have been analyzed in platform of related literatures in sphere of psychology and sociology of emotions theories (especially the Turner and Plutchik categorization of emotions. Findings examined that the pilgrims’ emotions was positive rather than negative. Thus security- fear dimension was not explicitly remarked. Besides “acceptance” was marked as a factor in building positive emotions while the “hate” was marked as a factor that creates negative emotions. Negative emotions indicate on the existence of gap between tourists’ expectation and their real trip. The hate, contempt and anger emotions of tourist have been described as outcome of not receiving desired respect and attention from host community, violation of ethical and accepted high social norms and finally, voilation of justice and fairness from Mashhad residents’ side.

Association between menstruation signs and anxiety, depression, and stress in school girls in Mashhad in 2011-2012

OpenAIRE

Mohamadirizi, Soheila; Kordi, Masoumeh

2013-01-01

Background: Menstruation signs are among the most common disorders in adolescents and are influenced by various environmental and psychosocial factors. This study aimed to define the association between menstruation signs and anxiety, depression, and stress in school girls in Mashhad in 2011-2012. Materials and Methods: This was a cross-sectional study on 407 high school girls in Mashhad who were selected through two-step random sampling. The students completed a questionnaire concerning demo...

Concentrations of Mercury, Lead, Chromium, Cadmium, Arsenic and Aluminum in Irrigation Water Wells and Wastewaters Used for Agriculture in Mashhad, Northeastern Iran

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SR Mousavi

2013-04-01

Full Text Available Background: Contamination of water by toxic chemicals has become commonly recognized as an environmental concern. Based on our clinical observation in Mashhad, northeastern Iran, many people might be at risk of exposure to high concentrations of toxic heavy metals in water. Because wastewater effluents as well as water wells have been commonly used for irrigation over the past decades, there has been some concern on the toxic metal exposure of crops and vegetables irrigated with the contaminated water. Objective: To measure the concentrations of mercury, lead, chromium, cadmium, arsenic and aluminium in irrigation water wells and wastewaters used for agriculture in Mashhad, northeastern Iran. Methods: 36 samples were taken from irrigation water wells and a wastewater refinery in North of Mashhad at four times—May 2008, March 2009, and June and July 2010. Atomic absorption spectrometry was used to measure the concentration of toxic metals. Graphite furnace was used for the measurement of lead, chromium, cadmium and aluminum. Mercury and arsenic concentrations were measured by mercury/hydride system. Results: Chromium, cadmium, lead and arsenic concentrations in the samples were within the standard range. The mean±SD concentration of mercury in irrigation wells (1.02±0.40 μg/L exceeded the FAO maximum permissible levels. The aluminum concentration in irrigation water varied significantly from month to month (p=0.03. All wastewater samples contained high mercury concentrations (6.64±2.53 μg/L. Conclusion: For high mercury and aluminum concentrations, the water sources studied should not be used for agricultural use. Regular monitoring of the level of heavy metals in water and employing the necessary environmental interventions in this area are strongly recommended.

Clinical evaluation of patients with migraine induced stroke in mashhad, iran.

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Ghandehari, Kavian; Sharifi, Atena; Nikbin, Zeynab; Fadaei, Sahar; Meybodi, Meysam Aghaei; Moshfegh, Mehdi; Hosseini, Mohammad Reza; Sarabi, Mohammad Reza Gerami; Maarufi, Parham

2010-01-01

Migraine Induced Stroke (MIS) is an important cause of brain infarction in the young people. Consecutive patients with MIS admitted in Ghaem hospital, Mashhad during 2006-2010 enrolled a prospective clinical study. All of the patients suspected to MIS had brain MRI with a 0.5 Tesla generation, Philips NT Intra, Netherland. All of the MIS patients underwent a standard battery of diagnostic investigations for detecting etiology of stroke. Disability of MIS patients was detected based on the modified Rankin scale at 90 days post stroke. 32 MIS patients (18 females, 14 males) with mean age 37.2 ± 3.8 years ranged 15-58 years were evaluated. Hypodense area of infarction corresponding to clinical manifestations was detected in MRI in 32% of our MIS patients. The mean disability score in our MIS patients was 1.09 ± 0.32, which is significantly lower than other stroke patients (z = 2.55, P = 0.007) MIS is an important cause of stroke in Persian young adults which have good prognosis.

Factors influencing job satisfaction among registered nurses: a questionnaire survey in Mashhad, Iran.

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Atefi, Narges; Lim Abdullah, Khatijah; Wong, Li Ping; Mazlom, Reza

2015-05-01

Job satisfaction is a critical factor in health care. Strong empirical evidence supports a causal relationship between job satisfaction, patient safety and quality of care. To determine the level of nurses' job satisfaction and its associated factors. A stratified random sample of 421 registered nurses working at a large hospital in Mashhad, Iran was surveyed. The results showed that autonomy, task requirement and work interaction had scores higher than their respective median on the subscales. There were significant differences between demographic characteristics and the autonomy, task requirement, work interaction, salary, work condition, professional development, supportive nursing management, decision making, professional status subscales and mean total job satisfaction. In univariate analysis, young age, being female and being married were significantly associated with a higher level of job satisfaction. The adjusted R(2) for this model was 0.14, indicating that the model explained 14% of the variability. The regression model was highly significant, F (4298) = 13.194, P job satisfaction. © 2013 John Wiley & Sons Ltd.

Mashhad Wise Water Forum: a path to sustainable water resources management in a semi-arid region of Iran

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Tabatabaee, Seyyed Alireza; Neyshaboori, Shahnaz; Basirat, Ali; Tavakoli Aminiyan, Samaneh; Mirbehrooziyan, Ahmad; Sakhdari, Hossein; Shafiei, Mojtaba; Davary, Kamran

2016-04-01

Water is key to sustainable development especially in semi-arid regions in which the main source of water provision is groundwater. Water has value from a social, economic and environmental perspective and is required to be managed within a sound, integrated socio-economic and environmental framework. Mashhad, the second big city in Iran, has been faced with rapid growth rates of population and economic activities. The groundwater in Mashhad basin has been overexploited to meet the increasing trend of water demand during the past 20 years. Consequently, the region has faced with water scarcity and water quality problems which originates from inefficient use and poor management. To tackle the water issue on a durable basis, within the economic, ecological, and political constraints (i.e. the integrated water resources management, IWRM concept), a Non-Governmental Organization (NGO), named as Mashhad Wise Water Forum (MWWF), has been established in 2013 that encompasses contribution of experts from academia, industry, and governmental policy-makers. The MWWF considers the UN-Water IWRM spiral conceptual model (which contains four stages: Recognizing and identifying; Conceptualizing; Coordinating and planning; Implementing, Monitoring and Evaluating) by implicating participatory water management (water users' involvement) methods in Mashhad basin. Furthermore, the MWWF has planned to look at all dimensions of water crisis (i.e. physical, economic, policy and institutional) particularly institutional dimension by gathering all stockholders, beneficiaries and experts in different parts of water policy making in Mashhad basin. The MWWF vision for Mashhad basin is achieving to sustainable equilibrium of water resources and consumptions in the basin by the prospect to 2040 year. So far, the MWWF has tried to understand and deal with regional diversity in legal systems as well as conflicts between private interests and public welfare in water allocation and management. At

Ultrasound screening of thyroid nodules in adults with no previous exposed to irradiation comparison between scanning, palpation and fine needle aspiration cytology. A study in Ghaem Hospital, Mashhad, North East of Iran

International Nuclear Information System (INIS)

Rahrouh, M.; Namadanian, G.R.; Zakavi, S.R.; Rezaei, H.

2003-01-01

There are a great number of studies on the association between childhood radiation exposure and thyroid nodules and cancer. Ultrasound imaging of thyroid nodules is valuable part of diagnostics and identifies abnormalities, because ultrasound can detect nodules as small as 2-3 mm and no radiation is involved , it has gained wide acceptance for the screening of nodular thyroid disease. 500 subjects were selected randomly from medical students in university of medical sciences in Mashhad North East of Iran. Individuals were screened by a health survey , thyroid ultrasounds, 99mTc-pertechnetate scans, palpation and fine needle aspiration obtained as necessary. The ultrasound was performed with a 7.5-MHz transducer in direct contact with the lubricated skin of the extended neck. Each ultrasound exam was read independently by two radiologists and one endocrinologist. Each nodule was characterized as follows: 1) presence; 2) size ; 3) location; ant or post; 4) location; upper pole, midportion of lobe, lower pole, or isthmus; and 5) type; solid, cystic, or mixed. In 500 cases (312 men, 188 women; age range, 18 - 30 years) underwent neck sonography. Normal findings were verified by clinical follow-up and thyroid disease was found in (5%) of subjectes. A total of 25 certain thyroid nodules were detected by the ultrasound examinations. Eighty eight percent nodules were less than 1.0 cm dimension.Among the subjects who had them thyroid nodules,(48%) were cystic , (44%) were hypoechoic lesions and (8 %) were hyperechoic .The abnormality of thyroid echo was solitary in (1,8%) ,multiple in (1,4%) and diffuse in (0,6%) of subjectes. All abnormal findings were verified by fine needle aspiration biopsy and correlated with thyroid scan, and surgery. The results reported here can be compared to several reports on the prevalence of ultrasound detected thyroid nodules in adult populations not exposed to radiation .The major advantage is that ultrasound can find clinically important

Analysis of Self-esteem and Academic Achievement among the Midwifery Students of Mashhad School of Nursing and Midwifery in 2013

OpenAIRE

Farzaneh Rashidi Fakari; Mahin Tafazzoli

2016-01-01

Introduction: The students’ academic achievement is of paramount significance for their future accomplishments. Academic achievement is associated with various effective factors, one of which is self-esteem. The current study was conducted to assess the correlation between self-esteem and academic achievement of the midwifery students at Mashhad University of Medical Sciences in 2013. Methods: This analytical study was carried out on the midwifery students of Mashhad School of Nursing and...

Mineralogy, geochemistry, genesis, and industrial application of silica in Arefi area, south of Mashhad

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Mohammad Hassan Karimpour

2014-10-01

Full Text Available Introduction Arefi quartz-bearing conglomerate (Middle Jurassic is situated within Binalud structural zone. The unit is trending NW-SE located 25 km south of Mashhad. More than 97% of the pebbles are quartz as mono-crystalline, poly-crystalline, and minor fragments of chert, quartzite, and mica schist. Less that 3% of the remaining minerals are feldspar, mica, chlorite, hornblende, tourmaline, zircon, sphene, and opaque minerals. The cement is mainly silica. Hashemi (Hashemi, 2004 suggested this unit is orthoquartzitic polymictic conglomerate. In this study, we carried out detailed mineralogical studies, geochemical analyses for SiO2 and troublesome elements, determination of quartz pebbles source using geological observations and fluid inclusion microthermometry, and industrial application studies with new insight for porcelain and ceramic factories as the nearest silica-rich reserve to Mashhad. Material and methods 1. Preparing geologic map in 1:10000 scale in the Arefi area. 2. Petrographic study of 65 samples from the quartz-bearing conglomerate unit. 3. Major elements such as SiO2, TFeO, TiO2, and CaO were analyzed at the Maghsoud Porcelain Factories Group, using a Philips PW1480 X-ray spectrometer. 4. Ore dressing analyses in Danesh Faravaran Engineering Company. 5. Fluid-inclusion studies in 4 samples doubly-polished wafers of quartz crystals were studied using standard techniques (Roedder, 1984 and Linkam THM 600 heating-freezing stage (from –190 to 600ºC mounted on a Olympus TH4–200 microscope stage at Ferdowsi University of Mashhad, Iran. Salinities and density of fluid inclusions were calculated using the Microsoft Excel spreadsheet HOKIEFLINCS-H2O-NACL (Steele-MacInnis et al., 2012; Lecumberri-Sanchez et al., 2012 Results and Discussion Fluid Inclusion studies of both mono- and poly- crystalline quartz revealed that the inclusions consist of three phases (LVS with NaCl crystals. Homogenization temperature is between 484 and more

Pulmonary function tests and respiratory symptoms among smokers in the city of mashhad (north east of Iran

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M.H. Boskabady

2011-09-01

Full Text Available The prevalence of smoking was studied using a questionnaire. Pulmonary function tests and respiratory symptoms were evaluated in 176 smokers. The total studied population with family and co-workers were 13289. The number of smokers among studied population was 11.7%. The rate of smoking among male subjects was 17.2% and in female 2.5%. All values of PFTs in smokers were significantly lower (p < 0.001 and respiratory symptoms higher than in non smokers (p < 0.05 for cough and p < 0.001 for wheeze and tightness. There were significant negative correlations between smoking duration and rate with values of PFT (p < 0.05-p < 0.001. In this study the prevalence of smoking in population of Mashhad city was shown. The prevalence of smoking was higher among male than females. Smoking leads to increased respiratory symptoms and reduction of PFTs values. Resumen: A prevalência do acto de fumar foi estudada através de um questionário. Os testes de função pulmonar e sintomas respiratórios foram avaliados em 176 fumadores. O total da população estudada com família e colaboradores foi de 13289. O número de fumadores entre a população estudada foi de 11,7%. A taxa do acto de fumar entre os homens foi de 17,2% e de 2,5% entre as mulheres. Todos os valores de TFP nos fumadores foram significativamente inferiores (p < 0.001 e os sintomas respiratórios foram superiores em relação aos não fumadores (p < 0,05 para tosse e p < 0,001 para pieira e aperto torácico. Registaram-se correlações negativas significativas entre a duração do acto de fumar e a taxa com valores de TFP (p < 0,05-p < 0,001. Neste estudo, foi apresentada a prevalência do acto de fumar na população da cidade de Mashhad. A prevalência do acto de fumar foi maior entre os homens do que entre as mulheres. Fumar leva a um aumento de sintomas respiratórios e à redução dos valores de TFP. Keywords: Prevalence of smoking, smoking duration, smoking amount

A Trans-Theoretical Approach to Physical Activity Profile in General Population of Mashhad

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Shaye, Zahra Abbasi; Bazzaz, Mojtaba Mousavi; Vakili, Veda

2015-01-01

Regular physical-activity is necessity for a healthy lifestyle. Despite public health efforts, a minority of population are involved in healthy levels of physical-activity. This study provides evidence about exercise patterns and predictors of Mashhad-Iran population according to TTM change stages. In this cross-sectional study, we surveyed a total number of 564 participants from Mashhad in 2014 by using stages of change questionnaire. Analysis showed 23.4% of participants were in pre-contemplation stage, 18 in contemplation, 24.6% in preparation, 8.10% in action, 14.4% in maintenance and 11.5% were in termination phase. Age, gender, BMI, alcohol consumption, sleep duration, having compeer and encouragement were identified as predictors of pre-contemplation stage. Genders, having company and using bicycle for transportation were predictors of termination phase. Tailor interventions based on the predictors to enhance the physical activity among specific subgroups would be of interest. PMID:26153203

Energy management installation at North Middlesex Hospital.

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Hart, V A

1986-05-01

The author is the Energy Conservation Officer for the Haringey Health Authority. The North Middlesex Hospital is an acute unit with approximately 700 beds. Currently, twenty-one outstations control the maternity/radio therapy tower complex plus the outpatients' department. Plans have been approved to extend the system and Phase 2 will cover pathology, administration, medical and surgical blocks together with x-ray and casualty blocks. Transmitton Ltd, as in Phase 1, will supply the hardware and contract management.

Investigating the Status of Training Quality of Ophthalmologic Residents in Khatam-Ol-Anbia Hospital in Mashhad, Based on the Standards of EFQM Organizational Excellence Model in the Academic Year 2012-2013

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Akbar Derakhshan

2016-05-01

Full Text Available  Background and Purpose: As the leaders of educational organizations, universities use various models and approaches in evaluating their activities. However, excellence model for evaluation of educational services can demonstrate the distinction of this evaluation procedure. The aim of this study is to investigate the status of training quality of ophthalmologic residents in Khatam-Ol-Anbia Hospital in Mashhad based on the standards of organizational excellence model EFQM in the educational year of 2012-2013.Methods: This descriptive cross-sectional study has been conducted in the second half of 2013 in the educational, research, and therapeutic hospital of Khatam-Ol-Anbia, among the hospitals affiliated with Mashhad University of Medical Sciences. All students in the stage of residency in Ophthalmology entered this study. In this research, 18 men and 6 women participated. Moreover, in the statistical population of this research, 14 of the residents were non-native and 10 were native. Using standardized questionnaire of organizational excellence model in higher education sector and the degree of achievement of the educational services outcomes presented to learners was investigated. This questionnaire was first adapted from the main booklet published by Sheffield University, England. Following the extraction of the preliminary questionnaire, normalization of the instrument for validity was done by expert judgment, to examine the internal consistency of the various sections of the instrument and the reliability, Cronbach’s alpha coefficient of 0.96 was obtained. The questionnaire consists of 4 main sections, each of which questions contain certain indices of educational services. Using SPSS 16 and congruent with the background and research questions, the results were obtained.Results: The mean value of general status of the training quality of Ophthalmology residents has been obtained as 6.66 (of a max of 10. The mean value for the indices of

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

African Journals Online (AJOL)

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

Macro-Level Modeling of Urban Transportation Safety: Case-Study of Mashhad (Iran

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Mohammadi Mehdi

2017-12-01

Full Text Available Transportation safety can be aimed at the planning stage in order to adopt safety management and evaluate the long-time policies. The main objective of this research was to make use of crash prediction models in urban transportation planning process. As such, it was attempted to gather data on the results of transportation master plan as well as Mashhad urban crash database. Two modelling method, generalized linear model with negative binomial distribution and geographically weighted regression, were considered as the methods used in this research. Trip variables, including trip by car, trip by bus, trip by bus services and trip by school services, were significant at 95%. The results indicated that both finalized models were competent in predicting urban crashes in Mashhad. Regarding to results urban transportation safety will be improved by changing the modal share for example from private car to bus. The application of the process presented in this study can improve the urban transportation safety management processes and lead to more accurate prediction in terms of crashes across urban traffic areas.

Assessing customers’ perception regarding service failure and recovery strategies and consumer future behavior in the restaurant industry ;Evidence from Mashhad, Iran

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Memarbashi, Shahryar

2012-01-01

ABSTRACT: The main objective of this research is to conduct a study to analyse service failure categories and service recovery strategies used and future customer behaviorin the context of hotelrestaurants in Mashhad, Iran. Also to evaluate the impact of demographic characteristics of customers on service failure, service recovery and customer intention. The Thesis involves 300 respondents from Mashhad, Iran. The sampling unit is hotel restaurant customers and the data needed for the researc...

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

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ADMIN

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

National Nosocomial Infection Surveillance System–based study in north eastern of Iran

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Maliheh Ziaee

2017-09-01

Full Text Available among about 10% of hospitalized patients. HAIs increase mortality and morbidity and prolonged hospital stay not to mention considerable costs they impose on the health care system. The present study was conducted in order to evaluate the prevalence of HAIs based on National Nosocomial Infection Surveillance System in hospitals of Mashhad, Iran.  Methods: The current prevalence study of HAI was carried out in 26 hospitals using a protocol updated yearly in Mashhad, Iran. The Centers for Disease Control and Prevention–National Nosocomial Infections Surveillance were used to define four HAIs. All patients admitted to the hospitals during a one-year period (March 1, 2015-February 30, 2016 were recruited in the study. Data was extracted using Iranian nosocomial infection surveillance software.  Results: The overall prevalence rate of HAI in our study was 0.8% among the hospitals with the most frequent HAIs found to be pneumonia (25%, followed by urinary tract infections (20%, and blood stream infections (19%. The highest prevalence rate was observed in 15- to 65-year old patients with more than 50% related to surgical site infection. Also, the most frequently isolated micro-organism was acinetobacter. In addition, the highest seasonal prevalence was seen in winter with pneumonia as the most frequent infection. A total of 4988 pathogens were isolated with 30.33% of clinical confirmation and 69.66% of positive culture.  Conclusion: These findings emphasize the need for appropriate measures for prevention, screening, labeling, and isolation precautions for infected patients.

General health literacy assessment of Iranian women in Mashhad.

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Jarahi, Lida; Asadi, Reza; Hakimi, Hamid Reza

2017-11-01

In women's health, literacy determines their participation in self and family health promotion. Low health literacy is as barrier for understanding medical recommendations, disease prevention and health care. To assess women's health literacy and relative factors in Mashhad (Iran). Women referring to healthcare centers in Mashhad in 2012 and 2013, participated in this cross-sectional study by stratified sampling method. The validated Persian version of Rapid Estimate of Adult Literacy in Medicine-revised questionnaire was used. Vocabulary comprehension and reading scores of health literacy was assessed. Comparisons were done in demographic subgroups by ANOVA, Mann-Whitney U, Kruskal-Wallis, Pearson correlation coefficient, and Chi-Square tests. In total, 250 women with a mean age of 32.1±10.23 years and the mean education level of 10.58±3.67 years were studied. The mean reading score was 11.58±2.51 and the mean vocabulary comprehension score was 17.24±4.73. Participants' health literacy score had positive correlation with age and education, and significant difference in health literacy scores between occupational groups was seen. Housewives' health literacy scores were lower than others (pliteracy was a common problem amongst younger women, especially among women who had less education. These women are at risk of early marriage and child bearing and require more health care. Health care professionals should use effective methods for easier transfer recommendation, also, producing medical information booklets, texts, and videos for different community subgroups through public media or even in cyberspace with clear and common words consisting of essential information.

Common Positioning Errors in Digital Panoramic Radiographies Taken In Mashhad Dental School

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Ali Bagherpour

2018-06-01

Full Text Available Introduction: The present study was aimed at evaluating common positioning errors on panoramic radiographs taken in the Radiology Department of Mashhad Dental School. Materials and methods: The study sample included 1,990 digital panoramic radiographs taken in the Radiology Department of Mashhad Dental School by a Planmeca Promax (Planmeca Oy, Helsinki, Finland, during a 2-year period (2010–2012. All radiographs, according to dentition and sex, were evaluated for positioning errors. Results: There were 1,927 (96.8% panoramic radiographs with one or more errors. While the number of errors in each image varied between one and five, most images had one error (48.4%. The most common error was that the tongue was not in contact with the hard palate (94.8%. "Open lips" was an error not seen in any patients. Conclusions:positioning errors are common in panoramic radiographies. The most common error observed in this study was a failure to place the tongue on the palate. This error and the other errors reported in this study can be reduced by training the technicians and spending little more time for patient positioning and more effective communication with the patients.

Organ doses of the cardiologists and their assistants during interventional cardiology procedures at teaching general hospitals in Mashhad/ Iran

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Bahreyni Toosi, M.; Zare, H.; Bayani, Sh.; Esmaili, S.

2006-01-01

Full text of publication follows: Protection of medical personnel in interventional cardiology is now days one of the most important issues of radiological protection. Due to the rapid increase of coronary heart disease in developed and developing countries, application of interventional techniques such as coronary angiography and angioplasty have also increased sharply over past two decades. While these procedures are carried out cardiologists and their assistants are remained close to the patient and within the hot area of the radiation field. Therefore they are subject to receive significant doses of radiation. In this study doses received by critical and more vulnerable organs of cardiologists and their assistants were measured by thermoluminescent dosimeters (T.L.D.). T.L.D. measurements were carried for 115 coronary angiography (C.A.) and 30 pre-cutaneous transluminal coronary angioplasty (P.T.C.A.) procedures at teaching general hospitals in Mashhad-Iran. Doses received by thyroid, gonad, right and left hands of the study groups were measured. For this purpose T.L.D. were placed on and underneath of the lead apron adjacent to gonads and on the wrist of both hands. The results of this study imply that: a) For both groups left hands are subject to receiving the highest mean dose (0.18 mGy/P.T.C.A.) b) Thyroid mean dose per P.T.C.A. received by the T.L.D. chips on the shield is 0.72 mGy and is much higher than corresponding value for the T.L.D. placed underneath the shield. c) Gonads would receive the highest mean dose per P.T.C.A. (0.16 mGy), second to left hand, if lead apron is not worn, but lead apron reduces the dose by a factor of nearly six. d) General speaking assistants, mostly stood on the right side of cardiologists, receive smaller dose. e) P.T.C.A. induces a higher dose to all organs of both cardiologists and their assistants when compared with the corresponding doses arising from C.A. procedure. (authors)

Organ doses of the cardiologists and their assistants during interventional cardiology procedures at teaching general hospitals in Mashhad/ Iran

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Bahreyni Toosi, M.; Zare, H.; Bayani, Sh.; Esmaili, S. [Mashhad University of Medical Sciences, Medical Physics Dep., Faculty of Medicine, Mashhad (Iran, Islamic Republic of)

2006-07-01

Full text of publication follows: Protection of medical personnel in interventional cardiology is now days one of the most important issues of radiological protection. Due to the rapid increase of coronary heart disease in developed and developing countries, application of interventional techniques such as coronary angiography and angioplasty have also increased sharply over past two decades. While these procedures are carried out cardiologists and their assistants are remained close to the patient and within the hot area of the radiation field. Therefore they are subject to receive significant doses of radiation. In this study doses received by critical and more vulnerable organs of cardiologists and their assistants were measured by thermoluminescent dosimeters (T.L.D.). T.L.D. measurements were carried for 115 coronary angiography (C.A.) and 30 pre-cutaneous transluminal coronary angioplasty (P.T.C.A.) procedures at teaching general hospitals in Mashhad-Iran. Doses received by thyroid, gonad, right and left hands of the study groups were measured. For this purpose T.L.D. were placed on and underneath of the lead apron adjacent to gonads and on the wrist of both hands. The results of this study imply that: a) For both groups left hands are subject to receiving the highest mean dose (0.18 mGy/P.T.C.A.) b) Thyroid mean dose per P.T.C.A. received by the T.L.D. chips on the shield is 0.72 mGy and is much higher than corresponding value for the T.L.D. placed underneath the shield. c) Gonads would receive the highest mean dose per P.T.C.A. (0.16 mGy), second to left hand, if lead apron is not worn, but lead apron reduces the dose by a factor of nearly six. d) General speaking assistants, mostly stood on the right side of cardiologists, receive smaller dose. e) P.T.C.A. induces a higher dose to all organs of both cardiologists and their assistants when compared with the corresponding doses arising from C.A. procedure. (authors)

A grounded theory approach to understand the process of decision making on fertility control methods in urban society of Mashhad, Iran

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Roudsari, Robab Latifnejad; Khadivzadeh, Talat; Bahrami, Masoud

2013-01-01

Background: More than 30% of pregnancies in Iran are unintended and most of them happen among the women who use various contraceptive methods. Results of Integrated Monitoring and Evaluation System (IMES) showed that the rate of innovative contraceptive use in Mashhad has been 41.5%-57% in different urban areas. This study was conducted to explore the process of making decision toward using family planning methods in women of reproductive age in urban society of Mashhad, Iran. Materials and M...

Clinical evaluation of patients with spinal cord infarction in mashhad, iran.

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Ghandehari, Kavian; Gerami Sarabi, Mohammad Reza; Maarufi, Parham

2010-10-26

Background. Spinal Cord Infarction (SCI) is a rare and disabling disease. This hospital-based study was conducted for clinical evaluation of SCI patients in east of Iran. Methods. Consecutive SCI patients admitted in Ghaem hospital,Mashhad during 2006-2010 were enrolled in a prospective clinical study. Diagnosis of SCI was made by neurologists and radiologists. Demographic features, clinical syndrome, and Magnetic Resonance Imaging (MRI) findings were recorded. All of the patients underwent a standard battery of diagnostic investigations. All of the patients suspected to SCI had MRI of spinal cord at the symptomatic level of cord with a 0.5 Tesla generation, Philips NT Intra, Netherland equipment. An equal number of patients with Brain Infarction (BI) were randomly selected from our stroke registry data bank. Etiology and degree of disability were compared between these groups of patients. Results. Fourteen SCI patients (9 females, 5 males) with mean age 38.8 ± SD: 19.9 years were evaluated. Miscellaneous causes consisted 50% of etiologies in patients with SCI. Uncertain etiology, atherosclerosis, and cardioembolisms consisted 35.7%, 7.1%, and 7.1% of SCI causes, respectively. Distribution of etiologies was significantly different between SCI and BI patients, X(2) = 12.94, df = 3, P = .003. Difference in mean disability score at acute phase of stroke was not significant between two studied groups, z = 1.54, P = .057. Difference in mean changes of disability score at 90 days postevent was significant in two groups of patients, z = 2.65, P = .019. Conclusion. SCI is a rare disease with poor recovery. Distribution of etiologies of SCI patients is quite different than of BI patients.

Clinical Evaluation of Patients with Spinal Cord Infarction in Mashhad, Iran

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Kavian Ghandehari

2010-01-01

Full Text Available Background. Spinal Cord Infarction (SCI is a rare and disabling disease. This hospital-based study was conducted for clinical evaluation of SCI patients in east of Iran. Methods. Consecutive SCI patients admitted in Ghaem hospital,Mashhad during 2006–2010 were enrolled in a prospective clinical study. Diagnosis of SCI was made by neurologists and radiologists. Demographic features, clinical syndrome, and Magnetic Resonance Imaging (MRI findings were recorded. All of the patients underwent a standard battery of diagnostic investigations. All of the patients suspected to SCI had MRI of spinal cord at the symptomatic level of cord with a 0.5 Tesla generation, Philips NT Intra, Netherland equipment. An equal number of patients with Brain Infarction (BI were randomly selected from our stroke registry data bank. Etiology and degree of disability were compared between these groups of patients. Results. Fourteen SCI patients (9 females, 5 males with mean age 38.8±SD: 19.9 years were evaluated. Miscellaneous causes consisted 50% of etiologies in patients with SCI. Uncertain etiology, atherosclerosis, and cardioembolisms consisted 35.7%, 7.1%, and 7.1% of SCI causes, respectively. Distribution of etiologies was significantly different between SCI and BI patients, X2=12.94, df=3, P=.003. Difference in mean disability score at acute phase of stroke was not significant between two studied groups, z=1.54, P=.057. Difference in mean changes of disability score at 90 days postevent was significant in two groups of patients, z=2.65, P=.019. Conclusion. SCI is a rare disease with poor recovery. Distribution of etiologies of SCI patients is quite different than of BI patients.

The causes for lack of interest to blood donation in eligible individuals, mashhad, northeastern iran.

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Shakeri, M T; Vafaee, A; Esmaeily, H; Shafiei, N; Bazargani, R; Khayamy, Me

2012-01-01

Donor recruitment and retention are significant problems in blood collection agencies around the world. The Aim of this study was to determine the causes of lack of interest to blood donation in eligible individu-als in Mashhad, Northeast of Iran. This was a descriptive study. Cases were 1130 non-donor individuals. Participants were selected from eligible individuals in different regions of Mashhad. In this study, surveys included information about age groups, gender, residence area, marriage, education; living situation and job as background variables. Less than 30% of the cases had enough knowledge about blood donation. There was a significant rela-tionship between location, age, education, occupation and social status with knowledge of blood donation, but there was not a correlation between gender and marital status. There are some factors which affect the decision for blood donation. There is a need to change the negative attitude by increasing the knowledge considering the individual and the social status.

Assessment of unhealthy days of urban marginal inhabitants and effective factors in Mashhad, Iran

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Maliheh Ziaee

2016-01-01

Full Text Available Background: The concept of the quality of life (HRQOL related to health and its determinants contain aspects of quality of life that clearly affect people’s physical or mental health. One of the newest ways to assess the health and also the quality of life-related to health is the self-assessed health of the individual. The aim of the present study was assessment of unhealthy days, self-reported health status, and its influencing factors on residents of the marginalpart of Mashhad, Iran. Methods: In the current cross-sectional study, 580 citizens of the marginal regions and slum areas of Mashhad city were enrolled through cluster sampling method using governmental health care services divisions. The Persian version of the questionnaire CDC HRQOL-4 was used to measure the unhealthy days. Data was analyzed using SPSS, version 11.5, running ANOVA, chi-square, and t-tests. P-value of less than 0.05 was considered as statistically significant. Results: In the present study, 359 persons (61% were women and the mean age of participants was 32.6±11.51 years. The means of unhealthy days, physically unhealthy days, mentally unhealthy days, and days with dysfunction were found to be 7.2, 2.8, 4.1, and 1.7 days, respectively. The unhealthiest days (physical and mental were seen in unemployed people and the best to excellent health days were seen in housewives. Conclusion: Unhealthy days and days with dysfunction were reported higher in slum inhabitants, especially female, low literacy, and housewife participants. Providing the education and employment facilities for people who live in marginal city areas might decrease the unhealthy days.Keywords: Unhealthy days; Health; Urban Marginal Inhabitants; Mashhad

Mortality and morbidity due to exposure to outdoor air pollution in Mashhad metropolis, Iran. The AirQ model approach.

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Miri, Mohammad; Derakhshan, Zahra; Allahabadi, Ahmad; Ahmadi, Ehsan; Oliveri Conti, Gea; Ferrante, Margherita; Aval, Hamideh Ebrahimi

2016-11-01

In the past two decades, epidemiological studies have shown that air pollution is one of the causes of morbidity and mortality. In this study the effect of PM10, PM2.5, NO2, SO2 and O3 pollutants on human health among the inhabitants of Mashhad has been evaluated. To evaluate the health effects due to air pollution, the AirQ model software 3.3.2, developed by WHO European Centre for Environment and Health, was used. The daily data related to the pollutants listed above has been used for the short term health effects (total mortality, cardiovascular and respiratory mortality, hospitalization due to cardiovascular and respiratory diseases, chronic obstructive pulmonary disease and acute myocardial infarction). PM2.5 had the most health effects on Mashhad inhabitants. With increasing in each 10μg/m3, relative risk rate of pollutant concentration for total mortality due to PM10, PM2.5, SO 2 , NO 2 and O 3 was increased of 0.6%, 1.5%, 0.4%, 0.3% and 0.46% respectively and, the attributable proportion of total mortality attributed to these pollutants was respectively equal to 4.24%, 4.57%, 0.99%, 2.21%, 2.08%, and 1.61% (CI 95%) of the total mortality (correct for the non-accident) occurred in the year of study. The results of this study have a good compatibly with other studies conducted on the effects of air pollution on humans. The AirQ software model can be used in decision-makings as a useful and easy tool. Copyright © 2016 Elsevier Inc. All rights reserved.

Comparative Study of the Effects of ENSO Phenomenon (El Niño, La Niña on Temperature and Precipitation of Mashhad

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vajiheh mohammadi sabet

2017-03-01

Full Text Available Introduction: The Southern Oscillation is a large scale phenomenon that changes the Normal oscillating air pressure on both sides of the Pacific Ocean. It disrupted the normal conditions and the patterns of temperature and precipitation change in the nearby region and other regions of the world. This phenomenon is caused by changing the water slope in the Pacific Ocean between Peru (northwestern South America and Northern Australia (about Indonesia and Malaysia. ENSO phenomenon is formed of Elnino (warm state and La Niña (cold state. There is high pressure system in the East and low pressure system in the West Pacific Ocean in normal conditions (Walker cycle. The trade winds blow from East to West with high intensity. ENSO start when the trade winds and temperature and pressure balance on both sides of the PacificOcean change. High pressure will form in the west and low pressure will form in the East. As a result, west will have high and east will have low rainfall. Temperature will change at these two locations. Enso longs about 6 to 18 months. This research investigated the impact of ENSO on monthly precipitation and temperature of Mashhad.The results showed that temperature and rainfall have a good relation with ENSO.This relation occurs in 0-5 month lag. Materials and Methods: The severity of ENSO phenomenon is known by an index which is called ENSO index. The index is the anomaly of sea surface temperature in the Pacific. The long-term temperature and precipitation data of Mashhad selected and analyzed. The Rainfall has no trend but temperature has trend. The trend of temperature modeled by MARS regression and trend was removed.The rainfall data changed to standard and temperature changed to anomaly for comparison with ENSO index. The 2016 annual and monthly temperature of Mashhad is not available. The 2016 Annual temperature was forecasted by ARMA (1,1 model. Then this forecast disaggregated to monthly temperature. For each period of

Strategy, leadership and change: the North York General Hospital transformation journey.

Science.gov (United States)

Adamson, Bonnie; Kwolek, Susan

2008-01-01

Improvements in the emergency department and general internal medicine will serve as a case study to examine how North York General Hospital cultural transformation efforts led to improvements in these departments, and why we believe this approach will enable the organization to sustain these improvements over time.

Short-Term Family-Focused Psycho-Educational Program for Bipolar Mood Disorder in Mashhad

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Atefeh Soltanifar

2009-06-01

Full Text Available Background: Bipolar mood disorder type 1 is one of the mostserious psychiatric disorders. We aimed to assess the efficacyof a short-term family–focused treatment for patients with bipolarmood disorder type 1 in a one-year follow-up period.Methods: Sixty patients with bipolar mood disorder and acutemania episodes who referred to Ibn-e-Sina Psychiatric Hospitalin Mashhad were recruited. Half of them were randomly assignedto the psycho-education group. Their available adultfamily members received a psycho-educational training sessionbefore the patients' discharge from the hospital. All patients receivedconcurrent appropriate pharmacotherapy and psychotherapy.All the patients were evaluated by a blind home-visit teamevery 3 months for a period of one year. The evaluation includedthe number of psychiatric visits, patients' adherence, relapsestatus, number of re-hospitalizations, and time to relapse.Results: Fifty-seven patients completed the trial. In the experimentalgroup, there were four patients with relapse(13.79% and in the control group nine patients (31.58% hadrelapse of the disorder (P=0.006. The mean time of takingmedications in the education group was 11.41 months. Thistime was 9.14 months in the control group (P<0.001. Therewas also a significant difference between the two groups interms of frequency of psychiatric visits (P<0.001.Conclusion: Short–term family-focused psycho-education isan effective adjunct to pharmacotherapy for bipolar mood disorder.Further studies are needed to evaluate the efficacy andcost-effectiveness of long-term family-focused psychoeducationaltreatment for patients with bipolar mood disorder.

Evaluation of Groundwater Quality Indices of Mashhad Plain using Geostatistics and GIS Techniques

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Mohammadreza Yazdani

2017-11-01

The outcomes illustrate that the qualitative conditions of underground water resources, particularly in TDS and TH are in the inappropriate condition in the southern parts of Mashhad. It is related to the high population density and the lack of proper drainage. It is needed to restrict over exploitation of groundwater resources in critical hot spots, along with defining alternative safe water sources for urban consumption.

Mercury and Lead Levels in Common Soaps from Local Markets in Mashhad, Iran

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Anahita Alizadeh

2017-06-01

Full Text Available Background: The potential toxicity of human exposure was investigated to heavy metals from diverse sources but few or none was on Iranian soaps. Hence, we aimed to determine the presence of lead and mercury in selected soaps commonly used in Mashhad, northeastern Iran. Methods: Different common brands of cosmetic, hygiene and contraband soaps were purchased from retail market of Mashhad in 2016. Levels of these metals were determined using atomic absorption spectroscopy technique. Results: All samples had the mercury and lead levels but did not exceed the maximum acceptable level (1 µg/g for mercury and 20 µg/g for lead recommended by FDA. The mean levels of mercury were 0.02, 0.08 and 0.23 µg/g, respectively in cosmetic, hygiene and contraband soaps. These levels for lead were 0.10, 0.19 and 0.13 µg/g. The highest mercury and lead levels were detected in Halazoon contraband and P hygiene brands, respectively. Conclusion: The content of mercury and lead in common soaps is currently not a concern in this city. However, as human body may be exposed to several toxic metals from different care products simultaneously, cumulative toxic effects of these metals must be considered important.

An Epidemiological Study of Gastroesophageal Reflux Disease and Related Risk Factors in Urban Population of Mashhad, Iran

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Vossoughinia, Hassan; Salari, Masoumeh; Mokhtari Amirmajdi, Elham; Saadatnia, Hassan; Abedini, Siavash; Shariati, Alireza; Shariati, Mohammadjavad; Khosravi Khorashad, Ahmad

2014-01-01

Background: Gastroesophageal Reflux Disease (GERD) is a chronic and common disease, which is characterized by heartburn and regurgitation. In the last couple of decades, GERD has received much attention and studies have shown an increase in its prevalence. Although there have been a few studies on the prevalence of GERD in Iran, no study has yet been done in the northeastern part of the country. The aim of our study was to evaluate the prevalence of GERD and its risk factors in a population from Mashhad. Objectives: To evaluate the epidemiology of GERD based on a population study in Mashhad. Patients and Methods: This was a cross sectional descriptive study conducted in 2010. In total, 2500 participants were selected based on cluster sampling. Modified and validated Mayo Clinic questionnaire for GERD was used for data collection. Overall, 1685 questionnaires were retrieved. Fifty-one participants were excluded because of pregnancies, history of abdominal surgery and being less than 18 years old. We analyzed data using the SPSS software version 16. Prevalence of GERD and significant risk factors (P value < 0.05) were determined. Results: In total, 420 participants (25.7%) had GERD symptoms. Risk factors with significant effects consisted of smoking, consumption of non-steroidal anti-inflammatory drugs (NASIDs), overeating, chronic diseases, tea and coffee consumption and GERD in spouse. Conclusions: The prevalence of GERD among people living in Mashhad was above the average prevalence in other cities of Iran. However, risk factors seemed to be similar to those reported by other studies. PMID:25763231

The Effect of Diet on Learning of Junior High School Students in Mashhad, North-east of Iran

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Zahra Saeidi

2015-04-01

Full Text Available Introduction Since nutrition, especially in childhood and adolescence is an important effect on intelligence and learning, so that malnutrition delayed to later periods of life, so that these people during the course of studies, will have many problems, this study was conducted to evaluate the effect of nutrition on student learning. Materials and Methods This study was a cross-sectional study  that was conducted. The sample size was  all students that studying in a boarding school in  five district of  Mashhad-Iran. The valid and reliable questionnaire, consisted of 19 questions and specialized feeding habits of the students. Data were analyzed with spss-13 software. Results 90 students participated in the study guide. 48.9 % were second grade  and 51.1 % were third grade of  Junior High School. 24.4% of students in their grade point average were between was between 15-13; 65.6%  were 15-18 and also 10% of them their grade point average were between 18-20. 67.8% of students said that they love so much sweetmeat and 61.1% of students with food, pickles and salt used as high. Results showed that 38.8% of students had used too much salt in food, and on the other hand, 27.8% of students had used salt moderate. Results showed that students who had a grade average lower, the consumption of fish, red and white  meat, green and orange vegetables and dairy products were lower than the other students (p

A Preliminary Parasitological Survey of Hepatozoon Spp. Infection in Dogs in Mashhad, Iran

OpenAIRE

Amoli, AA Rahmani; Khoshnegah, J; Razmi, GhR

2012-01-01

Background: We attempted to determine the prevalence of Hepatozoon spp. infection in Mashhad, northeast of Iran, via blood smear parasitology.Methods: The prevalence was investigated by examination of blood smear parasitology, using blood samples collected from 254 dogs (51 strays and 203 privately owned-dogs).Results: Two stray dogs (2/51; 3.92%) and two privately-owned dogs (2/203; 0.98%) were infected with Hepatozoon spp. Therefore, as per blood smear parasitology, the prevalence of Hepato...

Chemical Components of Noncommercial Alcohol Beverage Samples: A Study With the Viewpoint of Toxic Components in Mashhad, Iran.

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Dadpour, Bita; Hedjazi, Arya; Ghorbani, Hamideh; Khosrojerdi, Hamid; Vaziri, Seyed Mohsen; Malek Zadeh, Haleh; Habibi Tamijani, Amir

2016-06-01

Iran has one of the lowest alcoholic beverage use rates in comparison with other countries, because it is legally forbidden and because of religious beliefs. Even so, unrecorded and noncommercial alcohol remains a considerable concern, which needs special attention. In the current research, we have studied the general composition of noncommercial alcohol samples to identify potentially toxic components in the context of the city of Mashhad in IR Iran. Using a descriptive study, chemical composition records of alcohol samples obtained from Mashhad and its suburbs (from March 2013 to March 2014) were evaluated in terms of ethanol percentage and methanol percentage using gas chromatography. Likewise, the pH of the alcohol and the location of the sample were also considered. Some substances, such as inorganic elements, were not included because there was no information about these substances in the records. Of 877 reports of alcohol samples, more than 50% were obtained from Mashhad and the rest were from the suburbs. Of the reports, 57.5% were in the spring and summer, followed by 42.5% in the fall and winter. The mean (min-max) of ethanol percentage was 30.04% (0 - 98.4). In four cases, methanol was detected. The mean (min-max) of methanol percentage was 23% (4 - 95).The majority of the samples had an acidic pH. The composition of unrecorded samples did not raise major toxicological concern beyond ethanol in alcohol products. However, concentration levels of methanol in some unrecorded alcohol samples made these samples detrimental for human consumption.

Driving Behaviors in Iran: A Descriptive Study Among Drivers of Mashhad City in 2014

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Bazzaz, Mojtaba Mousavi; Zarifian, Ahmadreza; Emadzadeh, Maryam; Vakili, Veda

2015-01-01

Background: Driver-related behaviors are substantial causes for motor vehicle accidents. It has been estimated that about 95% of all accidents are due to driver-related dangerous behaviors and approximately 60% of accidents are directly caused by driving behaviors. The aim of this study was to assess driving behaviors and its possible related factors among drivers in Mashhad city, Iran. Method: In a cross-sectional design, a total number of 514 drivers in Mashhad, Iran Surveyed. Manchester driver behavior questionnaire with 50 questions evaluated dangerous driving behaviors in 4 categories “aggressive violations”, “ordinary violations”, “errors” and “lapses”. Results: In this study, the median age of drivers was 31. Besides, 58.2% of men mentioned having a history of driving accident. Our study indicated smoking and alcohol drinking as risk factors of having more accidents. Hookah abuse is a predictor of aggressive violations and errors. Conclusion: This is the first study to assess the relation of personal car and its market value with the likelihood of having accidents. Due to major influences of driving fines, cigarette smoking, alcohol consumption and addiction on violations and errors, we recommend pivotal measures to be taken by road safety practitioners regarding driving surveillance. PMID:26153202

Comparison of Oral Health-Related Quality Of Life among Adult Referred to Public and Private Dental Clinics of Mashhad, Iran

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Zahra Mohammadzadeh

2017-09-01

Full Text Available Introduction: Nowadays, appraisal of patients' perception of health has largely replaced the clinical evaluations. This study aimed to compare oral health-related quality of life in patients referring to public and private clinics in Mashhad, Iran. Materials and Methods: In this cross-sectional study, we enrolled 383 patients referred to five private and two public dental clinics in Mashhad, Iran. The study variables including age, gender, level of education, functional dentition status, decayed, missing, and filled teeth, and the reason for referral were recorded. Oral Impact on Daily Performance (OIDP score was calculated for each patient. To analyze the data, independent samples t-test, Man-Whitney U test, and Chi-squared test were run. Results: The reason for visiting the public and private clinics was significantly different (P

Study of Bacterial Infections Among Patients Receiving Kidney Transplant in Mashhad, Iran.

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Mansury, Davood; Khaledi, Azad; Ghazvini, Kiarash; Sabbagh, Mahin Ghorban; Zare, Hosna; Rokni-Hosseini, Mohammad Hossein; Vazini, Hossein

2017-11-15

Over the past 2 decades, significant advances have been made in the management of infections after transplant; however, transplant recipients are still at high risk of infectious complications. This study aimed to evaluate the prevalence of bacterial infections and antimicrobial resistance patterns in kidney transplant recipients. This cross-sectional study included 356 patients who received kidney transplants, regardless of the underlying disease, from 2013 to 2015 at the Montaserieh Transplant Hospital (Mashhad, Iran). Clinical samples collected from patients were sent to the microbiology laboratory for culture processing. Typing of bacteria was conducted, and susceptibility testing was performed according to the Clinical and Laboratory Standards Institute guideline by use the of disk diffusion agar method. Data were then analyzed by SPSS software (SPSS: An IBM Company, IBM Corporation, Armonk, NY, USA) using chi-square test. Among 356 kidney recipients (206 men and 150 women), 115 (32.3%) received transplants from living donors and 241 (67.7%) received transplants from deceased donors. Of 356 total patients, 112 patients (31.5%) had an infection at various times after transplant. The most common gram-negative and gram-positive isolated bacteria were Escherichia coli and coagulase-negative Staphylococcus, with prevalence rates of 66.1% and 48.6%. Most of the isolates were resistant against selected antibiotics. Because of the high prevalence of infection among transplant patients, infection prevention should receive more attention, and antibiotic susceptibility should be determined before treatment.

Assessment of Pain Management in Pediatric Emergency Department in Mashhad -Iran

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Ahmadshah Farhat

2013-12-01

Full Text Available Introduction: Pain may be described as a sensation of hurt or strong discomfort and is the body's way of sending message to the brain that an injury has occurred. Pain medicines block these messages or reduce their effect on the brain. Accurate administration of analgesia have a long –lasting effect on children whole experience of medical care and affects parents' and children's future reaction to pediatrics emergency departments. The purpose of this study was to evaluate pain management on children in our emergency department. Materials and Methods: In this study we evaluated the relief of pain and anxiety on 100 children who referred to our pediatric Emergency Department (ED in Imam Reza Hospital- Mashhad .The patients were assessed based on the American Academy of Pediatrics (AAP recommendations about pain.  Results: Patients were gone under IV Line 97%, Intubation 5% and Lumbar Puncture 28%. Training had been provided to 70% participants in the Emergency Department. Nonpharmacologic stress reduction was used in 35% of cases. Family presence was allowed only in 5%. Prehospital pain controlling was began on 20% of patients and continued in ED on 40%. At the time of discharge 40% prescribed analgesics. Sedation and pain prophylaxis was provided for 10% of patients undergoing painful procedures in ED.  Conclusion: According to results, pain management in our Pediatric Emergency Department was inadequate. Physicians and prehospital EMS providers should be justified about the importance of pain relieving and trained how to use all available analgesic and sedative options.

Assessment of life skills of medical students in Mashhad, Iran, in 2015.

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Rezayat, Arash Akhavan; Niroumand, Shabnam; Shiehzadeh, Elham; Saghebi, Ali; Oskooie, Reza Rahimzadeh; Dadgarmoghaddam, Maliheh

2017-10-01

Developing social skills and mental health is a crucial part of the psychosocial health status of medical students. The aim of this study was to assess the life skills of medical students in Mashhad University of Medical Sciences (MUMS). This cross-sectional study was performed in Mashhad University of Medical Sciences, Iran in 2015. By census method, 146 interns were entered into the study. The life skill questionnaire, consisting of 144 questions, was used as the measurement tool. Over 3 months, all the medical students in internship period were asked to complete the questionnaire. Data were analyzed by independent-samples t-test, one-way ANOVA, and Mann-Whitney with SPSS version 11.5 software. Women were shown to have higher decision-making ability than men (p=0.046). It was also shown in the study that social behavior (p=0.018), participation in activities that improve benefits (p=0.006), critical thinking (p=0.007), observing and using safety points (p=0.005), and mental health status (p=0.034) were significantly lower in men than in women. The data also suggests that men (13.97±4.7249) are more likely to become global citizens than women (12.15±3.6298) (p=0.010). Furthermore, there was a significant difference when comparing smoking and non-smoking in freedom and justice (p=0.003) and becoming a global citizen (p=0.012). Our study provides helpful information about medical students' life skills for policy makers and university authorities. We suggest that gender differences should be considered during life skill training.

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

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

2015-04-01

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

Outcomes of vaginal delivery and cesarean in Mashhad Ghaem University Hospital

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Hassan Boskabadi

2014-03-01

Conclusion: The results of this study showed in comparison with cesarean delivery, normal vaginal delivery provides better outcomes in terms of breast problems, breast feeding status, duration of labor and duration of maternal hospitalization for both mother and infant. So, adopting careful instructions in management and administration of deliveries will help the prevalence of making decisions for normal vaginal delivery and the recovery of delivery outcomes.

Leachate and Pollution Levels of Heavy Metals in the Groundwater near Municipal Solid Waste Landfill Site of Mashhad, Iran

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Borhan Mansouri

2014-06-01

Full Text Available Background: The purpose of this study is to investigate the concentration of metals (lead, cadmium, chromium, copper, and nickel in the landfill leachate and heavy metals in wells downstream of municipal solid waste landfill site in the city of Mashhad. Methods: In both winter and summer seasons in 2009 samples were collected from five wells that were in landfill downstream in Mashhad. Results: Among heavy metals, nickel concentration in summer and lead concentration in winter had the highest levels. The results showed that the mean concentration of heavy metals in the studied wells was below the national standards of drinking water of Iran, WHO, and the United States. Pearson correlation coefficients also indicated that there was a significant correlation among the studied metals in the wells. Conclusion: Cd and Cu concentrations in all of the wells (except Pb in winter and Ni in summer did not pose any significant water quality problems since these concentrations were below the standards acceptable levels of drinking water.

Utilizing QFD model to determine quality characteristics of the products and priority needs of customers in the medical industry products (Case Study: Plasma seat product in mashhad`s Sahateb medical equipment company

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Zeinab Armoun

2012-10-01

Full Text Available Quality Function Deployment (QFD as one of the quality engineering methods; originates from market study and product or service customers identification, where by determining their needs; tries to involve them in all stages of product or service development. This study uses QFD method to apply customers’ criteria in production of Coach Plasma in Mashhad`s Sahateb Company. Coach Plasma is used for healthy bloodletting. The proposed study of this paper designed and distributed a questionnaire, which includes identification & determination of customers’ needs and investigation of their satisfaction of manufactured products, while looking for technical and engineering characteristics related to their needs. The Coach Plasma costumers are categorized into two groups of local and external customers. Data collection was done based on available documents, experts opinions, structured interview with managers and questionnaire. Customers’ needs were studied in QFD teams. Collecting essential information such as needs importance degree and competitive benchmarking of customer`s needs, the weight of each need has been evaluated. In this research, House of Quality was used from first matrix of QFD leading to estimation of engineering & technical characteristics in order to enter to the quality deployment matrix. Take a look at obtained results, we could mention the role of each of these external factors in satisfaction of Sahateb Company customers and technical characteristics of the company in providing these factors and the prioritization of the customer's needs.

Ethnobotanical investigation of traditional medicinal plants commercialized in the markets of Mashhad, Iran

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Mohammad Sadegh Amiri

2013-05-01

Full Text Available Objective: An ethnobotanical survey on the medicinal plant species marketed in Mashhad city, northeastern Iran, was conducted in order to document traditional medicinal knowledge and application of medicinal plants. Materials and Methods: This study was undertaken between 2011 and 2012. The indigenous knowledge of traditional healers used for medicinal purposes were collected through questionnaire and personal interviews during field trips. Ethnobotanical data was arranged alphabetically by family name followed by botanical name, vernacular name, part used, folk use, and recipe. Correct identification was made with the help of the various Floras and different herbal literature at the Ferdowsi University of Mashhad Herbarium (FUMH. Results: The present investigation reported medicinal information for about 269 species, belonging to 87 vascular plant families and one fungus family. The most important family was Lamiaceae with 26 species, followed by Asteraceae with 23, Fabaceae with 20, and Apiaceae with 19. Herbal medicine uses reported by herbalists was classified into 132 different uses which show significant results to treat a wide spectrum of human ailments. Plants sold at the market were mostly used for digestive system disorders, respiratory problems, urological troubles, nervous system disorders, skin problems, and gynecological ailments. Conclusion: This survey showed that although people in study area have access to modern medical facilities,  a lot of them still continue to depend on medicinal plants for the treatment of healthcare problems. The present paper represents significant ethnobotanical information on medical plants which provides baseline data for future pharmacological and phytochemical studies.

The Relationship Between Job Satisfaction and Job Performance Among Midwives Working in Healthcare Centers of Mashhad, Iran

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Zahra Hadizadeh Talasaz

2014-07-01

Full Text Available Background and Aim: Job satisfaction represents individuals' positive or negative attitude towards their occupation. Job satisfaction is of high significance in health care field and could affects the quality of patients' health care and satisfaction. Every organization should pay considerable attention to job satisfaction and performance and continually monitor these indices. Therefore, we aimed to determine the relationship between job satisfaction and job performance of midwives, employed in health care centers of Mashhad, Iran. Methods: This descriptive correlational study was performed on 90 midwives, working in healthcare centers of Mashhad, Iran, in 2014 who were selected through multistage sampling from five healthcare centers. Data collection tools included a questionnaire to record demographic, personal and occupational data, Minnesota Job Satisfaction Questionnaire (MSQ as well as a self-structured observational checklist to measure the quality of educational, care, and communicative job performance of midwives. SPSS version 19 was used to analyze data through descriptive statistics, and also Spearman and Kruskal-Wallis tests. Results: The mean age of the participants was 39.63±6.92 years. Spearman correlation test showed a direct correlation between job satisfaction and the total score of job performance (P

Mashhad University of Medical Sciences

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Ali Shoeibi

2013-03-01

Full Text Available     Human T-cell lymphotropic virus (HTLV types 1 and 2 belong to the Oncorna group of retroviridae, a large family of viruses, grouped initially by pathogenic features, but later revised on the basis of genome structure and nucleotide sequence. HTLV-I was the first discovered human retrovirus to be associated with a malignancy in 1980. The malignancy, first described by Uchiyama and co-workers in southwestern Japan, was named Adult T-cell Leukemia/Lymphoma (ATL and characterized with cutaneous and respiratory involvement, hepatosplenomegaly, lymphadenopathy and various metabolic abnormalities such as hypercalcemia. The HTLV-I has been known to be endemic to certain parts of Iran like the province of Khorasan in the northeast since 1990, with a 2.3% prevalence rate of infection. The main manifestations of HTLV-I infection are neurologic and hematologic (such as ATL disorders, but it has also other manifestations such as uveitis, arthritis, dermatitis, vitiligo and lymphocytic alveolitis. Its main neurologic manifestation is a chronic progressive myelopathy that is referred to HTLV-I Associated Myelopathy (HAM in Japan and Tropical Spastic Paraparesis (TSP in Caribbean. But other disorders such as peripheral neuropathy, polyradiculoneuropathy, myopathy, peripheral facial paresis, and so on have been reported too. In this review we wish to give some brief information on the different aspects (including epidemiology, pathogenesis and pathology, clinical findings, and treatment of HTLV-I infection according to our twenty-year researches. The department of neurology of Mashhad University of Medical Sciences has been a pioneer in researches on HTLV-I in the last twenty years.  

Effects of Group Reminiscence Therapy on Disability of Nursing Home Residents in Mashhad –Iran 1390

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Hadi Kooshyar

2012-10-01

Full Text Available Objectives: Examine the effects of group reminiscence therapy on disability of nursing home residents in Mashhad -Iran. Methods & Materials: In this semi-experimental study, 56 residents of nursing homes in Mashhad –Iran were selected by convenience sampling. Subjects in each nursing home randomly assigned to reminiscence group therapy (30 and control group (26. Thus six groups with 4-8 members were made. Reminiscence group therapy was done one hour weekly for eight weeks. Disability, depression, cognitive function, and pain were measured by World Health Organization Disability Assessment Schedule II (WHODAS II, 15-Item Geriatric Depression Scale (GDS-15, Mini Mental State Examination (MMSE and Visual Analogue Scale (VAS respectively. SPSS version 11.5 and parametric and non-parametric tests were used for data analysis. Results: The result of ANOVA and Mann-Whitney tests showed there was no significant difference about total disability score (P=0.94 and its subscales: communication and understanding (P=0.20, getting around (P=0.20, self-care (P=0.92, dealing with other (P=0.72, and participation (P=0.88 between experimental and control group. Conclusion: One hour weekly group reminiscence therapy for eight weeks can't reduce disability and its subdivisions in nursing home residents. Therefore we advise further studies in this field.

Motorcycle crash-related emergency department visits and hospitalizations for traumatic brain injury in North Carolina.

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Harmon, Katherine J; Marshall, Stephen W; Proescholdbell, Scott K; Naumann, Rebecca B; Waller, Anna E

2015-01-01

To examine statewide emergency department (ED) visit data for motorcycle crash morbidity and healthcare utilization due to traumatic brain injuries (TBIs) and non-TBIs. North Carolina ED data (2010-2012) and hospital discharge data (2009-2011). Statewide ED visits and hospitalizations due to injuries from traffic-related motorcycle crashes stratified by TBI status. Descriptive study. Descriptive statistics include age, sex, mode of transport, disposition, expected source of payment, hospital length of stay, and hospital charges. Over the study period, there were 18 780 ED visits and 3737 hospitalizations due to motorcycle crashes. Twelve percent of ED visits for motorcycle crashes and 26% of hospitalizations for motorcycle crashes had a diagnosis of TBI. Motorcycle crash-related hospitalizations with a TBI diagnosis had median hospital charges that were nearly $9000 greater than hospitalizations without a TBI diagnosis. Emergency department visits and hospitalizations due to motorcycle crashes with a TBI diagnosis consumed more healthcare resources than motorcycle crash-related ED visits and hospitalizations without a TBI diagnosis. Increased awareness of motorcyclists by other road users and increased use of motorcycle helmets are 2 strategies to mitigate the incidence and severity of motorcycle crash injuries, including TBIs.

Epidemiology of Snake, Spider and Scorpion Envenomation in Mashhad, Khorasan Razavi, Iran (2004-2011

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Majid Khadem-Rezaiyan

2018-01-01

Full Text Available Backgrounds: Envenomation is common in Asia including Iran that induces morbidity and mortality. This study investigated the epidemiological characteristics of cases with snake, spider and scorpion bites. Methods: In this cross-sectional design, epidemiologic data of admitted cases to the Toxicology Department of Imam Reza Hospital of Mashhad, Iran were analyzed across a 7-yr period, from 2004 to 2011. SPSS was used for data analysis. Results: This study reports 686 admissions due to animal envenomation with an incidence rate of 2.9 per 100000. Mean (SD, min-max age of admitted patients was 30 (19, 1-90 yr, and 471 (69% were male. Snakebite (n, percentage, annual incidence (299, 44%, 1.3 per 100000 and spider bite (188, 27%, 0.8 per 100000 and scorpion sting (126, 18.4%, 0.5 per 100000 were most frequent cases. Overall, case fatality rate was 0.09 per 100000 which were due to scorpion and unknown bite. No cases of snakebites died in this period. The highest age-specific incidence rate was 4.6 per 100000 and related to 10-20 yr of age. Conclusion: Animal envenomation is frequent in this area and a matter of health concern. While deaths related to snake bite are no longer reported-presumably due to using effective anti-venom - managing unknown and scorpion bites need to be addressed. Envenomation was not overtly an age-specific event in this province.

Clinicopathological comparisons of open vein harvesting and endoscopic vein harvesting in coronary artery bypass grafting patients in Mashhad.

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Amouzeshi, Ahmad; Teshnisi, Mohamad Abbassi; Zirak, Nahid; Shamloo, Alireza Sepehri; Hoseinikhah, Hamid; Alizadeh, Behzad; Moeinipour, Aliasghar

2016-01-01

Harvesting of the greater saphenous vein is almost an inevitable part of coronary artery bypass grafting (CABG) operations, and it is done by two main techniques, i.e., conventional or open vein harvesting (OVH) and the minimally-invasive endoscopic vein harvesting (EVH). This study aimed to compare these two techniques in off-pump CABG procedures with respect to clinical and pathological outcomes. This cohort study was conducted on CABG candidates during a one-year period from October 2013 through September 2014 in the Department of Cardiac Surgery at Mashhad University of Medical Sciences. Eighty-seven patients voluntarily underwent EVH, and another 86 patients matched for age, gender, and other cardiovascular risk factors were selected for OVH. They were followed up for six weeks, and the main outcome measures were infections of the wound, pain, duration of hospital stay, and the costs of hospitalization. Paired sample t-test, independent t-test, or their non-parametric equivalents and the chi-squared test were used by SPSS version 17.0 for data analysis. The mean duration of time for vein harvesting was shorter in the EVH group (p < 0.001), and the pain score was lower (p = 0.04). No infections occurred at the site of the wound. The length of hospital stay was not significantly different for the two groups (OVH versus EVH: 8.5 ± 3.3 versus 8.4 ± 3.2 days; p-value: 0.08). Hospitalization costs were significantly higher in the EVH group (OVH versus EVH: 5.8 ± 4.7 versus 7.3 ± 2.0 million Tomman; p-value: 0.008), yet no difference was diagnosed with respect to endothelial damage in the vein grafts harvested by the EVH and OVH techniques. EVH is considered as a minimally invasive and safe vein harvesting technique in our Center, and it can reduce the harvesting time and post-operative pain. In addition, its efficiency was similar to that of OVH.

Association between menstruation signs and anxiety, depression, and stress in school girls in Mashhad in 2011-2012

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Mohamadirizi, Soheila; Kordi, Masoumeh

2013-01-01

Background: Menstruation signs are among the most common disorders in adolescents and are influenced by various environmental and psychosocial factors. This study aimed to define the association between menstruation signs and anxiety, depression, and stress in school girls in Mashhad in 2011-2012. Materials and Methods: This was a cross-sectional study on 407 high school girls in Mashhad who were selected through two-step random sampling. The students completed a questionnaire concerning demographic characteristics, menstruation, Depression, Anxiety, and Stress Scale of 21 questions (DASS-21), and menstruation signs in three phases of their menstruation. Data were analyzed by the statistical tests of Pearson correlation coefficient, Student's t-test, one-way analysis of variance (ANOVA), and regression through SPSS version 14. Results: Based on the findings, 74% of the subjects reported pre-menstruation signs, 94% reported signs during bleeding, and 40.8% reported post-menstruation signs. About 44.3% of the subjects had anxiety, 45.5% had depression, and 47.2% had stress. In addition, Pearson correlation coefficient test showed a significant positive correlation between menstruation signs and depression, anxiety, and stress (P menstruation signs and psycho-cognitive variables, prevention and treatment of these disorders by the authorities of education and training and the Ministry of Health are essential. PMID:24403944

Association between menstruation signs and anxiety, depression, and stress in school girls in Mashhad in 2011-2012.

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Mohamadirizi, Soheila; Kordi, Masoumeh

2013-09-01

Menstruation signs are among the most common disorders in adolescents and are influenced by various environmental and psychosocial factors. This study aimed to define the association between menstruation signs and anxiety, depression, and stress in school girls in Mashhad in 2011-2012. This was a cross-sectional study on 407 high school girls in Mashhad who were selected through two-step random sampling. The students completed a questionnaire concerning demographic characteristics, menstruation, Depression, Anxiety, and Stress Scale of 21 questions (DASS-21), and menstruation signs in three phases of their menstruation. Data were analyzed by the statistical tests of Pearson correlation coefficient, Student's t-test, one-way analysis of variance (ANOVA), and regression through SPSS version 14. Based on the findings, 74% of the subjects reported pre-menstruation signs, 94% reported signs during bleeding, and 40.8% reported post-menstruation signs. About 44.3% of the subjects had anxiety, 45.5% had depression, and 47.2% had stress. In addition, Pearson correlation coefficient test showed a significant positive correlation between menstruation signs and depression, anxiety, and stress (P menstruation signs and psycho-cognitive variables, prevention and treatment of these disorders by the authorities of education and training and the Ministry of Health are essential.

Asthma Burden in the Hospitalized Patients in North of Iran

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Javad Ghaffari

2014-10-01

Full Text Available Introduction: Asthma is a chronic inflammatory airway disease. Genetic and environmental factors have been important role in the induction of asthma. It's estimated that asthma affect 2.7 to 35.4% of child (in average 13.4% in Iran. The aims of this study to assess the costs of asthma patients admitted in Boali hospital in Sari in the north of Iran. Patients and Methods: This descriptive study was carried out in asthma patients 1 to 20 years old that admitted in the Boali hospital in Sari from 2008 to2012. Out of 455 folders, 22 folders excluded because incomplete registrations.Results: Out of 432 patients, 280 patients (64.81% were male. 349 patients were 1-5 years old (80.78%. Average annual cost in our asthmatic patients was 1219064 Rials(Iran currency ($ 121.9 per patient, 1183655 ($ 118.3 and 1284789($ 128.5 Rials per male and per female patient respectively. Conclusions: Our study showed asthma disease has been significantly cost for patient, family

Prevalence of internet addiction and associated factors among medical students from mashhad, iran in 2013.

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Salehi, Maryam; Norozi Khalili, Mina; Hojjat, Seyed Kaveh; Salehi, Mahta; Danesh, Ali

2014-05-01

Problematic internet use is on the increase and has caused serious problems in many areas. This issue seems to be more important for medical students. This study was designed to explore the prevalence of internet addiction and its related factors among the students of Mashhad University of Medical Sciences. A cross sectional study was conducted on 383 medical students of Mashhad in 2013. Four hundred participants were selected through two-stage stratified sampling method proportional to the number of students in each stage of education. Data Collection was done through using the Chen Internet Addiction Scale (CIAS) and a checklist of demographic details and characteristics of internet usage behavior. It was found that 2.1% of the studied population were at risk and 5.2% were addicted users. Chatting with new people, communicating with friends and families, and playing games were the most popular activities in these groups. The factors related to internet addiction included: male sex, stage of education, daily time spent on using internet, most frequent time of internet use, monthly cost of use, and tea consumption. Although our study showed the prevalence of internet addiction was not more than other populations and universities, since the prevalence of internet addiction is rapidly increasing worldwide, this population might also be at risk of addiction. Thus, focusing on related factors can help us in designing more effective interventions and treatments for this susceptible group.

Investigation of Possibility of Fennel (Foeniculum vulgar L. Autumnal Sowing in Mashhad Condition

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E. Azizi

2016-02-01

Full Text Available In order to investigate the possibility of Fennel autumnal sowing in Mashhad condition, 2 sets of experiments were conducted in Agricultural College, Ferdowsi University of Mashhad in 2003-2005. This experiment was performed in the manner of Split Blocks based on completely randomized Blocks with three replications. Treatments were two fennel ecotypes (Khorasan and Kerman and three planting dates (October, December and March. Fennel seeds only were planted in 2003 and in next year, plants were grown of remains parts of stem in surface of soil. Results showed in end of first years, number of remain plant in March planting dates, three times of October planting dates. In second years, number of remain plant in March planting dates 6.5 and 2.7 times October and December planting dates, respectively. Number of remain plant between Khorasan and Kerman ecotypes were not significantly different in two years. However, effects of planting date and ecotype on dry matter and number of primary and secondary branches were not significant but plant of October planting dates superior to the plant of December and March planting dates. Number of umbel without seed in October planting dates was 3.4 and 8.8 times of December and March planting dates. In spite of weight of seed in October planting dates highest than December and March planting dates, effect of planting dates on weight of seed in plant was not significant. In first year highest and lowest yield were obtained in October (68.7 gr/m2 and March (20.5 g/m2 planting dates. But in second year maximum and minimum of yield were obtained in March and October planting dates with 45.3 and 14.2 g/m2, respectively.

Frequency of convergence and accommodative disorders in a clinical population of Mashhad, Iran.

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Hoseini-Yazdi, Seyed Hosein; Yekta, AbbasAli; Nouri, Hosein; Heravian, Javad; Ostadimoghaddam, Hadi; Khabazkhoob, Mehdi

2015-01-01

To investigate the frequency of convergence and accommodation anomalies in an optometric clinical setting in Mashhad, Iran, and to determine tests with highest accuracy in diagnosing these anomalies. From 261 patients who came to the optometric clinics of Mashhad University of Medical Sciences during a month, 83 of them were included in the study based on the inclusion criteria. Near point of convergence (NPC), near and distance heterophoria, monocular and binocular accommodative facility (MAF and BAF, respectively), lag of accommodation, positive and negative fusional vergences (PFV and NFV, respectively), AC/A ratio, relative accommodation, and amplitude of accommodation (AA) were measured to diagnose the convergence and accommodation anomalies. The results were also compared between symptomatic and asymptomatic patients. The accuracy of these tests was explored using sensitivity (S), specificity (Sp), and positive and negative likelihood ratios (LR+, LR-). Mean age of the patients was 21.3 ± 3.5 years and 14.5% of them had specific binocular and accommodative symptoms. Convergence and accommodative anomalies were found in 19.3% of the patients; accommodative excess (4.8%) and convergence insufficiency (3.6%) were the most common accommodative and convergence disorders, respectively. Symptomatic patients showed lower values for BAF (p = .003), MAF (p = .001), as well as AA (p = .001) compared with asymptomatic patients. Moreover, BAF (S = 75%, Sp = 62%) and MAF (S = 62%, Sp = 89%) were the most accurate tests for detecting accommodative and convergence disorders in terms of both sensitivity and specificity. Convergence and accommodative anomalies are the most common binocular disorders in optometric patients. Including tests of monocular and binocular accommodative facility in routine eye examinations as accurate tests to diagnose these anomalies requires further investigation.

Cardiovascular, respiratory, and total mortality attributed to PM2.5 in Mashhad, Iran.

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Bonyadi, Ziaeddin; Ehrampoush, Mohammad Hasan; Ghaneian, Mohammad Taghi; Mokhtari, Mehdi; Sadeghi, Abbas

2016-10-01

Poor air quality is one of the most important environmental problems in many large cities of the world, which can cause a wide range of acute and chronic health effects, including partial physiological disorders and cardiac death due to respiratory and cardiovascular diseases. According to the latest edition of the national standard for air quality, maximum contamination level is 15 μg/m(3) per year and 35 μg/m(3) per day. The aim of this study was to evaluate cardiovascular, respiratory, and total mortality attributed to PM2.5 in the city of Mashhad during 2013. To this end, the Air Q model was used to assess health impacts of PM2.5 and human exposure to it. In this model, the attributable proportion of health outcome, annual number of excess cases of mortality for all causes, and cardiovascular and respiratory diseases were estimated. The results showed that the number of excess cases of mortality for all causes and cardiovascular and respiratory diseases attributable to PM2.5 was 32, 263, and 332 μg/m(3), respectively. Moreover, the annual average of PM2.5 in Mashhad was obtained to be 37.85 μg/m(3). This study demonstrated that a high percentage of mortality resulting from this pollutant could be due to the high average concentration of PM2.5 in the city during 2013. In this case, using the particle control methods, such as optimal use of fuel, management of air quality in urban areas, technical inspection of vehicles, faster development of public transport, and use of industrial technology can be effective in reducing air pollution in cities and turning existing situations into preferred ones.

Finite Element Method Application in Areal Rainfall Estimation Case Study; Mashhad Plain Basin

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M. Irani

2016-10-01

Full Text Available Introduction: The hydrological models are very important tools for planning and management of water resources. These models can be used for identifying basin and nature problems and choosing various managements. Precipitation is based on these models. Calculations of rainfall would be affected by displacement and region factor such as topography, etc. Estimating areal rainfall is one of the basic needs in meteorological, water resources and others studies. There are various methods for the estimation of rainfall, which can be evaluated by using statistical data and mathematical terms. In hydrological analysis, areal rainfall is so important because of displacement of precipitation. Estimating areal rainfall is divided to three methods: 1- graphical. 2-topographical. 3-numerical. This paper represented calculating mean precipitation (daily, monthly and annual using Galerkin’s method (numerical method and it was compared with other methods such as kriging, IDW, Thiessen and arithmetic mean. In this study, there were 42 actual gauges and thirteen dummies in Mashhad plain basin which is calculated by Galerkin’s method. The method included the use of interpolation functions, allowing an accurate representation of shape and relief of catchment with numerical integration performed by Gaussian quadrature and represented the allocation of weights to stations. Materials and Methods:The estimation of areal rainfall (daily, monthly,… is the basic need for meteorological project. In this field ,there are various methods that one of them is finite element method. Present study aimed to estimate areal rainfall with a 16-year period (1997-2012 by using Galerkin method ( finite element in Mashhad plain basin for 42 station. Therefore, it was compared with other usual methods such as arithmetic mean, Thiessen, Kriging and IDW. The analysis of Thiessen, Kriging and IDW were in ArcGIS10.0 software environment and finite element analysis did by using of Matlab

Comparing the quality of preconception care provided in healthcare centers in Mashhad in 2012.

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Sardasht, Fatemeh Ghaffari; Shourab, Nahid Jahani; Jafarnejad, Farzaneh; Esmaily, Habibollah

2015-01-01

Improving the quality of healthcare services is considered as the main strategy to improve maternal and neonatal health outcomes. Providing appropriate healthcare for mothers and their newborn children is facilitated significantly by considering the mothers' health and welfare before pregnancy occurs. Therefore, the aim of this study was to compare the quality of preconception care provided to women of reproductive age provided by five health centers in Mashhad in 2012 and 2013. Multi-stage sampling was used to select the participants in this descriptive study. As a result, 360 women of reproductive age and 39 healthcare providers from 24 healthcare centers in Mashhad were selected to participate. The data gathering tool was a checklist based on the Donabedian model that includes the three dimensions of structure, process, and outcome. The data were analyzed by SPSS software (version 11.5), Kruskal-Wallis tests, ANOVA, and Spearman rank correlation. The results showed that preconception care at the 24 healthcare centers had essentially the same conditions. But in the process and outcome components, the quality of the preconception care at five of the health centers was significantly different (p=0.008). The highest quality of care processes was identified at health center number 3. The difference in the component of outcomes being followed up by the healthcare providers at five of the health centers was statistically significant (p=0.000); however, there were no significant differences found among the satisfaction and awareness of the women who participated at the five health centers. The results showed that the performance of health personnel in providing preconception care and providing follow-up care was not satisfactory.

Introduction of Astigmatina and Oribatida Mites (Acari: Sarcoptiformes associated with Stored Food Products in Mashhad county

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Zohre Khaleghabadian

2016-09-01

Full Text Available Introduction: The occurrence and activity of mites in stored foods cause a variety of qualitative and quantitative damages, including reduction in the germinating power of the grains, bronchial asthma and allergic skin reactions. Among the mites associated with stored products, species of order Sarcoptiformes especially some species of Astigmatina including the genera Acarus, Suidasia and Tyrophagousare have economic importance and a worldwide distribution. The members of family Histiosomatidae also are cosmopolitan and often found in moist organic materials. In Iran, there have been a considerable number of studies on astigmatic mites. Kamali et al. have provided a list of stored product mites. fthe work of Bahrami et al. on species diversity of Acaroidea in Tehran, Ardeshir on population of stored grains in different seasons in Iran;Sayedi et al. on mites associated with stored rice in Guilan can be mentioned. Reviewing the literature revealed that in the only study that has been carried out in the study area, only 6 species of storage mites have previously been reported from Khorasan-e- +Razavi province. Literature review showed that although Oribatida consists of 9000 known species in the world, the number of recorded species from Iran is not considerable. Iranian studies on oribatid mites have limited to a few specific areas and recent years. By considering the limitation of knowledge on species diversity of stored product mites in the study area, the present study aimed to improve our knowledge on the mite associated with the stored food products in Mashhad city and the vicinity. Material and Methods: During years 2011−2012 a variety of food storages in Mashhad region were visited and sampled. These stored food products included wheat, barley, wheat bran, rice, flour mill, factories of pasta and bakeries, stockpiles of livestock’s food, and potato and onion storages in different parts of Mashhad. Mite specimens were extracted from

Simulation of Integrated Qualitative and Quantitative Allocation of Surafce and Underground Water Resources to Drinking Water Demand in Mashhad

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Mansoureh Atashi

2015-12-01

Full Text Available Despite the fact that both surface and groundwater resources inside and outside the city of Mashhad have been already exploited to their maximum capacity and that the large water transfer Doosti Dam Project has been already implemented to transfer a considerable quanity of water to Mashhad, the city will be encountering a daily water shortage of about 1.7 m3/s by 2021. The problem would be even worse if the quality of the water resources are taken into account, in which case, the shortage would start even sooner in 2011 when the water deficit will be about 0.9 m3/s. As a result, it is essential to develop short- and medium-term strategies for secure adequate water supplies for the city's domestic water demand. The present study aims to carry out a qualitative and quantitative modeling of surface and groundwater resources supplying Mashhad domestic water. The qualitative model is based on the quality indices of surface and groundwater resources according to which the resources are classified in the three quality categories of resources with no limitation, those with moderate limitations, and those with high limitations for use as domestic water supplies. The pressure zones are then examined with respect to the potable water demand and supply to be simulated in the MODSIM environment. The model thus developed is verified for the 2012 data based on the measures affecting water resources in the region and various scenarios are finally evaluated for a long-term 30-year period. Results show that the peak hourdaily water shortage in 2042for the zone supplied from no limitation resources will be 38%. However, this value will drop to 28% if limitations due to resource quality are also taken into account. Finally, dilution is suggested as a solution for exploiting the maximum quantitative and qualitative potential of the resources used as domestic water supplies. In this situation, the daily peak hour water shortage will be equal to 31%.

A grounded theory approach to understand the process of decision making on fertility control methods in urban society of Mashhad, Iran.

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Roudsari, Robab Latifnejad; Khadivzadeh, Talat; Bahrami, Masoud

2013-09-01

More than 30% of pregnancies in Iran are unintended and most of them happen among the women who use various contraceptive methods. Results of Integrated Monitoring and Evaluation System (IMES) showed that the rate of innovative contraceptive use in Mashhad has been 41.5%-57% in different urban areas. This study was conducted to explore the process of making decision toward using family planning methods in women of reproductive age in urban society of Mashhad, Iran. In this grounded theory study, semi-structured interviews were conducted with 45 purposefully selected participants including 28 women and 17 key informants including family health providers and managers, and participants' mothers and husbands, who lived in urban society of Mashhad, Iran, in 2011-2012. Participants' recruitment continued until data saturation occurred. Data were analyzed using Strauss and Corbin's mode of analysis through constant comparative method, applying levels of open, axial, and selective coding with MAXqda software. Study rigor was confirmed through prolonged engagement, member check, expert debriefing, and thick description of the data. The core category of "caring the comprehensive health of my family," which emerged from the data, described the process of couples' decision making toward using family planning methods in this study. Other developed categories which were presented into a theoretical scheme consisted of 1) shaping the ideas of fertility control, 2) developing cognition about the fertility control methods, 3) appraising available choices and choosing the most appropriate one, 4) managing the course of using methods, and 5) realizing the fertility intentions. It is important that family planning providers understand the motivations, perceptions, and knowledge of women about contraceptive methods in their contextual situation, which illustrates their mode of interaction in the arenas of family planning decision making.

A Survey over the Dentists' and Endodntists' Approaches towards the Management of Endodontic Emergencies in Mashhad, Iran.

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Bidar, Maryam; Gharechahi, Maryam; Soleimani, Tayebeh; Eslami, Neda

2015-01-01

Pain or swelling caused by various stages of inflammation/infection of the pulp/periradicular area is among endodontic emergencies. Determining the most effective method of emergency treatment is a challenging issue in endodontics. The goal of this study was to determine and compare the level of knowledge in general dentists and endodontists about endodontic emergency treatment plan in Mashhad, Iran in 2012-2013. In this cross-sectional descriptive study, 152 questionnaires were distributed among 120 general dentists and 32 endodontists of Mashhad. The questionnaire contained two separate parts. The first part included demographic information and in the second part different treatment protocols were suggested for 12 various conditions of pulp/periapical emergencies, and the participants were asked to choose the correct option(s). To determine the relationship between qualitative variables, the chi-square analysis was used. The level of significance was set at 0.05. There were significant differences between treatment plans presented by general dentists and endodontists about endodontic emergencies, especially in cases of necrotic pulp and subsequent swelling. Level of knowledge of dentists about the indications of incision and drainage, intra-canal medicament, root filing beyond the apical foramen and antibiotic prescription was not enough. These findings highlight the importance of refreshing courses for general dentists to improve their competency in the management of endodontic emergencies.

A Survey over the Dentists’ and Endodntists’ Approaches towards the Management of Endodontic Emergencies in Mashhad, Iran

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Bidar, Maryam; Gharechahi, Maryam; Soleimani, Tayebeh; Eslami, Neda

2015-01-01

Introduction: Pain or swelling caused by various stages of inflammation/infection of the pulp/periradicular area is among endodontic emergencies. Determining the most effective method of emergency treatment is a challenging issue in endodontics. The goal of this study was to determine and compare the level of knowledge in general dentists and endodontists about endodontic emergency treatment plan in Mashhad, Iran in 2012-2013. Methods and Materials: In this cross-sectional descriptive study, 152 questionnaires were distributed among 120 general dentists and 32 endodontists of Mashhad. The questionnaire contained two separate parts. The first part included demographic information and in the second part different treatment protocols were suggested for 12 various conditions of pulp/periapical emergencies, and the participants were asked to choose the correct option(s). To determine the relationship between qualitative variables, the chi-square analysis was used. The level of significance was set at 0.05. Results: There were significant differences between treatment plans presented by general dentists and endodontists about endodontic emergencies, especially in cases of necrotic pulp and subsequent swelling. Conclusion: Level of knowledge of dentists about the indications of incision and drainage, intra-canal medicament, root filing beyond the apical foramen and antibiotic prescription was not enough. These findings highlight the importance of refreshing courses for general dentists to improve their competency in the management of endodontic emergencies. PMID:26523142

Evaluation of Fall Sowing of Cold Tolerant Chickpa (Cicer arietinum L. Genotypes under Supplementary Irrigation in Mashhad

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A. Nezami

2011-01-01

Full Text Available Abstract In order to investigate of phenological and morphological characteristics, yield components and yield of cold tolerant chickpea genotypes in fall sowing, 9 cold tolerant chickpea genotypes and Karaj 12-60-31 as a control were evaluated in Experimental Field of College of Agriculture, Ferdowsi University of Mashhad in 2006-2007. The experiment was carried out based on randomized complete block design with four replications. The planting date was 25 October and three times of irrigation was done as supplementary irrigation at planting stage, 20 days after that and at flowering stage. The control was ruined at seedling stage due to the hard cold. Based on the results, the differences among the genotypes for all of measured traits including growth duration, plant height, number and length of branches, yield components (pod number per plant, seed number per pod and 100 seeds weight, seed yield and biological yield were significant (P≥0.05. There were positive and significant correlations between seed yield and vegetative (r=0.71** and reproductive (r=0.68** periods. MCC291, MCC349 and MCC207 produced the highest seed yield with 231, 229 and 217 g.m-2, respectively. Totally, it appears that some of genotypes have appropriate yield potential for fall sowing under supplementary irrigation at Mashhad. Keywords: Cold tolerant, Chickpea genotypes, Phenological and morphological characteristics, Seed yield, Yield components

Nosocomial Infections and Antibiotic Administration in Pediatric Department, Imam Reza Hospital, Mashhad-Iran

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Abdolkarim Hamedi

2014-04-01

Full Text Available Introduction: Nosocomial Infections (NI are a frequent and relevant problem, in other hands; those are responsible of mortality especially in pediatric ICU( Intensive Care Unit and NICUs (Neonatal Intensive Care Unit. Healthcare-associated infections are important in wide-ranging concern in the medical field. The most cause of Nosocomial infection include: bloodstream infection, urinary tract infection, pneumonia, and wound infection. The purpose of this study was to determine the epidemiology of the three most common NI in the Pediatric department.        Materials and Methods: We performed a prospective study in a single Pediatric department during 12 months. Children were assessed for 3 NI: wound infections, pneumonia and urinary tract infections (UTI, as the same method as Center of Disease Control criteria. All patients were followed up and individuals who had have NI and their treatment was entered in this study.          Results: In this study 811 patients were hospitalized that 60% of them were male and were older than 60 months. The main causes of hospitalization include: toxicity, seizure, respiratory infection and fever. Among them 15 cases had NI (1.87%. The most NI occurred in pediatric intensive care unit (PICU and it was followed in aspect of intubation. The most cultured organism was pseudomonas that they suspected to ceftazidime and isolate from blood and endotracheal tube.           Conclusion:  NI presence was associated with increased mortality and length of stay in hospital. This study highlights the importance of NIs in children admitted to a pediatric department especially PICU in a developing country. Clinical monitoring of NIs and bacterial resistance profiles are required in all pediatric units.

Hospitalizations for Endocarditis and Associated Health Care Costs Among Persons with Diagnosed Drug Dependence - North Carolina, 2010-2015.

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Fleischauer, Aaron T; Ruhl, Laura; Rhea, Sarah; Barnes, Erin

2017-06-09

Opioid dependence and overdose have increased to epidemic levels in the United States. The 2014 National Survey on Drug Use and Health estimated that 4.3 million persons were nonmedical users of prescription pain relievers (1). These users are 40 times more likely than the general population to use heroin or other injection drugs (2). Furthermore, CDC estimated a near quadrupling of heroin-related overdose deaths during 2002-2014 (3). Although overdose contributes most to drug-associated mortality, infectious complications of intravenous drug use constitute a major cause of morbidity leading to hospitalization (4). In addition to infections from hepatitis C virus (HCV) and human immunodeficiency virus (HIV), injecting drug users are at increased risk for acquiring invasive bacterial infections, including endocarditis (5,6). Evidence that hospitalizations for endocarditis are increasing in association with the current opioid epidemic exists (7-9). To examine trends in hospitalizations for endocarditis among persons in North Carolina with drug dependence during 2010-2015, data from the North Carolina Hospital Discharge database were analyzed. The incidence of hospital discharge diagnoses for drug dependence combined with endocarditis increased more than twelvefold from 0.2 to 2.7 per 100,000 persons per year over this 6-year period. Correspondingly, hospital costs for these patients increased eighteenfold, from $1.1 million in 2010 to $22.2 million in 2015. To reduce the risk for morbidity and mortality related to opioid-associated endocarditis, public health programs and health care systems should consider collaborating to implement syringe service programs, harm reduction strategies, and opioid treatment programs.

Yield estimation for nuclear explosions of semipalatinsk using rayleigh waves recorded at SRO, Mashhad

International Nuclear Information System (INIS)

Naghizadeh, M.; Javaherian, A.; Sadidkhooy, A.

2005-01-01

Surface wave amplitudes from explosion sources show less variation for a given event than body wave amplitudes, so it is natural to expect that yield estimation derived from surface waves will be more accurate than yield estimation derived from body waves. However yield estimation from surface waves is complicated by the presence of tectonic strain release, which acts like one or more earthquake sources superimposed on the explosion. Explosions on an island or near a mountain slope can exhibit anomalous surface waves similar to those caused by tectonic strain release. One of the methods in estimating the yield of nuclear explosions is to determine a relationship between the magnitude and the yield of an explosion. The kind of magnitude employed has an important role in this regard. In this paper, vertical component of long period seismograms at SRO, Mashhad from explosions occurred in semipalatinsk test site, semipalatinsk test site east of Kazakhstan) are considered. First, by using the relationships of IASPEI and Rezapour and Pearce (1998), we determined surface wave magnitude (MS) which is defined as the logarithm of the amplitude plus a distance correction. Then we derived a relation for M S versus yield for a data set which includes a 15 long period seismograms recorded at SRO Mashhad station from semipalatinsk test site nuclear explosions. Furthermore, by digitizing the vertical component of seismograms and transforming them to the frequency domain, the mean amplitude of records at frequency ranges of 0.04-0.06 Hz were calculated. Then, surface wave magnitudes in the frequency domain (M Sf ) and their corresponding yield-magnitude relationship were obtained. By comparing correlation coefficients of these two yield-magnitude relationships, following relationship M S = 1.079 log(Y) + 1.714, was chosen for estimating the yield of semipalatinsk test site nuclear explosion from seismograms of SRO

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

International Nuclear Information System (INIS)

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

2001-12-01

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

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

International Nuclear Information System (INIS)

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

2001-10-01

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

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

International Nuclear Information System (INIS)

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

2001-09-01

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

The Role of Religious Tourism in the Development and Growth of Urban Metropolis: (In The Case of Mashhad, Iran)

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Foruzan, Iman

2014-01-01

ABSTRACT: This study aims to examine three dimensions of development, namely, economic, environment, and social-cultural issues caused by religious tourism in Mashhad. A quantitative method used to investigate 288 residents’ perceptions who are settled around the Imam Reza holly shrine. Mean and standard division of the variable is calculated to understated to what extend respondents are agreed about positive impacts of religious tourism in terms of economic, environment, and social-cultural ...

Endoparasites of Stray Dogs in Mashhad, Khorasan Razavi Province, Northeast Iran with Special Reference to Zoonotic Parasites

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Amir Adinezadeh

2013-09-01

Full Text Available Background: To find out different species of helminthes and blood/tissue proto­zoan parasites of stray dogs and their potential role for transmission of zoonotic species to human in Mashhad, Khorasan Razavi Province, northeast Iran, during 2008-2009.Methods: Totally, 100 stray dogs were selected among Mashhad municipal collection from different sites of the city. Internal organs were examined for any parasites. Helminthes were identified based on morphological characteristics. Smears prepared from peripheral blood as well as liver, spleen and any skin lesion were stained by Giemsa and examined microscopically. Samples obtained from spleen were aseptically cultured in three culture media including NNN, Schneider’s Drosophila (HIMEDIA and RPMI1640 (GIBCO for isolation of Leishmania spp. The titer of anti-Leishmania and anti-Toxoplasma antibodies were measured by direct agglutination test (DAT and indirect fluorescent antibody test (IFAT, respectively.Results: 84% of dogs were infected at least with one species of intestinal helminthes. The species of parasites and rate of infection were as follows: Taenia hydatigena (61%, Dipylidium caninum (46%, Mesocestoides lineatus (19%, Echinococcus granulosus (10%, Toxascaris leonina (53% and Toxocara canis (7%. Anti-Leishmania antibodies were detected by DAT in 8 dogs (8% at 1:320 titers and higher. Forty seven dogs (47% showed anti-Toxoplasma titer at 1:10 and 17 (17% showed titer of ≥1:100. No blood parasites were found in prepared blood smears.Conclusion: The high rate of parasitic infection and presence of zoonotic species

Junk Food Consumption and Effects on Growth Status among Children Aged 6-24 Months in Mashhad, Northeastern Iran

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Rahim Vakili; Mohammad Ali Kiani; Masumeh Saeidi; Bibi Leila Hoseini; Mansoure Alipour Anbarani

2015-01-01

Introduction Junk food, due to the lack of vitamins, minerals and trace amounts of energy and protein, there is the risk that the child's stomach filled and by reducing her/his appetite, reduce the chance of nutritious foods. So it is necessary to determine the relationship between using of junk food with growth rate in children. Materials and Methods This cross-sectional descriptive-analytic study was conducted on 300 mothers and their babies , who were referring to 10 selected Mashhad healt...

Limited genetic diversity and extensive antimicrobial resistance in clinical isolates of Acinetobacter baumannii in north-east Iran.

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Farsiani, Hadi; Mosavat, Arman; Soleimanpour, Saman; Nasab, Mahbobeh Naderi; Salimizand, Himen; Jamehdar, Saeid Amel; Ghazvini, Kiarash; Aryan, Ehsan; Baghani, Ali-Asghar

2015-07-01

This study determined the mechanisms and patterns of antimicrobial resistance among the isolates obtained from different wards of a teaching hospital in the city of Mashhad in north-east Iran. Between January 2012 and the end of June 2012, 36 isolates of Acinetobacter baumannii were collected from different wards of Ghaem Hospital. Antimicrobial susceptibility testing and epsilometer testing (E-test) were performed. The genetic resistance determinants of A, B and D classes of β-lactamases, aminoglycoside modifying enzymes (AMEs), efflux pumps and ISAba1 elements were assessed by PCR. Repetitive extragenic palindromic element (REP)-PCR was performed to find the genetic relatedness of the isolates. Colistin was the most effective antibiotic of those tested, where all isolates were susceptible. E-test results revealed high rates of resistance to imipenem, ceftazidime and ciprofloxacin. The majority of isolates (97  %) were multidrug-resistant. OXA-51, OXA-23 and tetB genes were detected in all isolates, but OXA-58, IMP and tetA were not detected. The prevalence of OXA-24, bla(TEM), bla(ADC), bla(VIM) and adeB were 64, 95, 61, 64 and 86  %, respectively. ISAba1 was found to be inserted into the 5' end of OXA-23 in 35 isolates (97  %). Of the AMEs, aadA1 (89  %) was the most prevalent, followed by aphA1 (75  %). The band patterns reproduced by REP-PCR showed that 34 out of 36 isolates belonged to one clone and two singletons were identified. The results confirmed that refractory A. baumannii isolates were widely distributed and warned the hospital infection control team to exert strict measures to control the infection. An urgent surveillance system should be implemented.

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

International Nuclear Information System (INIS)

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

2003-09-01

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

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

International Nuclear Information System (INIS)

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

2002-01-01

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

Knowledge sharing Network analysis and its relationship with the experience and education of librarians at Ferdowsi University of Mashhad

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Maryam Salami

2017-03-01

Full Text Available As human resources are important resources in organization, it is important for organizations to use knowledge organization of human resources. Thus managing and sharing knowledge in organizations is so important. Libraries as well service-oriented and knowledge-based organizations, librarians’ contribution of knowledge management is important. The study tries to determine Ferdowsi University of Mashhad librarians’ participation in the process of knowledge sharing by knowledge sharing network analysis method. The application used for social network analysis is UCINET6. Determining the degree of centralization in the network of knowledge sharing can also help to detect factors may influence it. In this study, the degree of centralization in the network of knowledge sharing communicating with the librarians' qualifications and work experiences were tested. It is also determined the degree centralization of the whole of the knowledge sharing network with 26.76% that is not so satisfactory.  The results show that despite the positive relationship between level of education and the centrality of people, the experience no significant relationship. Statistically, there is also no significant difference between men and women in knowledge sharing degrees of librarians in Ferdowsi University of Mashhad. At the end, according to the results of this research some suggestions are given to increase degrees of knowledge sharing of librarians and generally knowledge sharing degree of the network knowledge sharing.

Evaluating Success of Pediatric Dentistry Department at Mashhad Dental School (Iran in Clinical Skills Education from Students’ Perspectives

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Hosein Nematollahi

Full Text Available Introduction: Periodic evaluation of educational programs provides insight into the course and teaching effectiveness. Effective evaluation provides valuable information, which contributes to both student’s and course success. The purpose of this study was to evaluate the success of pediatric dentistry department at Mashhad dental school in clinical education from students’ perspectives.Materials & Methods: This cross-sectional study was conducted on 116 fifth and sixth grade undergraduate dental students in pediatric dentistry at Mashhad dental school. A questionnaire including 21 multiple choice questions about 7 parts of clinical skills in pediatric dentistry was given to each student. Data were analyzed by Mann-Whitney in SPSS software. Results: According to the study results, among 7 different clinical skills in pediatric dentistry including: examination, behavior management, prevention, injection, restoration, pulp treatment and space management, the highest success rate of pediatric dentistry department was in prevention and injection and the lowest success rate in space management and behavior control. Furthermore, from the students’ perspective, male students compared to female students mentioned a higher rate of success in choosing the type of restoration material for pediatric dentistry department (P=0. 041. Conclusion: This study showed that the students’ self-reported clinical skills in different parts of pediatric dentistry has been adequate. Students reported a lack of confidence in “behavior management” and “space management” which warrants greater emphasis in the undergraduate curriculum.

Visual Impairment Registry of Patients from North Kolkata, Eastern India: A Hospital-based Study.

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Bandyopadhyay, Sabyasachi; Bandyopadhyay, Samir Kumar; Biswas, Jaya; Saha Dutta Chowdhury, Mita; Dey, Asim Kumar; Chakrabarti, Asim

2018-01-01

To study the demographic profile, severity and causes of visual impairment among registered patients in a tertiary care hospital in north Kolkata, eastern India, and to assess the magnitude of under-registration in that population. This is a retrospective analytical study. A review of all visually impaired patients registered at our tertiary care hospital during a ten-year period from January 2005 to December 2014, which is entitled for certification of people of north Kolkata, eastern India (with a population denominator of 1.1 million), was performed. Overall, 2472 eyes of 1236 patients were analyzed in terms of demographic characteristics, cause of visual impairment, and percentage of visual disability as per the guidelines established by the government of India. Male patients (844, 68.28%; 95% confidence interval [CI], 65.69-70.87) registered more often than female patients (392; 31.72%, P = 0.0004). The registration rate for visual impairment was 11.24 per 100,000 per annum; this is not the true incidence rate, as both new patients and those visiting for renewal of certification were included in the study. Optic atrophy was the most common cause of visual impairment (384 eyes, 15.53%; 95% CI, 14.1-16.96). Commonest cause of visual impairment was optic atrophy followed by microphthalmos. Under-registration is a prevalent problem as the registration system is voluntary rather than mandatory, and female patients are more likely to be unregistered in this area.

Maternal Knowledge and Attitude toward Exclusive Breast Milk Feeding (BMF in the First 6 Months of Infant Life in Mashhad

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Bibi Leila Hoseini

2014-01-01

Full Text Available Introduction: Breast milk is a complete food for growing children until 6 months of age, and mothers, as the most important child health care, play a decisive role in their growth. So promoting  their attitude toward the benefits of breastfeeding ensures guarantee child health in the future. This study aimed to assess maternal knowledge and attitude of Mashhad toward exclusive BMF in the first 6 months of infant life.   Materials and Methods: This cross-sectional descriptive-analytic study was conducted on 126 mothers who referring to Mashhad health-care centers for monitoring their 6-24 month year old infants. They completed questionnaire. Participants were selected by cluster and simple random sampling. Data were analyzed by descriptive- analytic tests and using SPSS 11.5.   Results: Mean score of maternal attitude toward exclusive BMF was 14.32±5.28 (out of 28 and maternal knowledge score toward advantages of breast milk was 19.59±4.80 (out of 28. The incidence of exclusive BMF in the first 6 months of life study was 73.8%. Child growth was as follows: excellent growth (5.6% and good growth (42.1%. ANOVA showed a significant difference between parents' education and maternal attitude towards exclusive BMF; whatever higher education of parents, more positive maternal attitude towards exclusive BMF (P

Maternal Knowledge and Attitude toward Exclusive Breast Milk Feeding (BMF in the First 6 Months of Infant in Mashhad-Iran

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M Saeidi

2014-04-01

Full Text Available Introduction: Breast milk is a complete food for growing children until 6 months of age, and mothers, as the most important child health care, play a decisive role in their growth. So promoting  their attitude toward the benefits of breastfeeding ensures guarantee child health in the future. This study aimed to assess maternal knowledge and attitude of Mashhad toward exclusive BMF in the first 6 months of infant life.   Materials and Methods: This cross-sectional descriptive-analytic study was conducted on 126 mothers who referring to Mashhad health-care centers for monitoring their 6-24 month year old infants. They completed questionnaire. Participants were selected by cluster and simple random sampling. Data were analyzed by descriptive- analytic tests and using SPSS 11.5.   Results: Mean score of maternal attitude toward exclusive BMF was 14.32±5.28 (out of 28 and maternal knowledge score toward advantages of breast milk was 19.59±4.80 (out of 28. The incidence of exclusive BMF in the first 6 months of life study was 73.8%. Child growth was as follows: excellent growth (5.6% and good growth (42.1%. ANOVA showed a significant difference between parents' education and maternal attitude towards exclusive BMF; whatever higher education of parents, more positive maternal attitude towards exclusive BMF (P

A preliminary parasitological survey of hepatozoon spp. Infection in dogs in mashhad, iran.

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Amoli, Aa Rahmani; Khoshnegah, J; Razmi, Ghr

2012-01-01

We attempted to determine the prevalence of Hepatozoon spp. infection in Mashhad, northeast of Iran, via blood smear parasitology. The prevalence was investigated by examination of blood smear parasitology, using blood samples collected from 254 dogs (51 strays and 203 privately owned-dogs). Two stray dogs (2/51; 3.92%) and two privately-owned dogs (2/203; 0.98%) were infected with Hepatozoon spp. Therefore, as per blood smear parasitology, the prevalence of Hepatozoon spp. infection was 1.57% (4/254). Sixteen out of 254 dogs (6.29%) were infested with ticks; all of which were Rhipicephalus sanguineus. One of the dogs infected with Hepatozoon spp. exhibited ticks at the time of examination. Concurrent infection with Ehrlichia canis and Leishmania infantum was not detected in the four Hepatozoon spp. infected dogs. This is the first epidemiological study on the prevalence of Hepatozoon spp. infection in dogs in Iran.

The effect of social capital on organizational citizenship behavior: A case study of employees in Mashhad Municipality

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Hossein Amintojjar

2015-06-01

Full Text Available Social capital is one of the key concepts in the success of employees and organizations in the third millennium. This study aimed to investigate whether there was a meaningful relation between social capital and different dimensions of organizational citizenship behavior (OCB including helpful behavior, magnanimity, loyalty, obedience, self initiative, civil behavior, and self development. The study followed a descriptive and statistical method. The data for the present study was gathered through library research and using standard OCB questionnaire and social capital questionnaire. The findings of the research indicated that there was a direct relation between social capital and organizational citizenship behavior among employees of Mashhad Municipality.

Comparison of the prevalence of respiratory viruses in patients with acute respiratory infections at different hospital settings in North China, 2012-2015.

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Yu, Jianxing; Xie, Zhengde; Zhang, Tiegang; Lu, Yanqin; Fan, Hongwei; Yang, Donghong; Bénet, Thomas; Vanhems, Philippe; Shen, Kunling; Huang, Fang; Han, Jinxiang; Li, Taisheng; Gao, Zhancheng; Ren, Lili; Wang, Jianwei

2018-02-08

Acute respiratory infections (ARIs) are a great public health challenge globally. The prevalence of respiratory viruses in patients with ARIs attending at different hospital settings is fully undetermined. Laboratory-based surveillance for ARIs was conducted at inpatient and outpatient settings of 11 hospitals in North China. The first 2-5 patients with ARIs were recruited in each hospital weekly from 2012 through 2015. The presence of respiratory viruses was screened by PCR assays. The prevalence of respiratory viruses was determined and compared between patients at different hospital settings. A total of 3487 hospitalized cases and 6437 outpatients/Emergency Department (ED) patients were enrolled. The most commonly detected viruses in the hospitalized cases were respiratory syncytial virus (RSV, 33.3%) in children less than two years old, adenoviruses (13.0%) in patients 15-34 years old, and influenza viruses (IFVs, 9.6%) in patients ≥65 years. IFVs were the most common virus in outpatient/ED patients across all age groups (22.7%). After controlling for the confounders caused by other viruses and covariates, adenoviruses (adjusted odds ratio [aOR]: 3.97, 99% confidence interval [99% CI]: 2.19-7.20) and RSV (aOR: 2.04, 99% CI: 1.34-3.11) were independently associated with increased hospitalization in children, as well as adenoviruses in adults (aOR: 2.14, 99% CI: 1.19-3.85). Additionally, co-infection of RSV with IFVs was associated with increased hospitalization in children (aOR: 12.20, 99% CI: 2.65-56.18). A substantial proportion of ARIs was associated with respiratory viruses in North China. RSV, adenoviruses, and co-infection of RSV and IFVs were more frequent in hospitalized children (or adenoviruses in adults), which might predict the severity of ARIs. Attending clinicians should be more vigilant of these infections.

Cleft lip and Palate: A 30-year Epidemiologic Study in North-East of Iran

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Hamid Reza Kianifar

2015-01-01

Full Text Available Introduction: Cleft lip and palate are among the most common congenital anomalies worldwide. This study was conducted in order to explore the incidence and related factors of cleft lip and/or palate (CL/P among live births in Mashhad, North-Eastern Iran.   Materials and Methods: In this cross-sectional study, records of 28,519 infants born between March 1982 and March 2011 at three major hospitals in Mashhad were screened for oral clefts. Clinical and demographic factors relating to diagnosed cases, including birth date, gender, birth weight, maternal age, number of pregnancies, type and side of cleft and presence of other congenital anomalies were recorded for analysis.   Results: The overall incidence of CL/P was 1.9 per 1,000 live births. Cleft lip associated with cleft palate (CLP was the most prevalent type of cleft (50%, followed by isolated cleft lip         (35.2% and isolated cleft palate (14.8%. A total of 92.6% of oral clefts were bilateral and 5.5% were located on the right side. In addition, clefts were found to be more common in male than female births (male/female ratio=2.3. The rate of associated congenital anomalies in CL/P newborns was 37%. No significant differences were observed in the incidence of oral clefts across three decades of study; except for CLP which was significantly more prevalent between 2002–2011 (P=0.027. There were no significant differences with regard to season of birth, associated anomalies or maternal age of affected newborns in the three time periods of the study. Furthermore, maternal age and number of pregnancies were not significantly different among the three types of cleft (P=0.43 and P=0.91, respectively. Although the mean birth weight of patients affected with isolated cleft palate was considerably lower than that of the other two types of cleft, the difference was not statistically significant (P=0.05.    Conclusion:  This study indicates a frequency of CL/P close to the findings

Detection of Yersinia enterocolitica in Retail Chicken Meat, Mashhad, Iran

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Khadigeh Sirghani

2018-01-01

Full Text Available Poultry meat is one of the most important sources of infection of Yersinia spp. for humans. The aim of the present study was to evaluate the incidence of Yersinia enterocolitica in chicken meat by using culture method on selective medium and confirmation by PCR assay. Also, biochemical methods were used for biotyping. A total of 100 chicken thigh meat samples were collected randomly from retail outlets in Mashhad, Iran. Samples were enriched in Peptone-Sorbitol-Bile (PSB broth and then cultured on Cefsulodin-Irgasan-Novobiocin (CIN agar containing antibiotics supplement. The DNA was extracted from suspected colonies of Yersinia spp. and then PCR test using specific primers for 16S rRNA gene of Yersinia enterocolitica was performed. In this study, 30% of chicken meat was contaminated with Yersinia spp. by culture method and 25% of chicken meat was contaminated with Yersinia enterocolitica. Biotyping of isolated colonies showed that all of the isolates belonged to biotype 1A. Culture and detection of Yersinia spp. from food samples traditionally take 4 days. Due to high accuracy and speed of PCR assay, it is a good alternative method for microbiological techniques. In conclusion, poultry meat can act as a source of Y. enterocolitica and could be considered as a public health hazard.

A Study on Oral Health of Children with Cardiac Diseases in Mashhad, Iran in 2004

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Mohammad Mahmoudi

2007-12-01

Full Text Available

Background and aims. Preventing oral disease is the most desirable way of ensuring good dental health for children with heart disease. Dental and gingival infections in patients with cardiac problems may lead to infective endocarditis. The aim of this study was to evaluate oral and dental health status in children with heart disease referred to a cardiac center compared with the control group.

Materials and Methods. In this descriptive cross-sectional study, case group consisting of 100 patients 2-12 years old with heart disease were examined for oral and dental status in Pediatric Cardiac Center in Mashhad, Iran, in 2004. Fifty healthy children with the same age as the case group referring to the Department of Pedodontics, Mashhad Faculty of Dentistry served as the control group. For each patient, dental and medical history, dmft, DMFT, debris index, tooth brushing status as well as parental knowledge of infective endocarditis and their economic status was registered on a questionnaire. Statistical analysis was performed using Kruskal-Wallis, chi-square and t-tests.

Results. There were no significant differences between case and control groups in dmft (3.92 ± 3.99 and 3.54 ± 3.33, respectively, DMFT (3.7 ± 4 and 1.47 ± 1.72, respectively and their components. Tooth brushing status and debris index were significantly worse in the study group (P = 0.001 and P = 0.008, respectively. 35% of parents were aware of the importance of good oral health in cardiac children although none of them knew about infective endocarditis. Most of the parents in study group had low (30% to medium (53% economic status.

Conclusion. In this study, the children with cardiac disease did not have a good oral and dental health status. Developing strategies toward preventive dental care of children with cardiac problems and informing their parents is suggested.

Prevalence of Clostridium difficile infection and colonization in a tertiary hospital and elderly community of North-Eastern Peninsular Malaysia.

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Zainul, N H; Ma, Z F; Besari, A; Siti Asma, H; Rahman, R A; Collins, D A; Hamid, N; Riley, T V; Lee, Y Y

2017-10-01

Little is known about Clostridium difficile infection (CDI) in Asia. The aims of our study were to explore (i) the prevalence, risk factors and molecular epidemiology of CDI and colonization in a tertiary academic hospital in North-Eastern Peninsular Malaysia; (ii) the rate of carriage of C. difficile among the elderly in the region; (iii) the awareness level of this infection among the hospital staffs and students. For stool samples collected from hospital inpatients with diarrhea (n = 76) and healthy community members (n = 138), C. difficile antigen and toxins were tested by enzyme immunoassay. Stool samples were subsequently analyzed by culture and molecular detection of toxin genes, and PCR ribotyping of isolates. To examine awareness among hospital staff and students, participants were asked to complete a self-administered questionnaire. For the hospital and community studies, the prevalence of non-toxigenic C. difficile colonization was 16% and 2%, respectively. The prevalence of CDI among hospital inpatients with diarrhea was 13%. Out of 22 C. difficile strains from hospital inpatients, the toxigenic ribotypes 043 and 017 were most common (both 14%). In univariate analysis, C. difficile colonization in hospital inpatients was significantly associated with greater duration of hospitalization and use of penicillin (both P difficile colonization is prevalent in a Malaysian hospital setting but not in the elderly community with little or no contact with hospitals. Awareness of CDI is alarmingly poor.

A Preliminary Parasitological Survey of Hepatozoon Spp. Infection in Dogs in Mashhad, Iran

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J Khoshnegah

2012-12-01

Full Text Available Background: We attempted to determine the prevalence of Hepatozoon spp. infection in Mashhad, northeast of Iran, via blood smear parasitology.Methods: The prevalence was investigated by examination of blood smear parasitology, using blood samples collected from 254 dogs (51 strays and 203 privately owned-dogs.Results: Two stray dogs (2/51; 3.92% and two privately-owned dogs (2/203; 0.98% were infected with Hepatozoon spp. Therefore, as per blood smear parasitology, the prevalence of Hepatozoon spp. infection was 1.57% (4/254. Sixteen out of 254 dogs (6.29% were infested with ticks; all of which were Rhipicephalus sanguineus. One of the dogs infected with Hepatozoon spp. exhibited ticks at the time of examination. Concurrent infection with Ehrlichia canis and Leishmania infantum was not detected in the four Hepatozoon spp. infected dogs.Conclusion: This is the first epidemiological study on the prevalence of Hepatozoon spp. infection in dogs in Iran.

Improvement of hospital processes through business process management in Qaem Teaching Hospital: A work in progress.

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Yarmohammadian, Mohammad H; Ebrahimipour, Hossein; Doosty, Farzaneh

2014-01-01

In a world of continuously changing business environments, organizations have no option; however, to deal with such a big level of transformation in order to adjust the consequential demands. Therefore, many companies need to continually improve and review their processes to maintain their competitive advantages in an uncertain environment. Meeting these challenges requires implementing the most efficient possible business processes, geared to the needs of the industry and market segments that the organization serves globally. In the last 10 years, total quality management, business process reengineering, and business process management (BPM) have been some of the management tools applied by organizations to increase business competiveness. This paper is an original article that presents implementation of "BPM" approach in the healthcare domain that allows an organization to improve and review its critical business processes. This project was performed in "Qaem Teaching Hospital" in Mashhad city, Iran and consists of four distinct steps; (1) identify business processes, (2) document the process, (3) analyze and measure the process, and (4) improve the process. Implementing BPM in Qaem Teaching Hospital changed the nature of management by allowing the organization to avoid the complexity of disparate, soloed systems. BPM instead enabled the organization to focus on business processes at a higher level.

Investigating the Effect of Humor Therapy on Chronic Pain in the Elderly Living in Nursing Homes in Mashhad, Iran

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Shohre behrouz

2017-07-01

Full Text Available Background: The prevalence of chronic pains in the elderly residing in nursing homes is high, which can bring about social isolation, depression, incidence of disabilities, as well as increased costs. Given the risks, medication therapy is not used for the elderly, and non-pharmaceutical methods, such as humor therapy as one of the complementary medicine techniques using thought distraction, have been advocated. Aim: This study aimed to determine the effect of humor therapy on pain intensity in the elderly living in nursing homes in Mashhad, Iran. Method: This two-group, randomized, controlled clinical trial was conducted on two groups of intervention (28 individuals and control (27 individuals at two similar nursing homes in Mashhad, Iran, 2016. Humor therapy was performed during six 60-minute sessions (once per week using humorous methods such as video clip displays, games, music plays, as well as telling funny jokes. Then, pain intensity was measured via the Modified German Version of the Brief Pain Inventory before the study and after the 3rd and 6th sessions of humor therapy. Finally, the data was analyzed using Mann-Whitney U test in SPSS, version 22. Results: The mean ages of the participants in the control and intervention groups were 73.9±4.3 and 73.9±5.8 years, respectively. The results of the Mann-Whitney U test also showed that pain intensity before the study in both groups was homogenous (P=0.15. Moreover, the mean scores of the highest, lowest, and moderate pain intensity after the 3rd (P

Importance of customer adjustment regions in the non-clinical property of thought: A home examination in low and high-income areas of Mashhad.

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Fazaeli, S; Yousefi, M; Banikazemi, S H; Ghazizadeh Hashemi, Sah; Khorsand, A; Badiee, Sh

2015-01-01

Responsiveness was proposed via WHO as a fundamental sign to evaluate the enforcement of wellness practices and evaluates with a standard organization of fields that are classified to 2 principal classes "Respect as characters" and "customer adjustment". The current research included the value of customer adjustment areas in low and high-income communities of Mashhad. In the current descriptive research, an example of 923 families was chosen stochastically of 2 low and high pay areas of Mashhad. WHO survey employed for information gathering. Regular rate reviews and Ordinal Logistic Regression (OLR) applied for information investigation. In overall, respondents chose basic amenities quality as the primary area, and the path to social care networks recognized as the wicked primary area. Families in high-income states obtained higher areas of immediate notations and selection associated with low-income. There is a meaningful correlation among parameters of ages, having a part whom required care and self-imposed health via the ranking of customer adjustment areas. The investigation of the homes' viewpoint concerning the classification of non-clinical perspectives of care quality, particularly while confronted by restricted sources, can assist in managing enterprises towards topics that are more relevant and results in the development of the wellness policy achievement and fecundity.

Evaluation of Drought Stress Thresholds in Ornamental Barberry (Berberis thunbergii cv. Atropurpurea Shrub in Mashhad Condition

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Reyhane Setayesh

2017-08-01

Full Text Available Introduction: The population growth and water requirement for domestic consumption, industry, agriculture and urban development in Mashhad megacity, increase pressures on freshwater resources. Therefore, planning for water use optimization is necessary. The new allocation of water resources for landscape greenish, especially in arid and semi-arid is difficult. Therefore, water allocation to landscape is valuable and should be used efficiently. According to water resource limitation, using drought-tolerant plant species and determine threshold of drought tolerance in landscape can improve water use management. Plants that naturally survive in your area are the ones best adapted to your soil, climate and rainfall. By selecting plants that either avoid or tolerate dry conditions, a beautiful, thriving landscape can be made possible. Drought-tolerant plants survive long periods of drought by storing water internally or by developing extensive root systems that sink deep into the soil. Many drought-tolerant plants have additional protection through a waxy coating that reduces evaporation or hairs on the leaf surface that reflect some of the light, insulating the plant. Most drought-tolerant plants use several of these features to survive on low amounts of precipitation. Japanese barberry is a compact woody deciduous shrub with arching branches. Leaf colours include green, bluish-green to dark red and purple. B. thunbergii's progress in the United States has, to date, been held in check to the south by, probably, its need for cold winter temperatures for stratification of the seeds, and to the west by, probably, drought conditions. Although very drought tolerant once established, a very dry terrain would tend to discourage its incursion. Rugged, adaptable, no serious problems or pests, easy to maintain, transplants readily, shade and drought tolerant, deer resistant is typical ad copy found at any site offering this shrub of colourful fall foliage. In

Predictors of Registered Nurses' Intention To Quit: Implications for the Management of Health Care Human Resources in North Dakota Hospitals.

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Pooyan, Abdullah; And Others

Turnover rates for nurses are among the highest for all professional employees. This study investigated the potential predictors of registered nurses' intention to quit. Survey questionnaires were mailed to a population of 779 registered nurses from two hospitals in North Dakota. Approximately 4 weeks later, usable responses were received from 353…

Determining the Organizational Intelligence Level of Hospitals in Our Region

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Khayat Moghadam S

2013-10-01

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

Best practices to promote occupational safety and satisfaction: a comparison of three North American hospitals.

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McCaughey, Deirdre; DelliFraine, Jami; Erwin, Cathleen O

2015-01-01

Hospitals in North America consistently have employee injury rates ranking among the highest of all industries. Organizations that mandate workplace safety training and emphasize safety compliance tend to have lower injury rates and better employee safety perceptions. However, it is unclear if the work environment in different national health care systems (United States vs. Canada) is associated with different employee safety perceptions or injury rates. This study examines occupational safety and workplace satisfaction in two different countries with employees working for the same organization. Survey data were collected from environmental services employees (n = 148) at three matched hospitals (two in Canada and one in the United States). The relationships that were examined included: (1) safety leadership and safety training with individual/unit safety perceptions; (2) supervisor and coworker support with individual job satisfaction and turnover intention; and (3) unit turnover, labor usage, and injury rates. Hierarchical regression analysis and ANO VA found safety leadership and safety training to be positively related to individual safety perceptions, and unit safety grade and effects were similar across all hospitals. Supervisor and coworker support were found to be related to individual and organizational outcomes and significant differences were found across the hospitals. Significant differences were found in injury rates, days missed, and turnover across the hospitals. This study offers support for occupational safety training as a viable mechanism to reduce employee injury rates and that a codified training program translates across national borders. Significant differences were found.between the hospitals with respect to employee and organizational outcomes (e.g., turnover). These findings suggest that work environment differences are reflective of the immediate work group and environment, and may reflect national health care system differences.

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

Energy Technology Data Exchange (ETDEWEB)

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

2001-10-15

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2001-09-15

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2001-12-15

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

The study of environmental impact quotient (EIQ of pesticides used in wheat and barley farms in Mashhad

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L maleki

2016-05-01

Full Text Available Introduction The environmental impact quotient (EIQ developed by Kovach et al (1992 is used an effort to fill an important gap; i.e. the need to provide farmers and others with easy-to-use information about the adverse effects of pesticides. It represents a method for calculating the environmental impacts of pesticides, and the values obtained from these calculations can be used to compare different pesticides and pest management programs with each other to ultimately determine which program or pesticide is likely to have the lowest environmental impact. The EIQ value for a particular active ingredient is calculated according to a formula that includes parameters for toxicity (dermal, chronic, bird, bee, fish, and beneficial arthropod, soil half-life, systemicity, leaching potential, and plant surface half-life. Each of these parameters is given a rating of 1, 3 or 5 to reflect its potential of causing harm. Six of these ratings are based on measured or known properties and the other five are based on judgments according to their potentially low, moderate or severe impact. Since the EIQ value is mainly a hazard indicator, additional calculations are required to obtain an indication of the pesticide risk. To account for exposure, an equation called the Field Use EIQ has been developed. This rating is calculated by multiplying the EIQ value for a specific chemical from the tables by the percent active ingredient in the formulation and its dosage rate used per hectare (usually in liters or kilograms of the formulated product. EIQ is used in different studies to compare the environmental effects of different pesticides and/or different production systems (Avila et al., 2011; Doris et al., 2011; Gallivan et al., 2001; Macharia et al., 2009. The aim of this study was to evaluate management strategies in using pesticides in wheat and barley farms in the city of Mashhad located in the Khorasan Razavi province in Iran. Materials and Methods Data related

Verification of Temperature and Precipitation Simulated Data by Individual and Ensemble Performance of Five AOGCM Models for North East of Iran

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B. Ashraf

2014-08-01

Full Text Available Scince climatic models are the basic tools to study climate change and because of the multiplicity of these models, selecting the most appropriate model for the studying location is very considerable. In this research the temperature and precipitation simulated data by BCM2, CGCM3, CNRMCM3, MRICGCM2.3 and MIROC3 models are downscaled with proportional method according A1B, A2 and B1 emission scenarios for Torbat-heydariye, Sabzevar and Mashhad initially. Then using coefficient of determination (R2, index of agreement (D and mean-square deviations (MSD, models were verified individually and as ensemble performance. The results showed that, based on individual performance and three emission scenarios, MRICGCM2.3 model in Torbat-heydariye and Mashhad and MIROC3.2 model in Sabzevar had the best performance in simulation of temperature and MIROC3.2, MRICGCM2.3 and CNRMCM3 models have provided the most accurate predictions for precipitation in Torbat-heydariye, Sabzevar and Mashahad respectively. Also simulated temperature by all models in Torbat-heydariye and Sabzevar base on B1 scenario and, in Mashhad based on A2 scenario had the lowest uncertainty. The most accuracy in modeling of precipitation was resulted based on A2 scenario in Torbat-heydariye and, B1 scenario in Sabzevar and Mashhad. Investigation of calculated statistics driven from ensemble performance of 5 selected models caused notable reduction of simulation error and thus increase the accuracy of predictions based on all emission scenarios generally. In this case, the best fitting of simulated and observed temperature data were achieved based on B1 scenario in Torbat-heydariye and Sabzevar and, A2 scenario in Mashhad. And the best fitting simulated and observed precipitation data were obtained based on A2 scenario in Torbat-heydariye and, B1 scenario in Sabzevar and Mashhad. According to the results of this research, before any climate change research it is necessary to select the

Positive Coping: A Unique Characteristic to Pre-Hospital Emergency Personnel.

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Ebadi, Abbas; Froutan, Razieh

2017-01-01

It is important to gain a thorough understanding of positive coping methods adopted by medical emergency personnel to manage stressful situations associated with accidents and emergencies. Thus, the purpose of this study was to gain a better understanding of positive coping strategies used by emergency medical service providers. This study was conducted using a qualitative content analysis method. The study participants included 28 pre-hospital emergency personnel selected from emergency medical service providers in bases located in different regions of the city of Mashhad, Iran, from April to November 2016. The purposive sampling method also was used in this study, which was continued until data saturation was reached. To collect the data, semistructured open interviews, observations, and field notes were used. Four categories and 10 subcategories were extracted from the data on the experiences of pre-hospital emergency personnel related to positive coping strategies. The four categories included work engagement, smart capability, positive feedback, and crisis pioneering. All the obtained categories had their own subcategories, which were determined based on their distinctly integrated properties. The results of this study show that positive coping consists of several concepts used by medical emergency personnel, management of stressful situations, and ultimately quality of pre-hospital clinical services. Given the fact that efficient methods such as positive coping can prevent debilitating stress in an individual, pre-hospital emergency authorities should seek to build and strengthen "positive coping" characteristics in pre-hospital medical emergency personnel to deal with accidents, emergencies, and injuries through adopting regular and dynamic policies.

Compliance to topical anti-glaucoma medications among patients at a tertiary hospital in North India

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Ketaki Rajurkar

2018-06-01

Full Text Available Purpose: The present study aims to estimate the prevalence of non-compliance and improper drop administration technique among glaucoma patients and describe common obstacles to medication compliance. Methods: A hospital-based cross-sectional study, using standardized questionnaire and direct observation by study personnel was conducted among glaucoma patients aged 18 years and above at a tertiary care charitable eye hospital in North India. 151 consecutive glaucoma patients on medical therapy following up at the glaucoma clinics for at least 6 months were recruited. Non-compliance was defined as missing at-least one drop of medication per week and (or the inability to accurately describe the medication regimen. Study personnel also assessed drop administration technique during application of eye drops by patients treating ophthalmologist-provided information, including measures of disease stability. Factors such as socioeconomic status, presence of caregiver, and number of medications with their effect on compliance were studied using chi-square statistics. Results: Among 151 patients interviewed, around 49% of patients reported problems in using glaucoma medications, with 16% of them reporting total non-compliance. 35% of patients demonstrated improper drop administration technique. Forgetfulness was cited as the main reason for being non-compliant and had a significant association with non-compliance (P = 0.00. Paying patients were more compliant as compared to subsidized patients (P = 0.05. Disease was more stable in compliant patients compared to non-compliant patients (P = 0.05. No other factor had significant association with compliance (P > 0.05. Conclusions: Over 50% of the patients surveyed were non-compliant, and 35% demonstrated improper administration technique. Glaucoma patients should be educated on the importance of compliance and aids that minimize forgetfulness, and delivery systems facilitating the delivery of

H-indices of Academic Pediatricians of Mashhad University of Medical Sciences.

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Hamidreza, Kianifar; Javad, Akhoondian; Ramin, Sadeghi; Leili, Zarifmahmoudi

2013-12-01

Web of Science, Scopus, and Google Scholar are three major sources which provide h-indices for individual researchers. In this study we aimed to compare the h-indices of the academic pediatricians of Mashhad University of Medical Sciences obtained from the above mentioned sources. Academic pediatrician who had at least 5 ISI indexed articles entered the study. Information required for evaluating the h-indices of the included researchers were retrieved from official websites Web of Science (WOS), Scopus, and Google Scholar (GS). Correlations between obtained h-indices from the mentioned databases were analyzed using Spearrman correlation coefficient. Ranks of each researcher according to each database h-index were also evaluated. In general, 16 pediatricians entered the study. Computed h-indices for individual authors were different in each database. Correlations between obtained h-indices were: 0.439 (ISI and Scopus), 0.488 (ISI and GS), and 0.810 (Scopus and GS). Despite differences between evaluated h-indices in each database for individual authors, the rankings according to these h-indices were almost similar. Although h-indices supplied by WOS, SCOPUS, and GS can be used interchangeably, their differences should be acknowledged. Setting up "ReasercherID" in WOS and "User profile" in GS, and giving regular feedback to SCOPUS can increase the validity of the calculated h-indices.

Hospital-acquired listeriosis.

Science.gov (United States)

Graham, J C; Lanser, S; Bignardi, G; Pedler, S; Hollyoak, V

2002-06-01

We report four cases of listeriosis that occurred over a two-month period in north east England. Due to the apparent nosocomial acquisition of infection and the clustering of cases in time and place, extended epidemiological investigation was performed and the outbreak was traced to a caterer who was providing sandwiches for hospital shops. We discuss the difficulties in preventing food-borne listeriosis in the hospital setting. Copyright 2002 The Hospital Infection Society.

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

Energy Technology Data Exchange (ETDEWEB)

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

2003-09-15

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

The Influence of Gender Role and Women's Empowerment on Couples' Fertility Experiences in Urban Society of Mashhad, Iran

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Talat Khadivzadeh

2014-07-01

Full Text Available Background and Aim: Iran has experienced a great variation in women's status in recent years. There is a little knowledge on how and why advancing gender equality and equity and the empowerment of women play a role in recent fertility reduction in the country. This study was conducted to gain insight into the role of gender beliefs and women's empowerment in the couples 'experiences of fertility in Mashhad, Iran in 2011-2012. Methods: In this exploratory qualitative study in-depth interviews were conducted with 54 purposefully selected eligible male and female participants and some key informants who lived in urban society of Mashhad. Data was collected until saturation was happened and analyzed adopting conventional content analysis approach through giving analytical codes and identification of categories using MAXqda software. Study rigor verified via prolonged engagement, thick description and validation of anlysis through member check. Results:Findings from data analysis demonstrated three major categories about the influence of women’s empowerment and gender role on fertility experiences including: 1 The couple’s understanding of gender roles 2 Women’s empowerment and changing gender roles 3 Couple’s interactions in complementary or parallel roles and 4 Fulfillment of fertility goals based on role division. Some aspects of couples' interaction including equal roles in fertility decisions, choosing and using best fit family planning method and participative child care influenced couples' fertility behavior. Women’s empowerment together with balanced gender role in the family resulted in success in attaining couple’s fertility desire. Conclusion: Managing fertility behaviors needs to understand the roles of spouses in their mutual interaction in fertility decision making and related behaviors. Imbalanced gender role in family acts as an obstacle to reach the fertility goals and leads to lower than desired fertility. Reproductive

Study of Pancytopenia in a Tertiary Care Hospital in North Karnataka

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Kulkarni Naveen S

2017-03-01

Full Text Available Introduction: Pancytopenia refers to the combination of anaemia, leukopenia and thrombocytopenia. Causes may be due to bone marrow failure, bone marrow infiltration, ineffective haematopoiesis or peripheral pooling/ destruction. A bone marrow aspirate is usually required to establish the diagnosis. Aetiologies of pancytopenia vary from one geographical region to other. Aim: Study of pancytopenia in patients admitted to a tertiary care hospital in north Karnataka. Methods: This study was conducted at SNMC and HSK, Bagalkot. This study was prospective, observational undertaken for 6-month period between July 2016-January 2017. History, physical examination, and primary blood investigations were done in all patients. Selected patients were evaluated with bone marrow examination. Materials: A total of 69 human subjects were enrolled. A thorough history, clinical examination and blood investigations were carried out. Results: Dimorphic anaemia is common than megaloblastic anaemia. Among those subjected for bone marrow megaloblastic anaemia was commoner than dual deficiency bone marrow. Other causes of pancytopenia were malaria, dengue, enteric fever, and less common causes included sepsis, MDS, TB, HIV, SLE. Conclusion: Nutritional anaemia is commonest cause for pancytopenia. This may be due to megaloblastic anaemia or deficiency of iron/vitamin B12/folate combined

Clinical Spectrum, Risk Factors, and Behavioral Abnormalities among Dementia Subtypes in a North Indian Population: A Hospital-Based Study

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Suman Kushwaha

2017-07-01

Full Text Available Background: As variability in the clinical profile of dementia subtypes had been reported with regional differences across the world, we conducted a retrospective hospital-based study in a North Indian population. Methods: We retrieved patient records from 2007 to 2014 for details of clinical evaluation, diagnosis, neuroimaging, biochemical investigations, and follow-up of 1,876 patients with dementia (PwD, and the data were analyzed using descriptive statistics. Results: Of the total PwD, Alzheimer disease (AD accounted for 30% followed by vascular dementia (VaD 26%, mixed dementia (MD 21%, Parkinson-related dementia 11%, frontotemporal dementia (FTD 7%, and infective dementia 5%. Of all PwD excluding the infective group (n = 1,777, 63% were men, 39% were from rural areas, 87% had behavioral abnormalities along with cognitive deficits, and 73% had impaired ADLs. Among dementia subtypes, a positive family history, cardiovascular and metabolic risk factors, and behavioral abnormalities were found to be distributed. However, there existed a predominance of specific behavioral pattern in each subtype. The mean duration of follow-up varied from 2.9 ± 2.3 (VaD to 3.6 ± 2.1 (AD and greater than 30% were found to be stable on treatment (except in dementia with Lewy body. Conclusions: This large hospital-based study provides a distribution pattern and clinical spectrum of dementia subtypes in a North Indian population.

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

Energy Technology Data Exchange (ETDEWEB)

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

2002-01-15

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

Variations of Ni, Cr and Mn Concentration in Soils Formed Along a Toposequence of Ultrabasic Rocks in Western Mashhad

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S. Akbari

2016-02-01

Full Text Available Introduction: Parent materials as one of the main soil formation factors have a great impact on the concentration of heavy metals in the soil. Heavy metals are released to the soil during weathering and pedogenic processes. Ultrabasic rocks are known as the potential natural source of heavy metals, especially Ni, Cr and Mn in the soil. Average concentrations of Ni and Cr in the soils are 84 and 34 mg kg-1, respectively; while, in soil derived from ultrabasic parent material, the concentration of these elements may reach up to 100000 mg kg-1. Binaloud zone in northeastern composed of different geological materials. There is a narrow band of ophiolitic rocks in this zone that located along Mashhad city. The geochemical behavior of ultrabsic rocks and the associated soil have been frequently studied mostly in humid regions. But, there are a few research works done in arid environments. The objective of this study was to investigate the physical and chemical properties and concentrations of Ni, Cr and Mn in soils formed along a toposequence of ultrabasic rocks in western Mashhad. Materials and Methods: The study area is located in the hilly land landscape of Binaloud zone in the Western part of Mashhad. Mean annual precipitation and temperature is 260 mm and 13.7 oC, respectively. Soil temperature and moisture regimes are thermic and aridic boarder on mesic, respectively. Studied soils developed on hornblendite rocks that are ultrabasic rocks with SiO2 less than 45% and contain ferromagnesian minerals. A toposequence was selected and, three soil profiles on shoulder, backslope and footslope geomorphic positions were described acoording to key to soil taxonmy 2014 and the soil horizons were sampled. Air-dried samples were passed through 2 mm sieve and were used for laboratory analysis. Pseudo-total concentrations of Ni, Cr and Mn were extracted by aqua regia digestion procedure. Free iron oxides (Fed and amorphous iron oxides (Feo were extracted by

Determination of Chilling and Heat Requirement of Four Apricot Cultivars of Khorasan Razavi Province

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zohreh hoshyar

2017-02-01

replications. First factor was various apricot cultivars (Noori- Dirras, Mashhad- Dirras, Shams Mashhad and Mashhad-44 and the second factor was chilling hours in five levels (0,100,300,500,700. About 45 branches of deciduous trees of each variety were collected when the temperature was below 7 °C. Finally, samples were taken in the greenhouse with an average temperature of 23° C and 16 hours of light and flowering percentage was recorded. For determination of chilling requirement in Utah, low chilling requirement and the North Carolina was performed in CU and Heat based on the degree of development hours (GDH was calculated. GDHs average hours of temperatures between 5-5 / 4 ° C and for any amount of time, sleep disruption and blossoming flowers will be calculated by 50% (5. Data analysis was done by JMP 8 and Excel softwares. Results: There were significant differences (1% between chilling hours, cultivars and their interactions on flowering percent. .Under laboratory condition, cultivars began flowering after 100 hours in 4°C.The results showed that there was a significant difference between 500 and 700 hours of chilling requirement. Most of the flowering was related to 700 hours and the lowest one was in control. There was a low difference in the chilling requirement. Heating requirement was 3300 growth degree hours (GDH for Noori- Dirras and Shams Mashhad to 3379 GDH for Dirras- Mashhad and Mashhad-44 cultivars. Although little differences exist in flowering onset of cultivars, the differentiation of flowering period among cultivars was around one week. Various cultivars revealed little differences in flowering onset in locations they meet their chilling requirement. The chill units estimated by Utah model was 1588. Chill units in Low chilling model and North Carolina model was 1291 and 1331, respectively while in chill hours was about 1100. The heat units in Noori- Dirras, Shams Mashhad was about 3,300 and it were calculated 3379 for Dirras Mashhad and Mashhad-44

Determinants of Nutritional Status in Children living in Mashhad, Iran

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Tahereh Shafieian

2013-12-01

Full Text Available Introduction: Children are one of the most vulnerable groups to sub-optimal nutritional intake in most societies. We have investigated some of the potential determinants of malnutrition in children of 2-5 years of age.   Methods and Materials: A cross sectional study was conducted to determine the relationship between nutritional status (weight for age, height for age and weight for height and dietary and socioeconomic factors in 671 children (24-59 months of age from selected health centers in Mashhad city, Iran. Children were assessed for weight and height and the care givers were interviewed and a questionnaire was completed by the interviewers. The data were analyzed using SPSS13 software and the Z-scores were calculated using the WHO anthropometric software package.   Results: The study showed that 24.4% of children were mildly underweight, 4.3% were underweight, 13% were mildly stunted, 23.6% of children were mildly wasted and 3.1% were stunted. Educational attainment, whether the children had been breast feed, average daily consumption of milk, feeding practices and type of first food were found to be the main factors determining nutritional status in our study.   Conclusion: A higher daily consumption of milk, lower age at which first solid food was started; lower age for consumption of meat and good feeding practices may resolve malnutrition in this population. These findings support the need for a family-based prevention program that focus on guiding parents to foster appropriate feeding practices as well as to promote healthy food intake in the children. Future research should determine the cost-effectiveness of both short- and long-term interventions for child malnutrition.  

75 FR 20390 - Robert Bosch LLC, Including On-Site Leased Workers From Bosch Management Services North America...

Science.gov (United States)

2010-04-19

...-site leased workers of Bosch Management Services North America, South Haven Community Hospital... leased workers of Bosch Management Services North America, South Haven Community Hospital, Huffmaster Inc..., Including On-Site Leased Workers From Bosch Management Services North America, South Haven Community...

Comparison of stress and burnout among anesthesia and surgical residents in a tertiary care teaching hospital in North India.

Science.gov (United States)

Gandhi, K; Sahni, N; Padhy, S K; Mathew, P J

2017-10-23

The residents undergoing training at hospitals in our country face challenges in terms of infrastructure and high workload with undefined working hours. The aim of the study was to compare the stress and burnout levels in trainee doctors doing residency in surgical fields and anesthesia at a tertiary care academic center in North India. A comparative, observational study was conducted in a tertiary care teaching hospital in North India. After Ethics Committee approval, 200 residents (100 each from surgical branches and anesthesia) were required to fill a questionnaire with information about age, sex, year of residency, marital status, and the Perceived Stress Scale-10, and Burnout Clinical Subtype Questionnaire-12. Burnout and perceived stress were compared between residents of anesthesia and surgical specialties. Residents of both surgical and anesthesia branches scored high in perceived stress, namely 21 and 18, respectively. The score was significantly higher in surgical residents (P = 0.03) and increased progressively with the year of residency. The majority of residents (90% surgical, 80% anesthesia) felt that they were being overloaded with work. However, only 20%-30% of respondents felt that there was lack of development of individual skills and still fewer (<10%) reported giving up in view of difficulties. There is high level of stress and overload dimension of burnout among the residents of anesthesia and surgical branches at our tertiary care academic institution and the surgical residents score marginally higher than anesthesia residents.

Electronic Cigarettes on Hospital Campuses

OpenAIRE

Meernik, Clare; Baker, Hannah M.; Paci, Karina; Fischer-Brown, Isaiah; Dunlap, Daniel; Goldstein, Adam O.

2015-01-01

Smoke and tobacco-free policies on hospital campuses have become more prevalent across the U.S. and Europe, de-normalizing smoking and reducing secondhand smoke exposure on hospital grounds. Concerns about the increasing use of electronic cigarettes (e-cigarettes) and the impact of such use on smoke and tobacco-free policies have arisen, but to date, no systematic data describes e-cigarette policies on hospital campuses. The study surveyed all hospitals in North Carolina (n = 121) to assess w...

Emergency Care Capabilities in North East Haiti: A Cross-sectional Observational Study.

Science.gov (United States)

De Wulf, Annelies; Aluisio, Adam R; Muhlfelder, Dana; Bloem, Christina

2015-12-01

The North East Department is a resource-limited region of Haiti. Health care is provided by hospitals and community clinics, with no formal Emergency Medical System and undefined emergency services. As a paucity of information exists on available emergency services in the North East Department of Haiti, the objective of this study was to assess systematically the existing emergency care resources in the region. This cross-sectional observational study was carried out at all Ministry of Public Health and Population (MSPP)-affiliated hospitals in the North East Department and all clinics within the Fort Liberté district. A modified version of the World Health Organization (WHO) Tool for Situational Analysis to Assess Emergency and Essential Surgical Care and Generic Essential Emergency Equipment Lists were completed for each facility. Three MSPP hospitals and five clinics were assessed. Among hospitals, all had a designated emergency ward with 24 hour staffing by a medical doctor. All hospitals had electricity with backup generators and access to running water; however, none had potable water. All hospitals had x-ray and ultrasound capabilities. No computed tomography scanners existed in the region. Invasive airway equipment and associated medications were not present consistently in the hospitals' emergency care areas, but they were available in the operating rooms. Pulse oximetry was unavailable uniformly. One hospital had intermittently functioning defibrillation equipment, and two hospitals had epinephrine. Basic supplies for managing obstetrical and traumatic emergencies were available at all hospitals. Surgical services were accessible at two hospitals. No critical care services were available in the region. Clinics varied widely in terms of equipment availability. They uniformly had limited emergency medical equipment. The clinics also had inconsistent access to basic assessment tools (sphygmomanometers 20% and stethoscopes 60%). A protocol for transferring

Seroprevalence of HIV in pregnant women in North India: a tertiary care hospital based study

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Singh Sarman

2007-11-01

Full Text Available Abstract Background Estimating the seroprevalence of HIV in a low risk population such as pregnant women provides essential information for an effective implementation of AIDS control programmes, and also for the monitoring of HIV spread within a country. Very few studies are available from north India showing the current trend in HIV prevalence in the antenatal population;which led us to carry outthis study at a tertiary care hospital in north India Methods Blood samples from pregnant women attending antenatal clinics at the All India Institute of Medical Sciences, New Delhi were collected after informed consent and pre-test counseling. The samples were tested for HIV antibodies as per the WHO guidelines, over a period of four years from January 2003 to December 2006. Results Of the 3529 pregnant women tested in four years, 0.88% (CI 0.5 – 1.24 women were found to be HIV seroreactive. Majority of the seroreactive pregnant women (41.9% were in the age group of 20–24 years followed by the 30–34 yrs (25.8% and 25–29 years (22.6% age group. The mean age of the HIV positive women was 24.9 years (SD ± 1.49 yrs. The HIV seroprevalence rates showed an increasing trend from 0.7% (CI 0.14 – 2.04 in 2003–2004 to 0.9% (CI 0.49 – 1.5 in 2005–2006. This prevalence rate indicates concern, as Delhi and its adjoining states are otherwise considered as 'low prevalence states'. Conclusion Seroprevalence of HIV infection was found to be increasing in the last four years amongst pregnant women of North India. These findings are in contrast to the national projections.

[North] Korea.

Science.gov (United States)

1986-05-01

In 1985, the population of the Democratic People's Republic of Korea (North Korea) stood at 20 million, with an annual growth rate of 2.3%. The infant mortality rate was 30/1000 live births and life expectancy was 66 years. The gross national product (GNP) was US$23 billion in 1984, with a per capita GNP of $1175. Both North Korea's labor force and natural resources have been concentrated in recent years on an effort to achieve rapid economic development. During the early 1970s, a large-scale modernization program involving the importation of Western technology, primarily in the heavy industiral sectors of the economy, was attempted and resulted in a massive foreign debt. North Korea has a strongly centralized government under the control of the communist Korean Workers' Party. Literacy in the country is at the 99% level. Medical treatment is free. There is 1 physician/600 population and 1 hospital bed/350 inhabitants.

Application of Donabedian quality-of-care framework to assess the outcomes of preconception care in urban health centers, Mashhad, Iran in 2012

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Fatemeh Ghaffari

2013-12-01

Full Text Available Background and aim: Improving patient health status is the primary goal of healthcare system. and planning to improve the health care services without taking into account the views of care receivers is not possible .In this regard, Donabedian Model as an appropriate framework in assessing the quality of health care, has particular attention to the issue of "outcomes", which are sometimes seen as the most important indicators of quality. This study therefore aimed to assess the outcomes of preconception care including changes to health knowledge as well as patient satisfaction in urban health centers, Mashhad, Iran in 2012. Methods: In this descriptive study, 350 women of reproductive age who received preconception care in urban health centers of Mashhad, Iran, were selected using a two stage sampling design. Demographic and obstetric data were collected through a self-structured questionnaire.  Outcomes of preconception care including health knowledge as well as patient satisfaction were measured using a questionnaire adopted from Donabedian Model. Data were analyzed with SPSS Software version 16 and statistical tests such as ANOVA, Chi-square and Pearson correlation coefficient. Findings: The mean age of women was 22.5 ± 26.93 and the mean score of their marriage years was 6.32±4.77.  67.4% of subjects experienced between one and six pregnancies. The mean score of health knowledge of preconception care was 53.4 ± 8.14 and the highest score of its subdomains was related to the personal hygiene. The mean score of patients' satisfaction of preconception care was 84.11 ± 56.75 and its highest score was in relation to counseling and provided care. Conclusion: According to the results, planning to provide better education services for clients, raising public awareness regarding preconception care and more emphasis on preconception care importance in continuous education of health care providers are recommended.  

Varied presentations of moyamoya disease in a tertiary care hospital of north-east India

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Papori Borah

2014-01-01

Full Text Available Introduction: Moyamoya disease is a chronic progressive cerebrovascular disorder, characterized by stenosis or occlusion of bilateral internal carotid arteries (ICAs, anterior cerebral arteries (ACAs and middle cerebral arteries (MCAs, accompanied by a collateral network of vessels formed at the base of the brain. Ischemia and intracranial hemorrhage are the common typical manifestations. However moyamoya disease has been associated with atypical presentations like headache, seizures and involuntary movements. Although frequently reported from Asian countries like Japan, China and Korea, only few studies reported on clinical manifestations of moyamoya disease from India. Objectives: To study the varied presentations of moyamoya disease in a tertiary care hospital of north-east India. Material and Methods: Relevant investigations were done to rule out other causes of moyamoya syndrome. Results: We report 6 cases of moyamoya disease with varied presentations from a tertiary care referral government hospital. Case 1, 2 and 6 presented with alternating hemiparesis. Case 3 had amaurosis fugax. Case 4 had history suggestive of ischemic stroke and presented with hemichorea. Case 4 had focal seizure as the only manifestation. Cases 4 and 5 notably had stenosis of posterior cerebral artery (PCA in addition to stenosis of bilateral ICAs, ACAs and MCAs. Conclusion: Owing to its low incidence in India, moyamoya disease is easily overlooked as a possible diagnosis. However, because of its progressive nature, it is imperative to diagnose this disease early and offer surgical treatment to the patients.

[Waste management in hospitals. Current situation in the state of North Rhine-Westphalia].

Science.gov (United States)

Popp, W; Hansen, D; Hilgenhöner, M; Grandek, M; Heinemann, A; Blättler, T

2009-07-01

In 20 hospitals in North Rhine-Westphalia in-plant handling wastes and the delivery of the waste to the disposer were examined. Deficits were seen regarding risk assessment and operating instructions, support by company doctors, personal protection equipment, and break areas for the waste collecting personnel. Also the qualification of the waste management officer and his/her time contingent, correct declaration of the wastes, the training of the waste collecting personnel, the cleaning of multi-use containers and transportation vehicles, storage of the wastes at the collecting points, and the use of sharp collecting boxes were to be partly criticized. Consequences and recommendations are given, concerning the company's obligations (e.g., provide risk assessment, operating instructions), waste management officer (e.g., qualification, enough time contingent, regular inspections), waste collecting personnel (e.g., training courses), industrial safety (e.g., protection equipment, break area wash places), company doctors, transportation vehicles in the house (e.g., regular cleaning), one-way collectors (e.g., labelling at the site of the collection), multi-use collectors (e.g., cleaning), and compressing containers (e.g., larger maintenance openings).

Determinants of Nutritional Status in Children living in Mashhad, Iran

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T Shafieian

2014-04-01

Full Text Available Introduction: Children are one of the most vulnerable groups to sub-optimal nutritional intake in most societies. We have investigated some of the potential determinants of malnutrition in children of 2-5 years of age.   Methods and Materials: A cross sectional study was conducted to determine the relationship between nutritional status (weight for age, height for age and weight for height and dietary and socioeconomic factors in 671 children (24-59 months of age from selected health centers in Mashhad city, Iran. Children were assessed for weight and height and the care givers were interviewed and a questionnaire was completed by the interviewers. The data were analyzed using SPSS13 software and the Z-scores were calculated using the WHO anthropometric software package.   Results: The study showed that 24.4% of children were mildly underweight, 4.3% were underweight, 13% were mildly stunted, 23.6% of children were mildly wasted and 3.1% were stunted. Educational attainment, whether the children had been breast feed, average daily consumption of milk, feeding practices and type of first food were found to be the main factors determining nutritional status in our study.   Conclusion: A higher daily consumption of milk, lower age at which first solid food was started; lower age for consumption of meat and good feeding practices may resolve malnutrition in this population. These findings support the need for a family-based prevention program that focus on guiding parents to foster appropriate feeding practices as well as to promote healthy food intake in the children. Future research should determine the cost-effectiveness of both short- and long-term interventions for child malnutrition.   Keywords:Malnutrition Prevention, Nutritional Intake, Nutritional Status, Preschool Children.  

Detection of Coxiella burnetii in Aborted Fetuses of Cattle and Sheep Using Polymerase Chain Reaction Assay in Mashhad City, Iran

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Zeinab Abiri

2016-02-01

Full Text Available Background: Coxiella burnetii is an important intracellular pathogen that ruminants can act as primary reservoirs. Reservoirs may excrete the bacterium into the placenta, vaginal mucus and feces. Objectives: The aim of this study was to detect C. burnetii in aborted samples from ruminant flocks in Mashhad city, northeast of Iran, using the polymerase chain reaction (PCR assay. Materials and Methods: A total number of 154 fetal tissue samples of cattle, sheep and goat were subjected to nested PCR assay. Results: Sixteen (17.3% out of 92 samples from sheep and 15 (25% from 60 cattle fetuses were positive. Conclusions: The results of this study indicate the presence of C. burnetii in aborted ruminants and these can be the potential reservoirs of C. burnetii in the mentioned area.

The effect of organic, biological and chemical fertilizers on yield, essential oil percentage and some agroecological characteristics of summer savory (Satureja hortensis L. under Mashhad conditions

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E Gholami Sharafkhane

2016-05-01

Full Text Available Introduction Savory (Satureja hortensis L. is an annual herbaceous plant that belongs to the Lamiaceae family. Nowadays, the use of biofertilizers is increased in agriculture and their role in increasing the crops production has been demonstrated in many research works (Vessey, 2003; Chen, 2006; Mahfouz & Sharaf- Eldin, 2007. One of the most important visions is sustainable production of enough food plus paying attention to social, economical and environmental aspects. (Gliessman, 1998 stated that the first step to achieve this goal is optimization and improvement of resources use efficiencies. Considering medicinal importance of savory and its role in the food and pharmaceutical industries (Omidbeigi, 2000, beside the limited nutrient resources and need to increase healthy production through using ecological inputs, this study was designed and conducted aimed to evaluate agroecological characteristics of savory as affected by the application of bio fertilizers, chemical and organic fertilizers under Mashhad conditions. Materials and methods In order to study the effects of organic, biological and chemical fertilizers on quantitative and qualitative characteristics of summer savory, a split-plot design based on RCBD with three replications was conducted during the growing season of 2012 at the Agricultural Research Station, College of Agriculture, Ferdowsi University of Mashhad, Iran. Different levels of cattle manure (0 and 25 t.ha-1 were assigned to the main plots and different types of bio fertilizers (Nitroxin, containing Azotobacter sp. and Azospirillum sp., Biophosphor, containing phosphate-solubilizing bacteria (Bacillus sp. and Pseudomonas sp., Biosulfur, containing sulfur-solubilizing bacteria (Thiobacillus ssp., combination of Nitroxin+Biophosphor+ Biosulfur, vermicompost (7 t.ha-1, chemical fertilizers (NPK: 60, 60 and 70 kg.ha-1 and control (no fertilizer were used in the sub- plots. Results and discussion According to the results

An evaluation of magnetic resonance imaging at the Royal North Shore Hospital of Sydney, 1986-1987

International Nuclear Information System (INIS)

Sorby, W.A.

1989-01-01

The diagnostic accuracy and clinical utility have been evaluated of 2810 consecutive magnetic-resonance-imaging examinations that were performed on a 1.5-T Signa magnetic-resonance-imaging unit at The Royal North Shore Hospital of Sydney between November 1986 and December 1987. The average accuracy of magnetic resonance imaging was 80%, and ranged from 21%-98% in various brain-disease and spinal-disease categories, compared with the average provisional premagnetic-resonance-imaging diagnostic accuracy of 64%, and an average accuracy of computed tomography of 45%. Clinical follow-up at three months after magnetic-resonance-imaging investigation indicated that, as a result of the magnetic-resonance-imaging examination, patient management was altered in 70% of cases, and patient outcome was altered in 62% of cases. 32 refs., 4 tabs

The Effect of Mother Empowerment Program on Mothers’ Attachment to their Hospitalized Premature Neonates

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Soheila Karbandi

2015-06-01

Full Text Available Background: Birth of a premature neonate is associated with hospital admission and separation from the family. Admission of the neonates intervenes on infant-mother attachment and so adversely affects on the quality of care given by the mother, and subsequently increases the risk of delayed behavioral problems in the children. Aim: To assess the effectiveness of mother empowerment program on the premature infant-mother attachment. Methods: In this randomized clinical trial, 70 mothers of premature infants, admitted to the neonatal intensive care unit (NICU of Omolbanin hospital of Mashhad in 2014, were divided into of intervention and control groups. The Empowerment program was a multi-step treatment program, in which information about the premature infants was provided to mothers through an illustrated booklet with a workbook and audio file in each step. Mothers in the control group received information and routine care according to the hospital guideline. The mother-infant attachment was measured after the intervention using the maternal and neonatal behaviors Avant tool. Data analysis was performed using chi-square and t-student tests by SPSS software version 11.5. Results:The mean scores of maternal attachment behaviors after the intervention in the empowerment and control groups were (56.62±8.06 and (39.51±7.77, respectively; the difference between the groups was statistically significant (P

Prevalence of Bovine Viral Diarrhoea Virus antibodies and antigen among the aborted cows in industrial dairy cattle herds in Mashhad area of Iran

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Naseri, Z.

2011-06-01

Full Text Available The measurement of antibody responses of animals exposed to BVDV either through a natural exposure or an immunization protocol is still a standard procedure. For BVDV, the test formats have been largely limited to ELISA which is a valuable diagnostic test to measure the level of BVDV specific antibodies as well as antigen in blood samples. In the present study, 120 blood samples were collected from the cows with the history of abortion in different period of pregnancy from different industrial dairy cattle herds of Mashhad area of Iran. Also 30 samples were collected from the cows with no history of abortion as control. The presence of antibody against BVDV from the 120 serum samples was investigated by indirect ELISA. From 120 serum samples which were collected from aborted cows, 89 samples were positive (%74.16. From these positive samples, 12(13.48%, 54 (60.68% and 23 (25.84% samples belong to the first, second and third trimester of pregnancy, respectively. From 89 positive samples, 12 (13.48% samples were related to stillbirth and 8 (8.99% samples were belongs to the mummified fetus. From 89 positive samples, 71 (79.78% were related to cattle between 2-5 years old and 18 (20.22% were associated to cattle more than 5 years old. In control group, 20 samples (66.66% were antibody positive. Also the presence of BVDV antigen in serum samples was investigated by Ag-capture ELISA. From 120 serum samples, 2 samples were positive (1.67%, which belongs to the second period of pregnancy. In control group, none of the samples were antigen positive. The results of this study showed that the prevalence of BVDV infection is high among the aborted cows of Mashhad area. Although this prevalence is higher than the control group, the observed difference is not significant.

A Survey on the Infrastructures and Skills Necessary to Establish Electronic Reference Services at Ferdowsi University of Mashhad

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Mehri Parirokh

2014-12-01

The study population were all librarians working in the Reference Services, information and Public services in Libraries of Ferdowsi University of Mashhad (32 person. Interviews were conducted with one of the administrative staff at the Central Library. The checklist was completed with the help of the head of each library. The findings showed that about 35% of reference librarians using less electronic reference services. in this field, Others evaluate themselves as moderate. And all the librarians (100 percent were mentioned that offer of electronic reference services is necessary. Meanwhile, only 28% believed that librarians have the Technology skills and nearly 50% believe that they have the searching skills. In this regard, more than 60% of librarians said they have suitable skills. Based on the finding and the gap between present and ideal situation it seems that the usage rate of technology in its ideal form has the deepest gap and with the librarian's individual skills has not it.

Serum 25-hydroxyvitamin D Levels in Patients Referred to Clinical Laboratories in Various Parts of Mashhad- Northeastern Iran

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Ali Akbar Shamsian

2015-06-01

Full Text Available Introduction: Vitamin D has an important role in maintaining human health. The main source of vitamin D production is skin exposure to sunlight. Accordingly with the spread of apartment life culture, growth of industrial cities and the increase of air pollution; vitamin D deficiency and its implications is an important factor in the appearance of debilitating diseases in different age categories (especially for children, adults and elderly people.   Materials and Methods: A retrospective cross-sectional study based on an objective was conducted on 1,110 patients who were selected randomly. These patients have been referred to “center of education culture and research” laboratories (2 laboratories and 8 specialized laboratories for vitamin D test in the city of Mashhad. And after conducting the study, the collected data was analyzed using SPSS 13 software.   Results: The prevalence of vitamin D deficiency in the population under study was 68.8%. Vitamin D levels were significantly lower in males in comparison with females (P

Analysing workplace violence towards health care staff in public hospitals using alternative ordered response models: the case of north-eastern Turkey.

Science.gov (United States)

Çelik, Ali Kemal; Oktay, Erkan; Çebi, Kübranur

2017-09-01

The main objective of this article is to determine key factors that may have a significant effect on the verbal abuse, emotional abuse and physical assault of health care workers in north-eastern Turkey. A self-administered survey was completed by 450 health care workers in three well-established hospitals in Erzurum, Turkey. Because of the discrete and ordered nature of the dependent variable of the survey, the data were analysed using four distinctive ordered response models. Results revealed that several key variables were found to be a significant determinant of workplace violence, such as the type of health institution, occupational position, weekly working hours, weekly shift hours, number of daily patient contacts, age group of the respondents, experience in the health sector, training against workplace violence and current policies of the hospitals and the Turkish Ministry of Health.

Soil Moisture Estimation Using MODIS Images (Case Study: Mashhad Plain Area

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M. Fashaee

2016-09-01

area is selected in the Mashhad plain in Khorasan Razavi province of I.R. Iran. Study area is about 1,200 square kilometers and is located around the Golmakan center of agricultural research. In this study, water deficit index (WDI was zoning by MODIS images in subset of Mashhad plain during water year of 2011-2012. Then, based on the close relationship between WDI and soil moisture parameter, a linear relationship between these two parameters were fitted. Soil moisture is measured by the TDR and every 7 days at 5 depths of 5, 10, 20, 30 and 50 cm from the surface. Remote Sensing (RS technology used as a tool for providing some of the data that is required. The moderate resolution imaging spectroradiometer (MODIS instrument is popular for monitoring soil moisture because of its high spectral (36 bands resolution, moderate spatial (250–1000 m resolution and various products for land surface properties. MODIS products used in the present study include: MOD09A1 land surface albedo data, MOD11A1 land surface temperature data, and MOD13A1 vegetation data. Using ArcMap 9.2 and ERDAS IMAGINE 2010 softwares, WDI was calculated pixel by pixel for 18 days (non-cloudy days and simultaneous with measurement of soil moisture at the station. Results and Discussion: The results showed that the northeastern region is predominantly rainfed and irrigated farmlands are under water stress. Conversely, the southwestern part of the area is mountainous with less water stress. Based on NDVI, there is also less crop cover in the southwestern part of the region during the year. The results showed that about 44% of the index values are in the range of 0.2-0.3. Then about 22% of the index values are in the range of 0.3-0.4. Thus it can be concluded that over 66% of the index values are in the range of 0.2-0.4. According to the maximum index value (WDI=0.59 on the 201th day of year and the minimum values (WDI=0.0004 on the 129th day of year during the time period of study, it seems that water

Tattoo Practices in North-East India: A Hospital-based Cross-sectional Study.

Science.gov (United States)

Thakur, Binod Kumar; Verma, Shikha

2016-01-01

Tattooing has become increasingly popular, particularly among young people. However, little is known about the tattoo practices in North-East India. The primary objective of this study was to know the reasons and motivations of tattoo application and tattoo removal in individuals asking for tattoo removal. The secondary objective was to identify the demography, methods and safety of tattoo practices in these tattooed individuals. A hospital-based cross-sectional study was carried out in 212 consecutive individuals seeking tattoo removal. Chi-square and Fisher's exact tests were performed for intergroup comparisons. There were 178 (84%) males and 34 (16%) females. The mean ± standard deviation (SD) age of individuals seeking tattoo removal was 21.8 ± 4 years. The mean ± SD age of doing tattoo was 15.8 ± 3 years. Most individuals possessed an amateur tattoo (94.3%), 4.2% a professional one and 1.4% had a combination. Sewing needle was the most common instrument used for making tattoos in 51.4%. The individuals made their tattoos in an unsterile manner in 49.1%. The most common reason for doing tattoo was for fashion in 87.7%. The participants wanted tattoo removal to qualify for jobs, especially in armed forces in 49.5% and due to regret in 21.7%. Black was the most preferred colour in 37.3% followed by green in 28.3%. The fabric ink was the choice of ink in maximum number of individuals, i.e. 93.9%. It was a hospital-based study done only on individuals seeking tattoo removal. It needs caution to generalise the findings in population. In addition, there may be recall bias in the participants. The tattoo was done mostly below 18 years of age in a crude unsterile way. The individuals had poor risk perceptions about various infections and complications of tattooing. There is an urgent need to caution and educate the youngsters and school-going children about safe tattooing and consequences of tattooing.

Tattoo practices in north-east India: A hospital-based cross-sectional study

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Binod Kumar Thakur

2016-01-01

Full Text Available Background: Tattooing has become increasingly popular, particularly among young people. However, little is known about the tattoo practices in North-East India. Objectives: The primary objective of this study was to know the reasons and motivations of tattoo application and tattoo removal in individuals asking for tattoo removal. The secondary objective was to identify the demography, methods and safety of tattoo practices in these tattooed individuals. Materials and Methods: A hospital-based cross-sectional study was carried out in 212 consecutive individuals seeking tattoo removal. Chi-square and Fisher's exact tests were performed for intergroup comparisons. Results: There were 178 (84% males and 34 (16% females. The mean ± standard deviation (SD age of individuals seeking tattoo removal was 21.8 ± 4 years. The mean ± SD age of doing tattoo was 15.8 ± 3 years. Most individuals possessed an amateur tattoo (94.3%, 4.2% a professional one and 1.4% had a combination. Sewing needle was the most common instrument used for making tattoos in 51.4%. The individuals made their tattoos in an unsterile manner in 49.1%. The most common reason for doing tattoo was for fashion in 87.7%. The participants wanted tattoo removal to qualify for jobs, especially in armed forces in 49.5% and due to regret in 21.7%. Black was the most preferred colour in 37.3% followed by green in 28.3%. The fabric ink was the choice of ink in maximum number of individuals, i.e. 93.9%. Limitations: It was a hospital-based study done only on individuals seeking tattoo removal. It needs caution to generalise the findings in population. In addition, there may be recall bias in the participants. Conclusion: The tattoo was done mostly below 18 years of age in a crude unsterile way. The individuals had poor risk perceptions about various infections and complications of tattooing. There is an urgent need to caution and educate the youngsters and school-going children about safe

Tattoo Practices in North-East India: A Hospital-based Cross-sectional Study

Science.gov (United States)

Thakur, Binod Kumar; Verma, Shikha

2016-01-01

Background: Tattooing has become increasingly popular, particularly among young people. However, little is known about the tattoo practices in North-East India. Objectives: The primary objective of this study was to know the reasons and motivations of tattoo application and tattoo removal in individuals asking for tattoo removal. The secondary objective was to identify the demography, methods and safety of tattoo practices in these tattooed individuals. Materials and Methods: A hospital-based cross-sectional study was carried out in 212 consecutive individuals seeking tattoo removal. Chi-square and Fisher's exact tests were performed for intergroup comparisons. Results: There were 178 (84%) males and 34 (16%) females. The mean ± standard deviation (SD) age of individuals seeking tattoo removal was 21.8 ± 4 years. The mean ± SD age of doing tattoo was 15.8 ± 3 years. Most individuals possessed an amateur tattoo (94.3%), 4.2% a professional one and 1.4% had a combination. Sewing needle was the most common instrument used for making tattoos in 51.4%. The individuals made their tattoos in an unsterile manner in 49.1%. The most common reason for doing tattoo was for fashion in 87.7%. The participants wanted tattoo removal to qualify for jobs, especially in armed forces in 49.5% and due to regret in 21.7%. Black was the most preferred colour in 37.3% followed by green in 28.3%. The fabric ink was the choice of ink in maximum number of individuals, i.e. 93.9%. Limitations: It was a hospital-based study done only on individuals seeking tattoo removal. It needs caution to generalise the findings in population. In addition, there may be recall bias in the participants. Conclusion: The tattoo was done mostly below 18 years of age in a crude unsterile way. The individuals had poor risk perceptions about various infections and complications of tattooing. There is an urgent need to caution and educate the youngsters and school-going children about safe tattooing and

Analysis of different inputs share and determination of energy Indices in broilers production in Mashhad city

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H Sadrnia

2017-05-01

largest producer of broilers in Iran. This research was performed because it is necessary to have energy consumption status; also there is a few data about broiler’s energy consumption in Mashhad. In this research, the data of Mashhad’s broilers was analyzed by Data Envelopment Analysis Method. The other objectives of this study were to separate efficient and inefficient units to use energy resource efficiently and determine total energy saving. Materials and Methods This study was performed in 2013 in Mashhad, Iran. The data were collected through interviews and questionnaires from 36 poultry farmers for a growing period of April to May. Input energies were the feed, fuel (gas and gas oil, electricity, labor, equipment and chicken, and the output energies were the chicken meat and the manure. The energy consumption for each element was calculated by multiplied amount of inputs/outputs to energy equivalents. Results and Discussion The total of input and output energies were obtained 125.2, 24.9 GJ/1000Birds, respectively. Energy indices such as energy ratio, energy efficiency and specific energy were determined to be 0.2, 0.019 kg/MJ and 52.55 MJ/kg, respectively. The highest share of energy consumption were 50.84 and 42.43%, for fuel (natural gas and diesel fuel and feed respectively, the lowest share among the input energies were 0.39 and 0.06%, for chicken and labor respectively. Comparison of energy in three levels of farm sizes (≤15000, 15000-30000 and ≥30000 chicks showed the energy ratio for large farms were higher than the other levels. Data Envelopment Analysis (DEA was used to evaluate the poultry efficiency. The results showed that 13 poultry units had average technical efficiency (0.93 in the definition of Constant Returns to Scale (CRS, and 21 poultry units had pure technical efficiency (0.99 in the definition of Variable Returns to Scale (VRS. Conclusions The Fuel (natural gas and diesel fuel consumption energy had the highest shares of energy

Effect of Chemical Fertilizer, Cow Manure and Municipal Compost on Yield, Yield Components and Oil Quantity of three Sesame (Sesamum indicum L. Cultivars in Mashhad

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P Rezvani Moghaddam

2013-10-01

Full Text Available In order to evaluate the effects of different organic and chemical fertilizers on yield, yield components and seed oil content of sesame an experiment was conducted in a split plot layout based on randomized complete block design with four replications at Research Station, Faculty of Agriculture, Ferdowsi University of Mashhad in year 2006. Four types of fertilizer, including chemical fertilizer, cow manure, municipal compost and no fertilizer (control were allocated as main plots and three sesame cultivars (two local varieties of Kalat and Esfarayen, and Oltan cultivar were used as sub plots. The results showed that fertilizer treatments had significant effect (P

Evaluation of Fall Planting Dates of Cumin (Cuminum cyminum L. Ecotypes in Mashhad Conditions

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Z Khorasani

2012-07-01

Full Text Available In order to study the effects of fall planting dates on yield and yield components of six cumin (Cuminum cyminum L. ecotypes an experiment was arranged in a randomized complete block design as a split-plot with three replications during 2007-08 growing season at the Agricultural Research Station of Ferdowsi University of Mashhad. Three planting dates (18 Oct. (first, 8 Nov. (second and 29 Dec. (third and six cumin ecotypes (Torbat heydarieh, Khaf, Sabzevar, Ghaen, Ghoochan and RZ19 were allocated to main and sub plots, respectively. Results showed that the effects of planting dates, ecotypes and interaction effects of planting dates and cumin ecotypes were significant for yield components (winter survival percentage, number of umbel per plant, number of seeds per umbel and 1000-seed weight and seed yield and biological yield. There was a reduction on yield components (number of umbel per plant, number of seeds per umbel and 1000-seed weight, seed yield and biological yield due to delay planting date from 18 Oct. to 29 Dec. The highest winter survival percentage was achieved on the third planting date. The highest and lowest amount for all of the traits, were achieved in Ghaen and RZ19 ecotypes, respectively. According to the useful results and for the deployment of cumin fall planting in other locations of province, continuation of this study to recommended.

Comparison of Social Adjustment in Blind Children and Normal in Primary School in Mashhad

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AA ModdaresMoghaddam

2014-05-01

Methods:This is a descriptive, analytical study in which 270 blind and viewing students of primary schools in Mashhad participated in the academic years 2012-13. The blind students were chosen by census and viewing students through a stratified random sampling from normal schools. For data collection, a standard questionnaire that was social adjustment questionnaire was used. It was made in 1974 in America by Lambert, Wind Miller, Cole & Figueroa, which was translated in 1992 by Dr. Shahny Yeylagh, to be used for children of 7 to 13 years. It was conducted on 1500 boy and girl students of the first to fifth grade in elementary schools of Ahvaz. This test consists of 11 subscales, 38 sub-categories and 260 items. For data analysis, descriptive and inferential statistics such as t-test was used. (P <0.05. Results:The mean scores of social adjustment of students showed no statistically significant difference between the viewing and the blind (p=0.8. Also the mean of social adjustment in blind girls and boys was not statistically significant (p=0.1, but the incompatibility was found in more boys than the girls. Conclusion: Regarding the results, social incompatibility was higher in the blind girl students than the viewing girl students. Also this incompatibility was higher in the boys than the girls thereby requiring scientific and coherent planning for them.

Determining the Status Quo of Infection Prevention and Control Standards in the Hospitals of Iran: A Case Study in 23 Hospitals

OpenAIRE

Shojaee, Jalil; Moosazadeh, Mahmood

2014-01-01

Background: Applying Prevention and Control of Infection (PCI) standards in hospitals reduces probable risks to patients, staff and visitors; it also increases efficiency, and ultimately improves productivity of hospitals. Objective: The current study aimed to determine the status quo of international standards of PCI in hospitals located in the north of Iran. Materials and Methods: This cross-sectional study was conducted in 23 hospitals. Data collection tool was a questionnaire with confirm...

A Conceptual Model of Technology and E-services Acceptance among Universities\\\\\\' Students (Case Study: Ferdowsi University of Mashhad

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Shamsodin Nazemi

2012-12-01

Full Text Available : In spite of increasing interests and trends among Iranian organizations to incorporate information and communication technology (ICT into service provision to their customers, there is still considerable gap between existing and expected diffusion. The aim of this study was to identify and evaluate main determinants of technology adoption and use on the basis of modified TAM model. The developed model was validated through survey research and data collected from a randomly selected sample of 263 students at Ferdowsi University of Mashhad. Data analysis was conducted using appropriate statistical techniques including regression, and Chaves analysis. The findings of research confirmed the validity of principle model , confirming ease of use and perceived usefulness as main determinants of technology acceptance as suggested by Davis. This study also suggested that the quality of system and personal ability to use technology were good predictors of ease of use, while social interaction and images appeared to be good predictors of perceived usefulness of technology. Furthermore, personal innovativeness proved to have significant effect on intention to use among potential ICT users.

Intelligent Pressure Management to Reduce Leakage in Urban Water Supply Networks, A Case Study of Sarafrazan District, Mashhad

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Mohammad Soltani Asl

2009-09-01

Full Text Available Water losses are inevitable in urban water distribution systems. The two approaches adopted nowadays to combat this problem include management of hydraulic parameters such as pressure and leakage detection in the network. Intellitgent pressure management is a suitable technique for controlling leakage and reducing damages due to high operating pressures in a network. This paper aims to investigate the effects of pressure reduction on leakage. The EPANET 2.10 software is used to simulate the water distribution network in the Sarafrazan District,Mashhad, assuming leakage from network nodes. The results are then used to develop a pressure variation program based on the patterns obtained from the simulation, which is applied to the pressure reducing valve. The results show that pressure management can reduce nightly leakage by up to 35% while maintaining a more uniform pressure distribution. Implementation of the time-dependent pressure pattern by applying programmable pressure reducing valves in a real urban water distribution network is feasible and plays a key role in reducing water losses to leakage.

Mercury contamination of fish and shrimp samples available in markets of Mashhad, Iran.

Science.gov (United States)

Vahabzadeh, Maryam; Balali-Mood, Mahdi; Mousavi, Seyed-Reza; Moradi, Valiollah; Mokhtari, Mehrangiz; Riahi-Zanjani, Bamdad

2013-09-01

Fish and shrimp are common healthy sources of protein to a large percentage of the world's population. Hence, it is vital to evaluate the content of possible contamination of these marine-foods. Six species of fishes and two species of shrimps were collected from the local markets of Mashhad, Iran. The mercury (Hg) concentration of samples was determined by atomic absorption spectrophotometry using a mercuric hydride system (MHS 10). High concentration of total Hg was found in Clupeonella cultriventris caspia (0.93 ± 0.14 μg/g) while the lowest level was detected in Penaeus indicus (0.37 ± 0.03 μg/g). Mean Hg levels in fish and shrimp samples were 0.77 ± 0.08 μg/g and 0.51 ± 0.05 μg/g, respectively. Farmed species (except for P. indicus) and all samples from Persian Gulf and the Caspian Sea had mean mercury concentrations above 0.5 μg/g, which is the maximum standard level recommended by Joint FAO/WHO/Expert Committee on Food Additives (JECFA). All samples had also mean Hg concentrations that exceeded EPA's established safety level of 0.3 μg/g. A little more extensive analysis of data showed that weekly intake of mercury for the proportion of the Iranian population consuming Hg contaminated fish and shrimp is not predicted to exceed the respective provisional tolerable weekly intakes recommended by JECFA. However, the Iranian health and environmental authorities should monitor Hg contamination of the fishes and shrimps before marketing.

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

International Nuclear Information System (INIS)

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

2002-01-01

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

Perspectives of Residents of Mashhad School of Dentistry about the Curriculum of Residency Program

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Javad Sarabadani

2015-09-01

Full Text Available Introduction: This study was carried out to analyze the viewpoint of the residents of school of dentistry about the curriculum presented in the residency program to students of Mashhad School of Dentistry. Methods: To evaluate the perspectives of residents of dental school about the curriculum and regulations of residency program, a questionnaire was designed whose validity and reliability were confirmed by the authorities of School of Dentistry and test-retest reliability, respectively. The questionnaire was distributed among 100 residents and 80 of them completed the questionnaires. The data were analyzed by SPSS software (version 11.5. Results: A total of 43% of residents were informed of the curriculum (e.g. academic leave, transfer, removal of semester, etc.. As for the ability to write research proposal, 42.7% of residents were reported to have a favorable status, i.e. they were able to write more than 80% of their proposal. From among the residents, 30.4% had specialized English language certificate. Most of them (77% were satisfied with the professional staff, faculty members, of the faculty. Many students liked to participate in the teaching method courses of the residency program. Conclusion: Residents maintained that the curriculum in such domains as educational and research issues and special capabilities had some weak points. Thus, appropriate strategies are recommended to be applied to revise the curriculum using the residents’ views on these programs.

Assessment the Relationship Between Parents' Literacy Level with Children Growth in Mashhad: An Analytic Descriptive Study

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Masumeh Saeidi

2013-12-01

Full Text Available Introduction: Present children are the investments of community in the future. Preparing children health which leads to the stability of community health, provided to accurate implementation of educational and health programs in the community and especially in mothers. So it is necessary to determine the relationship between parents' literacy  with growth rate in children. Materials and Methods: This cross-sectional descriptive-analytic study was conducted on 300 mothers referring to 10 selected Mashhad health-care centers for monitoring their 6-24-month year old infants. They completed questionnaire. Participants were selected by cluster and simple random sampling. Data were analyzed by descriptive- analytic statistics and using SPSS 16. Results: Presentfindings showed a significant relationship between literacy  level of parents with child growth status, breast feeding rate, junk food consumption, referring to health care center for growth monitoring, the age of initiating supplementary nutrition, the use of oil and butter in baby food and rate of attending in educational classes. So that higher literacy  level of parents was associated with using more formula, less junk food, oil and butter in baby's food and more referring times to health care center for monitoring child growth, desirable growth, and  also initiating supplementary food more at the assigned time (p

Assessment the Relationship between Parents' Literacy Level with Children Growth in Mashhad: An Analytic Descriptive Study

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Bibi Leila Hoseini

2014-04-01

Full Text Available Introduction: Present children are the investments of community in the future. Preparing children health which leads to the stability of community health, provided to accurate implementation of educational and health programs in the community and especially in mothers. So it is necessary to determine the relationship between parents' literacy with growth rate in children.   Materials and Methods: This cross-sectional descriptive-analytic study was conducted on 300 mothers referring to 10 selected Mashhad health-care centers for monitoring their 6-24-month year old infants. They completed questionnaire. Participants were selected by cluster and simple random sampling. Data were analyzed by descriptive- analytic statistics and using SPSS 16.   Results: Presentfindings showed a significant relationship between literacy  level of parents with child growth status, breast feeding rate, junk food consumption, referring to health care center for growth monitoring, the age of initiating supplementary nutrition, the use of oil and butter in baby food and rate of attending in educational classes. So that higher literacy  level of parents was associated with using more formula, less junk food, oil and butter in baby's food and more referring times to health care center for monitoring child growth, desirable growth, and  also initiating supplementary food more at the assigned time (P

The consequences upon patient care of moving Brits Hospital: A ...

African Journals Online (AJOL)

Background. In 2001, North West Province took the decision to increase bed capacity at Brits Hospital from 66 beds to 267 beds. After careful consideration of costs and an assessment of available land, it was decided to demolish the existing hospital and rebuild the new hospital on the same site. It was planned that during ...

CMS penalizes 758 hospitals for safety incidents

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Robbins RA

2015-12-01

Full Text Available No abstract available. Article truncated after 150 words. The Centers for Medicare and Medicaid Services (CMS is penalizing 758 hospitals with higher rates of patient safety incidents, and more than half of those were also fined last year, as reported by Kaiser Health News (1. Among the hospitals being financially punished are some well-known institutions, including Yale New Haven Hospital, Medstar Washington Hospital Center in DC, Grady Memorial Hospital, Northwestern Memorial Hospital in Chicago, Indiana University Health, Brigham and Womens Hospital, Tufts Medical Center, University of North Carolina Hospital, the Cleveland Clinic, Hospital of the University of Pennsylvania, Parkland Health and Hospital, and the University of Virginia Medical Center (Complete List of Hospitals Penalized 2016. In the Southwest the list includes Banner University Medical Center in Tucson, Ronald Reagan UCLA Medical Center, Stanford Health Care, Denver Health Medical Center and the University of New Mexico Medical Center (for list of Southwest hospitals see Appendix 1. In total, CMS ...

Bio-social Predictors of Low Birth Weight- A Prospective study at a Tertiary care Hospital of North Karnataka, India

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DP Paneru

2013-12-01

Full Text Available BACKGROUND: Low Birth Weight is a multi-factorial problem of health and social concern Worldwide. India accounts for 40 percent of Low birth weight (LBW babies of the developing World and more than half of those in Asia. Despite the multitude of services rendered to improve maternal health care, LBW remains a public health problem in India. Objective: To determine bio-social predictors of low birth weight amongst the institutional births in North Karnataka, India. METHODS: A prospective hospital based study was conducted in Belgaum district of north Karnataka during July 2012-March 2013. A total of 426 pregnant women registered within 20 weeks of gestation during July–September 2013; eventually delivered in the same hospital were included in the study. Birth weight was measured by a digital weighing scale of 100 gram accuracy. Data were collected through individual interviews using pretested questionnaire. Data were analyzed by SPSS (16.0 Version. Descriptive statistics and multivariate regression were applied. P value < 0.05 considered significant. RESULTS: Mean age of subjects was 23.2254±3.09 years. About 96.7% were literates. Mean age at first pregnancy was 21.37±2.70 years. Low birth weight was observed amongst 22.5% new born (Mean weight: 2089.58±268.31gm. Almost 10.0% were preterm births. Paternal education and occupation, socio-economic status, religion, maternal blood group and gestation age at delivery were found to be the independent and significant bio-social factors predicting the low birth weight. About 68.0% variations in the birth weight were explained by these predictors. CONCLUSIONS: Low paternal education and occupation (farmers/laborers, low socio-economic status, maternal blood group (A is protective and prematurity were found to be independent bio-social predicators of LBW. Programme targeting paternal education may be useful and study of biological plausibility associated with the maternal blood group is recommended.

Bio-social Predictors of Low Birth Weight- A Prospective study at a Tertiary care Hospital of North Karnataka, India

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D P Paneru

2013-12-01

Full Text Available BACKGROUND: Low Birth Weight is a multi-factorial problem of health and social concern Worldwide. India accounts for 40 percent of Low birth weight (LBW babies of the developing World and more than half of those in Asia. Despite the multitude of services rendered to improve maternal health care, LBW remains a public health problem in India. Objective: To determine bio-social predictors of low birth weight amongst the institutional births in North Karnataka, India. METHODS: A prospective hospital based study was conducted in Belgaum district of north Karnataka during July 2012-March 2013. A total of 426 pregnant women registered within 20 weeks of gestation during July–September 2013; eventually delivered in the same hospital were included in the study. Birth weight was measured by a digital weighing scale of 100 gram accuracy. Data were collected through individual interviews using pretested questionnaire. Data were analyzed by SPSS (16.0 Version. Descriptive statistics and multivariate regression were applied. P value < 0.05 considered significant. RESULTS: Mean age of subjects was 23.2254±3.09 years. About 96.7% were literates. Mean age at first pregnancy was 21.37±2.70 years. Low birth weight was observed amongst 22.5% new born (Mean weight: 2089.58±268.31gm. Almost 10.0% were preterm births. Paternal education and occupation, socio-economic status, religion, maternal blood group and gestation age at delivery were found to be the independent and significant bio-social factors predicting the low birth weight. About 68.0% variations in the birth weight were explained by these predictors. CONCLUSIONS: Low paternal education and occupation (farmers/laborers, low socio-economic status, maternal blood group (A is protective and prematurity were found to be independent bio-social predicators of LBW. Programme targeting paternal education may be useful and study of biological plausibility associated with the maternal blood group is

Learning Styles of Medical and Midwifery Students in Mashhad University of Medical Sciences

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A Zeraati

2009-11-01

Full Text Available Background: Students have individual learning style preferences including visual (V; learning from graphs, charts, and flow diagrams, auditory (A; learning from speech, read-write(R; learning from reading and writing, and kinesthetic (K; learning from touch, hearing, smell, taste, and sight.These preferences can be assessed using the VARK questionnaire.Purpose: We aimed to assess different learning styles of medical students in our collage.Methods: This study was conducted to describe learning styles of 214 Medical and Midwifery students in Mashhad University of medical sciences. By using the English version of the VARK questionnaire, we measured the difference in learning styles of medical students and midwifery students and compared with 57336 global general students who completed the test in VARK website up to Sep 2007.Results: The dominant learning preference of our students was Aural preference (30.8% followed by Read/Write (20.6%, while (7.5% were in Kinesthetic and (5.6% were Visual learners; still most of the students (35.5% represented a multimodal learning preference. No significant difference was found between males and females. The general pattern between medical student and Midwifery student is the same. There was a significant relation between Internship Entrance Exam score and thelearning styles of medical student and who were more Read/Write got higher scores.Conclusion: Knowing that our students have different preferred learning modes will help medical instructors in our faculty develop appropriate learning approaches and explore opportunities so that they will be able to make the educational experience more productive.Key words: MEDICAL EDUCATION, LEARNING MODELS VARK, VISUAL, AUDITORY, READ-WRITE, KINESTHETIC, SSTUDENTS.

Customers’ Complaints and its Determinants: The Case of a Training Educational Hospital in Iran

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Hossein Ebrahimipour

2013-11-01

Full Text Available BackgroundToday, despite the efforts of the medical community and healthcare staff along with the advancements in medical technology, patients’ dissatisfaction and complaints have been increased. The present study aimed at making a survey on the patients’ complaints in a large training hospital affiliated to Mashhad University of Medical Sciences (MUMS. MethodsThis descriptive, cross-sectional study was conducted on written and verbal complaints of patients and their relatives in a tertiary (specialty and sub-specialty training hospital. All the recorded patients’ complaints, from March to December 2012, were reviewed. Data were categorized and analyzed using descriptive statistics by Microsoft Excel 2007. ResultsA total of 233 complaints were reviewed, of which 46.35%, 31.34% and 22.31%, respectively, were verbal, written and made on the phone. The main reasons for complaints were accessibility to medical staff (21.46%, communication failures (20.17% and dissatisfaction with the provided care (14.59%. Thirty one (13.31% cases were solved at first place, 194 (83.26% referred to the complaints from the committee and 3.43% referred to the legal authorities. The average response time was about six to seven days. ConclusionThe findings of the study suggest that sufficient availability of medical staff, improvement in communication skills and paying attention to the patients’ needs and expectations may reduce complaints from public health facilities.

Retrospective assessment of the status and determinants of tuberculosis treatment outcome among patients treated in government hospitals in North Shoa Administrative Zone, Amhara Regional State, Ethiopia

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Hailemeskel S

2017-06-01

Full Text Available Solomon Hailemeskel,1 Osman Yimer Mohammed,1 Abdurahman Mohammed Ahmed2 1Department of Midwifery, 2Department of Nursing, College of Health Sciences, Institute of Medicine and Health Science, Debre Berhan University, Debre Berhan, Ethiopia Background: One of the specific targets of Directly Observed Treatment, Short-course detailed in the updated Global Plan (2011–2015 was to achieve a treatment success rate of 87% by 2015. This strategy was introduced to Ethiopia in 1995 to reach full coverage in 2005; however, by 2009, treatment had not been as successful as expected.Objective: This study was conducted to determine treatment success rate and identify risk factors for tuberculosis (TB treatment outcomes in North Shoa Administrative Zone, Amhara Regional State, Ethiopia.Methods: A retrospective cohort study was conducted on all TB patients (739 who registered for TB treatment from September 1, 2012 to August 31, 2014 at public hospitals in North Shoa Administrative Zone, Ethiopia. Data were gathered by using a pretested structured medical record checklist. Four data collectors and two supervisors were involved in gathering the data. The data were analyzed using descriptive statistics and logistic regression and were entered into Epi Info and analyzed by using the SPSS software package version 20.Results: This study revealed that the TB treatment success rate was 86.1% (169 [22.9%] cured and 467 [63.2%] completed. In addition, 22 (3% of the study participants defaulted their treatment of which 19 (86.4% withdrew during the intensive phase. The multiple logistic regression model revealed that the study year of treatment, sputum smear positivity at the second-month follow-up, history of treatment default, and subsequent hospitalization were significantly associated with the TB treatment outcome.Conclusion: The TB treatment success rate in the study area was low compared to that estimated by World Health Organization to achieve by 2015. Therefore

Hospital mergers: a panacea?

Science.gov (United States)

Weil, Thomas

2010-10-01

Hospital mergers in Europe and North America have been launched to scale down expenditure, enhance the delivery of health care and elevate quality. However, the outcome of mergers suggest that they neither generated cost savings nor improved the quality of care. Almost all consolidations fall short, since those in leadership positions lack the necessary understanding and appreciation of the differences in culture, values and goals of the existing facilities. In spite of these shortcomings, hospital mergers will continue to be pursued in order to improve market share, eliminate excess capacity, gain access to capital and enhance the personal egos of the organizations' leaders.

Mandibular Flexure in Anterior-Posterior and Transverse Plane on Edentulous Patients in Mashhad Faculty of Dentistry

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Azam Sadat Madani

2013-01-01

Full Text Available Introduction: Angle and internal position of lateral pterygoid muscle leads to contraction over two half of the mandible in maximum opening and protrusion position so it can affects impression prosthetic procedures. The aim of this study was to evaluate the mandibular flexure in two transverse and antro-posterior dimensions. Methods: Seventy edentulous patients at Mashhad Faculty of Dentistry as the main group and 50 dentulous patients as the control group were selected. In these patients, transverse dimensions between second molar areas and also canine eminence from one side to another side, and longitudinal dimensions based on the distance between canine to second molar area at centric occlusion and maximum mouth opening were measured. Dimensional differences as the mandibular flexure were measured. Results: The mandibular dimensions in maximum opening and closed mouth were different. Average reduction in transverse dimension on second molar region at maximum mouth opening and closing position were almost equal to -0.0787 mm for target group and 0.7512 mm for control group. On anterior side, averages of these changes were equal to 0.3069 mm for target group and were 0.2254 mm for control group. Conclusion: Transverse dimensions in anterior region at maximum opening position are smaller than the same dimension at closed mouth in edentulous and dentulous patients.

Evaluation of Risk Factors Related with Neonatal Patent Ductus Arteriosus in Hospitalized Neonates of Neonatal Intensive Care Unit

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Reza Saeidi

2012-06-01

Full Text Available Background: Patent ductus arteriosus or patent arterial duct (PDA is a condition in which a structure called the ductus arteriosus, normal in fetal life, remains into infancy and onwards, when it should have disappeared. Thus, in this study we want to discuss about frequency of its symptoms and risk factors. Materials and Methods: It is a descriptive study which has been done among 100 newborns registered in Ghaem Hospital of Mashhad. Sampling was gathered easily.Results: The most prevalent symptom among newborn babies was systolic heart murmur (89%. According to the obtained risk factors, hypoxia (71% and acidosis (70% are followed by prematurity (41%. Out of all registered newborn babies 68% were suffering from associated disorders.Conclusion: For achieving an on-time diagnosis of PDA, clinical examination of heart and respiratory symptoms must be examined very precisely. Newborn babies must be examined in terms of two risk factors: prematurity and light weight.

Evaluating Midwives Communication Skills from the Perspective of Parturient Women Attending to Hospitals for Delivery

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Maryam Sadat Katebi

2017-04-01

Full Text Available Background & aim: Communication is a fundamental human need. Medical students and healthcare professionals must be attuned to the needs of patients using effective communication skills. With regards to medical training, currently the focus is on theoretical matters and communication skills are taken for granted. This problem has caused miscommunication with patients referred to teaching hospitals. We conducted this study to assess communication skills of midwives from the perspective of parturient women. Methods: In this descriptive study, we evaluated 50 midwives working in maternity wards of Ghaem, Imam Reza, Omolbanin, and Hasheminejad hospitals in Mashhad, Iran. Three parturient women were selected per one midwife in a maternity ward. The parturient women participating in this study were in labor, delivery, admission or postpartum stages and completed the Interpersonal Communication Skills inventory by interview. To analyze the data, descriptive statistics, t-test, ANOVA, and Pearson product-moment correlation were performed, using SPSS 16. Results: The mean scores of communication behaviors of midwives with parturient in delivery, admission, and postpartum stages were 92.61±10.81, 93.31±10.59, and 94.19±8.26, respectively. Between the previous delivery of parturient, with communication behavior of midwives in the stage of admiss­ion or post-partum (P=0.015 and satisfaction of pregnancy with communication behavior of midwife in labor stage (P

Epidemiology of MRSA: the North/South study of MRSA in Ireland 1999.

LENUS (Irish Health Repository)

McDonald, P

2003-06-01

The North\\/South Study of methicillin-resistant Staphylococcus aureus (MRSA) in Ireland, 1999, includes a joint review of the epidemiology of MRSA across both jurisdictions on the island of Ireland. Data were gathered on all MRSA cases identified in laboratories in Northern Ireland (the North) and in the Republic of Ireland (the South) over a two-week period. The prevalence rate per 100000 population was 11.4 in the North and 14.0 in the South, with a marked variation across geographical regions. MRSA cases were located throughout hospitals and the community, were slightly more common in males than females, and occurred in all age groups, especially in the elderly. The majority of cases were inpatients in acute hospitals and were distributed across all types of wards. Most cases were colonized with MRSA but 5% of cases in the North and 10% in the South had invasive infection. Invasive infection was associated with intravascular lines and invasive procedures\\/surgery. Continuous surveillance is recommended to monitor the epidemiology of MRSA and the effectiveness of control measures.

Evaluation of Dissolved Inorganic and Organic Carbon Concentrations (DIC, DOC and Their Isotopic Compositions (δ 13C-DOC, δ 13C-DIC in Water Resources of the Karde Catchment (North of Mashhad

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Hossein Mohammadzadeh

2015-07-01

Full Text Available In this paper, the variations of dissolved inorganic and organic carbon (DIC, DOC concentrations and their isotopic compositions (δ13C- DIC, δ13C- DOC were evaluated in both surface and ground water resources in the Karde catchment area (with an area of about 547 Km2, located in the North of Mashhad. To identify the sources of the dissolved carbon (DIC and DOC, samples were collected in June 2011 from surface and ground water resources (river, dam’s lake, springs, wells, and Qanat and from depths of 1, 5, 10, 15, and 20 meters of Karde dam lakeat a point located near the dam outlet. Field parameters (T, EC, and TDS were measured during sampling. All measurements were performed in the G.G. Hatch Stable Isotope Laboratory at the University of Ottawa, Canada. The concentrations and isotopic compositions of DIC and DOC were determined using TCA and CF-IRMS instruments, respectively. Based on the results obt 1-دانشیار،مرکزتحقیقاتآبهایزیرزمینی متآب،دانشکدهعلوم،دانشگاهفردوسی مشهد،،مشهد، ایران 2- دانشجوی کارشناسی ارشدهیدروژئولوژی، مرکزتحقیقاتآبهایزیرزمینی متآب،دانشکده علوم،دانشگاهفردوسیمشهد، مشهد، ایران *نویسنده مسئول، پست الکترونیکی:mohammadzadeh@um.ac.ir           ained, the average values of DIC are 54.1 mg/l and 66.8 mg/l in the surface and ground water resources in the Karde catchment area, respectively; the average values of DOC are 2.2 mg/l and 0.45 mg/l; the average values of δ13C-DIC are -7‰ and -11 ‰; and the average values of δ13C-DOC are -31.6‰ and -29.5 ‰, respectively. In general, the concentrations of DIC, DOC, and their isotopic compositions (δ13C-DIC, δ13C-DOC are different in the various water resources (surface and ground water in the catchment and the major source of dissolved carbon in the catchment area is

Contribution of efflux pumps in fluroquinolone resistance in multi-drug resistant nosocomial isolates of Pseudomanas aeruginosa from a tertiary referral hospital in north east India

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D Choudhury

2015-01-01

Full Text Available Background: Pseudomonas aeruginosa is one of the leading opportunistic pathogen and its ability to acquire resistance against series of antimicrobial agents confine treatment option for nosocomial infections. Increasing resistance to fluroquinolone (FQ agents has further worsened the scenario. The major mechanism of resistance to FQs includes mutation in FQs target genes in bacteria (DNA gyrase and/or topoisomerases and overexpression of antibiotic efflux pumps. Objective: We have investigated the role of efflux pump mediated FQ resistance in nosocomial isolates of P. aeruginosa from a tertiary referral hospital in north eastern part of India. Materials and Methods: A total of 234 non-duplicate, consecutive clinical isolates of P. aeruginosa were obtained from a tertiary referral hospital of north-east India. An efflux pump inhibitor (EPI, carbonyl cyanide m-chlorophenylhydrazone (CCCP based method was used for determination of efflux pump activity and multiplex polymerase chain reaction (PCR was performed for molecular characterisation of efflux pump. Minimum inhibitory concentration (MIC reduction assay was also performed for all the isolates. Results and Conclusion: A total number of 56 (23% have shown efflux mediated FQ resistance. MexAB-OprM efflux system was predominant type. This is the first report of efflux pump mediated FQ resistance from this part of the world and the continued emergence of these mutants with such high MIC range from this part of the world demands serious awareness, diagnostic intervention, and proper therapeutic option.

Partial Hospitalization Programs: A Current Perspective.

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Whitelaw, Carolyn A.; Perez, Edgardo L.

1987-01-01

Reviews the historical background, standards, the issue of day treatment versus day care, functional issues, specialization, efficacy and cost effectiveness, utilization issues, and alternative models of care of partial hospitalization programs in North America. Emphasizes issues of relevance when planning alternative programs to inpatient…

Sex selection through traditional drugs in rural north India

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Bandyopadhyay S

2007-01-01

Full Text Available Background : Repidly declining sex ratio has highlighted a strong son preference among many societies various methods are employed by people to get a son. Objective: To determine the use pattern of sex selection drugs (SSDs in rural North India. Methods: An integrated qualitative and quantitative study was conducted in rural North India. A rapid population and hospital based survey of women in their early reproductive life was done in the study area to enlist the respondents. Few SSD samples were collected and analyzed. Results: SSDs were freely available from grocers, chemist shops and specific people in villages. These contained Shivalingi (Bryonia Laciniosa and Majuphal (Gtuercus infectoria. SSD use rate was 46% and 30% in community based and hospital based studies respectively. Use rate was significantly higher in women who did not have any son. Of the SSD samples and two individual ingredients analyzed by thin layer chromatography, 3 contained testosterone and one progesterone; one ingredient contained testosterone and the other natural steroids. Conclusion: Use of SSDs seems to be very common in North India. Implication of presence of steroids in SSDs needs further evaluation.

Practice environment as perceived by nurses in acute care hospitals in Sharjah and North Emirates.

Science.gov (United States)

Al-Maaitah, Rowaida; AbuAlRub, Raeda F; Al Blooshi, Sumaya

2018-04-01

To explore nurses' perceptions of their practice environment in acute care hospitals in Sharjah and North Emirates in the United Arab Emirates (UAE). The health of the environment in which registered nurses' work is critical to nursing outcomes. The interest to examine the practice environment extended to the Gulf area which has a complex healthcare system including the UAE. The study used an exploratory descriptive design with a qualitative part using two focus group interviews. The sample size was 450 nurses selected through a random sampling method. A self-administered questionnaire including the Practice Environment Scale of Nursing Work Index (PES-NWI) was used. In addition, semi-structured interviews for two focus groups were done. The results showed that UAE practicing nurses reported favorable perceptions of most aspects of their practice environment. Unfavorable perceptions were only reported for Staffing and Resource Adequacy. The analysis of focus group discussions resulted in different emerged themes such as Lack of Recognition and Career Promotion, and Nurses' Workload due to Paper and Administrative Work. The findings of this study suggest that strategic interventions are needed to secure adequate staff and resources and implement an effective system for evaluation of performance. © 2018 Wiley Periodicals, Inc.

Into the black. 1993 Hospital Turnaround Contest winners.

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Cerne, F; Bergman, R

1993-07-20

Turning a hospital around takes a lot more than adjusting the financials, as the winners and finalists in the Great Comebacks 1993: The Hospital Turnaround Contest demonstrate. In every case we report on, the hospital being recognized has worked intensively with its community to reassess the services needed by its patients, build support for major management and delivery changes, and articulate the reasons for the strategies being used. Each of the eight hospital organizations we profile, which are spread across the country from Texas to Wisconsin to Maine to North Carolina--has put together its own version of success--in other words, eight lessons in innovation and progress.

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

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Olugbenga A. Silas

2009-01-01

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

Physical and Chemical Characterization of Fat and Oil Deposits in Mashhad City Sewer Lines and the Solutions Developed

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Mahdi kamali

2017-01-01

Full Text Available Formation of oil, fat, and grease deposits in sewer pipelines is a major concern as they result in sewage overflow and pose health problems. Analysis of two sample deposits collected from the sewer lines of Imam Reza Street in the city of Mashhad suggested that the chemical reactions promoted by edible oils in the sewer lines lead to the formation of insoluble soap and deposits. Being sticky, the deposits accumulate over time to eventually block the lines. The analysis also showed that the moisture content of the samples ranged between 50‒62%, indicating that water does not play a main role in their formation. The samples were also found to contain 61.78% and 84.35% saturated fatty acids, with palmitic acid being the dominant one. Calcium was the main metal in the samples, which is due to both water hardness and corrosion of the sewer lines. Based on the results obtained, the origin of these deposits, and the relevant protocols for the management of oil and fat wastes, solutions were proposed to prevent deposit formation and sewer line clogging that suit the special cultural and environmental conditions of the city. These proposals are under consideration for implementation in the region.

Relationship between gender role attitude and fertility rate in women referring to health centers in Mashhad in 2013.

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Golmakani, Nahid; Fazeli, Elham; Taghipour, Ali; Shakeri, Mohammad Taghi

2015-01-01

Fertility rate apparently is a non-interventional behavior, but in practice, it is influenced by social values and norms in which culture and traditional beliefs play a significant role. In this regard, some studies have shown that gender roles can be associated with reproductive behaviors. With regard to the importance of annual reduction of population growth rate and its outcomes, the present study was performed to determine the relationship between gender role attitude and fertility rate in women referring to Mashhad health centers in 2013. The present study is an analytical cross-sectional and multistage sampling study performed on 712 women. Data were collected by a questionnaire consisting of two sections: Personal information and gender role attitude questionnaire that contained two dimensions, i.e. gender stereotypes and gender egalitarianism. Its validity was determined by content validity and its reliability by internal consistency (r = 0.77). Data were analyzed by SPSS software version 16. Initial analysis of the data indicated that there was a significant relationship between acceptance of gender stereotypes (P = 0.008) and gender egalitarianism (P role attitude and fertility. Paying attention to women's attitude is very important for successful planning in the improvement of fertility rate and population policy.

Self-medication practices in patients attending a Tertiary Care Teaching Hospital in Urban North-West India

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Shilpa Patrick

2018-01-01

Full Text Available Background: This study was designed to determine the frequency, reasons, and the association of self-medication with demographic and other factors reported by participants. Materials and Methods: This study was conducted in 500 patients visiting a tertiary hospital in Ludhiana, North Western India. Participants were interviewed with a preset questionnaire. Data were entered into Microsoft Excel and analysis was performed using SPSS software version 16. Frequencies and proportions were calculated. Results: Of 500 study participants, 93.8% reported self-medication with no gender difference. The participants who took self-medication were of the opinion that self-medication resulted in quick cure of illness 50.75%, saved their time 17.46%, and gave them a sense of independence in 17.06%, respectively. The common reasons self-medication 45.84% for fever, 18.34% for pain, and 10.87% for headache with nonsteroidal anti-inflammatory drugs 49.4% followed by antibiotics (11.6% be the common medication. The most common source of information is local chemists/pharmacy 39%. Conclusions: Self-medication is described as a double-edged sword in India, and regulation of over-the-counter sale of antibiotics prescription medication is necessary to safeguard the populace.

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

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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.

Electronic Cigarettes on Hospital Campuses

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Clare Meernik

2015-12-01

Full Text Available Smoke and tobacco-free policies on hospital campuses have become more prevalent across the U.S. and Europe, de-normalizing smoking and reducing secondhand smoke exposure on hospital grounds. Concerns about the increasing use of electronic cigarettes (e-cigarettes and the impact of such use on smoke and tobacco-free policies have arisen, but to date, no systematic data describes e-cigarette policies on hospital campuses. The study surveyed all hospitals in North Carolina (n = 121 to assess what proportion of hospitals have developed e-cigarette policies, how policies have been implemented and communicated, and what motivators and barriers have influenced the development of e-cigarette regulations. Seventy-five hospitals (62% completed the survey. Over 80% of hospitals reported the existence of a policy regulating the use of e-cigarettes on campus and roughly half of the hospitals without a current e-cigarette policy are likely to develop one within the next year. Most e-cigarette policies have been incorporated into existing tobacco-free policies with few reported barriers, though effective communication of e-cigarette policies is lacking. The majority of hospitals strongly agree that e-cigarette use on campus should be prohibited for staff, patients, and visitors. Widespread incorporation of e-cigarette policies into existing hospital smoke and tobacco-free campus policies is feasible but needs communication to staff, patients, and visitors.

Electronic Cigarettes on Hospital Campuses.

Science.gov (United States)

Meernik, Clare; Baker, Hannah M; Paci, Karina; Fischer-Brown, Isaiah; Dunlap, Daniel; Goldstein, Adam O

2015-12-29

Smoke and tobacco-free policies on hospital campuses have become more prevalent across the U.S. and Europe, de-normalizing smoking and reducing secondhand smoke exposure on hospital grounds. Concerns about the increasing use of electronic cigarettes (e-cigarettes) and the impact of such use on smoke and tobacco-free policies have arisen, but to date, no systematic data describes e-cigarette policies on hospital campuses. The study surveyed all hospitals in North Carolina (n = 121) to assess what proportion of hospitals have developed e-cigarette policies, how policies have been implemented and communicated, and what motivators and barriers have influenced the development of e-cigarette regulations. Seventy-five hospitals (62%) completed the survey. Over 80% of hospitals reported the existence of a policy regulating the use of e-cigarettes on campus and roughly half of the hospitals without a current e-cigarette policy are likely to develop one within the next year. Most e-cigarette policies have been incorporated into existing tobacco-free policies with few reported barriers, though effective communication of e-cigarette policies is lacking. The majority of hospitals strongly agree that e-cigarette use on campus should be prohibited for staff, patients, and visitors. Widespread incorporation of e-cigarette policies into existing hospital smoke and tobacco-free campus policies is feasible but needs communication to staff, patients, and visitors.

Predicting the Impact of Urban Green Areas on Microclimate Changes of Mashhad Residential Areas during the Hottest Period

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zahra karimian

2017-09-01

Full Text Available Introduction: With regard to two adverse climatic phenomena of urban heat islands and global warming that has been leading to increase temperature in many cities in the world, providing human thermal comfort especially in large cities with hot and dry climates, during the hottest periods of the year is crucial. Mainly vegetation with three methods: shading, evapotranspiration and wind breaking can affect micro-climate. The aim of this study was to asses and simulate the impact of existing and proposed vegetation on the human thermal comfort and micro climate changes in some residential areas of Mashhad during the hottest periods of the year by using a modeling and computer simulation approach. Materials and Methods: This research was performed in the Ghasemabad residential area, Andisheh and Hesabi blocks, and in the hottest period of the year 2012 in Mashhad. Recorded data in the residential sites along with observed data from Mashhad weather station that included temperature, relative humidity, wind speed and direction. Soil data (soil temperature and humidity, soil\\ type, plant data (plant type, plant height, leaf area index and building data (inner temperature in the building, height and area buildings as input data were used in the ENVI-met model. Both two sites, Andishe and Hesabi residential blocks, with vegetation (different trees and bushes plants, for example Acacia, ash, sycamore, mulberry, chinaberry, barberry, boxwood and Cotoneaster that all of them are tolerant and semi-tolerant to drought about 20% were simulated. Regarding the area of simulating, 3 receptors were considered in per sites. Simulation was commenced from 6 AM and continued until 18 pm, but just data of 11-15 hours were analysed (the hours of peak traffic. Results and Discussion: Analysis of outputs data revealed that the temperature of two residential sites in all three receptors during the study were almost the same. In general, the maximum temperature difference

(drls) for radiography examinations in north eastern nigeria

African Journals Online (AJOL)

Nwokem et al.

in two university teaching hospitals in north eastern Nigeria. Seven hundred ... review of procedures and the equipment in order to determine whether the .... The information obtained for the ... products of Variant medical system manufactured in China ... which is connected to the Reader via a serial communications port. a.

Effect of Nutritional Management on Yield and Yield Components of Roselle (Hibiscus sabdariffa as a Medicinal Plant in Mashhad Condition

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P Rezvani Moghaddam

2018-02-01

Full Text Available Introduction Roselle (Hibiscus sabdariffa is an annual plant with a height of about 64 to 429 cm belongs to Malvaceae family. Roselle is self-pollinated and sensitive to cold. Sepals of Roselle are used in food and pharmaceutical industries. It has been reported that Roselle is not native to Iran but it is cultivated extensively in Sistan and Baluchistan province, Iran. In order to achieve high quality and quantity yield of Roselle sepal it is necessary to improve nutritional systems of plant. Proper management of soil fertility and plant nutrition can preserve environment, improve biodiversity and also increase inputs efficiency. Results showed that use of nutritional resources will improve plant growth. Organic fertilizers such as compost can improve soil fertility as an important source of food that increase yield of plants. Nabila and Aly (2002 observed that use of hen and cow manure increased plant height, number of lateral branches, numbers of fruit and sepal yield of Roselle. Each plant species has the maximum potential in favorable conditions. Therefore, evaluation the effect of climatic and agronomic factors and nutritional management for plants is essential. This experiment was conducted to evaluate the yield and yield components of Roselle in response to use of single and combined nutritional resources. Materials and Methods In order to study the effects of single and combined organic, biological and chemical fertilizers on yield and yield components of Roselle (Hibiscus sabdariffa, a field experiment was conducted with 12 treatments based on a Randomized Complete Block Design with three replications at Research Station, Faculty of Agriculture, Ferdowsi University of Mashhad, Iran, in 2013-2014. Treatments included: 1- mycorrhiza (Glomus intraradices, 2- cow manure, 3- chemical fertilizer, 4- vermicompost, 5- chemical fertilizer + cow manure, 6- chemical fertilizer + vermicompost, 7- chemical fertilizer + mycorrhiza, 8- cow manure

Factors Associated with Potential Food-Drug Interaction in Hospitalized Patients: A Cross-Sectional Study in Northeast Iran

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Mostafa Abdollahi

2018-04-01

Full Text Available Background: The minimization of adverse food-drug interactions will improve patient care by optimizing the therapeutic effects and maintaining proper nutritional status. Aim: The aim of the present study was to find the main factors that may place the hospitalized patients at risk of potential food-drug interactions. Method: This cross-sectional, descriptive study was conducted on 400 inpatients admitted to the Department of Internal Medicine of a teaching hospital in Mashhad, Northeast Iran, within 20 March 2013 to 20 April 2013. The potential food-drug interactions were evaluated for 19 commonly prescribed medications. The main factors (e.g., age, gender, education level, number of medications, and duration of the disease that may place the patients at risk of potential food-drug interactions were analyzed for each patient. Results: Out of the 19 commonly prescribed medications, 17 drugs (89% were not properly used with respect to meal. Furthermore, 14 commonly prescribed drugs were found to have a high frequency (≥50% of potential food-drug interactions. Most of the patients (n=359, 89.8% consumed their medicines at inappropriate time with respect to meals. The results of a multiple logistic regression after adjustment for confounders revealed that the age [β=0.005, CI: 0.0-0.01; P=033], number of medications [β=0.1, CI: 0.083-0.117; P

What Is The Role of Thesis In Dentistry? Evaluation of the View Point of Senior and Graduated Students and Supervisor Teachers of Mashhad Dental School in 2010

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Samane Habibi

Full Text Available Introduction: In the education system in the country, thesis works as a way to solve research problems and thesis presentation is based as part of the research. To improve the quality of dissertations, it is essential to have an accurate evaluation of the objectives, practical process, process and efficiency of the course by supervisors, graduates and students. The purpose of this study was evaluation of the view point of senior and graduated students and supervisor teachers of Mashhad dental school about thesis.Materials & Methods: Forty eight supervisors, 40 students and 50 graduates from Mashhad dental school participated in this cross sectional descriptive study in the year 2010. Three questionnaires, which proved to be valid and reliable, were used for data collection. Results were analyzed according to the frequency distribution of variable and average of description. Common questions were compared by Kruskal-Wallis test at a significance level of 95%.Results: The data indicated that the effect of thesis presentation on the activities leading to production and basic science and increase in professional knowledge and skills were average while it was very effective in teaching research methods. Students, graduates and supervisors together agreed on the completion of a joint research project in the early years of school and covering an education subject about thesis goals. Supervisors estimated the effect of thesis result in community to be more than that of the graduates (P=0.03. In addition, supervisors had less agreement on thesis as a voluntary course compared to students and graduates (P=0.01.Conclusion: Based on findings of this study, because of the great amount of budget and time spent on thesis, it is better to optimize the presented results and recommendations in this regard. It also seems that the greatest impact on improving the process would be created through revising the rules, creating supportive organizations actively and

Survival and neurological outcome following in-hospital paediatric cardiopulmonary resuscitation in North India.

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Rathore, Vinay; Bansal, Arun; Singhi, Sunit C; Singhi, Pratibha; Muralidharan, Jayashree

2016-05-01

Data on outcome of children undergoing in-hospital cardiopulmonary resuscitation (CPR) in low- and middle-income countries are scarce. To describe the clinical profile and outcome of children undergoing in-hospital CPR. This prospective observational study was undertaken in the Advanced Pediatric Center, PGIMER, Chandigarh. All patients aged 1 month to 12 years who underwent in-hospital CPR between July 2010 and March 2011 were included. Data were recorded using the 'Utstein style'. Outcome variables included 'sustained return of spontaneous circulation' (ROSC), survival at discharge and neurological outcome at 1 year. The incidence of in-hospital CPR in all hospital admissions (n = 4654) was 6.7% (n = 314). 64.6% (n = 203) achieved ROSC, 14% (n = 44) survived to hospital discharge and 11.1% (n = 35) survived at 1 year. Three-quarters of survivors had a good neurological outcome at 1-year follow-up. Sixty per cent of patients were malnourished. The Median Pediatric Risk of Mortality-III (PRISM-III) score was 16 (IQR 9-25). Sepsis (71%), respiratory (39.5%) and neurological (31.5%) illness were the most common diagnoses. The most common initial arrhythmia was bradycardia (52.2%). On multivariate logistic regression, duration of CPR, diagnosis of sepsis and requirement for vasoactive support prior to arrest were independent predictors of decreased hospital survival. The requirement for in-hospital CPR is common in PGIMER. ROSC was achieved in two-thirds of children, but mortality was higher than in high-income countries because of delayed presentation, malnutrition and severity of illness. CPR >15 min was associated with death. Survivors had good long-term neurological outcome, demonstrating the value of timely CPR.

Effects of Image Gently and the North American guidelines: administered activities in children at 13 North American pediatric hospitals.

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Fahey, Frederic H; Ziniel, Sonja I; Manion, Dacie; Treves, S Ted

2015-06-01

The goal of this investigation was to assess the impact of the publication of the 2010 North American guidelines on the practice of nuclear medicine in children at 13 dedicated pediatric institutions within the United States and Canada by comparing results of similar surveys from 2007 and 2013. In 2013, a follow-up survey was performed of the original 13 dedicated pediatric institutions initially surveyed in 2007. Both surveys inquired about the administered activities for 16 nuclear medicine procedures commonly performed on children. The administered activity per body mass, the maximum activity, and the minimum activity for patients for each procedure were requested from each site. For each parameter the minimum and maximum reported values, as well as the median and the mean, were tabulated. The mean difference in the mean between 2007 and 2013 was calculated, as well as the 95% confidence intervals for the mean administered activity per body mass for both years. The factor of variation used with the previous survey for each parameter was calculated by taking the ratio of the maximum and minimum reported values. For the 8 procedures addressed in the 2010 North American guidelines, the percentage of institutions that were compliant (defined as within 20%) for each parameter were noted for both surveys. Institutions were asked whether they were familiar with "Image Gently," the North American guidelines, and the "Go with the Guidelines" campaign and whether they adjusted their administered activities on the basis of these guidelines. In general, the 13 pediatric institutions have reduced their administered activities in children, particularly for those procedures addressed by the 2010 North American guidelines. The average variability in the activity per body mass and the minimum activity as measured by the factor of variation were substantially reduced by 9.7% (from 3.1 to 2.8) and 24% (from 10.0 to 7.6). The average variability of the maximum activity was

[On comparison of hospital performance].

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Kjekshus, L E

2000-10-20

The motivation to identify the causes of rising health care cost and variations across providers has intensified in all industrialized countries. These countries have an ongoing debate on efficiency and effectiveness in hospital production. In this debate, national and international comparative studies are important. There are very few international comparative studies that include Norwegian hospitals. Actually we know very little about how Norwegian hospitals are performing compared to others. This paper gives an introduction to comparative studies and to the DEA model which is often used in such studies and also a multilevel model which is not so common. A short review is given of a comparative study of Norwegian and North American hospitals. I also discuss the feasibility of comparative studies of hospitals from the Nordic countries, with references to several comparative studies performed in these countries. Comparative studies are often closely linked to national health politics, policy making and reforms; thus the outcome of such studies is important for the hospitals included. This makes such studies a sensitive field of research. It is important to be aware of the strength and weaknesses of comparative studies and acknowledge their importance beyond the development of new knowledge.

Geochronology, radiogenic isotope geochemistry, and petrogenesis of Sang bast Paleo-tethys monzogranite, Mashhad, Iran

International Nuclear Information System (INIS)

Karimpour, M. H.; Farmer, G.L.; Stern, C.R.

2010-01-01

The study area is located in northeastern Iran (south of Mashhad). Paleo-Tethys Ocean opened during Silurian time and subduction under Turan plate was started in Late Devonian. By Late Triassic (225 Ma) there was no Paleo-Tethys left on an Iranian transect, therefore Turan plate obducted over Iran Plate. Two stages of low grade regional metamorphism are exposed, that are related to Hercynian (Late Paleozoic) and Cimmerian (Jurassic) oro genies. The Paleo-Tethys remnants (meta-ophiolite and meta-flysch) were intruded by Sang bast monzogranite. Chemically, monzogranite is moderately peraluminous S-type granitoid. It has low values of magnetic susceptibility [(5 to 11) * 10 -5 SI] therefore it is classified as belonging to the ilmenite-series of reduced type granitoids. Monzogranite is characterized by strong light rare earth element enrichment and less low heavy rare earth element. All samples have very small negative Eu anomalies (Eu/Eu * = 0.62 to 0.88). Total rare earth element content of monzogranite is between 212-481 ppm. The result of U-Pb zircon age dating of monzogranite is 201.3 ± 3.6 Ma (Upper Triassic, Rhaetian time). The initial 87 Sr/ 86 Sr and 143 Nd/ 144 Nd ratios for monzogranite is (0.706776 and 0.512219) when recalculated to an age of 201 Ma, consistent with the new radiometric. The initial 87 Sr/ 86 Sr and 143 Nd/ 144 Nd ratios for slate is (0.720613 and 0.511601) respectively when recalculated to an age of 201 Ma, consistent with the new radiometric results. Initial εNd isotope values for monzogranite is -3.13 and the slate is -15.19. Based on radiogenic isotopic data and rare earth element monzogranite magma originated either from lower continental crust which was very different from slate or it is originated from mantle and contaminated in continental crust during ascending.

STUDY OF PATTERN AND OUTCOME OF ACUTE POISONING CASES AT TERTIARY CARE HOSPITAL IN NORTH INDIA

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Irteqa Ali

2017-01-01

Full Text Available BACKGROUND Poisoning is a global public health problem causing significant morbidity and mortality. It is important to know the pattern and outcome of acute poisoning cases for proper planning, prevention and management of these cases. The aim of the study is to determine the mode (suicidal, accidental, homicidal and type of poisoning in North Indian population; relation to age, sex, occupation, marital status; outcome of different type of poisons and requirement of ventilatory support in different type of poisonings. MATERIALS AND METHODS This observational study was conducted in Department of Medicine of a tertiary care hospital in North India. A total of 379 patients were enrolled in the study after obtaining informed consent. RESULTS Poisoning was more common among males (59.89%. Maximum number of patients were in the age group 21-30 years (40.63% and consumption was found to be more prevalent in rural population (75.99%. Most of the patients were farmers and students. Most common types of poisoning were organophosphate (n=95, 25.07%, snake bite (n=77, 20.32% followed by aluminium phosphide (n=71, 18.73%. Out of 379 patients, 318 (83.91% improved while 61 (16.09% expired. Mortality was highest in aluminium phosphide poisoning. Requirement of ventilatory support was most commonly associated with aluminium phosphide poisoning (37.89% followed by organophosphate poisoning (28.42%. CONCLUSION Poisoning was more common in young males. Pesticides and snake bite were major causes of poisoning. Of the total, 318 improved while rest of the 61 expired. Mortality was higher with use of aluminium phosphide poisoning (57.38%, snake bite (21.31% and organophosphate consumption (9.84%. Requirement of ventilator was most commonly associated with aluminium phosphide poisoning. We suggest strict statutory measures covering import, manufacture, sale, transport, distribution and use of pesticides. Training of peripheral health center personnel to manage cases

The Challenges and Opportunities of Social Media in the Hospitality Industry. A Study of the North East Region of Romania

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Andreea Maha

2015-05-01

and YouTube are apparently not that popular. Social Media accounts are not used at their full capacity and from the total number identified on each segment, not all have a direct reference from their own site, for in case of Facebook 31 out of 48, Twitter 7 out of 10 and YouTube 7 out of 10. The most important limitation is considered to be the consistency of the sample we used. We only investigated the hotels (rated 3 to 5 stars from the North-East region of Romania. A sample including all the hotels from Romania would have given a more realistic view of the use of Social Media in the hospitality industry. Another possible study limitation can be that the Social Media accounts may have been missed as it did not feature in the first three pages search results. The worst part is that the same mistake would be made by the potential customers searching for that hotel that is why we considered this error an acceptable one. As we made only a qualitative research, the results must be validated in a future research. The results of this research can be used by hotel managers and also by those who manage Internet websites. Business people who intend to enter on hospitality market might also be interested in this information. For the North-East region of Romania, during our documentation stage for this article, there was no study identified, similar to the one we realized. Also Romania, as a country where tourism industry it is in early stages of development, needs to benefit from this kind of research, for creating new strategies and implement best practices in the field.

Manual accidents, biological risk control, and quality indicators at a children's hospital in north-east Italy.

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Parco, Sergio; Vascotto, Fulvia; Simeone, Roberto; Visconti, Patrizia

2015-01-01

Working in health care carries the risk of transmission of infected blood to patients by hospital workers and to other health personnel in the form of occupational infections. Conscientious application of the standard precautions is the main method used to avoid needle stick injuries, contamination of skin and mucous membranes, cuts with sharp tools, and inadequate disposal and recapping of needles. The aim of this work was to investigate in Friuli Venezia Giulia, a region in north-east Italy, the enhancement carried out to prevent situations of biologic risk for health care workers, and to verify the related laboratory analyses. Biological accidents occurring during the years 2012-2013 in the departments of oncology and pediatric-obstetric surgery, and in the intensive care unit at Burlo Garofolo Children's Hospital in Trieste (a large town in Friuli Venezia Giulia) were reviewed, and a new panel of tests was introduced for patients and health care workers, to also detect human immunodeficiency virus (HIV), hepatitis C virus (HCV), hepatitis B virus (HBV), and aspartate transaminase and immunoglobulin G. All tests were submitted for external quality assessment. In total, 230 nosocomial events were reported by health care workers in the above-mentioned hospital departments in 2012-2013. There were 158 accidents in 2012, including 55 accidental needle stick injuries (34.81%), 59 blood splashes (37.34%), and 44 cuts with infected instruments (27.84%). The risk of sustaining a cut was related to movement error during surgery when the appropriate procedure was not followed or when devices were being assembled and passed between doctors and nurses. Most accidents happened among physicians compared to nurses; the high percentage of needle stick injuries (34.81%) versus nurses (25.94%) were due to incorrect recapping of needles after use. No cases of health care workers being infected with HCV, HBV, or HIV were identified. In 2013, the number of biological accidents

Outcomes of planned home births with certified professional midwives: large prospective study in North America.

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Johnson, Kenneth C; Daviss, Betty-Anne

2005-06-18

To evaluate the safety of home births in North America involving direct entry midwives, in jurisdictions where the practice is not well integrated into the healthcare system. Prospective cohort study. All home births involving certified professional midwives across the United States (98% of cohort) and Canada, 2000. All 5418 women expecting to deliver in 2000 supported by midwives with a common certification and who planned to deliver at home when labour began. Intrapartum and neonatal mortality, perinatal transfer to hospital care, medical intervention during labour, breast feeding, and maternal satisfaction. 655 (12.1%) women who intended to deliver at home when labour began were transferred to hospital. Medical intervention rates included epidural (4.7%), episiotomy (2.1%), forceps (1.0%), vacuum extraction (0.6%), and caesarean section (3.7%); these rates were substantially lower than for low risk US women having hospital births. The intrapartum and neonatal mortality among women considered at low risk at start of labour, excluding deaths concerning life threatening congenital anomalies, was 1.7 deaths per 1000 planned home births, similar to risks in other studies of low risk home and hospital births in North America. No mothers died. No discrepancies were found for perinatal outcomes independently validated. Planned home birth for low risk women in North America using certified professional midwives was associated with lower rates of medical intervention but similar intrapartum and neonatal mortality to that of low risk hospital births in the United States.

Factors Related to Return to Work in Women After Breast Cancer in Iran.

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Azarkish, Fatemeh; Mirzaii Najmabadi, Khadijeh; Latifnejad Roudsari, Robab; Homaei Shandiz, Fatemeh

2015-09-01

Most women are diagnosed with breast cancer (BC) when they are still at the appropriate age for employment. The increasing survival rates of patients with BC call for more attention to their ability to return to work. The aim of this study was to identify factors related to the return to work in Iranian women underwent BC treatment. A total of 175 women with BC, who met the inclusion criteria, were enrolled in this cross-sectional study. The subjects were recruited from four hospitals affiliated to Mashhad university of medical sciences. These hospitals are oncology referral centers in eastern Iran. All records of employed women with BC were studied in four hospitals of Mashhad city, Iran, during 2000 - 2010. The researchers designed a questionnaire, which consisted of questions regarding social/demographic, health/disease, and work characteristics. The questionnaires were completed through interviews. Data were analyzed using SPSS software, version 11.5. The mean age of the patients at the time of interview was 44.3 ± 6.72 years. Mean age of "Return- to-work" group was 42.71 and "No return-to-work" group was 51.06. Most women (80%) were married. At the time of the interview, 80% had returned to work after a BC diagnosis. Older patients (OR = 0.796; 95% CI, 0.625 - 0.907, P = 0.002), and those with a great deal of work experience (OR = 0.861; 95% CI, 0.752 - 0.986, P = 0.030) were less likely to return to work. Also, women who had no pain or surgery scar (OR = 23.03; 95% CI, 4.53 - 117.02, P work (OR = 22.373; 95% CI, 4.04 - 23.892, P work after BC treatment in working women in Mashhad city, Iran. These predictors should be taken into account in order to improve the patient's life quality.

Junk Food Consumption and Effects on Growth Status among Children Aged 6-24 Months in Mashhad, Northeastern Iran

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Rahim Vakili

2015-08-01

Full Text Available Introduction Junk food, due to the lack of vitamins, minerals and trace amounts of energy and protein, there is the risk that the child's stomach filled and by reducing her/his appetite, reduce the chance of nutritious foods. So it is necessary to determine the relationship between using of junk food with growth rate in children. Materials and Methods This cross-sectional descriptive-analytic study was conducted on 300 mothers and their babies , who were referring to 10 selected Mashhad health-care centers for monitoring their 6-24 months children. Participants were selected by cluster and simple random sampling and valid and reliable   questionnaire was used to collect data. Data were analyzed by descriptive- analytic statistics and using SPSS version 16. Results In growth chart, 86.7 percent of children showed appropriate growth, 10.3 percent had delayed growth and 3 percent had horizontal growth curve. In 11.3 percent of families, the junk food has been used for children regularly, 44.7 percent did not believe in these snacks and 44 percent of mothers sometimes used this junk food for their children. Results showed the statistical correlation between junk food consumption and  growth status of children was significant, so children whom haven’t had junk food, have grown more favorable than the other kids (P

Does being under treatment improve knowledge attitude practice for hypertension: A hospital-based study from North India

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Rajiv Kumar Gupta

2017-01-01

Full Text Available Background: Studies suggest that approximately half of patients with raised blood pressure (BP are undetected, that half of those detected are not treated, and that half of those treated are not controlled, famously described as the “rule of halves.” Importantly, the cornerstone of the primary prevention of cardiovascular diseases is early detection and drug treatment (antihypertensive of patients with high BP. Studies across populations in developed world have shown that awareness and management of high BP levels are far from optimal. The present study was planned with the aim to assess the knowledge, attitude, and practices (KAP regarding hypertension in hypertensive patients visiting Tertiary Care Hospital in North-West India. Materials and Methods: Already diagnosed hypertensive patients seeking care at the tertiary care center were selected for this study. The participants were recruited using consecutive sampling technique. All participants were interviewed with the help of a semi-structured questionnaire after obtaining a written informed consent. The components of the KAP were recorded using a score sheet. Results: In all, 394 hypertensive patients of whom majority (239/394; 61% were males, were included in the study. The KAP score among the study subjects was 88.4%, 90.83%, and 95.83%, respectively. Males had higher knowledge about normal BP levels which was statistically significant (P < 0.01. Among the attitude, regular intake of anti-hypertensive drugs, regular investigations, lifestyle changes, avoidance of salt and allopathic medicines being the best for the treatment of hypertension were found to be significant statistically (P < 0.01. Conclusion: The high score among the study population can be attributed to the fact that all study participants were diagnosed patients of hypertension seeking care in a tertiary care hospital.

Consanguinity and isolated atrial septal defect in North East of Iran.

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Moghaddam, Hasan Mottaghi; Esfehani, Reza Jafarzadeh; Panah, Nader Yazdan; Esfehani, Ali Jafarzadeh

2014-01-01

The rate of consanguineous marriage is high in Middle Eastern countries such as Iran. The relationship between consanguineous marriage and congenital heart disease is discussed in some studies, but there is not much data for relationship between atrial septal defect (ASD) and consanguineous marriage. The aim of this study was to evaluate the relationship between consanguineous marriage and ASD echocardiographic characteristics. This was a cross-sectional study approved by Mashhad University of Medical Sciences ethics committee and took place in Mashhad, Iran, for a period of 3 years from August 2008 till September 2011. In this cross-sectional study, 113 ASD patients participated and they were categorized into 3 groups on the basis of family relationship between their parents: first group-"no relationship," second group- "third degree relationship," and third group- "far relationship." Among the 54 male and 59 female ASD patients, the most prevalent type of ASD was ASD secundum (85.0%) followed by sinus venosus (8.8%). A total of 56% patients were present in the first group and 15% and 29% in the second group and the third group, respectively." The relationship between consanguinity and type of ASD (P relationship between the age of onset of disease and consanguinity (P=.003) was also observed. Considering the fact that there is a high prevalence of ASD and consanguineous marriage in Iran and bearing in mind the results of the present study, we recommend educating couples about the outcomes of consanguineous marriage in pre-marriage counseling.

Comparison of midwifery students' satisfaction with direct observation of procedural skills and current methods in evaluation of procedural skills in Mashhad Nursing and Midwifery School.

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Hoseini, Bibi Leila; Mazloum, Seyed Reza; Jafarnejad, Farzaneh; Foroughipour, Mohsen

2013-03-01

The clinical evaluation, as one of the most important elements in medical education, must measure students' competencies and abilities. The implementation of any assessment tool is basically dependent on the acceptance of students. This study tried to assess midwifery students' satisfaction with Direct Observation of Procedural Skills (DOPS) and current clinical evaluation methods. This quasi-experimental study was conducted in the university hospitals affiliated to Mashhad University of Medical Sciences. The subjects comprised 67 undergraduate midwifery students selected by convenience sampling and allocated to control and intervention groups according to the training transposition. Current method was performed in the control group, and DOPS was conducted in the intervention group. The applied tools included DOPS rating scales, logbook, and satisfaction questionnaires with clinical evaluation methods. Validity and reliability of these tools were approved. At the end of training, students' satisfaction with the evaluation methods was assessed by the mentioned tools. The data were analyzed by descriptive and analytical statistics. Satisfaction mean scores of midwifery students with DOPS and current methods were 76.7 ± 12.9 and 62.6 ± 14.7 (out of 100), respectively. DOPS students' satisfaction mean score was significantly higher than the score obtained in current method (P satisfactory domains in the current method were "consistence with learning objectives" (71.2 ± 14.9) and "objectiveness" in DOPS (87.9 ± 15.0). In contrast, the least satisfactory domains in the current method were "interested in applying the method" (57.8 ± 26.5) and "number of assessments for each skill" (58.8 ± 25.9) in DOPS method. This study showed that DOPS method is associated with greater students' satisfaction. Since the students' satisfaction with the current method was also acceptable, we recommend combining this new clinical evaluation method with the current method, which covers

Traffic accident injuries in a referral Orthopedic Hospital in North West of Iran during summer 2009

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Amir Mohammad Navali

2015-03-01

Full Text Available Introduction: Road traffic injuries are a major public health problem, requiring huge efforts for effective and sustainable prevention. Because of the high occurrence of traffic accidents in Iran, basic data acquisition is highly needed to implement prevention plans. The present research is conducted as an epidemiological study of the traffic accident victims referred to a referral orthopedic center in North West of Iran. Methods: A cross-sectional study was conducted during a 3 months period from June to September 2009 in Tabriz, Iran. A total of 16681 patients were admitted to the emergency ward, and 3246 patients (19.5% were hospitalized during this period because of traffic related injuries. After randomization, 630 cases were selected to be enrolled in the study. The location of an accident, position of road users, type of crashed vehicle, cause of accident, type of injury, time interval from accident to hospitalization and treatment outcome were recorded. Statistical analyses were carried out using SPSS software. Results: The mean age of the patients was 31 years (range, 6 months to 98 years and 77.0% of patients (468 cases were men. A total of 193 (36.6% patients sustained traffic accident in open roads and 335 (63.4% in urban corridors. In 67 (12.9% of accidents, there was only a single occupant in the vehicle. The time interval between the accident and admission was 6.6 ± 3.2 hours. Of the 608 cases, 45.7% were drivers, 30.3% passengers, and 24.0% pedestrians. Most cases of the car accident happened in urban areas, and the male victims were largely in the driver group. The most frequent type of injury was knee, leg and head trauma. Conclusion: The large number of traffic-related injuries admitted to our emergency ward that comprise mostly young adults should be considered as an alarming signal to policy makers and health providers in our province. Strict control on drivers’ behavior should be taken into account if increasing human

Epidemiology of urinary tract infections and antibiotics sensitivity among pregnant women at Khartoum North Hospital

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Ali Salah K

2011-01-01

Full Text Available Abstract Background Urinary tract infections (UTI can lead to poor maternal and perinatal outcomes. Investigating epidemiology of UTI and antibiotics sensitivity among pregnant women is fundamental for care-givers and health planners. Methods A cross sectional study has been conducted at Khartoum north teaching hospital Antenatal Care Clinic between February-June 2010, to investigate epidemiology of UTI and antibiotics resistance among pregnant women. Structured questionnaires were used to gather data from pregnant women. UTI was diagnosed using mid stream urine culture on standard culture media Results Out of 235 pregnant women included, 66 (28.0% were symptomatic and 169 (71.9% asymptomatic. the prevalence of bacteriuria among symptomatic and asymptomatic pregnant women were (12.1%, and (14.7% respectively, with no significant difference between the two groups (P = 0.596, and the overall prevalence of UTI was (14.0%. In multivariate analyses, age, gestational age, parity, and history of UTI in index pregnancy were not associated with bacteriuria. Escherichia coli (42.4% and S. aureus (39.3% were the commonest isolated bacteria. Four, 2, 2, 3, 4, 2 and 0 out of 14 E. coli isolates, showed resistance to amoxicillin, naladixic acid, nitrofurantoin, ciprofloxacin, co-trimoxazole, amoxicillin/clavulanate and norfloxacin, respectively Conclusion Escherichia coli were the most prevalent causative organisms and showing multi drug resistance pattern, asymptomatic bacteriuria is more prevalent than symptomatic among pregnant women. Urine culture for screening and diagnosis purpose for all pregnant is recommended.

Epidemiology of urinary tract infections and antibiotics sensitivity among pregnant women at Khartoum North Hospital.

Science.gov (United States)

Hamdan, Hamdan Z; Ziad, Abdel Haliem M; Ali, Salah K; Adam, Ishag

2011-01-18

Urinary tract infections (UTI) can lead to poor maternal and perinatal outcomes. Investigating epidemiology of UTI and antibiotics sensitivity among pregnant women is fundamental for care-givers and health planners. A cross sectional study has been conducted at Khartoum north teaching hospital Antenatal Care Clinic between February-June 2010, to investigate epidemiology of UTI and antibiotics resistance among pregnant women. Structured questionnaires were used to gather data from pregnant women. UTI was diagnosed using mid stream urine culture on standard culture media Out of 235 pregnant women included, 66 (28.0%) were symptomatic and 169 (71.9%) asymptomatic. the prevalence of bacteriuria among symptomatic and asymptomatic pregnant women were (12.1%), and (14.7%) respectively, with no significant difference between the two groups (P = 0.596), and the overall prevalence of UTI was (14.0%). In multivariate analyses, age, gestational age, parity, and history of UTI in index pregnancy were not associated with bacteriuria. Escherichia coli (42.4%) and S. aureus (39.3%) were the commonest isolated bacteria. Four, 2, 2, 3, 4, 2 and 0 out of 14 E. coli isolates, showed resistance to amoxicillin, naladixic acid, nitrofurantoin, ciprofloxacin, co-trimoxazole, amoxicillin/clavulanate and norfloxacin, respectively. Escherichia coli were the most prevalent causative organisms and showing multi drug resistance pattern, asymptomatic bacteriuria is more prevalent than symptomatic among pregnant women. Urine culture for screening and diagnosis purpose for all pregnant is recommended.

Drug prescribing patterns for outpatients in three hospitals in north ...

African Journals Online (AJOL)

Background: Information about drug utilization at the out patient departments of the Hospitals in Ethiopia is scanty although a large segment of the patients are being served at the outpatient departments. Objective: To evaluate and compare patterns of drug prescribing practiced in the outpatient departments of three ...

Mass awareness regarding snake bite induced early morning neuroparalysis can prevent many deaths in North India

OpenAIRE

Sharma, Rupinder; Dogra, Varundeep; Sharma, Gurudutt; Chauhan, Vivek

2016-01-01

Introduction: In North India snake bite deaths are predominantly seen with neurotoxic envenomations (NEs) whereas in South India the hemotoxic envenomation (HE) is more common. Krait is responsible for most deaths in North India. It bites people sleeping on the floors, mostly at night. We describe the profile of venomous snake bites over 1 year in 2013. Materials and Methods: The study was conducted in a rural tertiary care hospital in North India. Demographics, circumstances of bite, envenom...

Prevalence of hypodontia in nine- to fourteen-year-old children who attended the Mashhad School of Dentistry.

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Ajami, Behgat-al-molok; Shabzendedar, Mahboobeh; Mehrjerdian, Maryam

2010-01-01

Hypodontia is defined as the congenital absence of one or a few teeth, and is also the most common anomaly in dental development. This condition occurs either individually or as part of the symptoms of a syndrome, and it is more common in permanent teeth than in deciduous teeth, reporting a prevalence of between 1.6 and 9.6%. The objective of this study is to investigate the prevalence of hypodontia for permanent teeth in nine- to 14-year-old children who attended the Mashhad School of Dentistry in 2007. We conducted this descriptive, analytical, cross-sectional study, to determine the mentioned aims. In this descriptive, cross-sectional study, panoramic radiographs belonging to 600 children (351 girls and 249 boys), aged nine to 14 years, were available for examination. All related findings were recorded in the respective forms. The data were processed using Exact and Chi-square tests. The prevalence of hypodontia in the girls was 9.2%, in the boys 8.8%, and in both sexes combined 9%. The most and the least frequent cases of absent teeth were the mandibular second premolars and the maxillary central incisor (only one child), respectively. The most commonly absent teeth were the mandibular second premolars, the maxillary lateral incisors, the mandibular central incisor, and the maxillary second premolars, in that order. This study showed a high frequency of hypodontia among the understudied population. Thus, due to the complicated treatment, accurate examination of children for on-time diagnosis of this developmental anomaly is crucial.

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

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

2012-01-01

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

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

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

2002-01-15

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

The relationship between oncologists and peripheral hospital radiologists in the north-west of England

International Nuclear Information System (INIS)

Bungay, Peter M.; Carrington, Bernadette M.; Corgie, Delphine; Eardley, Anne

2002-01-01

AIM: To audit the relationship between Cancer Centre oncologists visiting peripheral hospitals and peripheral hospital radiologists by assessing (i) oncologists' knowledge of local radiological services; (ii) oncologists' perceptions of peripheral radiological services; (iii) peripheral radiologist's perceptions of oncologists; (iv) barriers to communication. MATERIALS AND METHODS: A postal questionnaire was sent to all radiology departments visited by an oncologist, and to all medical and clinical oncologists from two regional oncology centres. RESULTS: The response rate was 100% (21 peripheral hospital radiology departments and all 35 oncologists). (i) Oncologists' knowledge of peripheral hospital imaging modalities was limited (especially MRI and intervention). (ii) 72% of oncologists rated the peripheral hospital radiology service as excellent or good, 46% rated the radiology report quality excellent to good. Deficiencies in oncological reports were identified. (iii) 44% of radiologists thought the oncologist did not relate well with the local radiology department. 50% of radiologists did not know the visiting oncologist's specialist interest. (iv) 69% of oncologists did not regularly attend peripheral hospital clinico-radiological meetings. Lack of written and oral information was hampering both specialities. CONCLUSION: Communication between oncologists and the local radiology department should include: (1) information about local radiology services for visiting oncologists (including trainees) and on the oncology team for radiologists; (2) standardized report content; (3) improved clinical information for radiologists; (4) regular clinico-radiological meetings. Bungay, P.M. et al. (2002)

Determining the status quo of infection prevention and control standards in the hospitals of iran: a case study in 23 hospitals.

Science.gov (United States)

Shojaee, Jalil; Moosazadeh, Mahmood

2014-02-01

Applying Prevention and Control of Infection (PCI) standards in hospitals reduces probable risks to patients, staff and visitors; it also increases efficiency, and ultimately improves productivity of hospitals. The current study aimed to determine the status quo of international standards of PCI in hospitals located in the north of Iran. This cross-sectional study was conducted in 23 hospitals. Data collection tool was a questionnaire with confirmed validity and reliability. . In this regard, 260 managers, section supervisors and infection control nurses participated in the study according to census basis. SPSS software version 16 was employed to analyze the data through descriptive and analytical statistics. Among the studied hospitals, 18 hospitals were public. Hospitals enjoyed 77.2% of leadership and programming, 80.8% of focus of programs, 67.4% of isolating methods, 88.2% of hand health and protection techniques, 78.8% of improving patient's safety and quality, 90.3% of training personnel, and 78.7% of the average status quo of PCI standards. This study revealed that PCI standards were significantly observed in the studied hospitals and that there were necessary conditions for full deployment of nosocomial infection surveillance.

Cost of delivering secondary-level health care services through public sector district hospitals in India

Science.gov (United States)

Prinja, Shankar; Balasubramanian, Deepak; Jeet, Gursimer; Verma, Ramesh; Kumar, Dinesh; Bahuguna, Pankaj; Kaur, Manmeet; Kumar, Rajesh

2017-01-01

Background & objectives: Despite an impetus for strengthening public sector district hospitals for provision of secondary health care in India, there is lack of robust evidence on cost of services provided through these district hospitals. In this study, an attempt was made to determine the unit cost of an outpatient visit consultation, inpatient bed-day of hospitalization, surgical procedure and overall per-capita cost of providing secondary care through district hospitals. Methods: Economic costing of five randomly selected district hospitals in two north Indian States - Haryana and Punjab, was undertaken. Cost analysis was done using a health system perspective and employing bottom-up costing methodology. Quantity of all resources - capital or recurrent, used for delivering services was measured and valued. Median unit costs were estimated along with their 95 per cent confidence intervals. Sensitivity analysis was undertaken to assess the effect of uncertainties in prices and other assumptions; and to generalize the findings for Indian set-up. Results: The overall annual cost of delivering secondary-level health care services through a public sector district hospital in north India was 11,44,13,282 [US Dollars (USD) 2,103,185]. Human resources accounted for 53 per cent of the overall cost. The unit cost of an inpatient bed-day, surgical procedure and outpatient consultation was 844 (USD 15.5), i; 3481 (USD 64) and 170 (USD 3.1), respectively. With the current set of resource allocation, per-capita cost of providing health care through district hospitals in north India was 139 (USD 2.5). Interpretation & conclusions: The estimates obtained in our study can be used for Fiscal planning of scaling up secondary-level health services. Further, these may be particularly useful for future research such as benefit-incidence analysis, cost-effectiveness analysis and national health accounts including disease-specific accounts in India. PMID:29355142

Cost of delivering secondary-level health care services through public sector district hospitals in India.

Science.gov (United States)

Prinja, Shankar; Balasubramanian, Deepak; Jeet, Gursimer; Verma, Ramesh; Kumar, Dinesh; Bahuguna, Pankaj; Kaur, Manmeet; Kumar, Rajesh

2017-09-01

Despite an impetus for strengthening public sector district hospitals for provision of secondary health care in India, there is lack of robust evidence on cost of services provided through these district hospitals. In this study, an attempt was made to determine the unit cost of an outpatient visit consultation, inpatient bed-day of hospitalization, surgical procedure and overall per-capita cost of providing secondary care through district hospitals. Economic costing of five randomly selected district hospitals in two north Indian States - Haryana and Punjab, was undertaken. Cost analysis was done using a health system perspective and employing bottom-up costing methodology. Quantity of all resources - capital or recurrent, used for delivering services was measured and valued. Median unit costs were estimated along with their 95 per cent confidence intervals. Sensitivity analysis was undertaken to assess the effect of uncertainties in prices and other assumptions; and to generalize the findings for Indian set-up. The overall annual cost of delivering secondary-level health care services through a public sector district hospital in north India was ' 11,44,13,282 [US Dollars (USD) 2,103,185]. Human resources accounted for 53 per cent of the overall cost. The unit cost of an inpatient bed-day, surgical procedure and outpatient consultation was ' 844 (USD 15.5), ' 3481 (USD 64) and ' 170 (USD 3.1), respectively. With the current set of resource allocation, per-capita cost of providing health care through district hospitals in north India was ' 139 (USD 2.5). The estimates obtained in our study can be used for Fiscal planning of scaling up secondary-level health services. Further, these may be particularly useful for future research such as benefit-incidence analysis, cost-effectiveness analysis and national health accounts including disease-specific accounts in India.

HIV-Sero- prevalence trend among blood donors in North East ...

African Journals Online (AJOL)

2017-09-03

Sep 3, 2017 ... On the other hand, significantly declining fashion of. HIV seroprevalence were observed in the studies done in blood banks of Jimma University Specialized Hos- pital and Gonder University hospital7,8 and NorthWest. Ethiopia.9 The Federal Ministry of Health reported the. National HIV prevalence as 3.5% ...

Performance of MBBR in the Treatment of Combined Municipal and Industrial Wastewater A Case Study: Mashhad Sewage Treatment Plant of Parkandabad

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Nasrin Mohammadyari

2008-03-01

Full Text Available MBBR is a combination of three systems: Activated sludge, Fixed film, and Fluidized bed. This system has been designed in a manner to include the advantages of the above systems but removing most of their disadvantages. The main characteristic of the system is the growth of a biofilm on the small packing that moves through the reactor. Because of the biofilm growth on the kaldnes packing, the internal special area of the MBBR is high and around 350 m2/m3. Evidenced by reports in the literature, MBBR has been successfully used for the treatment of different industrial effluents from dairy industries, food industries, slaughter houses, paper mills, refineries, and chemical plants. In this study, the operation of MBBR in treating the combined municipal and industrial wastewater (Parkand Abad Wastewater Treatment Plant, Mashhad, Iran is studied. The results from the pilot study revealed that MBBR was capable of reducing COD levels to 43, 57, 76% at such low hydraulic retention times of 8, 12, 24 hrs, respectively. The system was also found to be capable of handling hydraulic shocks such that the system regained its stability over a short time after the shock and that the effluent COD fluctuation before and after the shock was as low as 70 mg/l.

The use of cimetidine in hospitalized patients.

Science.gov (United States)

Kopala, L

1984-01-01

Cimetidine is the most commonly prescribed drug in North America. A clinical review was conducted to identify physicians' prescribing habits. From September 1, 1981 to March 31, 1982, the charts were reviewed of 50 patients receiving cimetidine in an isolated coastal community hospital in British Columbia. It was discovered that physicians prescribed the drug for reasons approved by the Food and Drug Administration (FDA) only 14% of the time. The FDA guidelines approve cimetidine for duodenal ulcer, Zollinger-Ellison syndrome, and other hypersecretory states. A literature review was conducted, and guidelines on prescribing cimetidine were given to all members of the hospital's medical staff.

Comparing the Effects of Progressive Muscle Relaxation and Guided Imagery on sleep quality in primigravida women referring to Mashhad health care centers-1393

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Nahid Golmakani

2015-04-01

Full Text Available Background & aim: Decreased sleep quality is a common complaint during pregnancy. Relaxation is one of the non-pharmaceutical treatments for sleep disorders. Different techniques could have different impacts on various biological and mental stressors. Therefore, this study aimed to compare the effects of progressive muscle relaxation and guided imagery on the sleep quality of primigravida women. Methods:This three-group clinical trial was conducted on 100 primigravida women, referring to Mashhad health care centers in 2014. All women, who met the inclusion criteria, were randomly assigned to three groups: progressive muscle relaxation, guided imagery, and control groups. The intervention groups performed the exercises twice a day for a period of four weeks at home after two sessions of relaxation training (held during two weeks. Then, the quality of sleep was measured using Pittsburgh Sleep Quality Index. For data analysis, ANOVA, Kruskal-Wallis, paired t-test, and post-hoc test were performed, using SPSS version 11.5. Results: The total score of sleep quality and its components (except use of sleep medication was significantly lower after the intervention, compared to the pre-intervention period in progressive muscle relaxation and guided imagery groups (P

Scrub typhus meningoencephalitis, a diagnostic challenge for clinicians: A hospital based study from North-East India

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M D Jamil

2015-01-01

Full Text Available Central nervous system (CNS involvement is a known complication of scrub typhus which range from mild meningitis to frank meninigoencephalitis.Aims and objectives: To study the clinical feature, laboratory parameters and response to treatment of scrub typhus meningitis/meningoencephalitis.Methods and Materials: This is a hospital based prospective observational study from North Eastern India. Diagnosis was based on clinical features and positive serological test (Weil's Felix test and IgM antibody card test.Results: 13 patients of scrub typhus with features of meningitis/meningoencephalitis were included. The mean duration of fever before presentation was 5.61±3.08 days and 4 (30.76 % patients had eschar. Altered sensorium, headache, seizure and meningeal sign were present in 13 (100%, 13 (100%, 6 (46.15% and 10 (76.92% patients respectively. Mean CSF protein, glucose and Adenosine deaminase was 152.16±16.88mg/dl, 55.23±21.7mg/dl, and 16.98±7.37U/L respectively. Mean total count of CSF leukocyte and lymphocyte percentage was 46.07±131 cell/cumm and 98.66±3.09% respectively. Tablet doxycycline with or without injection azithromycin was used and that shows good response 15.38% of patients died and all of them had multi organ dysfunction. Conclusion: Meningoencephalitis is a common manifestation of scrub typhus and diagnosis requires high degree of clinical suspicion which if diagnosed early and specific treatment started, patients usually recover completely with few complications.

Steroidal Hormone Receptor Expression in Male Breast Cancer

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Fatemeh Homaei-Shandiz

2014-01-01

Full Text Available Introduction: The etiology of male breast cancer is unclear, but hormonal levels may play a role in development of this disease. It seems that the risk of male breast cancer related to increased lifelong exposure to estrogen or reduced androgen. The aim of this study was to investigate the expression of the steroid hormone receptors including estrogen receptor (ER and progesterone receptor (PR in Iranian cases with male breast cancer. Methods: This is a prospective review of 18 cases of male breast cancer in in Omid Hospital, Mashhad, North East of Iran, between October 2001 and October 2006. ER and PR were measured by immunohistochemistry. Clinicopathologic features and family history were obtained by interview. Data were analyzed with SPSS 13 using descriptive statistics.  Results: The median age was 63.2 year. All the cases were infiltrating ductal carcinoma. A high rate of expression of ER (88.8% and PR (66.6% was found in the studied cases. Conclusion: Cancers of the male breast are significantly more likely than cancers of the female breast to express hormonal receptors.

Bulletin of Materials Science | Indian Academy of Sciences

Indian Academy of Sciences (India)

Author Affiliations. M EBRAHIMIZADEH ABRISHAMI1 V ZAHABI2. Materials and Electroceramics Laboratory, Department of Physics, Ferdowsi University of Mashhad, Mashhad 9177948974, Iran; Department of Civil Engineering, Islamic Azad University, Mashhad 9187147578, Iran ...

Identification of Homogeneous Stations for Quality Monitoring Network of Mashhad Aquifer Based on Nitrate Pollution

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Moslem Akbarzadeh

2017-01-01

Full Text Available Introduction: For water resources monitoring, Evaluation of groundwater quality obtained via detailed analysis of pollution data. The most fundamental analysis is to identify the exact measurement of dangerous zones and homogenous station identification in terms of pollution. In case of quality evaluation, the monitoring improvement could be achieved via identifying homogenous wells in terms of pollution. Presenting a method for clustering is essential in large amounts of quality data for aquifer monitoring and quality evaluation, including identification of homogeneous stations of monitoring network and their clustering based on pollution. In this study, with the purpose of Mashhad aquifer quality evaluation, clustering have been studied based on Euclidean distance and Entropy criteria. Cluster analysis is the task of grouping a set of objects in such a way that objects in the same group (called a cluster are more similar (in some sense or another to each other than to those in other groups (clusters. SNI as a combined entropy measure for clustering calculated from dividing mutual information of two values (pollution index values to the joint entropy. These measures apply as similar distance criteria for monitoring stations clustering. Materials and Methods: First, nitrate data (as pollution index and electrical conductivity (EC (as covariate collected from the related locational situation of 287 wells in statistical period 2002 to 2011. Having identified the outlying data and estimating non-observed points by spatial-temporal Kriging method and then standardizes them, the clustering process was carried out. A similar distance of wells calculated through a clustering process based on Euclidean distance and Entropy (SNI criteria. This difference explained by characteristics such as the location of wells (longitude & latitude and the pollution index (nitrate. Having obtained a similar distance of each well to others, the hierarchical clustering

Radiographic Evaluation of Idiopathic Osteosclerosis in Patients Referring to Mashhad Dental School from November 2002 to May 2004

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M Eatemadi-Sadjadi

2006-07-01

Full Text Available Introduction: Idiopathic osteosclerosis is a common radiopaque lesion in the jaw bones, which is asymptomatic and usually detected accidentally in various radiographs. The purpose of this study was to determine the radiographic features of idiopathic osteosclerosis in the jawbones of patients referring to the maxillofacial radiology center of Mashhad Dental Faculty. Methods: In this descriptive study, panoramic radiographs of 300 patients ( 125 males, 175 females who had referred to the maxillofacial radiology department were evaluated for the presence of idiopathic osteosclerosis. The radiographic information included location, number, shape, size, relationship with teeth, pattern of density ( trabecular-cortical and demographic data ( age, sex and evidence of disease in the gastrointestinal tract and kidneys were also recorded . Then data was analyzed using chi-square and t-student test. Results : A total of 27 patients (9%, exhibited 40 foci of idiopathic osteosclerosis with different shapes and sizes (4 cm2 to 1/09 cm 2 , most of which had well defined borders (65% and trabecular density (62/5% . The most common region for these lesions was in the mandible, especially in the second premolar (47/5% and first molar (42/5% regions and the majority had no connection to the teeth (57/5%. The lesions were most prevalent in the second decade of life (29/6% followed by third and fourth decades. (25/9% Conclusion: The results of this study were the same as that of previous similar studies. In addition, chronic renal failure was seen in 1/3 of patients with idiopathic osteosclerosis .

The determinants of patient waiting time in the general outpatient department of Debre Markos and Felege Hiwot hospitals in Amhara regional state, North West, Ethiopia

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Melesse Belayneh

2017-01-01

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

Hepatic fascioliasis in Mashhad, Northeast Iran: first report.

Science.gov (United States)

Badirzadeh, Alireza; Sabzevari, Sadaf

2017-01-01

Fascioliasis is a zoonotic disease caused by a leaf-like worm (fluke) called Fasciola. Herein, we present a case of human hepatic fascioliasis. A 57-year-old man was referred to the hospital for ambiguous gastrointestinal symptoms with suspected hemangioma. Hepatic fascioliasis was diagnosed using abdominal computed tomography and serology. He tested positive for the IgG antibody against Fasciola hepatica. The patient was treated successfully with triclabendazole. This is the first published report on the occurrence of fascioliasis in Northeast Iran, a non-endemic area for fascioliasis. Our results suggest the emergence of a new focus in the region.

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.

Healthcare in Canada's North: Are We Getting Value for Money?

Science.gov (United States)

Young, T Kue; Chatwood, Susan; Marchildon, Gregory P

2016-08-01

To determine if Canadians are getting value for money in providing health services to our northern residents. Secondary analyses of data from Statistics Canada, the Canadian Institute of Health Information and territorial government agencies on health status, health expenditures and health system performance indicators. Per capita health expenditures in Canada's northern territories are double that of Canada as a whole and are among the highest in the world. The North lags behind the rest of the country in preventable mortality, hospitalization for ambulatory care sensitive conditions and other performance indicators. The higher health expenditure in the North is to be expected from its unique geography and demography. If the North is not performing as well as Canada, it is not due to lack of money, and policy makers should be concerned about whether healthcare can be as good as it could be. Copyright © 2016 Longwoods Publishing.

The Blood Stocks Management Scheme, a partnership venture between the National Blood Service of England and North Wales and participating hospitals for maximizing blood supply chain management.

Science.gov (United States)

Chapman, J F; Cook, R

2002-10-01

The Blood Stocks Management Scheme (BSMS) has been established as a joint venture between the National Blood Service (NBS) in England and North Wales and participating hospitals to monitor the blood supply chain. Stock and wastage data are submitted to a web-based data-management system, facilitating continuous and complete red cell data collection and 'real time' data extraction. The data-management system enables peer review of performance in respect of stock holding levels and red cell wastage. The BSMS has developed an innovative web-based data-management system that enables data collection and benchmarking of practice, which should drive changes in stock management practice, therefore optimizing the use of donated blood.

Investigation of Breakpoint and Trend of Daily Air Temperature Range for Mashhad, Iran

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shideh shams

2017-01-01

Full Text Available Introduction: Air temperature as an important climatic factor can influence variability and distribution of other climatic parameters. Therefore, tracking the changes in air temperature is a popular procedure in climate change studies.. According to the national academy in the last decade, global temperature has raised 0.4 to 0.8⁰C. Instrumental records show that, with the exception of 1998, the 10 warmest year (during the last 150 years, occurred since 2000, and 2014 was the warmest year. Investigation of maximum and minimum air temperature temporal trend indicates that these two parameters behave differently over time. It has been shown that the minimum air temperature raises noticeably more than the maximum air temperature, which causes a reduction in the difference of maximum and minimum daily air temperature (daily temperature range, DTR. There are several factors that have an influence on reducing DTR such as: Urban development, farms’ irrigation and desertification. It has been shown that DTR reduction occurs mostly during winter and is less frequent during summer, which shows the season’s effect on the temperature trend. Considering the significant effects of the climatological factors on economic and agricultural management issues, the aim of this study is to investigate daily air temperature range for yearly, seasonal and monthly time scales, using available statistical methods. Materials and Methods: Daily maximum and minimum air temperature records (from 1950 to 2010 were obtained from Mashhad Meteorological Organization. In order to control the quality of daily Tmax and Tmin data, four different types of quality controls were applied. First of all, gross errors were checked. In this step maximum and minimum air temperature data exceeding unlikely air temperature values, were eliminated from data series. Second, data tolerance was checked by searching for periods longer than a certain number of consecutive days with exactly the

surgical treatment for chronic pancreatitis: report of three cases

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Abdollahi A

2009-01-01

Full Text Available "nBackground: Chronic pancreatitis is a progressive fibrosis of the pancreas that leads to loss of endocrine and exocrine function of pancreas. The most common symptom is intractable pain. Which adversely effects quality of life, remains the most common indication for surgery in patients with chronic pancreatitis. Case report: Three patients underwent operations for chronic pancreatitis at the Ghaem hospital, Mashhad University of Medical Sciences Mashhad, Iran. Indication for operation in all cases were intractable abdominal pain. In all of the three patients complete relief of symptoms was obtained. There was no morbidity and mortality. In one patient exocrine function of pancreas and malabsorpation resolved after surgery. Conclusions: Although chronic pancreatitis is uncommon, but in persistent abdominal pain surgery should be considered. Surgery for patients with chronic pancreatitis can be performed safely with minimal morbidity and effective in control of pain and malabsorption.  

The Relationship between Serum Hemoglobin and Creatinine Levels and Intra-Hospital Mortality and Morbidity in Acute Myocardial Infarction

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Afsoon Fazlinezhad

2014-09-01

Full Text Available Background: Studies have shown that Glomerular Filtration Rate (GFR and Hemoglobin (Hb concentrations are two predictive values for ST-elevation Myocardial Infarction (MI mortality.. Objectives: This study aimed to investigate the relationship between GFR and Hb concentrations and intra-hospital mortality and electrocardiographic (ECG and echocardiographic abnormalities in ST-elevation MI patients admitted to a highly equipped hospital in Mashhad. The results will help define some factors to manage these patients more efficiently.. Patients and Methods: This descriptive study aimed to assess the relationship between Hb and GFR concentrations and mortality and morbidity among 294 randomly selected patients with ST-elevation MI. Echocardiography, ECG, and routine laboratory tests, including Hb and creatinine, were performed for all the patients. Then, the data were entered into the SPSS statistical software, version 16 and were analyzed using chi-square, t-test, and ANOVA. P < 0.05 was considered as statistically significant.. Results: Intra-hospital mortality rate was 10.5%. Besides, the results showed higher levels of serum blood sugar (P < 0.001, higher levels of creatinine (P < 0.001, lower levels of GFR (P < 0.001, lower ejection fraction (P < 0.001, higher grades of left ventricular diastolic dysfunction (P = 0.002, and lower mean Hb concentration (P = 0.022 in the dead compared to the alive cases. Besides, the patients with mechanical complications had lower Hb levels (P = 0.008. The results showed no significant relationship between creatinine level and mechanical and electrical complications (P = 0.430 and P = 0.095, respectively. However, ejection fraction was significantly associated with GFR (P = 0.016.. Conclusions: According to the results, low levels of Hb and GFR could predict mortality caused by ST-elevation MI and ECG abnormalities could notify intra-hospital death. Moreover, lower Hb levels were associated with mechanical

Malignant Neoplasms Of The Ear, Nose And Throat In North Eastern ...

African Journals Online (AJOL)

The few cases seen in this study are the tip of the Iceberg. The apperent low figure in this region could be due to high cost of hospitalization, distant location of health facilities and absence of radiotherapy unit in our centre. Key words: ENT cancers, nasopharyngeal carcinoma, malignant midline reticulosis, and north eastern ...

Hepatic fascioliasis in Mashhad, Northeast Iran: first report

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Alireza Badirzadeh

Full Text Available Abstract Fascioliasis is a zoonotic disease caused by a leaf-like worm (fluke called Fasciola. Herein, we present a case of human hepatic fascioliasis. A 57-year-old man was referred to the hospital for ambiguous gastrointestinal symptoms with suspected hemangioma. Hepatic fascioliasis was diagnosed using abdominal computed tomography and serology. He tested positive for the IgG antibody against Fasciola hepatica. The patient was treated successfully with triclabendazole. This is the first published report on the occurrence of fascioliasis in Northeast Iran, a non-endemic area for fascioliasis. Our results suggest the emergence of a new focus in the region.

A study on sexually transmitted diseases in patients in a STD clinic in a district hospital in North India

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Neerja Puri

2014-07-01

Full Text Available Introduction: The Sexually transmitted diseases (STDs are a global health problem of great magnitude. The pattern of STDs differs from country to country and from region to region. The increased risk of the transmission of HIV is known to be associated with the presence of sexually transmitted diseases (STDs and despite the presence of the National STD Control Program in India the number of people with STDs remains high. Aim: The aim of our study was to study the profile of patients in a STD clinic in North India and to study various sexually transmitted infections in both male and female patients. Material and Methods: A prospective study of the patients attending STD clinic in a district hospital in North India from December 2009 to December 2012 was done. A total of 2700 patients attending the STDclinic in three years from December 2009 to December 2012 were taken up for the study. Results: The commonest sexually transmitted infection in males was herpes genitalis (30% followed by 20% cases of genital warts. 10% patients had gonorrhoea, genital molluscum contagiosum, syphilis and genital scabies each and 5% patients had nongonococcal urethritis. Only 5% of the total patients had chancroid, donovanosis and LGV. The commonest sexually transmitted infection in females was vaginal discharge seen in 40% patients, lower abdominal pain in 20% patients, herpes genitalis in 15% patients followed by 20% cases of genital warts and syphilis each. Genital molluscum contagiosum was seen in 5% patients only. Conclusions: The treatment of STD’s is important as both non-ulcerative and ulcerative STDs increase the susceptibility to or transmissibility of HIV infection and as such, an increase in STD prevalence as revealed by clinic attendance in this study was bound to facilitate the spread of HIV/AIDS. Perhaps it is high time health planners adopted a more aggressive and result oriented HIV/AIDS/STD awareness campaign strategy.

Follow-up analysis of federal process of care data reported from three acute care hospitals in rural Appalachia

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Sills ES

2013-03-01

Full Text Available E Scott Sills,1,2 Liubomir Chiriac,3 Denis Vaughan,4 Christopher A Jones,5 Shala A Salem11Division of Reproductive Endocrinology, Pacific Reproductive Center, Irvine, CA, USA; 2Graduate School of Life Sciences, University of Westminster, London, UK; 3Department of Mathematics, California Institute of Technology, Pasadena, CA, USA; 4Department of Obstetrics and Gynaecology, School of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland; 5Global Health Economics Unit and Department of Surgery, Center for Clinical and Translational Science, University of Vermont College of Medicine, Burlington, VT, USABackground: This investigation evaluated standardized process of care data collected on selected hospitals serving a remote rural section of westernmost North Carolina.Methods: Centers for Medicare and Medicaid Services data were analyzed retrospectively for multiple clinical parameters at Fannin Regional Hospital, Murphy Medical Center, and Union General Hospital. Data were analyzed by paired t-test for individual comparisons among the three study hospitals to compare the three facilities with each other, as well as with state and national average for each parameter.Results: Centers for Medicare and Medicaid Services “Hospital Compare” data from 2011 showed Fannin Regional Hospital to have significantly higher composite scores on standardized clinical process of care measures relative to the national average, compared with Murphy Medical Center (P = 0.01 and Union General Hospital (P = 0.01. This difference was noted to persist when Fannin Regional Hospital was compared with Union General Hospital using common state reference data (P = 0.02. When compared with national averages, mean process of care scores reported from Murphy Medical Center and Union General Hospital were both lower but not significantly different (−3.44 versus −6.07, respectively, P = 0.54.Conclusion: The range of process of care scores submitted by acute care

Manual accidents, biological risk control, and quality indicators at a children's hospital in north-east Italy

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Parco S

2015-04-01

Full Text Available Sergio Parco, Fulvia Vascotto, Roberto Simeone, Patrizia Visconti Department of Health Technology Assessment, Institute for Maternal and Child Health, Trieste, Italy Background: Working in health care carries the risk of transmission of infected blood to patients by hospital workers and to other health personnel in the form of occupational infections. Conscientious application of the standard precautions is the main method used to avoid needle stick injuries, contamination of skin and mucous membranes, cuts with sharp tools, and inadequate disposal and recapping of needles. The aim of this work was to investigate in Friuli Venezia Giulia, a region in north-east Italy, the enhancement carried out to prevent situations of biologic risk for health care workers, and to verify the related laboratory analyses. Methods: Biological accidents occurring during the years 2012–2013 in the departments of oncology and pediatric-obstetric surgery, and in the intensive care unit at Burlo Garofolo Children's Hospital in Trieste (a large town in Friuli Venezia Giulia were reviewed, and a new panel of tests was introduced for patients and health care workers, to also detect human immunodeficiency virus (HIV, hepatitis C virus (HCV, hepatitis B virus (HBV, and aspartate transaminase and immunoglobulin G. All tests were submitted for external quality assessment. Results: In total, 230 nosocomial events were reported by health care workers in the above-mentioned hospital departments in 2012–2013. There were 158 accidents in 2012, including 55 accidental needle stick injuries (34.81%, 59 blood splashes (37.34%, and 44 cuts with infected instruments (27.84%. The risk of sustaining a cut was related to movement error during surgery when the appropriate procedure was not followed or when devices were being assembled and passed between doctors and nurses. Most accidents happened among physicians compared to nurses; the high percentage of needle stick injuries (34

Evaluating Michigan's community hospital access: spatial methods for decision support

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Varnakovida Pariwate

2006-09-01

Full Text Available Abstract Background Community hospital placement is dictated by a diverse set of geographical factors and historical contingency. In the summer of 2004, a multi-organizational committee headed by the State of Michigan's Department of Community Health approached the authors of this paper with questions about how spatial analyses might be employed to develop a revised community hospital approval procedure. Three objectives were set. First, the committee needed visualizations of both the spatial pattern of Michigan's population and its 139 community hospitals. Second, the committee required a clear, defensible assessment methodology to quantify access to existing hospitals statewide, taking into account factors such as distance to nearest hospital and road network density to estimate travel time. Third, the committee wanted to contrast the spatial distribution of existing community hospitals with a theoretical configuration that best met statewide demand. This paper presents our efforts to first describe the distribution of Michigan's current community hospital pattern and its people, and second, develop two models, access-based and demand-based, to identify areas with inadequate access to existing hospitals. Results Using the product from the access-based model and contiguity and population criteria, two areas were identified as being "under-served." The lower area, located north/northeast of Detroit, contained the greater total land area and population of the two areas. The upper area was centered north of Grand Rapids. A demand-based model was applied to evaluate the existing facility arrangement by allocating daily bed demand in each ZIP code to the closest facility. We found 1,887 beds per day were demanded by ZIP centroids more than 16.1 kilometers from the nearest existing hospital. This represented 12.7% of the average statewide daily bed demand. If a 32.3 kilometer radius was employed, unmet demand dropped to 160 beds per day (1

Profile of glaucoma in a major eye hospital in North India

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Das Jayachandra

2001-01-01

Full Text Available Purpose: To study the clinical profile and distribution of various subtypes of glaucoma in a referral practice in North India. Method: A retrospective analysis was done of 2425 patients who attended the glaucoma clinic in a tertiary eye-care centre for five years from Januaryl995 to December 1999. A detailed history was obtained and a thorough examination was performed, including gonioscopy, disc assessment, applanation tonometry and automated perimetry. Diurnal variation of IOP and provocative tests for glaucoma were done where applicable. Result: Primary angle closure glaucoma (PACG was the most common glaucoma subtype. The primary open angle glaucoma (POAG to the PACG ratio was 37:63. Chronic angle closure glaucoma (CACG was the most common PACG subtype. The majority of CACG cases were relatively asymptomatic. Male dominance was seen for POAG, juvenile open angle glaucoma (JOAG, CACG, normal tension glaucoma (NTG and secondary glaucomas. Female dominance was seen for ocular hypertension (OHT, acute or intermittent ACG and developmental glaucomas. The mean age in years at presentation was POAG: 60.54 years (males 61.54 years, females 59.01 years and PACG: 55.13 years (males 57.25 years, females 53.60. The three common secondary glaucomas were: glaucoma secondary to adherent leucoma, aphakic and pseudophakic glaucomas and traumatic glaucomas. Advanced glaucoma was detected in 42 to 53% of patients and bilateral blindness in 8 to 14% of patients in various subtypes. Conclusion: Compared to Caucasians, glaucoma patients in North India seem to present nearly a decade earlier and the disease is more advanced at presentation. While PACG is the most commonly encountered glaucoma, NTG and exfoliative glaucoma are relatively rare.

Clinical Outcomes after Arthroscopic Release for Recalcitrant Frozen Shoulder

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Ebrahimzadeh, Mohammad H; Moradi, Ali; Pour, Mostafa Khalili; Moghadam, Mohammad Hallaj; Kachooei, Amir Reza

2014-01-01

Background: To explain the role of arthroscopic release in intractable frozen shoulders. We used different questionnaires and measuring tools to understand whether arthroscopic release is the superior modality to treat patients with intractable frozen shoulders. Methods: Between 2007 and 2013, in a prospective study, we enrolled 80 patients (52 females and 28 males) with recalcitrant frozen shoulder, who underwent arthroscopic release at Ghaem Hospital, a tertiary referral center, in Mashhad,...

Assessing the Quality of Hospitals’ Websites in Khorasan Razavi Province

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Meisam Dastani

2017-06-01

Full Text Available Background and Objectives: The aim of the present study was to demonstrate a clear vision of the quality status of Khorasan Razavi hospitals’ websites in four dimensions of content, performance, management and using the website. Material and Methods: This was a survey study. The sample size consisted of 49 hospital websites of Khorasan Razavi province. A check list including 21 components and four criteria (content, performance, management and how to use the website was used as the assessing instrument. Its validity and reliability have been proved through previous studies. Also, the data were analyzed using descriptive statistics. Results: The findings showed that only 59% of the hospitals in Khorasan Razavi had active websites.  The overall status of the websites showed the following: too weak (51%, moderate (26.5% and weak (16.3%, respectively. Regarding the content, performance, management and using the website and design criteria, the findings showed that 40.8% of the websites had an unfavorable condition. Of the 16 high quality websites selected, only three websites including Sina Hospital in Mashhad, Javdoll-Aemeh in Mashhad and Razavi were in good condition; meanwhile the others were in poor condition. Conclusion: The results of this study indicated that most websites do not consider minimal medical standards and also, they could not establish good relationships with their audiences. In fact, in Iran, considering the quality and performance of websites has not been a priority for improving service quality in hospitals. The findings of this study can be effective in the identification and development of hospital websites quality criteria in terms of design, content, performance and management and how to use websites.

Skin cancer patients profile at faculty of medicine university of North Sumatera pathology anatomy laboratory and Haji Adam Malik general hospital in the year of 2012-2015

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Sembiring, E. K.; Delyuzar; Soekimin

2018-03-01

The most common types of skin cancer found worldwide are basal cell carcinoma, squamous cell carcinoma, and malignant melanoma. In America, about 800,000 people suffer from skin cancer every year and 75% are basal cell carcinoma. According to WHO, around 160,000 people suffer from malignant melanoma every year and 48,000 deaths were reported every year. In Jakarta, in 2000-2009, dr. CiptoMangunkusumo Hospital (RSCM) reported 261 cases of basal cell carcinoma, followed by 69 cases of squamous cell carcinoma and 22 cases of malignant melanoma.This study was descriptive study with retrospective design and consecutive sampling method. Data consisted of age, gender, tumor location, occupation and histopathology subtype which were taken from skin cancer patients’ medical record at Faculty of Medicine University of North Sumatera Pathology Anatomy Laboratory and Haji Adam Malik General Hospital Medan in 2012-2015. Data were analyzed using SPSS program and classified based on WHO. From 92 study subjects, squamous cell carcinoma is the most common form of skin cancer which is 59 cases (64.13%), found in 48 women (52.2%), and often found between 45-47 years old (30.4%).

What Went Wrong at University Hospital? An Exercise Assessing Training Effectiveness.

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Brown, Trevor C.; Li, Stan X.; Sargent, Leisa D.; Tasa, Kevin

2003-01-01

In an experiential exercise, management students portrayed consultants assessing the effectiveness of a hospital's training program. Feedback from 28 North American and 17 Australian students indicated overall satisfaction and effective achievement of the objective: learning to apply the instructional systems design model to evaluation of training…

Comparison of the Topography of Carotid Territory Stenosis in North American and Iranian Stroke Patients

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A Shoayb

2007-01-01

Full Text Available Introduction: Atherosclerotic stenosis of carotid territory is the most common cause of ischemic stroke. A higher frequency of intracranial arterial stenosis has been reported in Africa and the Far East. Methods: 304 geriatric ischemic stroke patients admitted in Mackenzie hospital, Canada and the same number of geriatric ischemic stroke patients with similar sex ratio admitted in Valie-Asr hospital, Iran during 2003-2005 were enrolled in a double center and prospective study. Diagnosis of brain infarction in the carotid territory was made by stroke neurologists. All of the patients underwent transcranial and carotid doppler studies. Doppler studies performed were based on the standard method by a neurosonologist. Fisher exact test served for statistical analysis and p<0.05 was declared significant. Results: In Iranian group 71 patients (23.3% and in North American group 83 patients (27.3% had extracranial ICA stenosis without a significant difference df=1, p=0.305. Sever ³70% Extracranial ICA stenosis was found in 14 Iranian patients (4.6% and 23 North American patients (7.5% without a significant difference. df=1, p=0.17. In Iranian group, 14 cases (4.6% and in North American group 5 cases (1.6% had intracranial stenosis in carotid territory which was significantly different df=1, p=0.038. Mixed intracranial and extracranial carotid territory stenosis was present in 2 Iranian and 1 North American patient. Conclusion: Atherosclerotic stenosis of intracranial branches of carotid territory is more common in Iranian than North American populations.

Homogeneous SLOWPOKE reactors for Mo-99/Tc-99m production in North America

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Hilborn, J.W., E-mail: hilbovanw@sympatico.ca [Deep River, Ontario (Canada); Bonin, H.W. [Royal Military College of Canada, Kingston, Ontario (Canada)

2014-07-01

The 15 month shutdown of NRU in 2009 - 2010 caused an overall isotope shortage of approximately 30%; and in North America, the annual Tc-99m demand decreased from an estimated 20 million unit doses to about 15 million unit doses. Mo-99/Tc-99m is produced from HEU targets, irradiated in NRU for 11 days, and after chemical removal of uranium it is shipped to Nordion in Kanata, Ontario. Nordion further purifies the material and sends it to Lantheus Medical Imaging in the USA for manufacture of Mo-99 generators, which are then distributed to hundreds of hospital radiopharmacies throughout North America. One other American company, Covidien, manufactures and distributes Mo-99 generators like Lantheus, but they import bulk Mo-99 from Europe or South Africa. At the hospitals, Tc-99m is chemically extracted daily from the Mo-99 generators and loaded into syringes for immediate clinical use. Fortuitously, the 66 hour half-life of Mo-99 allows the replenishment of Tc-99m in the generator over a growth period of about 20 hours; and a generator can be 'milked' daily for up to two weeks. A more efficient model is the direct production and distribution of Tc-99m unit doses to regional hospitals from 10 'industrial' radiopharmacies located at existing licensed reactor sites in North America. A 20 kW homogeneous SLOWPOKE reactor at each site would deliver 15 litres of irradiated uranyl sulphate fuel solution daily to industrial-scale hot cells for extraction of Mo-99, which would be incorporated in large Mo-99/Tc-99m generators for extraction of Tc-99m five days a week; and the Low Enriched Uranium (LEU) would be recycled. Each automated hot-cell facility would be designed to load up to 7,000 Tc-99m syringes daily, for courier delivery to all of the Nuclear Medicine hospitals within a 3 hour average range by road transport. Typically, the delivered doses would be in the range 10 to 30 mCi. Assuming an average unit dose of 25 mCi at the hospital and 5 x 52

Trend of human brucellosis over a decade at tertiary care centre in North Karnataka.

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Patil, D P; Ajantha, G S; Shubhada, C; Jain, P A; Kalabhavi, A; Shetty, P C; Hosamani, M; Appannanavar, S; Kulkarni, R D

2016-01-01

Brucellosis is an important zoonotic disease. India having a major agrarian population is expected to have a higher prevalence. However, due to lack of laboratory facility or awareness among clinicians, the disease is largely underreported. The aim of this study was to know the prevalence and trend of human brucellosis over a decade, in patients attending a teaching hospital in North Karnataka, and to understand their geographical distribution. The study was conducted from January 2006 to December 2015 at a tertiary care teaching hospital in North Karnataka. A total of 3610 serum samples were evaluated from suspected cases of brucellosis. All serum samples were initially screened by Rose Bengal plate test, and positive samples were further analysed by Serum agglutination test (SAT) using standard Brucella abortus antigen from Indian Veterinary Research Institute, Izatnagar, Uttar Pradesh, India. A titre above or equal to 1:80 IU/ml was considered as positive. Demographic data such as age, sex and native place of these patients were also analysed. We observed that human brucellosis is present in North Karnataka. The overall seropositivity of brucellosis in suspected cases was 5.1%. The positive titres ranged from 1:80 to 163,840 IU/ml. The majority of the patients were from Gadag, Koppal and Haveri districts of North Karnataka. Our study confirms the presence of human brucellosis in the northern part of Karnataka. Further studies to understand the prevalence of animal brucellosis in these areas will help in implementing prevention measures.

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

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Inma Crespo

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

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

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

2015-01-01

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

Population Dynamics of Macrosiphum rosae (L. on Different Cultivars of Rose (Rosahybrida, Rosaceae and Biodiversity of its Predators in Mashhad

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M. Keykhosravi

2016-06-01

in landscapes of Mashhad and also to determine the diversity and abundance of the rose aphid predators throughout the seasonal growth in the study area. Material and Methods: Research to investigate the resistance of different rose cultivars against rose aphid and the biodiversity of its predators was conducted at the campus of Ferdowsi University of Mashhad from Mid-March of 2013 to late march 2014. Six rose cultivars including Ice berg, Miniature, Josephine bruce, Piccadilly, Fairy & Blessing were sampled weekly in three sampling sites. For sampling, four cut sections (5 centimeters of terminal part of randomly selected shoot of each cultivar in each site were cut and put in a plastic bag and brought to the laboratory for counting the number of different stages of rose aphid as well as the associated predators. For purpose of identification of immature stages of the aphid predators, immature stage was kept until they reach to adult stage in the laboratory. Results and Discussion: A seasonal fluctuation of rose aphid was recorded throughout the season on six rose cultivars (Table 1. Overall, this aphid was more numerous in spring and early fall on all studied cultivars (Figure 1. By approaching the summer, the population of rose aphid on all rose cultivars, except the Fairy and Miniature varieties declined to zero. Analysis of variance showed that differences in mean population of rose aphid among studied cultivars was significant (P

The Rural Obstetric Workforce in US Hospitals: Challenges and Opportunities

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Kozhimannil, Katy B.; Casey, Michelle M.; Hung, Peiyin; Han, Xinxin; Prasad, Shailendra; Moscovice, Ira S.

2015-01-01

Purpose The purpose of this study was to describe the types and combinations of clinicians who are delivering babies in rural hospitals, their employment status, the relationship between hospital birth volume and staffing models, and the staffing challenges faced by rural hospitals. Methods We conducted a telephone survey of 306 rural hospitals in 9 states: Colorado, Iowa, Kentucky, New York, North Carolina, Oregon, Vermont, Washington, and Wisconsin, from November 2013-March 2014 to assess their obstetric workforce. Bivariate associations between hospitals’ annual birth volume and obstetric workforce characteristics were examined, as well as qualitative analysis of workforce changes and staffing challenges. Findings Hospitals with lower birth volume (< 240 births per year) are more likely to have family physicians and general surgeons attending deliveries, while those with a higher birth volume more frequently have obstetricians and midwives attending deliveries. Reported staffing challenges include scheduling, training, census fluctuation, recruitment and retention, and intra-hospital relationships. Conclusions Individual hospitals working in isolation may struggle to address staffing challenges. Federal and state policy makers, regional collaboratives, and health care delivery systems can facilitate solutions through programs such as telehealth, simulation training, and interprofessional education. PMID:25808202

Prevalence of haemoparasites in pet, working and stray dogs of Assam and North-East India: A hospital based study

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K. Bhattacharjee

2013-10-01

Full Text Available Aim:This research work is aimed to find out the prevalence of haemoparasitic infections in different categories of dogs.Materials and Methods: Out of 2104 dogs registered in the Teaching Veterinary Clinical Complex of the College ofVeterinary Science, Khanapara, Guwahati during January 2009 to December 2010, blood of 424 cases suspected forhaemoparasites on the basis of clinical history were microscopically examined in wet blood film and giemsa stained bloodsmears.Results: The prevalence was 57.31% in the hospital population comprising pet (58.03% and working (54.54% dogs and63.64% in stray dog population. A total of 7 species viz. Babesia gibsoni (47.16%, Ehrlichia (Anaplasma platys (8.49%,Dirofilaria immitis (2.83%, Ehrlichia canis (2.12%, Babesia canis (1.41%, Hepatozoon canis (1.41% and Ehrlichiaewingii (0.47% in single or mixed infections were recorded. B. gibsoni was found to be most predominant haemoprotozoanspecies. However, B. canis, the large form of Babesia was detected in very few dogs. Similarly, inclusion of E. platys insideblood platelets, although rare in occurrence, was more easily detectable than that of E. canis inside the monocytes andlymphocytes. Infection with D. immitis in pet dogs (2.38% was comparatively lower than in working dogs (4.54% and foundin single and mixed infections with B. gibsoni, B. canis and E. platys. Hepatozoon canis was recorded in 6 hospital dogs eitherin single or mixed infection with B. gibsoni and E. platys. Six species of haemoparasites namely B. gibsoni (47.72%, D.immitis (27.27%, E. platys (4.54%, E. canis (2.27%, E. ewingii (2.27% and H. canis (2.27% were detected in blood ofstray dogs. Trypanosoma evansi as recorded in dogs from other parts of the country was not detected in this study.Conclusion: Present findings led to a significant conclusion that Assam and adjoining states of North East region of India arehighly enzootic for the vector borne haemoparasites of dog.

Hospital-at-home Integrated Care Program for Older Patients With Orthopedic Processes: An Efficient Alternative to Usual Hospital-Based Care.

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Closa, Conxita; Mas, Miquel À; Santaeugènia, Sebastià J; Inzitari, Marco; Ribera, Aida; Gallofré, Miquel

2017-09-01

To compare outcomes and costs for patients with orthogeriatric conditions in a home-based integrated care program versus conventional hospital-based care. Quasi-experimental longitudinal study. An acute care hospital, an intermediate care hospital, and the community of an urban area in the North of Barcelona, in Southern Europe. In a 2-year period, we recruited 367 older patients attended at an orthopedic/traumatology unit in an acute hospital for fractures and/or arthroplasty. Patients were referred to a hospital-at-home integrated care unit or to standard hospital-based postacute orthogeriatric unit, based on their social support and availability of the resource. We compared home-based care versus hospital-based care for Relative Functional Gain (gain/loss of function measured by the Barthel Index), mean direct costs, and potential savings in terms of reduction of stay in the acute care hospital. No differences were found in Relative Functional Gain, median (Q25-Q75) = 0.92 (0.64-1.09) in the home-based group versus 0.93 (0.59-1) in the hospital-based group, P =.333. Total health service direct cost [mean (standard deviation)] was significantly lower for patients receiving home-based care: €7120 (3381) versus €12,149 (6322), P home-based care [10.1 (7)] than in patients discharged to the postacute orthogeriatric hospital-based unit [15.3 (12) days, P home integrated care program was suitable for managing older patients with orthopedic conditions who have good social support for home care. It provided clinical care comparable to the hospital-based model, and it seems to enable earlier acute hospital discharge and lower direct costs. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Prehospital characteristics in the North East Department of Haiti: a cross-sectional study from a low-income setting without prehospital systems.

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Aluisio, Adam R; Gore, Robert; Decome, Isnelle; De Wulf, Annelies; Bloem, Christina

2014-06-01

Although prehospital care is recognized as key in health systems development, it has been largely neglected in Haiti. The North East Department is one of the poorest areas of Haiti, and is a region where no data on out-of-hospital health care exists. This research assessed prehospital characteristics in the North East Department with the aim of providing baseline data to inform prehospital systems development. In this observational study, data were collected from patients presenting at the Fort Liberté Hospital, the public regional referral health center in the North East Department. Data were accrued from April 2, 2012 through June 5, 2012. All patients accessing acute care at the hospital were eligible for enrollment. After obtaining consent, data on demographics, health needs, and prehospital information were gathered via a standardized questionnaire administered by hospital staff trained in study protocols. Data were collected from 441 patient visits. The median age was 24 years, with 62% of the population being female. Medical complaints comprised 75% of visits, with fever and gastrointestinal complaints being the most common reasons for presentation. Traumatic injuries accounted for 25% of encounters, with an equal distribution of blunt and penetrating events. Extremity injuries were the most common traumatic subclassification. The majority of patients (67.2%) were transported by motorcycle taxi and paid transport fees. Trauma patients were more likely to be transported without charge (OR = 9.10; 95% CI, 2.19-37.76; P Haiti. Out-of-hospital care is nearly nonexistent in the region and its development has the potential to yield public health benefits.

Evaluation of factors influencing patient satisfaction in social security hospitals in Mazandaran province, North of Iran.

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Jafari Kelarijani, Seyed Ebrahim; Jamshidi, Reza; Heidarian, Ali Reza; Khorshidi, Mohamad

2014-01-01

Patient satisfaction is affected by hospital services and may have an effect on the cultural, social and personal conditions of the people living in the region. This research aimed to evaluate the patient satisfaction in social security hospitals in Mazandaran province. From Spring 2012 to Summer 2013, all patients admitted to social security hospitals in Mazandaran province were entered in the study. Data regarding to inhabitation, sex, income and patients' educational level and satisfaction with the hospital services were collected. Seven hundred seventy-six patients with mean age of 47.35±7.41 years were analyzed. Patient's inhabitant, educational attainment and income level had a significant relationship with patient satisfaction level (ppatients' gender. The results show that the patient's inhabitant, educational and income level are related to attain patients' satisfaction.

Effectiveness of an intervention package on knowledge, attitude, and practices of food handlers in a tertiary care hospital of north India: A before and after comparison study.

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Dudeja, Puja; Singh, Amarjeet; Sahni, Nancy; Kaur, Sukhpal; Goel, Sonu

2017-01-01

Food-borne illnesses have been a recognized hazard for decades. Recent promulgation of Food Safety and Standards Act (FSSA), 2006, indicates the concern of our Govt. for food safety. Research on effectiveness of food safety interventions in our country is remarkably scarce. Hence, the present study was conducted in a tertiary care hospital of north India to create evidence-based results for food safety interventions. The study was before and after intervention trial which was registered with CTRI. Data collection was paperless using a software. All food handlers ( n  = 280) working inside the hospital were recruited. Intervention package comprised Self-Instructional Manual in Hindi for food handlers, short film for sensitization of food handlers on food safety titled 'Gravy Extra', and a documentary titled 'Food Safety from farm to Fork'. Chi square test, paired t test, and Wilcoxon sign rank test were used. The mean age of food handlers was 35 ± 2 years. Majority (61.7%) of food handlers were educated less than 10th standard. Nearly 60% of them had up to five years of experience. At base line majority (68.9%) had a fair knowledge about food safety issues. There was a significant improvement in food safety knowledge and practice score of food handlers after the intervention ( p  < 0.05). Their attitude toward food safety changed in a positive direction ( p  < 0.05). The intervention package was useful in improving the knowledge, creating a positive attitude and enhancing the food safety practices of food handlers working inside a tertiary care hospital.

Insomnia in the elderly—A hospital-based study from North India

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Indrajeet Singh Gambhir, MBBS, MD; Sankha Shubhra Chakrabarti, MBBS; Amit Raj Sharma, MBBS, MD; Dharam Prakash Saran, MBBS

2014-01-01

Background/Purpose: Insomnia affects the elderly population significantly. The Indian elderly population is growing rapidly and the epidemiology of insomnia needs to be studied in detail in this group. Methods: An observational study was carried out using a standard questionnaire on 304 male and 200 female Indian elderly patients presenting to the geriatric clinic of the Sir Sunderlal Hospital of the Institute of Medical Sciences, Banaras Hindu University, to study the prevalence and natur...

Evaluation of the causes of neonatal jaundice, based on the infant’s age at disease onset and age at hospital admission

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Hassan Boskabadi

2016-01-01

Full Text Available Background: Jaundice is the most common cause of neonatal admission within the first month after birth. Therefore, by identifying the causes of jaundice based on the infant’s age at disease onset and age at hospital admission and providing the required training, jaundice can be managed and its associated complications can be prevented. This study was performed to evaluate the causes of neonatal jaundice, based on the infant’s age at disease onset and age at hospital admission. Methods: In this cross-sectional study, out of 3,130 infants with jaundice, referring to Ghaem Hospital, Mashhad, Iran, from 2003 to 2015, 2,658 newborns were selected. Causes of jaundice are determined based on hematocrit, direct and indirect bilirubin, Coombs test, reticulocyte count, blood group and Rh of mother and neonate, thyroid tests, glucose-6-phosphate dehydrogenase (G6PD enzyme testing, urinalysis, urine culture, and If necessary, Na, blood urea nitrogen, creatinine and other tests depending on the doctor's supervision. After confirming jaundice in infants, based on the physician’s diagnosis and laboratory results, a researcher-made questionnaire including the infant’s characteristics, was completed. Results: Based on our study, 27.9% of infants had identified as causes of jaundice. Known causes of jaundice were blood group incompatibility (40%, infection (19%, G6PD enzyme deficiency (12%, endocrine disorders (8%, neonatal hypernatremic dehydration (7%, polycythemia (6%, congenital heart disease (CHD (4%, occult bleeding (3% and Crigler-Najjar syndrome (2%. The most common time of hospital admission of jaundice was 4-6 days after birth due to blood incompatibilities, occult bleeding, endocrine disorders, hypernatremic dehydration, CHD, polycythemia and G6PD enzyme deficiency. Moreover, the most common time of admission due to infection was after the first week of birth. Conclusion: The most common age of onset of jaundice was first three days of birth

Patient Satisfaction Analysis in Emergency Department in Imam Reza Hospital of Mashhad

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Hamidreza Reihani

2015-01-01

Conclusion: Attempt for reducing waiting time,  providing comfort environment, increasing  the time of visit with emergency physicians and enhance service quality based on patient needs can reduce the patient dissatisfaction.

Trend of human brucellosis over a decade at tertiary care centre in North Karnataka

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D P Patil

2016-01-01

Full Text Available Background: Brucellosis is an important zoonotic disease. India having a major agrarian population is expected to have a higher prevalence. However, due to lack of laboratory facility or awareness among clinicians, the disease is largely underreported. The aim of this study was to know the prevalence and trend of human brucellosis over a decade, in patients attending a teaching hospital in North Karnataka, and to understand their geographical distribution. Materials and Methods: The study was conducted from January 2006 to December 2015 at a tertiary care teaching hospital in North Karnataka. A total of 3610 serum samples were evaluated from suspected cases of brucellosis. All serum samples were initially screened by Rose Bengal plate test, and positive samples were further analysed by Serum agglutination test (SAT using standard Brucella abortus antigen from Indian Veterinary Research Institute, Izatnagar, Uttar Pradesh, India. A titre above or equal to 1:80 IU/ml was considered as positive. Demographic data such as age, sex and native place of these patients were also analysed. Results: We observed that human brucellosis is present in North Karnataka. The overall seropositivity of brucellosis in suspected cases was 5.1%. The positive titres ranged from 1:80 to 163,840 IU/ml. The majority of the patients were from Gadag, Koppal and Haveri districts of North Karnataka. Conclusion: Our study confirms the presence of human brucellosis in the northern part of Karnataka. Further studies to understand the prevalence of animal brucellosis in these areas will help in implementing prevention measures.

An Evaluation of the Adjusted DeLone and McLean Model of Information Systems Success; the case of financial information system in Ferdowsi University of Mashhad

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Mohammad Lagzian

2012-07-01

Full Text Available Assessing the success of information systems within organizations has been identified as one of the most critical subjects of information system management in both public and private organizations. It is therefore important to measure the success of information systems from the user's perspective. The purpose of the current study was to evaluate the degree of information system success by the adjusted DeLone and McLean’s model in the field financial information system (FIS in an Iranian University. The relationships among the dimensions in an extended systems success measurement framework were tested. Data were collected by questionnaire from end-users of a financial information system at Ferdowsi University of Mashhad. The adjusted DeLone and McLean model was contained five variables (system quality, information quality, system use, user satisfaction, and individual impact. The results revealed that system quality was significant predictor of system use, user satisfaction and individual impact. Information quality was also a significant predictor of user satisfaction and individual impact, but not of system use. System use and user satisfaction were positively related to individual impact. The influence of user satisfaction on system use was insignificant

Workplace Violence against Health Care Workers in North Chinese Hospitals: A Cross-Sectional Survey.

Science.gov (United States)

Sun, Peihang; Zhang, Xue; Sun, Yihua; Ma, Hongkun; Jiao, Mingli; Xing, Kai; Kang, Zheng; Ning, Ning; Fu, Yapeng; Wu, Qunhong; Yin, Mei

2017-01-19

This research aimed to determine the prevalence of workplace violence (WPV) against healthcare workers, explore the frequency distribution of violence in different occupational groups, and determine which healthcare occupation suffers from WPV most frequently. Furthermore, the current study aimed to compare risk factors affecting different types of WPV in Chinese hospitals. A cross-sectional design was utilized. A total of 1899 healthcare workers from Heilongjiang, a province in Northeastern China, completed the questionnaire. Of the respondents, 83.3% reported exposure to workplace violence, and 68.9% reported non-physical violence. Gender, education, shift work, anxiety level, and occupation were significantly correlated with physical violence ( p gender, age, profession, anxiety, and shift work were predictive of workplace violence toward healthcare workers. Doctors appeared to experience non-physical workplace violence with particularly higher frequency when compared to nurses and other workers in hospitals. For healthcare workers, interventions aimed at WPV reduction should be enacted according to the types of violence, profession, and other factors underlying the various types of WPV in hospitals.

Selecting public relations personnel of hospitals by analytic network process.

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Liao, Sen-Kuei; Chang, Kuei-Lun

2009-01-01

This study describes the use of analytic network process (ANP) in the Taiwanese hospital public relations personnel selection process. Starting with interviewing 48 practitioners and executives in north Taiwan, we collected selection criteria. Then, we retained the 12 critical criteria that were mentioned above 40 times by theses respondents, including: interpersonal skill, experience, negotiation, language, ability to follow orders, cognitive ability, adaptation to environment, adaptation to company, emotion, loyalty, attitude, and Response. Finally, we discussed with the 20 executives to take these important criteria into three perspectives to structure the hierarchy for hospital public relations personnel selection. After discussing with practitioners and executives, we find that selecting criteria are interrelated. The ANP, which incorporates interdependence relationships, is a new approach for multi-criteria decision-making. Thus, we apply ANP to select the most optimal public relations personnel of hospitals. An empirical study of public relations personnel selection problems in Taiwan hospitals is conducted to illustrate how the selection procedure works.

Study of Genetic Diversity of Some Persian walnut Genotypes in Mashhad Commercial Orchards by using ISSR Marker

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Shadi Attar

2018-02-01

Full Text Available Introduction: Persian walnut (Juglans regia L., belonging to the Juglandaceae family, has its natural origin in the mountainous regions of central Asia and especially northern forests of Iran. Most walnut genotypes are seedling and sexually reproduced. Conducting studies on the genetic structure of these genotypes to identify, select and maintain their genetic resources is important. Identifying and collecting local varieties of fruit trees is considered as the first step on the path of breeding programs and lack of information regarding plants genetic characteristics causes the breeding work to be done slowly. Various methods have been used for studying genetic diversity and determining the genetic relationship between European and Asian varieties of walnut and identifying commercial walnut varieties, among which we can mention: Morphologic indices, Alozyme, Isozym, RFLP, RAPD, AFLP and ISSR markers. ISSR molecular marker was used in order to investigate genetic diversity of some genotypes of Persian walnut (Juglans regia L. in Mashhad orchards. . Materials and methods: To begin with, about 56 walnut trees from 4 orchards in Mashhad (Esteghlal (1, Golestan (2, Alandasht (3 and Emam Reza (4 were selected and tagged from 2014 to 2016. In the spring of 2014 with the beginning of trees growth and opening of leaves, a number of leaves from each genotype were collected. After DNA extraction, the quality of samples by agarose gel (1 percentage and electrophoresis method and quantity of them via spectrophotometer device at 260 and 280 nm wavelengths were determined. First, 24 primers of ISSR marker were prepared and after initial evaluation on 5 random genotypes, 9 primers with high polymorphism and repeatability were selected for further investigation. For PCR reaction, Amplicon kit (code 180 301, made in Denmark was used. Gel electrophoresis images of primers that produced polymorphic bands with suitable resolution were analyzed manually. After

The Management of Sexual Assault Victims at Odi District Hospital in ...

African Journals Online (AJOL)

Background: This six-month study at Odi Hospital in the district of Mabopane in the North-West Province was undertaken to gain insight into the way in which alleged sexual assault victims experienced the treatment they received from doctors, nurses and others and how the quality of the care they received can be improved.

Colorectal Cancer: A Study of Risk Factors in a Tertiary Care Hospital of North Bengal

OpenAIRE

Bhattacharya, Sumanta; Bhattacharya, Saikat; Basu, Rivu; Bera, Pranati; Halder, Aniket

2014-01-01

Aim: Age, sex, living place (urban or rural), smoking, alcohol consumption, dietary pattern, obesity are considered as risk factors for Colorectal cancer. Our study was done to evaluate the association between these risk factors and colorectal cancer in the population of North Bengal.

[Level of Development of Clinical Ethics Consultation in Psychiatry - Results of a Survey Among Psychiatric Acute Clinics and Forensic Psychiatric Hospitals].

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Gather, Jakov; Kaufmann, Sarah; Otte, Ina; Juckel, Georg; Schildmann, Jan; Vollmann, Jochen

2018-04-17

The aim of this article is to assess the level of development of clinical ethics consultation in psychiatric institutions in North Rhine-Westphalia. Survey among medical directors, directors of nursing and administrative directors of all psychiatric acute clinics and forensic psychiatric hospitals in North Rhine-Westphalia. 113 persons working in psychiatric acute clinics responded (reponse rate: 48 %) and 13 persons working in forensic psychiatric hospitals (response rate 54 %). We received at least one response from 89 % of all psychiatric acute clinics and from 100 % of all forensic psychiatric hospitals. 90 % of the responding psychiatric acute clinics and 29 % of the responding forensic psychiatric hospitals have already implemented clinical ethics consultation. Clinical ethics consultation is more widespread in psychiatric institutions than was hitherto assumed. Future medical ethics research should therefore give greater attention to the methodology and the quality of clinical ethics consultation in psychiatric practice. © Georg Thieme Verlag KG Stuttgart · New York.

The effects of regional economic integration in Europe of the pattern north-north and north-south

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Antevski Miroslav

2007-01-01

Full Text Available This paper examines the effects of regional economic integration in Europe, especially the North-North and North-South integration patterns, and how the benefits and costs of integration are divided between countries. Outcomes depend on: comparative advantages, factor endowments, factor intensities, competitive advantages, FDI flows, transfers of technology, knowledge spillovers, economies of scale, transport costs, industry/GDP ratios, and agglomeration forces. The North-North integration between high income countries tends to lead to convergence of country incomes. Contrary, the South-South integration between low income countries causes divergence. Low income countries are likely to be better served by the North-South integration.

Pilot monitoring study of ibuprofen in surface waters of north of Portugal.

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Paíga, Paula; Santos, Lúcia H M L M; Amorim, Célia G; Araújo, Alberto N; Montenegro, M Conceição B S M; Pena, Angelina; Delerue-Matos, Cristina

2013-04-01

Ibuprofen is amongst the most worldwide consumed pharmaceuticals. The present work presents the first data in the occurrence of ibuprofen in Portuguese surface waters, focusing in the north area of the country, which is one of the most densely populated areas of Portugal. Analysis of ibuprofen is based on pre-concentration of the analyte with solid phase extraction and subsequent determination with liquid chromatography coupled to fluorescence detection. A total of 42 water samples, including surface waters, landfill leachates, Wastewater Treatment Plant (WWTP), and hospital effluents, were analyzed in order to evaluate the occurrence of ibuprofen in the north of Portugal. In general, the highest concentrations were found in the river mouths and in the estuarine zone. The maximum concentrations found were 48,720 ng L(-1) in the landfill leachate, 3,868 ng L(-1) in hospital effluent, 616 ng L(-1) in WWTP effluent, and 723 ng L(-1) in surface waters (Lima river). Environmental risk assessment was evaluated and at the measured concentrations only landfill leachates reveal potential ecotoxicological risk for aquatic organisms. Owing to a high consumption rate of ibuprofen among Portuguese population, as prescribed and non-prescribed medicine, the importance of hospitals, WWTPs, and landfills as sources of entrance of pharmaceuticals in the environment was pointed out. Landfill leachates showed the highest contribution for ibuprofen mass loading into surface waters. On the basis of our findings, more studies are needed as an attempt to assess more vulnerable areas.

Workplace Violence against Health Care Workers in North Chinese Hospitals: A Cross-Sectional Survey

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Peihang Sun

2017-01-01

Full Text Available This research aimed to determine the prevalence of workplace violence (WPV against healthcare workers, explore the frequency distribution of violence in different occupational groups, and determine which healthcare occupation suffers from WPV most frequently. Furthermore, the current study aimed to compare risk factors affecting different types of WPV in Chinese hospitals. A cross-sectional design was utilized. A total of 1899 healthcare workers from Heilongjiang, a province in Northeastern China, completed the questionnaire. Of the respondents, 83.3% reported exposure to workplace violence, and 68.9% reported non-physical violence. Gender, education, shift work, anxiety level, and occupation were significantly correlated with physical violence (p < 0.05 for all correlations. Additionally, age, professional title, and occupation were correlated with non-physical violence, which critically affected doctors. Thus, gender, age, profession, anxiety, and shift work were predictive of workplace violence toward healthcare workers. Doctors appeared to experience non-physical workplace violence with particularly higher frequency when compared to nurses and other workers in hospitals. For healthcare workers, interventions aimed at WPV reduction should be enacted according to the types of violence, profession, and other factors underlying the various types of WPV in hospitals.

Investigating the Relationship between Anxiety of School-age Children Undergoing Surgery and Parental State-trait Anxiety

OpenAIRE

Fatemeh Heshmati Nabavi; Malihe Shoja; Monir Ramezani; Azadeh Saki; Marjan Joodi

2017-01-01

Background: Surgery is a stressful experience for children, and preoperative anxiety in children could be affected by the level of parental anxiety. Aim: The aim of this study was to determine the relationship between anxiety in school-age children before surgery and parental state-trait anxiety. Method: This descriptive study was performed on 81 children within the age group of 6-12 years admitted for elective surgical operation and 128 parents in Doctor Sheikh Hospital, Mashhad, Iran, 2016....

Ophthalmic, Hearing, Speaking and School Readiness Outcomes in Low Birth Weight and Normal Birth Weight Primary School Children in Mashhad-Iran

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Ashraf Mohammadzadeh

2011-01-01

Full Text Available Low Birth weight infants are at risk of many problems. Therefore their outcome must evaluate in different ages especially in school age. In this study we determined prevalence of ophthalmic, hearing, speaking and school readiness problems in children who were born low birth weight and compared them with normal birth weight children. In a cross-sectional and retrospective study, all Primary School children referred to special educational organization center for screening before entrance to school were elected in Mashhad, Iran. In this study 2400 children enrolled to study and were checked for ophthalmic, hearing, speaking and school readiness problems by valid instrument. Data were analyzed by SPSS 11.5. This study showed that 8.3% of our population had birth weight less than 2500 gram. Visual impairment in LBW (Low Birth Weight and NBW (Normal Birth Weight was 8.29% vs. 5.74% and there was statistically significant difference between them (P=0.015. Hearing problem in LBW and NBW was 2.1% vs. 1.3 and it was not statistically significant. Speaking problem in LBW and NBW was 2.6% vs. 2.2% and it was not statistically significant. School readiness problem in LBW and NBW was 12.4% vs. 5.8% and it was statistically significant (P<0.001. According to the results, neurological problems in our society is more than other society and pay attention to this problem is critical. We believe that in our country, it is necessary to provide a program to routinely evaluate LBW children.

Resurgence of diphtheria in rural areas of North Karnataka, India.

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Parande, Mahantesh V; Roy, Subarna; Mantur, B G; Parande, Aisha M; Shinde, Rupali S

2017-01-01

A diphtheria outbreak was identified from Vijayapura (formerly Bijapur) district in the South Indian state of Karnataka in 2011. There was a surge in the number of throat swab samples received under the Integrated Disease Surveillance Programme (IDSP) in North Karnataka since then. A microbiological study was undertaken to generate information on the status of resurgence of the disease in the region. Throat swabs from 432 suspected cases of diphtheria during 2012-2015 were obtained from government hospitals and primary health centres of 8 districts in North Karnataka and were processed for the culture and identification of Corynebacterium diphtheriae. Polymerase chain reaction for the presence of toxin gene (toxA and toxB) was carried out on the isolates. Antibiotic sensitivity tests were performed on the isolates with a panel of 14 antibiotics. Thirty-eight (8.79%) out of 432 samples yielded C. diphtheriae on culture. All isolates possessed the diphtheria toxin gene. Out of the 38 confirmed cases, whereas 21 (55.26%) were between 1 and 5 years of age, 14 (36.84%) were aged between 5 and 10 years. Male children were three times more than females in confirmed cases. No information was available on the immunisation status of the cases. Emergence of resistance to penicillin was found with minimum inhibitory concentration reaching up to 6.00 μg/ml. Our study identified an upsurge in cases of diphtheria in North Karnataka, particularly in Vijayapura District, and to the best of our knowledge, reports the emergence of penicillin resistance for the first time in India. The study calls for enhanced surveillance for the disease, making antidiphtheritic serum available in key hospitals in the region and serves to provide a baseline for future assessment of the impact of the recently launched 'Mission Indradhanush' programme in strengthening Universal Immunisation Programme (UIP).

A survey on the quality of Master of Medical Education e-learning Course at Mashhad University of Medical Sciences

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M nobakht

2017-03-01

Full Text Available Introduction:Universities and educational institutes provide a great variety of e-learning programs to accommodate the increasing demands for higher education. However, some specialists believe that many of these courses fail to meet the required standards of e-learning, thus cannot achieve the goals of implemented programs. Therefore, regular quality assessment of e-learning programs should be carried out by education providers. This study aimed to assess the quality of medical education e-learning course at Mashhad University of Medical Science. Methods:In the first step, most important components of e-learning standards were extracted through a comprehensive literature review of previous studies and a rating scale consisting of nine elements and 173 items were designed. Content validity of the scale was assured by consulting with ten different instructional design experts using Lawshe's Content Validity Ratio. Reliability of this scale is also investigated by inter-rater reliability coefficient which was 88% . In the next step we provided three instructional design experts with the above mentioned scale to collect required information for each sample lesson. Data was analyzed through SPSS Ver 16.0 software. Result: The elements associated with ‘quality of contents’ and ‘accessibility’ were satisfactory, elements related to ‘instructional design’, ’learning management system’, ’multimedia’ and ‘student assessment’ were relatively satisfactory, and elements associated with ‘interaction’, ‘feedback’ and ‘student support’ were unsatisfactory. Overall, we evaluated the quality of the medical education e-learning course as relatively satisfactory. Conclusion: Although the quality of the assessed e-learning course was relatively satisfactory, it is still necessary for corresponding administrators to reassess those items with an average of less than 1.66 (satisfactory level and pay their special attentions to

The Relationship between Maternal-Fetal Attachment and Mother-Infant Attachment Behaviors in Primiparous Women Referring to Mashhad Health Care Centers

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Mahin Taffazoli

2015-04-01

Full Text Available Background & aim: Mother-infant bonding and interactions after childbirth are shaped by maternal-fetal attachment during pregnancy. Although many studies have shown the positive correlation between maternal-fetal attachment and mother-infant attachment behaviors, some controversial studies have shown otherwise. Therefore, this study aimed to evaluate the correlation between maternal-fetal attachment and mother-infant attachment behaviors in primiparous women. Methods:This descriptive correlational study was conducted on 100 primiparous women, referring to the selected heath care centers of Mashhad. Data were collected using Cranley's maternal–fetal attachment scale, Avant’s mother-infant attachment tool, Edinburgh postnatal depression scale, and a demographic/obstetric questionnaire including demographic data, obstetric information, delivery outcomes, and postpartum data. Pregnant women with a gestational age of 35-41 weeks, who met the inclusion criteria, completed Cranley's questionnaire, as well as the demographic/obstetric questionnaire. Four and eight weeks after delivery, the subjects were asked to complete the Edinburgh questionnaire and postpartum information; then, they were asked to breastfeed their infants on a chair in a quiet place for 15 minutes. The researcher observed the mothers’ behaviors toward their neonates. For data analysis, descriptive and analytical tests were performed, using SPSS version 16. Results: There was a direct positive relationship between maternal-fetal attachment and mothers’ emotional behaviors toward infants four and eight weeks after delivery. However, four and eight weeks after childbirth, no significant correlation was found between maternal-fetal attachment and mothers’ caring behaviors. Conclusion: According to the findings, maternal-fetal attachment is one of the most important factors for mother-infant attachment. These findings could be applied for enriching mother-infant attachment

Improved Ascertainment of Pregnancy-Associated Suicides and Homicides in North Carolina.

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Austin, Anna E; Vladutiu, Catherine J; Jones-Vessey, Kathleen A; Norwood, Tammy S; Proescholdbell, Scott K; Menard, M Kathryn

2016-11-01

Injuries, including those resulting from violence, are a leading cause of death during pregnancy and the postpartum period. North Carolina, along with other states, has implemented surveillance systems to improve reporting of maternal deaths, but their ability to capture violent deaths is unknown. The purpose of this study was to quantify the improvement in ascertainment of pregnancy-associated suicides and homicides by linking data from the North Carolina Violent Death Reporting System (NC-VDRS) to traditional maternal mortality surveillance files. Enhanced case ascertainment was used to identify suicides and homicides that occurred during or up to 1 year after pregnancy from 2005 to 2011 in North Carolina. NC-VDRS data were linked to traditional maternal mortality surveillance files (i.e., death certificates with any mention of pregnancy or matched to a live birth or fetal death record and hospital discharge records for women who died in the hospital with a pregnancy-related diagnosis). Mortality ratios were calculated by case ascertainment method. Analyses were conducted in 2015. A total of 29 suicides and 55 homicides were identified among pregnant and postpartum women through enhanced case ascertainment as compared with 20 and 34, respectively, from traditional case ascertainment. Linkage to NC-VDRS captured 55.6% more pregnancy-associated violent deaths than traditional surveillance alone, resulting in higher mortality ratios for suicide (2.3 vs 3.3 deaths per 100,000 live births) and homicide (3.9 vs 6.2 deaths per 100,000 live births). Linking traditional maternal mortality files to NC-VDRS provided a notable improvement in ascertainment of pregnancy-associated violent deaths. Published by Elsevier Inc.

2014 outbreak of enterovirus D68 in North America.

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Messacar, Kevin; Abzug, Mark J; Dominguez, Samuel R

2016-05-01

Enterovirus D68 (EV-D68) is an emerging picornavirus which causes severe respiratory disease, predominantly in children. In 2014, the largest and most widespread outbreak of EV-D68 described to date was reported in North America. Hospitals throughout the United States and Canada reported surges in patient volumes and resource utilization from August to October, 2014. In the US a total of 1,153 infections were confirmed in 49 states, although this is an underestimate of the likely millions of cases that occurred but were not tested. EV-D68 was detected in 14 patients who died; the role of the virus in these deaths is unknown. A possible association between EV-D68 and cases of acute flaccid paralysis with spinal cord gray matter lesions, known as acute flaccid myelitis, was observed during the outbreak and is under investigation. The 2014 outbreak of EV-D68 in North America demonstrates the public health importance of this emerging pathogen. © 2015 Wiley Periodicals, Inc.

Emergency Response of Iranian Hospitals Against Disasters: A Practical Framework for Improvement.

Science.gov (United States)

Janati, Ali; Sadeghi-Bazargani, Homayoun; Hasanpoor, Edris; Sokhanvar, Mobin; HaghGoshyie, Elaheh; Salehi, Abdollah

2018-04-01

Hospital emergency management is a continuous process that requires monolithic integration of planning and response attempts with local and national schemes. The aim of the current study is to evaluate emergency response by hospitals against potential disasters in Tabriz, north-west Iran. A cross-sectional study was conducted in the city of Tabriz, in Iran, in 2016. The study population included all hospitals in Tabriz. A total of 18 hospitals were assessed. The hospital emergency response checklist was used to collect data. Tool components included command and control, communication, safety and security, triage, surge capacity, continuity of essential services, human resources, logistics and supply management, and post-disaster recovery. Data entry and analysis were carried out using SPSS software (version 20). The results showed that the emergency response rate of hospitals was 54.26% in Tabriz. The lowest response rates were for Shafaa hospital (18.89%) and the highest response rates were for Razi Hospital (91.67%). The components of hospital emergency response were assessed to be between 48.07% (surge capacity) and 58.95% (communication). On the basis of the World Health Organization checklist, the emergency response rate for hospitals in Tabriz was only 54.26%. Therefore, hospital emergency responses against disasters have to be improved and must be made to reach 100%. It is essential to design a comprehensive framework for hospital emergency response. (Disaster Med Public Health Preparedness. 2018;12:166-171).

The profile of infertility in a teaching Hospital in North West Nigeria

OpenAIRE

Abubakar A Panti; Yusuf T Sununu

2014-01-01

Background: Infertility is a global health problem and a socially destabilizing condition for couples carrying several stigmas and a cause of marital disharmony. We determined the prevalence, causes, and clinical pattern of infertility at Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto. Materials and Methods: This was a prospective study conducted at the Gynecological Department of UDUTH Sokoto between 1 st January, 2011 and 31 st July, 2011. All the patients that presented with...

Interannual variability of western North Pacific SST anomalies and its impact on North Pacific and North America

Science.gov (United States)

Park, Jae-Heung; An, Soon-Il; Kug, Jong-Seong

2017-12-01

In this study, the interannual variability of sea surface temperature (SST) and its atmospheric teleconnection over the western North Pacific (WNP) toward the North Pacific/North America during boreal winter are investigated. First, we defined the WNP mode as the first empirical orthogonal function (EOF) mode of SST anomalies over the WNP region (100-165°E, 0-35°N), of which the principle component time-series are significantly correlated with several well-known climate modes such as the warm pool mode which is the second EOF mode of the tropical to North Pacific SST anomalies, North Pacific oscillation (NPO), North Pacific gyre oscillation (NPGO), and central Pacific (CP)-El Niño at 95% confidence level, but not correlated with the eastern Pacific (EP)-El Niño. The warm phase of the WNP mode (sea surface warming) is initiated by anomalous southerly winds through reduction of wind speed with the background of northerly mean winds over the WNP during boreal winter, i.e., reduced evaporative cooling. Meanwhile, the atmospheric response to the SST warming pattern and its diabatic heating further enhance the southerly wind anomaly, referred to the wind-evaporation-SST (WES) feedback. Thus, the WNP mode is developed and maintained through winter until spring, when the northerly mean wind disappears. Furthermore, it is also known that anomalous upper-level divergence associated with WNP mode leads to the NPO-like structure over the North Pacific and the east-west pressure contrast pattern over the North America through Rossby wave propagation, impacting the climate over the North Pacific and North America.

A Study on the Application of Different Types of Mulches on Some Growth Characteristics of Two Varieties of Tagetes in Mashhad Urban Vegetation

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P. Pakdel

2015-01-01

Full Text Available In this study, the effects of four types of mulch including wood chips, municipal compost, sawdust and gravel in three different thicknesses on temperature soil, moisture and growth characteristics of two cultivars of Tagetes (Tagetes patella var Durango Bee and Tagetes erecta var Antigua were examined in Mashhad area with semi-arid climate. The research was conducted as a split plot based on a completely random block design with four replications. Treatments included control (no mulching and four types of mulch including wood chips, municipal compost, sawdust and gravel in three thickness levels (4, 8 and 12 cm. During the study, soil moisture and temperature, total flower number, fresh and dry weight of plant, plant height and fresh weight of root were measured. Sawdust mulch with 12 cm thickness had the highest soil moisture (23.62% and lowest soil temperature (25.01ºC, and led to greater increases in growth characteristics of the two cultivars. In both cultivars, increasing of mulch thickness led to the increased rate of growth. The Antigua cultivar showed a better vegetative growth, smaller flower number, and larger flowers in comparison with Durango Bee cultivar. All mulch types were significantly different from control. Overall, in both cultivars the highest and smallest growth taits were detected in sawdust and control, respectively. It seems that sawdust by preserving soil moisture and reducing drought stress out performs the other mulches in dry and semi-arid areas.

Hospital Presbiteriano Valley

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Luckman, Charles

1964-12-01

Full Text Available This hospital is built on the circular system. This arrangement has economic and functional advantages. The nurses walk 40 % less distance than in a hospital of similar size, of conventional layout. The rooms are situated along the external perimeter and the beds are orientated towards the corridor, rather than towards the window. However, the patients can see out of doors by turning on their side. The hospital is most carefully fitted out, and is very comfortable. There is air conditioning, and patients can control their own TV sets. There are also curtains separating each bed form the rest, thus providing maximum independence. Warm colours have been adopted in the decoration of rooms facing north, whilst those facing south are painted in cooler tones. The circular design arrangement makes the distribution far more flexible, and it will be easier to include further units later on; by adding small adjustments to the central building. To reduce external noise, and to improve the surrounding landscape, small sand hills have been provided in the garden, and the parking site also serves to partially absorb the noise.Presenta esta solución de unidades circulares numerosas ventajas de tipo económico, ahorra espacio y da eficiencia a la circulación— las enfermeras recorren un 40 por 100 menos de camino que en otro hospital de dimensiones similares—. Las habitaciones están distribuidas a lo largo del perímetro exterior y tienen las camas orientadas hacia los corredores, en lugar de hacia las ventanas, pero de tal modo que los pacientes puedan contemplar el exterior al volverse sobre uno de sus costados. Están cuidadosamente diseñadas y dotadas de las máximas comodidades: aire acondicionado y aparatos de televisión controlados por el paciente; así como cortinas divisorias que le proporcionan el grado de aislamiento deseado.

Factors associated with pneumonia in Yanomami children hospitalized for Ambulatory Care sensitive conditions in the north of Brazil.

Science.gov (United States)

Caldart, Raquel Voges; Marrero, Lihsieh; Basta, Paulo Cesar; Orellana, Jesem Douglas Yamall

2016-05-01

In developing countries, pneumonia is the leading cause of sickness and mortality in childhood, especially among vulnerable groups. The scope of this study was to analyze the factors associated with pneumonia in Yanomami children hospitalized for Ambulatory Care Sensitive Conditions (ACSC). Hospital admissions were divided into two groups: i) pneumonia; and ii) other causes, according to the Brazilian ACSC list. Adjusted hospitalization rates were estimated and unconditional logistic regression was used to analyze factors associated with pneumonia. Over 90% of the registered cases were considered ACSC. The adjusted rate of ACSC was 18.6/1000. The odds ratio of hospitalization for pneumonia was 2.7 (CI: 1.3-5.4) times higher in children aged between 0.1 and 5.9 months; 1.9 (CI: 1.1-3.3) times higher in children who were hospitalized for 8-14 days; and three (CI: 1.2-7.5) times higher in children with a secondary diagnosis of malnutrition. The excess of avoidable hospitalizations is a clear indication of the low quality of care and limited accessibility to primary health care in indigenous territories, which is contrary to the assistance model proposed by the indigenous healthcare subsystem in Brazil, which should in theory focus on welfare technologies based on primary health care.

Hospital organizational response to the nuclear accident at Three Mile Island: implications for future-oriented disaster planning

International Nuclear Information System (INIS)

Maxwell, C.

1982-01-01

The 1979 nuclear accident at Three Mile Island (TMI) near Harrisburg, Pennsylvania, caused severe organizational problems for neighboring health care institutions. Dauphin County, just north of TMI, contained four hospitals ranging in distance from 9.5 to 13.5 miles from the stricken plant. Crash plans put into effect within 48 hours of the initial incident successfully reduced hospital census to below 50 per cent of capacity, but retained bedridden and critically ill patients within the risk-zone. No plans existed for area-wide evacuation of hospitalized patients. Future-oriented disaster planning should include resource files of host institution bed capacity and transportation capabilities for the crash evacuation of hospitalized patients during non-traditional disasters

Growth Comparison of Red Jabon in North Bolaang Mongondow and North Minahasa

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arif irawan

2016-04-01

Full Text Available Red Jabon is priority species that projected to be developed in plantation forests of North Minahasa Regency. Red Jabon is can adapt well various environmental conditions. The natural habitat of the red Jabon in North Sulawesi region was known in North Bolaang Mongondow. This study aimed to compare the growth of red jabon at the age of 1 year in North Minahasa Regency and North Bolaang Mongondow. The experiment was conducted in two (2 locations i.e. in Talawaan Village (North Minahasa Regency and Nunuka Village (North Bolaang Mongondow. Two independent samples t test was conducted to determine the differences in height and diameter growth parameters at two test sites.The results showed that there was no difference in the growth of red Jabon between North Minahasa and North Bolaang Mongondow. The average height and diameter of red Jabon in North Minahasa Regency is at 215.84 cm and 4.34 cm, while the same parameters of North Bolaang Mongondow amounted to 231.79 cm and 4.14 cm. The development efforts on the plantations of red Jabon North Minahasa Regency need to be improved because of the environmental conditions in this region is very suitable for the growth of red Jabon.

The pattern of acute poisoning in a teaching hospital, north-west Ethiopia.

Science.gov (United States)

Abula, Teferra; Wondmikun, Yared

2006-04-01

Poisoning by means of hazardous chemicals through ignorance, mishap or intentionally is becoming a serious health problem worldwide. Epidemiological data on this important health issue are, however, scarce in Ethiopia. The purpose of this study is to assess the pattern of acute poisonings and determine the approaches employed for the management of poisoning. The medical records of patients with acute poisonings presented to the Gondar University hospital between July 2001 and June 2004 were reviewed retrospectively. One hundred and two patients presenting to the emergency department of the hospital were due to acute poisoning; accounting for about 0.45% of emergency room admissions. Organophosphates, rat poison and alcohol were the commonly encountered poisoning agents (in about 70% of cases) mainly in adults possibly with suicidal or para-suicidal intention. The approaches employed in the management of poisoning mainly involved gastrointestinal decontamination procedures. Specific antidotes were used in a substantial number of patients. The fatality rate was 2.4%. Poisoning with suicidal intention is becoming a serious health problem particularly in adults. Pesticides are commonly used toxicants. The approaches in the management of poisoning are justifiable in some cases. However, much is to be done to improve the recording of patient-related information and record-keeping processes. Further large scale studies are required to investigate national trends of poisoning and factors associated with poisoning.

Bourdieu at the bedside: briefing parents in a pediatric hospital.

Science.gov (United States)

LeGrow, Karen; Hodnett, Ellen; Stremler, Robyn; McKeever, Patricia; Cohen, Eyal

2014-12-01

The philosophy of family-centered care (FCC) promotes partnerships between families and staff to plan, deliver, and evaluate services for children and has been officially adopted by a majority of pediatric hospitals throughout North America. However, studies indicated that many parents have continued to be dissatisfied with their decision-making roles in their child's care. This is particularly salient for parents of children with chronic ongoing complex health problems. These children are dependent upon medical technology and require frequent hospitalizations during which parents must contribute to difficult decisions regarding their child's care. Given this clinical issue, an alternative theoretical perspective was explored to redress this problem. Pierre Bourdieu's theoretical concepts of field, capital, and habitus were used to analyze the hierarchical relationships in pediatric acute care hospitals and to design a briefing intervention aimed at improving parents' satisfaction with decision making in that health care setting. © 2014 John Wiley & Sons Ltd.

AKI in Children Hospitalized with Nephrotic Syndrome.

Science.gov (United States)

Rheault, Michelle N; Zhang, Lei; Selewski, David T; Kallash, Mahmoud; Tran, Cheryl L; Seamon, Meredith; Katsoufis, Chryso; Ashoor, Isa; Hernandez, Joel; Supe-Markovina, Katarina; D'Alessandri-Silva, Cynthia; DeJesus-Gonzalez, Nilka; Vasylyeva, Tetyana L; Formeck, Cassandra; Woll, Christopher; Gbadegesin, Rasheed; Geier, Pavel; Devarajan, Prasad; Carpenter, Shannon L; Kerlin, Bryce A; Smoyer, William E

2015-12-07

Children with nephrotic syndrome can develop life-threatening complications, including infection and thrombosis. While AKI is associated with adverse outcomes in hospitalized children, little is known about the epidemiology of AKI in children with nephrotic syndrome. The main objectives of this study were to determine the incidence, epidemiology, and hospital outcomes associated with AKI in a modern cohort of children hospitalized with nephrotic syndrome. Records of children with nephrotic syndrome admitted to 17 pediatric nephrology centers across North America from 2010 to 2012 were reviewed. AKI was classified using the pediatric RIFLE definition. AKI occurred in 58.6% of 336 children and 50.9% of 615 hospitalizations (27.3% in stage R, 17.2% in stage I, and 6.3% in stage F). After adjustment for race, sex, age at admission, and clinical diagnosis, infection (odds ratio, 2.24; 95% confidence interval, 1.37 to 3.65; P=0.001), nephrotoxic medication exposure (odds ratio, 1.35; 95% confidence interval, 1.11 to 1.64; P=0.002), days of nephrotoxic medication exposure (odds ratio, 1.10; 95% confidence interval, 1.05 to 1.15; Pchildren with nephrotic syndrome. Nephrotoxic medication exposure was common in this population, and each additional nephrotoxic medication received during a hospitalization was associated with 38% higher risk of AKI. AKI was associated with longer hospital stay after adjustment for race, sex, age at admission, clinical diagnosis, and infection (difference, 0.45 [log]days; 95% confidence interval, 0.36 to 0.53 [log]days; Pchildren hospitalized with nephrotic syndrome and should be deemed the third major complication of nephrotic syndrome in children in addition to infection and venous thromboembolism. Risk factors for AKI include steroid-resistant nephrotic syndrome, infection, and nephrotoxic medication exposure. Children with AKI have longer hospital lengths of stay and increased need for intensive care unit admission. Copyright © 2015 by the

Depressive Affect and Hospitalization Risk in Incident Hemodialysis Patients

Science.gov (United States)

Bruce, Lisa; Li, Nien-Chen; Mooney, Ann; Maddux, Franklin W.

2014-01-01

Background and objectives Recent studies demonstrated an association between depressive affect and higher mortality risk in incident hemodialysis patients. This study sought to determine whether an association also exists with hospitalization risk. Design, setting, participants, & measurements All 8776 adult incident hemodialysis patients with Medical Outcomes Study Short Form 36 survey results treated in Fresenius Medical Care North America facilities in 2006 were followed for 1 year from the date of survey, and all hospitalization events lasting >24 hours were tracked. A depressive affect score was derived from responses to two Medical Outcomes Study Short Form 36 questions (“down in the dumps” and “downhearted and blue”). A high depressive affect score corresponded with an average response of “some of the time” or more frequent occurrence. Cox and Poisson models were constructed to determine associations of depressive affect scores with risk for time to first hospitalization and risk for hospitalization events, as well as total days spent in the hospital, respectively. Results Incident patients with high depressive affect score made up 41% of the cohort and had a median (interquartile range) hospitalization event rate of one (0, 3) and 4 (0, 15) total hospital days; the values for patients with low depressive affect scores were one (0, 2) event and 2 (0, 11) days, respectively. For high-scoring patients, the adjusted hazard ratio for first hospitalization was 1.12 (1.04, 1.20). When multiple hospital events were considered, the adjusted risk ratio was 1.13 (1.02, 1.25) and the corresponding risk ratio for total hospital days was 1.20 (1.07, 1.35). High depressive affect score was generally associated with lower physical and mental component scores, but these covariates were adjusted for in the models. Conclusions Depressive affect in incident hemodialysis patients was associated with higher risk of hospitalization and more hospital days. Future

Fat embolism syndrome in long bone trauma following vehicular accidents: Experience from a tertiary care hospital in north India

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Parvaiz A Koul

2013-01-01

Full Text Available Background: Fat embolism syndrome (FES is a clinical problem arising mainly due to fractures particularly of long bones and pelvis. Not much literature is available about FES from the Indian subcontinent. Materials and Methods: Thirty-five patients referred/admitted prospectively over a 3-year period for suspected FES to a north Indian tertiary care center and satisfying the clinical criteria proposed by Gurd and Wilson, and Schonfeld were included in the study. Clinical features, risk factors, complications, response to treatment and any sequelae were recorded. Results: The patients (all male presented with acute onset breathlessness, 36-120 hours following major bone trauma due to vehicular accidents. Associated features included features of cerebral dysfunction ( n = 24, 69%, petechial rash (14%, tachycardia (94% and fever (46%. Hypoxemia was demonstrable in 80% cases, thrombocytopenia in 91%, anemia in 94% and hypoalbuminemia in 59%. Bilateral alveolar infiltrates were seen on chest radiography in 28 patients and there was evidence of bilateral ground glass appearance in 5 patients on CT. Eleven patients required ventilatory assistance whereas others were treated with supportive management. Three patients expired due to associated sepsis and respiratory failure, whereas others recovered with a mean hospital stay of 9 days. No long term sequelae were observed. Conclusion: FES remains a clinical challenge and is a diagnosis of exclusion based only on clinical grounds because of the absence of any specific laboratory test. A high index of suspicion is required for diagnosis and initiating supportive management in patients with traumatic fractures, especially in those having undergone an invasive orthopedic procedure.

65 Nigerian Journal of Chemical Research Vol.12, 2007 ...

African Journals Online (AJOL)

HP USER

Comparison of Experimental and Theoretical study of Solvent effect on Interfacial head group ... Department of Biochemistry, Mashhad Islamic Azad university of Medical science, Mashhad. ..... atoms were involved in critical dihedral angles,.

Botanical Criteria of Baharkish Rangeland in Quchan, Khorasan ...

African Journals Online (AJOL)

ADOWIE PERE

University of Mashhad International Campus, Mashhad, I.R of IRAN ... ABSTRACT: Rangelands are natural ecosystems containing a range of resources of genetic ..... Ecology of world vegetation. .... Science Journal of Islamic Azad University,.

Psychiatric units in Brazilian general hospitals: a growing philanthropic field.

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Botega, Neury José

2002-06-01

Some countries, mainly in North America and Europe, have adopted psychiatric wards in the general hospital as an alternative to the classic psychiatric hospital. In Brazil there are 6,169 general hospitals, 1.3% of which with a psychiatric unit. This service strategy is scarcely developed in the country and comprises only 4% of all psychiatric admissions. There was no information on the facilities and functioning of the psychiatric units in general hospitals. To determine the main characteristics of psychiatric units in Brazilian general hospitals and to assess the current trends in the services provided. A mailing survey assessed all 94 Brazilian general hospitals which made psychiatric admissions. A two-page questionnaire was designed to determine the main characteristics of each institution and of the psychiatric unit. Seventy-nine (84%) questionnaires were returned. In contrast to the 1970s and 1980s, in the last decade the installation of psychiatric units has spread to smaller philanthropic institutions that are not linked to medical schools. A fifth of hospitals admit psychiatric patients to medical wards because there is no specialist psychiatric ward. They try to meet all the local emergency demands, usually alcohol-dependent patients who need short term admission. This could signal the beginning of a program through which mental health professionals may become an integral part of general health services. The inauguration of psychiatric wards in philanthropic hospitals, as well as the admission of psychiatric patients in their medical wards, is a phenomenon peculiar to this decade. The installation of psychiatric services in these and other general hospitals would overcome two of major difficulties encountered: prejudice and a lack of financial resources.

North by Northwestern: initial experience with PACS at Northwestern Memorial Hospital

Science.gov (United States)

Channin, David S.; Hawkins, Rodney C.; Enzmann, Dieter R.

2000-05-01

This paper describes the initial phases and configuration of the Picture Archive and Communication System (PACS) deployed at Northwestern Memorial Hospital. The primary goals of the project were to improve service to patients, improve service to referring physicians, and improve the process of radiology. Secondary goals were to enhance the academic mission, and modernize institutional information systems. The system consists of a large number of heterogeneous imaging modalities sending imaging studies via DICOM to a GE medical Systems PathSpeed PACS. The radiology department workflow is briefly described. The system is currently storing approximately 140,000 studies and over 5 million images, growing by approximately 600 studies and 25,000 images per day. Data reflecting use of the short term and long term storage is provided.

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...

Charles Bernard Puestow (1902-1973): American surgeon and commander of the 27th Evacuation Hospital during the Second World War.

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Bosmia, Anand N; Christein, John D

2017-08-01

Dr. Charles Bernard Puestow (1902-1973) was an American surgeon who is well known for developing the longitudinal pancreaticojejunostomy, which is known as the "Puestow procedure" in his honor. Puestow served in the American military during the Second World War and commanded the 27th Evacuation Hospital, which provided medical and surgical services to wounded individuals in Europe and North Africa. In 1946, he founded the surgical residency training program at the Hines Veterans Hospital, which was the first such program in the United States based at a veterans hospital.

Healthcare associated infections in Paediatric Intensive Care Unit of a tertiary care hospital in India: Hospital stay & extra costs.

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Sodhi, Jitender; Satpathy, Sidhartha; Sharma, D K; Lodha, Rakesh; Kapil, Arti; Wadhwa, Nitya; Gupta, Shakti Kumar

2016-04-01

Healthcare associated infections (HAIs) increase the length of stay in the hospital and consequently costs as reported from studies done in developed countries. The current study was undertaken to evaluate the impact of HAIs on length of stay and costs of health care in children admitted to Paediatric Intensive Care Unit (PICU) of a tertiary care hospital in north India. This prospective study was done in the seven bedded PICU of a large multi-specialty tertiary care hospital in New Delhi, India. A total of 20 children with HAI (cases) and 35 children without HAI (controls), admitted to the PICU during the study period (January 2012 to June 2012), were matched for gender, age, and average severity of illness score. Each patient's length of stay was obtained prospectively. Costs of healthcare were estimated according to traditional and time driven activity based costing methods approach. The median extra length of PICU stay for children with HAI (cases), compared with children with no HAI (controls), was seven days (IQR 3-16). The mean total costs of patients with and without HAI were ' 2,04,787 (US$ 3,413) and ' 56,587 (US$ 943), respectively and the mean difference in the total cost between cases and controls was ' 1,48,200 (95% CI 55,716 to 2,40,685, pcosts for PICU patients, especially costs due to prolongation of hospital stay, and suggests the need to develop effective strategies for prevention of HAI to reduce costs of health care.

Resurgence of diphtheria in rural areas of North Karnataka, India

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Mahantesh V Parande

2017-01-01

Full Text Available Background: A diphtheria outbreak was identified from Vijayapura (formerly Bijapur district in the South Indian state of Karnataka in 2011. There was a surge in the number of throat swab samples received under the Integrated Disease Surveillance Programme (IDSP in North Karnataka since then. Objectives: A microbiological study was undertaken to generate information on the status of resurgence of the disease in the region. Materials and Methods: Throat swabs from 432 suspected cases of diphtheria during 2012–2015 were obtained from government hospitals and primary health centres of 8 districts in North Karnataka and were processed for the culture and identification of Corynebacterium diphtheriae. Polymerase chain reaction for the presence of toxin gene (toxA and toxB was carried out on the isolates. Antibiotic sensitivity tests were performed on the isolates with a panel of 14 antibiotics. Results: Thirty-eight (8.79% out of 432 samples yielded C. diphtheriae on culture. All isolates possessed the diphtheria toxin gene. Out of the 38 confirmed cases, whereas 21 (55.26% were between 1 and 5 years of age, 14 (36.84% were aged between 5 and 10 years. Male children were three times more than females in confirmed cases. No information was available on the immunisation status of the cases. Emergence of resistance to penicillin was found with minimum inhibitory concentration reaching up to 6.00 μg/ml. Conclusion and Discussion: Our study identified an upsurge in cases of diphtheria in North Karnataka, particularly in Vijayapura District, and to the best of our knowledge, reports the emergence of penicillin resistance for the first time in India. The study calls for enhanced surveillance for the disease, making antidiphtheritic serum available in key hospitals in the region and serves to provide a baseline for future assessment of the impact of the recently launched 'Mission Indradhanush' programme in strengthening Universal Immunisation Programme

I. Monographic Section
Hospitals, money and other riches. Writing and practising economy in late medieval Italian charitable institutions

OpenAIRE

Marina Gazzini (a cura di); Antonio Olivieri (a cura di)

2016-01-01

The section contains contributions focusing on the practices and records relating to the economics of hospitals in late medieval Italy. Experts from different disciplines – economic historians, historians of the document, historians of the Middle Ages and of welfare institutions – offer a significant overview of hospitals situated in the north, the center and the south of the Italian peninsula between the fourteenth and sixteenth centuries. They investigate the mechanisms of funding of charit...

The North Zealand CAP Monitor

DEFF Research Database (Denmark)

Nielsen, Minna; Ravn, Pernille; Notander Clausen, Lise

with CAP. We started with 34 audit variables. Through repeated cycles of testing, feedback and discussions, we reduced the number of indicators to 22 and time per audit from 20 to 10 minutes. Strategy for change To link the monitoring system with our patient pathway for CAP we established an improvement...... Designing a database Designing and testing a dashboard to present indicators in a balanced way Messages for others Auditing patients with a common disease as CAP is useful to identify areas for improvement for a large group of patients. The baseline audit can serve as a basis for a monitoring system......Contect We describe how we developed a monitoring system for community acquired pneumonia (CAP) at North Zealand Regional hospital. We serve 310.000 inhabitants and annually around 3200 patients with CAP are admitted. As part of a program of clinical pathways for common conditions, a pathway...

Independent Predictive Factors of Hospitalization in a North-West Burn Center of Iran; an Epidemiologic Study

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Samad Shams Vahdati

2015-01-01

Full Text Available Introduction: A high grade burn is one of the most devastating injuries with several medical, social, economic, and psychological effects. These injuries are the most common cause of accidental deaths after traffic injuries in both the developed and developing countries. Therefore this research was aimed to determine demographic characteristics of patients with burn injury admitted to the emergency department and identify predictive factors of hospitalization. Methods: This is a cross sectional descriptive study, which is done in 20 March up to 20 September 2011 in emergency department of Sina Hospital, Tabriz, Iran. Patients’ information including demographic characteristic, cause of burn, place of accident, anatomical areas burned, grading and percent of burning and disposition were gathered and analyzed using SPSS version 18.0 statistical software. Stepwise multivariate regression analysis was used for recognition of independent predictive factors of hospitalization in burned patients. Results: One hundred and sixty patients were enrolled (54.4% female. The average age of those was 20.47±13.5 years. The prevalence of burn was significantly higher in ages under 20 years (p<0.001. Lower limb (37.5%, head and neck (21.25% and upper limb (17.5% were three frequent site of burn. The most common cause of burns was boiling water scalding (34.4%. Home related burn was significantly higher than other place (p<0.001. The most frequent percent of burn was <5% (46.25%. Finally 50 (31.25% cases hospitalized. Univariate analysis demonstrated that age under 20 years old (p=0.02 female gender (p=0.02, burning site (p=0.002, cause (p=0.005, place (p<0.001, grade (p<0.001, and percent (p<0.001 was related to disposition of patients. Stepwise multiple logistic regression showed female gender (OR=3.52; 95% CI: 1.57-7.88; p=0.002, work related burning (OR=1.78; 95% CI: 1.26-2.52; p=0.001, and burning over 5 percent (OR=2.15; 95% CI: 1.35-3.41; p=0.001 as

Where is North?

OpenAIRE

Macmillan, Susan; Shanahan, Tom

2010-01-01

To find your way using a magnetic compass with a map, you need to know the difference between magnetic north and map north. This difference is called ‘grid magnetic angle’, and in the UK it is derived from a model of the Earth’s magnetic field, which is updated every year. The variation To go north, you just follow your compass towards magnetic north, right? Not quite. Geophysicists have to work hard so we can continue to navigate with map and compass. Susan Macm...

Journal of Chemical Sciences | Indian Academy of Sciences

Indian Academy of Sciences (India)

Chemical Engineering Department, Engineering Faculty, Ferdowsi University of Mashhad, Mashhad, Iran; Department of Chemistry, Simon Fraser University, Burnaby, BC, Canada; School of Chemical Engineering- University College of Engineering-University of Tehran, Tehran, Iran; School of Chemistry- University ...

A study of the provision of hospital based dental General Anaesthetic services for children in the North West of England: Part 2--the views and experience of families and dentists regarding service needs, treatment and prevention.

Science.gov (United States)

Goodwin, Michaela; Pretty, Iain A; Sanders, Caroline

2015-04-09

Patterns of service delivery and the organisation of Dental General Anaesthesia (DGA) have been found to differ across hospitals. This paper reports on qualitative research aimed to understand the impact of such variation by exploring views and experiences of families receiving care in different hospital sites, as well as dentists involved in referral and delivery of care. Qualitative semi-structured interviews were conducted with 26 people comprising parents (n = 15), dentists working in primary care (n = 6) and operating dentists (n = 5) in relation to DGA. Participants were recruited from areas across the North West of England to ensure a variety referral and treatment experiences were captured. Field notes were made during visits to all settings included in the study and explored alongside interview transcripts to elicit key themes. A variety of positive and negative impacts on children and parents throughout the referral process and operation day were apparent. Key themes established were clustered around three key topics: 1. Organisational and professional concerns regarding referrals, delivery of treatment and prevention. 2. The role of hospital environment and routine on the emotional experiences of children. 3. The influence of the wider social context on dental health. These findings suggest the need and perceived value of: tailored services for children (such as play specialists) and improved information, such as clear guidance regarding wait times and what is to be expected on the day of the procedure. These features were viewed to be helpful in alleviating the stress and anxiety often associated with DGA. While some elements will always be restricted in part to the hospital setting in which they occur, there are several aspects where best practice could be shared amongst hospitals and, where issues such as wait times have been acknowledged, alternative pathways can be explored in order to address areas which can impact negatively on children.

Perceived sustainability of community telepharmacy in North Dakota.

Science.gov (United States)

Scott, David M; Friesner, Daniel L; Undem, Teri; Anderson, Gabrielle; Sem, Kelli; Peterson, Charles D

To assess the sustainability of the business model underlying the North Dakota Telepharmacy Project (NDTP). Of the 38 community pharmacy organizations (14 central, 24 remote), 27 organizations (11 central and 16 remote sites) in North Dakota provided a useable set of responses (71.1% response rate). A twelfth organization (a community pharmacy) ceased operations over the study's time frame and was not included in the data analysis. Emphasis is placed on NDTP community telepharmacies, because the community telepharmacy business model is more established than hospital telepharmacies. Yet little is known about the long-run financial viability of telepharmacies. Originally funded by a series of federal grants, the goal of the NDTP was to create the infrastructure necessary to support the development of telepharmacy sites. A 48-item questionnaire assessed the self-reported operational, financial, and community impacts of a community telepharmacy. The questionnaire was administered from December 2015 to February 2016 to all NDTP community telepharmacy owners-managers. Thus, 1 participant (owner-manager) addressed both central and remote-site locations served by a pharmacy. Most respondents reported that their telepharmacy sites (especially remote sites) generate small positive financial returns for the organization. Respondents also reported that the closure of their remote sites would significantly harm the communities they serve. NDTP aims of restoration and retention have been achieved via the investment and shared decision making with pharmacy owners in North Dakota. The telepharmacy model is sustainable, even if it does not generate significant economic profit. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Effect of Different Nitrogen Levels on Phenology, Growth Indices and Yield of two Lentil Cultivars under Rainfed Conditions in Mashhad

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M Bannayan Aval

2018-02-01

Full Text Available Introduction Lentil (Lens Culinarris Medik. is an important pulse crop in Iran and is usually grown in rainfed areas. The average lentil yield in Iran is 1195 and 476 Kg.ha-1 in irrigated and rainfed farms, respectively. Low productivity occurs due to different factors. One of these factors is poor agronomic management practices that applied by the farmers, e.g. Limitation or inappropriate fertilizer distribution. Plant development occurs in a number of consecutive phases. These phases can be affected by temperature, moisture, photoperiod, cultivar and other factors. The amount of available nitrogen affects the distribution of assimilates between vegetative and reproductive organs and phenological stages of growth. Therefore, analysis of growth indices and its effective factors can be used as a suitable tool in evaluating the yield. The aim of this study was to evaluate the effect of different nitrogen levels on phenology and growth indices of two lentil cultivars in rainfed conditions of Mashhad. Materials and Methods The experiment was conducted as split plot layout based on randomized complete blocks design with three replications at the Agricultural Research Station, Ferdowsi University of Mashhad, during growth season 2016. Nitrogen fertilizer as urea (in three levels i.e. 0, 40 and 80 kg.ha-1 and cultivar (in two levels i.e. Birjand and Robat were in main plots and sub plots, respectively. To determine the leaf area and dry matter, sampling was done every two weeks during the growing season. Phenological stages timing for each plot were determined based on 50% of emergence, 50% of flowering, 50% of maturity. Final yield was estimated from three square meter from each plot. Data were analyzed with the SAS software; the means were compared with Duncan's multiple range tests at the 5% level of probability. The graphs were prepared by SigmaPlot software. Results and Discussion The results showed that the effect of urea fertilizer was

The Economic Contribution of North Dakota Cooperatives to the North Dakota State Economy

OpenAIRE

McKee, Gregory J.

2011-01-01

Cooperatives are a vital component of the North Dakota economy. Owned by their customers or by privately-held firms, cooperatives provide a variety of goods and services to North Dakota. Based on data provided by the North Dakota Secretary of State, 332 businesses operating in North Dakota identified themselves as cooperatives in 2010; 256 are headquartered in the state. The economic contribution of the North Dakota cooperatives reaches beyond the local communities where they are headquartere...

Implementation of nursing process in clinical settings: the case of three governmental hospitals in Ethiopia, 2017.

Science.gov (United States)

Semachew, Ayele

2018-03-13

The purpose of this survey was to evaluate the implementation of the nursing process at three randomly selected governmental hospitals found in Amhara Region North West Ethiopia. From the total 338 reviewed documents, 264 (78.1%) have a nursing process format attached with the patient's profile/file, 107 (31.7%) had no nursing diagnosis, 185 (54.7%) of nurses stated their plan of care based on priority, 173 (51.2%) of nurses did not document their interventions based on plan and 179 (53.0%) of nurses did not evaluate their interventions. The overall implementation of nursing process among Felege Hiwot Referal hospital, Debretabor general hospital and Finoteselam general hospitals were 49.12, 68.18, and 69.42% respectively. Nursing professionals shall improve documentation required in implementing the nursing process. Nursing managers (matron, ward heads) shall supervise the overall implementation of nursing process. Hospital nursing services managers (matrons) shall arrange and facilitate case presentations by the nursing staffs which focus on documentation and updates on nursing process. Hospitals need to establish and support nursing process coordinating staff in their institution.

SHORT COMMUNICATION SYNTHESIS AND CRYSTAL ...

African Journals Online (AJOL)

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2012 Chemical Society of Ethiopia ... 2Department of Chemistry, School of Sciences, Ferdowsi University of Mashhad, Mashhad,. P.O. Box ... There are diverse hydrogen bonding interactions such as O—H···N and O—H···O contacts, which.

Length of stay and economic consequences with rivaroxaban vs enoxaparin/vitamin K antagonist in patients with DVT and PE: findings from the North American EINSTEIN clinical trial program.

Science.gov (United States)

Bookhart, Brahim K; Haskell, Lloyd; Bamber, Luke; Wang, Maria; Schein, Jeff; Mody, Samir H

2014-10-01

Venous thromboembolism (VTE) (deep vein thrombosis [DVT] and pulmonary embolism [(PE]) represents a substantial economic burden to the healthcare system. Using data from the randomized EINSTEIN DVT and PE trials, this North American sub-group analysis investigated the potential of rivaroxaban to reduce the length of initial hospitalization in patients with acute symptomatic DVT or PE. A post-hoc analysis of hospitalization and length-of-stay (LOS) data was conducted in the North American sub-set of patients from the randomized, open-label EINSTEIN trial program. Patients received either rivaroxaban (15 mg twice daily for 3 weeks followed by 20 mg once daily; n = 405) or dose-adjusted subcutaneous enoxaparin overlapping with (guideline-recommended 'bridging' therapy) and followed by a vitamin K antagonist (VKA) (international normalized ratio = 2.0-3.0; n = 401). The open-label study design allowed for the comparison of LOS between treatment arms under conditions reflecting normal clinical practice. LOS was evaluated using investigator records of dates of admission and discharge. Analyses were carried out in the intention-to-treat population using parametric tests. Costs were applied to the LOS based on weighted mean cost per day for DVT and PE diagnoses obtained from the Healthcare Cost and Utilization Project dataset. Of 382 patients hospitalized, 321 (84%), had acute symptomatic PE; few DVT patients required hospitalization. Similar rates of VTE patients were hospitalized in the rivaroxaban and enoxaparin/VKA treatment groups, 189/405 (47%) and 193/401 (48%), respectively. In hospitalized VTE patients, rivaroxaban treatment produced a 1.6-day mean reduction in LOS (median = 1 day) compared with enoxaparin/VKA (mean = 4.5 vs 6.1; median = 3 vs 4), translating to total costs that were $3419 lower in rivaroxaban-treated patients. In hospitalized North American patients with VTE, treatment with rivaroxaban produced a statistically

Retrospective Study on the Prevalence and Antibiotic Resistance Pattern of Staphylococcus Aureus and Staphylococcus Epidermidis Among Patients Suspicious of Bacteremia During 2006 - 2011

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Mohammad Ali Mohaghegh

2015-05-01

Full Text Available Background: Staphylococci bacteria cause different diseases, varies from mild skin infections to serious bacteremia. Also they are a major cause of nosocomial and community-acquired infections globally. Staphylococcus aureus and Staphylococcus epidermidis are the two important opportunistic pathogens of the staphylococci that both can cause bacteremia. Objectives: The aim of the present study was to investigate the prevalence and antibiotic resistance pattern of S. aureus and S. epidermidis among blood culture of patients of Ghaem Educational, Research and Treatment Center, Mashhad, Iran, during 6 years (2006 - 2011. Patients and Methods: In this retrospective study, hospital medical records of 28000 patients referred to Ghaem Educational, Research and Treatment Center, Mashhad, Iran, who were suspicious of blood infections during 6 years (2005-2011, were extracted. The patient’s blood culture with staphylococcal growth and their antibiogram results during 2006 - 2011 were collected and studied. Results: Staphylococcus spp. were isolated from 600 (2.14% out of 28000 blood cultures. Furthermore, 420 (70%, 170 (28.3% and 10 (1.7% out of 600 bacterial isolates identified as S. epidermidis, S. aureus and other Staphylococcus spp., respectively. Ampicillin, amoxicillin, cefixime, ceftazidime, penicillin, oxacillin, nalidixic acid and cephepime were the most antibiotics that the isolates were resistant against. Also vancommycin and chloramphenicol were the most effective antibiotics against S. epidermidis and S. aureus, respectively. Conclusions: Prevalence of Staphylococcal bacteremia caused by S. epidermidis is fairly high comparing to S. aureus among patients referred to Ghaem Educational, Research and Treatment Center, Mashhad, Iran. Also the resistance rate of Staphylococcus spp. isolated from blood against commonly used antibiotic is high, but there are some highly sensitive antibiotic against the infection.

North Korean nuclear negotiation drama

International Nuclear Information System (INIS)

Kim, Jai Bok

1995-06-01

This book reports negotiation on North Korean nuclear among South Korea, North Korea and U. S. It includes an account about international issues on North Korean nuclear activities, a new aspect on the problems of North Korean nuclear, pressure on North Korea and startup for dialogue trying to solve problems by communication, investigation by IAEA, IAEA resolution and high tension on Korean peninsula with North Korean nuclear.

North Korean nuclear negotiation drama

Energy Technology Data Exchange (ETDEWEB)

Kim, Jai Bok

1995-06-15

This book reports negotiation on North Korean nuclear among South Korea, North Korea and U. S. It includes an account about international issues on North Korean nuclear activities, a new aspect on the problems of North Korean nuclear, pressure on North Korea and startup for dialogue trying to solve problems by communication, investigation by IAEA, IAEA resolution and high tension on Korean peninsula with North Korean nuclear.

Screening for nutritional risk in hospitalized children: comparison of two instruments

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Dwi Novianti

2017-06-01

Full Text Available Background Malnutrition in hospitalized children has negative impact on morbidity, mortality, length of stay, and health-care cost. A simple screening tool is needed to detect hospital malnutrition risk in children. Objective To compare the level of agreement of the Screening Tool for Malnutrition in Pediatrics (STAMP and Pediatric Nutritional Risk Score (PNRS with anthropometric measurements, as screening tools for hospital malnutrition in children. Methods A cross-sectional study was conducted from February to July 2014 in the Pediatric and Surgery Wards at H. Adam Malik Hospital, Medan, North Sumatera. Inclusion criteria were children aged 2 to 18 years who were hospitalized for more than 72 hours. Subjects were screened using STAMP and PNRS, and underwent anthropometric measurement on admission. The weight measurements were repeated on the 3rd and 7th days, and just before discharge. The STAMP and PNRS results were compared in terms of level of agreement with anthropometric measurements. Data were analyzed by Kappa value and Spearman’s correlation test. Results A total of 127 children were screened with both instruments. The PNRS had slight agreement with hospital malnutrition prevalence (κ=0.175; P=0.028, while STAMP had not  (κ=0.080; P=0.193. Both screening tools had weak positive correlations with length of stay, but the correlation was stronger for PNRS than for STAMP (r=0.218; P=0.014 vs. r=0.188; P=0.034, respectively. The prevalence of hospital malnutrition was 40.9%.  Conclusions The PNRS screening tool has slight agreement with anthropometric measurement for identifying hospital malnutrition risk in children.

Reinforcing graphene oxide/cement composite with NH2 ...

Indian Academy of Sciences (India)

Reinforcing graphene oxide/cement composite with NH2 functionalizing group. M EBRAHIMIZADEH ABRISHAMI1,∗ and V ZAHABI2. 1Materials and Electroceramics Laboratory, Department of Physics, Ferdowsi University of Mashhad, Mashhad. 9177948974, Iran. 2Department of Civil Engineering, Islamic Azad University, ...

How restaurant and bar owners view clean indoor air legislation five years after implementation in North Carolina, 2015

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Ann Houston Staples

2017-08-01

This study reveals successes of North Carolina’s smoke-free law. The majority of respondents reported experiencing at least one benefit of the law and some reported that they had implemented additional voluntary policies. Learning more about how hospitality businesses experience smoke-free laws can help other states and communities deal with similar policy changes in the future.

Pattern of burn injury at north of Jordan.

Science.gov (United States)

Bataineh, Ziad A; Al Quran, Thekraiat M; Al Balas, Hamzeh; Khammash, Muhmammad R

2018-01-01

To the best of our knowledge, pattern of burn injury was not reported yet at our region, our hospital considered the only tertiary referral center with the only burn unit at the region since 2001 till date, a retrospective analysis of our computerized filing system recorded 527 burn patients between 2001-2016, mean age was 26 years; 1.27:1 was the male to female ratio, 79 patients were found to have major burns, 46% of admissions were below 20 years' age, 92% was at domestic site of affection and 65% due to flame burn followed by scald burn in about 23%. The limbs were the most affected body site, majority of patients were below 15% TBSA and partial thickness, 77 patients found to have inhalational injury. Our mean hospital stay was 16 days and mortality was 8.2%. Mortality was associated with high TBSA affection, depth and flame type. This study shows the pattern of burn at north of Jordan, preventive measures by education and observation will reduce the incidence of burn and its sequel, non-flammable cook plates and stoves will probably help in decrease burn morbidity and mortality.

At first glance, informal payments experience on track: why accept or refuse? Patients' perceive in cardiac surgery department of public hospitals, northeast of Iran 2013.

Science.gov (United States)

Vafaei Najar, Ali; Ebrahimipour, Hossein; Pourtaleb, Arefeh; Esmaily, Habibollah; Jafari, Mehdi; Nejatzadegan, Zohre; Taleghani, Yasamin Molavi

2017-03-14

Patient's Informal payments is among the main source of health care financing in some countries. This paper aimed at determining the patient informal payments and relative factors in Cardiac Surgery Departments (CSD) in hospitals affiliated to Mashhad University of Medical Sciences (MUMS) in 2013. In this cross-sectional study, 316 discharged patients were selected using multi-stage sampling. Data gathering tool was a questionnaire which was filled by structured telephone interviews. We used quantitative content analysis for open-ended questions besides descriptive statistics and nonparametric tests by SPSS 16 at 0.05 Sig level. Sixteen (5.93%) patients made voluntary informal payments. The purpose of payment was: "gratitude" (43.75%), satisfaction with health services provided" (31.25%) and (18.75%) for better quality of services. About 75% of the payments were occurred during receiving health care services. The main causes were "no request for informal payments" (98.14%), "not affording to pay for informal payments" (73.33%) and "paying the hospital expenses by taking out a loan" (55.91%). Responders said they would pay informally in demand situation (51.85%) just for patient's health priority, 40.71% would also "search for other alternative solutions" and 27.33% "accepted the demand as a kind of gratitude culture". Twenty four patients (8.9%) had experienced mandatory informal payments during the last 6 months. The minimum amount of payment was 62.5$ and the maximum was 3125$. There was a significant relationship between the way of referring to medical centers and informal patient's payment (P ≤0.05). Despite the widespread prevalent belief about informal payments in public hospitals -particularly to the well-known physicians - such judgment cannot be generalized. The main reasons for the low informal payments in the current study were the personality characteristics of the physicians and hospital staff, their moral conscience and commitment to professional

Effect of Irrigation Intervals, Type of Fertilizers and Harvesting Time on Essence Content and Yield of Three Medicinal Plants: Lavender (lavandula angustifolia, Rosemary (Rosemarinus officinalis and Hyssop (Hyssopus officinalis in Mashhad Condition.

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A Koocheki

2012-12-01

Full Text Available In order to investigate the effect of fertilizer types and irrigation regimes on quality criteria of three medicinal plants: Lavander, Rosemary and Hyssop, an experiment was conducted at Research Field of Faculty of Agriculture, Ferdowsi University of Mashhad, during two growing years of 2007-2009. A split plot design with three replications was used. Treatments were three irrigation intervals (10, 20, 30 days as main plots and six fertilizers: including (control, Nitroxin (5lit/ha, nitrogen fertilizer (50 and 100 (kg/ha, cow manure (10 and 20 ton/ha and three medicinal plants as sub-subplots. Animal manure and chemical fertilizer were applied at the time of transferring seedlings to the field and Nitroxin was used with the first irrigation. Results indicated that the effect of irrigation intervals on yield of essential oil in all species was significant (p≤0.01. The highest essential oil content was from Rosemary (1.5% but the highest yield of essential oil was obtained from three species, Lavander (10kg/ha, Rosemary (7kg/ha and Hyssop (12kg/ha with application of biological fertilizer. Application of fertilizer affected significantly (P

Investigation Patients with Urinary Stones from the Aspect of Epidemiologic Parameters Admitted at Urology Department of Imam Reza Hospital During Years 2005-2008

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K. Tavakkoli Tabassi

2013-10-01

Full Text Available Background: Urolithiasis is one of the most frequent diseases of urinary system which forms high percentage of patients who come to Urology wards. Therefore, study of epidemiological characteristics of patients of each ward can be helpful for making the best general decision. Methods: First, we devided 5133 cases who had come to Urology department of imam Reza hospital of mashhad during 2005-2008, in 2 groups and then in 6 groups. We investigated and compared 2 groups of lithotripsy and surgery from the aspect of epidemiological characteristics. So, we did for 6 groups: pyelolithotomy and nephrolithotomy, ureterolithotomy, ureteroscopy and TUL, PNL, ESWL, cystolitholapaxy. Results: From 5133 cases, mean age of 43.41, men to female ratio 2.1, 90.1% had done lithotripsy and 9.2% surgery. Percentage of patients of pyelolithotomy and nephrolithotomy was 3.5% ureterolithotomy 0.8%, ureteroscopy and TUL39.5%, PNL 4.9%, ESWL 49.5%, cystolitholapaxy 1.9%. Mean stay in hospital for 1.31±0.19 and for surgery 4.84±0.16, in ESWL 0.81±0.25 and in pyelolithotomy and nephrolithotomy 5.09±0.17 days. During years 2005-2008 percentage of ESWL was : 59.9, 51.4 & 38.4% of all admissions in these years. PNLs percentage was: 3.8, 5.51, 5.53%. Choosing of PNL in urban people was highest (84.5% and for rural people pyelolithotomy and nephrolithotomy is the most technique in use. Conclusion: Despite of other advanced countries high percentage of our patients undergo open surgery especially in rural people, yet. So, we should provide facilities of education and financials for modern and lower costs of urinary tract stone treatments.

Seroprevalence of Neospora Spp. in Horses in North East of Iran

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MH Hosseini

2011-06-01

Full Text Available Background: Neospora caninum, an obligate intracellular protozoan parasite, is recognized as a major cause of abortion in cattle, while limited information is presently available on the seropreva­lence of Neospora antibodies in horses' worldwide .The aim of the present study was to de­termine serologic prevalence of Neospora infection in horses in Iran.Methods: Sera from 150 horses from Mashhad suburb in Razavi Khorasan Province, northeast Iran were examined for antibodies to Neospora spp. using Neospora modified direct agglutina­tion test (N-MAT.Results: Antibodies to this parasite were detected in 45 (30% of the examined serum samples. Thirty four percent of the samples had titer of 1:40 while then reduced to 30% when 1:80 serum dilution was applied as significant cut off titer.Conclusion: This study is the first investigation carried out on the Neospora in horses in Iran and indi­cates that horses in Iran are exposed to this parasite.

Existence of positive weak solutions for (p, q)-Laplacian nonlinear ...

Indian Academy of Sciences (India)

Samira Ala1 G A Afrouzi2 A Niknam3. Department of Mathematics, Science and Research Branch, Islamic Azad University (IAU), Tehran, Iran; Department of Mathematics, Faculty of Mathematical Sciences, University of Mazandaran, Babolsar, Iran; Department of Mathematics, Ferdowsi University of Mashhad, Mashhad, ...

Epidemiology of psychiatric disorders: The situation of Mashhad city during 2010-2016

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Hoda Khatibi Moghaddam

2017-10-01

Results: In this study, 43770 hospital admissions had occurred which was reduced to 4333 cases after aggregating readmissions. The mean age was 42.2 ± 12.5 years, and the highest prevalence rate was observed in the age group of 50-59 years (352 in 100000 of the population. Most admitted patients were male (75%, 3234, married (60%, 2523 and unemployed (71%, 2740. The most common admission cause was mood disorders in both genders (51% of females and 37% of males, P

Alcohol dependence and physical comorbidity: Increased prevalence but reduced relevance of individual comorbidities for hospital-based mortality during a 12.5-year observation period in general hospital admissions in urban North-West England.

Science.gov (United States)

Schoepf, D; Heun, R

2015-06-01

Alcohol dependence (AD) is associated with an increase in physical comorbidities. The effects of these diseases on general hospital-based mortality are unclear. Consequently, we conducted a mortality study in which we investigated if the burden of physical comorbidities and their relevance on general hospital-based mortality differs between individuals with and without AD during a 12.5-year observation period in general hospital admissions. During 1 January 2000 and 30 June 2012, 23,371 individuals with AD were admitted at least once to seven General Manchester Hospitals. Their physical comorbidities with a prevalence≥1% were compared to those of 233,710 randomly selected hospital controls, group-matched for age and gender (regardless of primary admission diagnosis or specialized treatments). Physical comorbidities that increased the risk of hospital-based mortality (but not outside of the hospital) during the observation period were identified using multiple logistic regression analyses. Hospital-based mortality rates were 20.4% in the AD sample and 8.3% in the control sample. Individuals with AD compared to controls had a higher burden of physical comorbidities, i.e. alcoholic liver and pancreatic diseases, diseases of the conducting airways, neurological and circulatory diseases, diseases of the upper gastrointestinal tract, renal diseases, cellulitis, iron deficiency anemia, fracture neck of femur, and peripheral vascular disease. In contrast, coronary heart related diseases, risk factors of cardiovascular disease, diverticular disease and cataracts were less frequent in individuals with AD than in controls. Thirty-two individual physical comorbidities contributed to the prediction of hospital-based mortality in univariate analyses in the AD sample; alcoholic liver disease (33.7%), hypertension (16.9%), chronic obstructive pulmonary disease (14.1%), and pneumonia (13.3%) were the most frequent diagnoses in deceased individuals with AD. Multiple forward

Workplace Violence against Health Care Workers in North Chinese Hospitals: A Cross-Sectional Survey

OpenAIRE

Peihang Sun; Xue Zhang; Yihua Sun; Hongkun Ma; Mingli Jiao; Kai Xing; Zheng Kang; Ning Ning; Yapeng Fu; Qunhong Wu; Mei Yin

2017-01-01

This research aimed to determine the prevalence of workplace violence (WPV) against healthcare workers, explore the frequency distribution of violence in different occupational groups, and determine which healthcare occupation suffers from WPV most frequently. Furthermore, the current study aimed to compare risk factors affecting different types of WPV in Chinese hospitals. A cross-sectional design was utilized. A total of 1899 healthcare workers from Heilongjiang, a province in Northeastern ...

Effectiveness of palliative home-care services in reducing hospital admissions and determinants of hospitalization for terminally ill patients followed up by a palliative home-care team: a retrospective cohort study.

Science.gov (United States)

Riolfi, Mirko; Buja, Alessandra; Zanardo, Chiara; Marangon, Chiara Francesca; Manno, Pietro; Baldo, Vincenzo

2014-05-01

It has been demonstrated that most patients in the terminal stages of cancer would benefit from palliative home-care services. The aim of this study was to assess the effectiveness of appropriate palliative home-care services in reducing hospital admissions, and to identify factors predicting the likelihood of patients treated at home being hospitalized. Retrospective cohort study. We enrolled all 402 patients listed by the Local Health Authority No. 5, Veneto Region (North-East Italy), as dying of cancer in 2011. Of the cohort considered, 39.9% patients had been taken into care by a palliative home-care team. Irrespective of age, gender, and type of tumor, patients taken into care by the palliative home-care team were more likely to die at home, less likely to be hospitalized, and spent fewer days in hospital in the last 2 months of their life. Among the patients taken into care by the palliative home-care team, those with hematological cancers and hepatocellular carcinoma were more likely to be hospitalized, and certain symptoms (such as dyspnea and delirium) were predictive of hospitalization. Our study confirms the effectiveness of palliative home care in enabling patients to spend the final period of their lives at home. The services of a palliative home-care team reduced the consumption of hospital resources. This study also provided evidence of some types of cancer (e.g. hematological cancers and hepatocellular carcinoma) being more likely to require hospitalization, suggesting the need to reconsider the pathways of care for these diseases.

Coherent changes of wintertime surface air temperatures over North Asia and North America.

Science.gov (United States)

Yu, Bin; Lin, Hai

2018-03-29

The surface temperature variance and its potential change with global warming are most prominent in winter over Northern Hemisphere mid-high latitudes. Consistent wintertime surface temperature variability has been observed over large areas in Eurasia and North America on a broad range of time scales. However, it remains a challenge to quantify where and how the coherent change of temperature anomalies occur over the two continents. Here we demonstrate the coherent change of wintertime surface temperature anomalies over North Asia and the central-eastern parts of North America for the period from 1951 to 2015. This is supported by the results from the empirical orthogonal function analysis of surface temperature and temperature trend anomalies over the Northern Hemisphere extratropical lands and the timeseries analysis of the regional averaged temperature anomalies over North Asia and the Great Plains and Great Lakes. The Asian-Bering-North American (ABNA) teleconnection provides a pathway to connect the regional temperature anomalies over the two continents. The ABNA is also responsible for the decadal variation of the temperature relationship between North Asia and North America.

Research Article

African Journals Online (AJOL)

Ph.D Student in Biology - Plant Physiology, Faculty of Basic Sciences, Ferdowsi University of. Mashhad, Mashhad, Iran. 4. Quality Control Manager of Tomate Agro-Industry Company of Khoshab factories. Published online: 15 May 2016. ABSTRACT. In recent years, the use of synthetic antioxidants and the degradation ...

Cross Cultural Adaptation of the Menopause Specific Questionnaire ...

African Journals Online (AJOL)

Cross Cultural Adaptation of the Menopause Specific. Questionnaire into the Persian Language. Ghazanfarpour M, Kaviani M1, Rezaiee M2, Ghaderi E3, Zandvakili F2. Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, 1Nursing and Midwifery College, Shiraz ...

Association Between Transcatheter Aortic Valve Replacement and Subsequent Infective Endocarditis and In-Hospital Death

DEFF Research Database (Denmark)

Regueiro, Ander; Linke, Axel; Latib, Azeem

2016-01-01

IMPORTANCE: Limited data exist on clinical characteristics and outcomes of patients who had infective endocarditis after undergoing transcatheter aortic valve replacement (TAVR). OBJECTIVE: To determine the associated factors, clinical characteristics, and outcomes of patients who had infective...... endocarditis after TAVR. DESIGN, SETTING, AND PARTICIPANTS: The Infectious Endocarditis after TAVR International Registry included patients with definite infective endocarditis after TAVR from 47 centers from Europe, North America, and South America between June 2005 and October 2015. EXPOSURE: Transcatheter...... aortic valve replacement for incidence of infective endocarditis and infective endocarditis for in-hospital mortality. MAIN OUTCOMES AND MEASURES: Infective endocarditis and in-hospital mortality after infective endocarditis. RESULTS: A total of 250 cases of infective endocarditis occurred in 20...

Strangers on the Doorstep: Hostility and Hospitality in A Distant Shore

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Lin Ching-Huan

2016-12-01

Full Text Available This article focuses on the rising hostility against immigrants / refugees and growing demand for hospitality, in both regional and transnational senses, in Caryl Phillips’s novel A Distant Shore, set in a local place in North England. I think that the author, in examining the parallel conditions of being a stranger in a village and an outsider to the nation, shows that the demands of hospitality are similarly urgent whether sought by nationals or foreigners though these are calibrated differently in terms of scales of belonging. My broader argument is that hospitality is an ethical practice of everyday life that requires continual renegotiation. Inspired by Levinasian ethics, I turn to Derrida’s and Rosello’s meditations on hospitality, which emphasise the metaphorical nature of the host-guest relationship and the tension it inscribes between the finiteness of politics and the infinity of ethics. By exploring the complex relationship between politics and ethics as this is made manifest in the literary representations of ordinary British citizens’ everyday practices, I suggest that this novel not only deals with the UK’s domestic tensions of multiculturalism and ethnic conflict, but also critically reflects on its bewildered (but hardly new attitude toward the ongoing transnational integration of the new Europe in the postwar period.

Relying on the National Mobile Disaster Hospital as a business continuity strategy in the aftermath of a tornado: The Louisville experience.

Science.gov (United States)

Kearns, Randy D; Stringer, Lew; Craig, James; Godette-Crawford, Regina; Black, Paul S; Andra, David L; Winslow, James

2017-01-01

On 28th April, 2014, a tornado left much of Louisville, MS and the local hospital, Winston Medical Center, in ruin. In the USA, temporary hospital solutions have been used to augment the mainstream healthcare system since the American Civil War. As memories fade, however, the necessary readiness for a temporary hospital also fades, at times leaving a patchwork of resources either underfunded or abandoned. With the creation of the Hospital Preparedness Program, several temporary hospital solutions were created in various states across the USA. In the present case, Mississippi and North Carolina resources were used in Louisville in the aftermath of a direct impact that destroyed the hospital and nursing home. In the hours that followed, after lives were saved and patients safely relocated, a frank assessment confirmed the structural loss of the hospital. Local emergency responders, hospital staff, state and federal representatives all rallied with the aim of saving the community's only hospital. The steps taken in Louisville and the deliberate restoration of these essential services offer a learning opportunity for all involved in healthcare disaster preparedness, response and recovery.

Study of Relationship between Hypernatremia in Neonates and Way of Maternal Breast Feeding

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H Boskabadi

2014-04-01

Full Text Available Introduction: The extreme reduction in breast milk intake during the first days of life leads to weight loss, kidney failure and hypernatremia. The aim of this study was to examine the relationship between hypernatremia in neonates and way of maternal breastfeeding in hospitalized infants in Ghaem Hospital of Mashhad.   Materials and Methods: After obtaining parental consent, 687 infants referred to the neonatal ward and clinic of Ghaem hospital of Mashhad participated in this cross-sectional study. First, complete history of the mother and baby regarding pregnancy and delivery problems, way of breastfeeding, and the first time of lactation beginning were obtained. Then neonates were divided into two groups of normal and hypernatremia (sodium≥150 mg/dl according to the amount of blood sodium level. Data was analyzed using correlation tests, chi-square, t test and Mann-Whitney tests with SPSS software (version 11.5.   Results: According to the findings of this study, the average age (P=0.911, Apgar scores (P=0.192, time of the first lactation (P=0.081 and breast feeding duration (P=o.108 showed no statistically significant difference between normal and hypernatremia groups. But the admission weight (P=0.011, times of lactation (P=0.108, breast-feeding status (P=0.001, let down reflex in mother’s breast (0.001, kind of nutrition (P=o.oo1, breast filling after childbirth and lactation (P=0.000, and breast softening after breast-feeding (P=0.000, urination frequency (P=0.000, defecation frequency (P=0.000 and duration of maternal hospitalization (P=0.007 showed statistically significant difference between the groups.   Conclusion: Neonatal weight control, times of lactation, lactation status, breast changes during breast feeding and frequency of urination and defecation may be effective in the early detection of the reduced breast milk intake and the control of the related complications.   Key Words: Breast Feedinf, Breast Milk

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%.

Global surgery in a postconflict setting - 5-year results of implementation in the Russian North Caucasus

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Fatima I. Lunze

2015-10-01

Full Text Available Background: Collaborations for global surgery face many challenges to achieve fair and safe patient care and to build sustainable capacity. The 2004 terrorist attack on a school in Beslan in North Ossetia in the Russian North Caucasus left many victims with complex otologic barotrauma. In response, we implemented a global surgery partnership between the Vladikavkaz Children's Hospital, international surgical teams, the North Ossetian Health Ministry, and civil society organizations. This study's aim was to describe the implementation and 5-year results of capacity building for complex surgery in a postconflict, mid-income setting. Design: We conducted an observational study at the Children's Hospital in Vladikavkaz in the autonomous Republic of North Ossetia-Alania, part of the Russian Federation. We assessed the outcomes of 15 initial patients who received otologic surgeries for complex barotrauma resulting from the Beslan terrorism attack and for other indications, and report the incidence of intra- and postoperative complications. Results: Patients were treated for trauma related to terrorism (53% and for indications not related to violence (47%. None of the patients developed peri- or postoperative complications. Three patients (two victims of terrorism who underwent repair of tympanic perforations presented with re-perforations. Four junior and senior surgeons were trained on-site and in Germany to perform and teach similar procedures autonomously. Conclusions: In mid-income, postconflict settings, complex surgery can be safely implemented and achieve patient outcomes comparable to global standards. Capacity building can build on existing resources, such as operation room management, nursing, and anesthesia services. In postconflict environments, substantial surgical burden is not directly attributable to conflict-related injury and disease, but to health systems weakened by conflicts. Extending training and safe surgical care to include

COMPARISON OF DIFFERENT HELIPORT SOLUTIONS FOR THE CLINICAL HOSPITAL CENTER IN OSIJEK

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Tatjana Timko

2017-01-01

Full Text Available Complexity in takeoff and landing operations of helicopters require careful planning and designing of heliport infrastructure. The world's biggest aviation organization, namely Federal Aviation Administration and International Civil Aviation Organization, published their standards and designing recommendations for heliport designers to implement that are analyzed and compared in this paper. In the Republic of Croatia, helicopters are designed according to the recommendations of National heliport regulations which are based on recommendations of International Civil Aviation Organization (Annex 14. The practical part of the paper deals with the implementation of national heliport standard recommendations in two variants of heliport designs for emergency medical service for the clinical hospital center in Osijek. As a potential location of the new heliport for emergency medical transportation a transit port is analyzed because it is close to the clinical hospital center in Osijek and is well connected with the existing road infrastructure, and it is also possible to make a direct access to the hospital complex from the north side. Two solutions were analyzed and compared upon the criteria of accessibility, security of operations and possibility for instrument flight conditions, size of heliport and necessary areas, costs of building and maintenance and helicopter noise. There is an intention that regional capital cities that have clinical hospital centers need to have infrastructure for emergency helicopter transportation near the hospital.

An epidemiological survey on intestinal helminths of stray dogs in Mashhad, North-east of Iran.

Science.gov (United States)

Emamapour, Seyed Rasoul; Borji, Hassan; Nagibi, Abolghasem

2015-06-01

This research was conducted to determine the prevalence of gastrointestinal helminths in stray dogs in the northeast of Iran, with special attention to those parasites that can be transmitted to human. In this experiment, a total of 72 adult and 18 juvenile stray dogs were collected and necropsied for the presence of helminth parasites from October 2011 to August 2012. The overall prevalence of gastrointestinal helminths was 86 % (95 % CI: 79.2-92.8 %). The observed helminths of the gastrointestinal tract were listed as follows: Toxocara canis (29 %), Toxascaris leonina (7 %), Ancylostoma caninum (2 %), Taenia hydatigena (43 %), Dipylidium caninum (39 %), Echinococcus granulosus (38 %), Mesocestoides lineatus (16 %), Taenia multiceps (11 %), Taenia ovis (3 %). There were no significant differences for the prevalence of gastrointestinal helminths between female (83.6 %) and male (89.7 %) and between young (89 %) and adult (72.2 %) animals. However, the prevalence of E. granulosus, T. hydatigena and D. caninum showed an increasing trend with increasing host age, significantly. Based on our data, it is important to point out the presence of zoonotic agents, namely E. granulosus and T. canis in stray dogs in the investigated area. Due to its impact on public health, appropriate control measures should be taken and it is recommended to determine the most appropriate preventive methods.

I. Monographic Section Hospitals, money and other riches. Writing and practising economy in late medieval Italian charitable institutions

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Marina Gazzini (a cura di

2016-05-01

Full Text Available The section contains contributions focusing on the practices and records relating to the economics of hospitals in late medieval Italy. Experts from different disciplines – economic historians, historians of the document, historians of the Middle Ages and of welfare institutions – offer a significant overview of hospitals situated in the north, the center and the south of the Italian peninsula between the fourteenth and sixteenth centuries. They investigate the mechanisms of funding of charities, the social and public implications of hospital care, the techniques and the accounting systems of revenue and expenditure, and finally, the religious merits connected not only to the care of the poor and sick, but also to the scriptures that recorded this activity.

31 CFR 500.554 - Gifts of North Korean, North Vietnamese, Cambodian, or South Vietnamese origin.

Science.gov (United States)

2010-07-01

... Vietnamese, Cambodian, or South Vietnamese origin. 500.554 Section 500.554 Money and Finance: Treasury... § 500.554 Gifts of North Korean, North Vietnamese, Cambodian, or South Vietnamese origin. (a) Except as... importation of North Korean, North Vietnamese, Cambodian, or South Vietnamese origin goods sent as gifts to...

Pattern of fractures and dislocations in a tertiary care hospital, north east Karnataka

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Bhaskara K, Padmanabha T S, Nandini T, Sindhu

2014-11-01

Full Text Available Background: Trauma including accidents are today’s world concern forming a major non-communicable epidemic accounting for mortality and morbidity. The aim of the study was to determine and account the types of fractures and dislocations presented to Bidar Institute of Medical Sciences (BRIMS, Bidar, Karnataka, India. Methods and Material: This study is of retrospective in nature with a review of hospital inpatient case sheets of orthopaedic department in our hospital presented between July 2011 to Dec 2011. The data gathered was analysed by percentages. Results: Out of 132 cases analysed males (82.56%, outnumbered female (17.42%; 67.42 % of cases were between 18-45 years age group; femur (22.17 % was the most commonly involved bone followed by tibia (13.21%, foot (10.85%; tibia & fibular (8.96% involvement. Less common were spine (0.47%, vertebra (0.94% and scapula (0.94%. Fracture-dislocation was more common in lower limb (59.91% – ankle joint was most common-50% compared to upper limb (30.66%- shoulder joint: 12.5%. Conclusions: Among of 132 cases admitted 212 fractures & dislocation was noted. Male (82.56% was more common than females (17.42%. Age group most commonly involved was between 18-45 years (67.42%. Fracture was more common in femur (22.17% & dislocation was common in hip (42.86% because of high velocity injury. Approach towards the prevention of accidents by effective safety education, good roads and early intervention which is the need of the hour. Effective drugs should be made available in the casuality so that crush injuries are managed without complications like septicemia and tetanus.

Clinico-microbiological study of dermatophytosis in a tertiary-care hospital in North Karnataka

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Tonita M Noronha

2016-01-01

Full Text Available Context: The dermatophytoses constitute a group of superficial fungal infections of keratinized tissues, namely, the epidermis, hair, and nails. The distribution and frequency of dermatophytosis and their etiologic agents vary according to the geographic region studied, the socio-economic level of the population, the time of study, the climatic variations, the presence of domestic animals, and age. Aims: The present study was undertaken to assess the clinical profile of dermatophytic infections and to identify the causative fungal species in the various clinical presentations. Settings and Design: This was a hospital-based observational study. Materials and Methods: One hundred and fifty clinically suspected cases of dermatophytosis attending the outpatient department of a tertiary care hospital were included in the study. History was taken, general physical and cutaneous examination was done and details of skin lesions noted. Direct microscopy in 10% KOH (40% KOH for nail and fungal culture on SDA with 0.05% chloramphenicol and 0.5% cycloheximide was done in every case. Statistical Analysis Used: Statistical analysis was done using SPSS 17.0 software. Chi-square test and contingency coefficient test were used as significant tests for analysis. Results: Out of 150 patients studied, majority belonged to the age group of 21–30 years (22.7%. Male-to-female ratio was 1.63:1. Tinea corporis (24.7% was the most common clinical type observed. The overall positivity by culture was 40% and by direct microscopy was 59.3%. Trichophyton mentagrophytes was the predominant species isolated (48.3%. Conclusions: The present study reveals the changing trend in the prevalence of dermatophyte species in this part of Karnataka.

Audit of emergency obstetric referrals from a secondary level hospital in Haryana, North India

Directory of Open Access Journals (Sweden)

Shashi Kant

2018-01-01

Full Text Available Background: The maternal mortality ratio in India is high. An effective emergency obstetric care (EmOC strategy has been identified as a priority to reduce maternal deaths. Since the capacity of different levels of public health facilities to provide EmOC is varied, an effective referral system is crucial. However, few studies have evaluated the functioning and quality of referral systems in India. A systematic monitoring of referrals helps to identify current gaps in the provision of essential obstetric care. Objective: This study was conducted to identify the medical and logistic reasons for emergency obstetric referrals from a subdistrict hospital (SDH. Methods: An audit of emergency referrals during the period January 2015–December 2015 was carried out. Records of all obstetric patients referred from the maternity ward during the study period were reviewed. Results: The referral rate was found to be 31.7%. Preterm labor (30.6%, pregnancy-induced hypertension (17%, and fetal distress (10.6% were the main reasons for referral. Deficiencies were found in critical determinants of functionality, that is, nonavailability of emergency cesarean, neonatal care unit, and blood bank. Conclusions: The referral rate at the SDH was high. Lack of workforce and infrastructural facilities led to referrals of women who ought to have been managed at this level of the hospital.

Disparities in universal prenatal screening for group B streptococcus--North Carolina, 2002-2003.

Science.gov (United States)

2005-07-22

Group B streptococcus (GBS) is a leading cause of neonatal morbidity and mortality in the United States. Intrapartum antibiotics administered to women at risk for transmitting GBS to their newborns are effective in preventing perinatal GBS infection. In 2002, CDC, the American Academy of Pediatrics, and the American College of Obstetricians and Gynecologists recommended universal prenatal screening for vaginal and rectal GBS colonization at 35-37 weeks' gestation. To examine prenatal GBS screening among pregnant women in North Carolina, CDC analyzed 2002 and 2003 data from the North Carolina Pregnancy Risk Assessment Monitoring System (PRAMS). The proportions of women reporting prenatal screening for GBS were similar in 2002 and 2003 (70% and 74%, respectively); however, for both years, women of Hispanic ethnicity and women who received prenatal care at a hospital or health department clinic were less likely to report prenatal screening for GBS. These findings underscore the need to increase GBS-related education and prevention activities targeted to these populations.

Coat protein of Turnip mosaic virus in oilseed rape (Brassica napus)

African Journals Online (AJOL)

mohammad

2Department of Plant Breeding and Biotechnology, Faculty of Agriculture, Ferdowsi University of Mashhad, Mashhad,. Iran. Accepted 15 August, 2012 ... led to prevalence of infectious diseases. Turnip mosaic virus (TuMV) is an .... During the sampling of canola plants for the detection of virus, some colonies of aphids were ...

Variability of North Sea pH and CO2 in response to North Atlantic Oscillation forcing

DEFF Research Database (Denmark)

Salt, Lesley A.; Thomas, Helmuth; Prowe, Friederike

2013-01-01

[1] High biological activity causes a distinct seasonality of surface water pH in the North Sea, which is a strong sink for atmospheric CO2 via an effective shelf pump. The intimate connection between the North Sea and the North Atlantic Ocean suggests that the variability of the CO2 system...... of the North Atlantic Ocean may, in part, be responsible for the observed variability of pH and CO2 in the North Sea. In this work, we demonstrate the role of the North Atlantic Oscillation (NAO), the dominant climate mode for the North Atlantic, in governing this variability. Based on three extensive...... observational records covering the relevant levels of the NAO index, we provide evidence that the North Sea pH and CO2 system strongly responds to external and internal expressions of the NAO. Under positive NAO, the higher rates of inflow of water from the North Atlantic Ocean and the Baltic outflow lead...

Hospitality within hospital meals—Socio-material assemblages

DEFF Research Database (Denmark)

Justesen, Lise; Gyimóthy, Szilvia; Mikkelsen, Bent E.

2016-01-01

Hospital meals and their role in nutritional care have been studied primarily from a life and natural science perspective. This article takes a different approach and explores the idea of hospitality inspired by Jacques Derrida’s work on the ontology of hospitality. By drawing on ethnographic fie...... and management involved in hospital food service and in nutritional care to work more systematically with the environment for improved hospital meal experiences in the future......Hospital meals and their role in nutritional care have been studied primarily from a life and natural science perspective. This article takes a different approach and explores the idea of hospitality inspired by Jacques Derrida’s work on the ontology of hospitality. By drawing on ethnographic...

Hospital Prices Increase in California, Especially Among Hospitals in the Largest Multi-hospital Systems

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Glenn A. Melnick PhD

2016-06-01

Full Text Available A surge in hospital consolidation is fueling formation of ever larger multi-hospital systems throughout the United States. This article examines hospital prices in California over time with a focus on hospitals in the largest multi-hospital systems. Our data show that hospital prices in California grew substantially (+76% per hospital admission across all hospitals and all services between 2004 and 2013 and that prices at hospitals that are members of the largest, multi-hospital systems grew substantially more (113% than prices paid to all other California hospitals (70%. Prices were similar in both groups at the start of the period (approximately $9200 per admission. By the end of the period, prices at hospitals in the largest systems exceeded prices at other California hospitals by almost $4000 per patient admission. Our study findings are potentially useful to policy makers across the country for several reasons. Our data measure actual prices for a large sample of hospitals over a long period of time in California. California experienced its wave of consolidation much earlier than the rest of the country and as such our findings may provide some insights into what may happen across the United States from hospital consolidation including growth of large, multi-hospital systems now forming in the rest of the rest of the country.

The mossy north

DEFF Research Database (Denmark)

Mateo, Ruben G.; Broennimann, Olivier; Normand, Signe

2016-01-01

, as predicted by theory, and whether the assembly mechanisms differ among taxonomic groups. SR increases towards the south in spermatophytes, but towards the north in ferns and bryophytes. SR patterns in spermatophytes are consistent with their patterns of beta diversity, with high levels of nestedness...... and turnover in the north and in the south, respectively, indicating species exclusion towards the north and increased opportunities for speciation in the south. Liverworts exhibit the highest levels of nestedness, suggesting that they represent the most sensitive group to the impact of past climate change...

US of tissue banking and transplantation in North America

International Nuclear Information System (INIS)

Strong, M.; Moogk, M.

1999-01-01

Tissue banking in North America began as surgical bone banking in individual hospitals and progressed to recovery of cadaveric tissues, initially by the United States Navy Tissue Bank and more recently to regional tissue banks throughout North America. The American Association of Tissue Banks was established in 1976 to develop standards for tissue banking and the eventual inspection and accreditation of tissue banks. The gathering of statistics of tissue banking practices was first undertaken in 1992, from accredited tissue banks. The most recent statistics were compiled in 1997 and will be reported at this conference.There are currently 63 accredited tissue banks in North America, 60 in the United States and three in Canada. Overall, tissue donation has increased by 48% during this 5 year reporting time. During the same period, the number of living surgical bone donors has decreased from nearly 3,000 to less than 500. This impact is largely due to the new regulations that have been implemented by the Food and Drug Administration (FDA). There were over 340,000 bone grafts distributed in 1996, an increase of 20% over 1992, 33% were not sterilized, 21% were sterilized using irradiation, and 45% were demineralized. Only 1% were processed using ethylene oxide as a sterilant, a decrease from 15% in 1992. The primary mode of preservation and storage is freeze-drying with 90% of the tissues falling into this category and the rest being frozen. The second largest number of grafts distributed were skin grafts. Total tissue grafts distributed including cornea was 445,417. In January 1998, the FDA Final Rule regarding regulation of tissue banking became effective. The elements of that Final Rule and new tissue banking rules the FDA has proposed will be discussed along with regulations recently published by the Health and Human Services Department relative to organ and tissue donor referrals. Tissue Banking in North America continues to evolve and has become more and more

Greater healthcare utilization and costs among Black persons compared to White persons with aphasia in the North Carolina stroke belt.

Science.gov (United States)

Ellis, Charles; Hardy, Rose Y; Lindrooth, Richard C

2017-05-15

To examine racial differences in healthcare utilization and costs for persons with aphasia (PWA) being treated in acute care hospitals in North Carolina (NC). NC Healthcare Cost and Utilization Project State Inpatient Database (HCUP-SID) data from 2011-2012 were analyzed to examine healthcare utilization and costs of care for stroke patients with aphasia. Analyses emphasized length of stay, charges and cost of general hospital services. Generalized linear models (GLM) were constructed to determine the impact of demographic characteristics, stroke/illness severity, and observed hospital characteristics on utilization and costs. Hospital fixed effects were included to yield within-hospital estimates of disparities. GLM models demonstrated that Blacks with aphasia experienced 1.9days longer lengths of stay compared to Whites with aphasia after controlling for demographic characteristics, 1.4days controlling for stroke/illness severity, 1.2days controlling for observed hospital characteristics, and ~1 extra day controlling for unobserved hospital characteristics. Similarly, Blacks accrued ~$2047 greater total costs compared to Whites after controlling for demographic characteristics, $1659 controlling for stroke/illness severity, $1338 controlling for observed hospital characteristics, and ~$1311 greater total costs after controlling for unobserved hospital characteristics. In the acute hospital setting, Blacks with aphasia utilize greater hospital services during longer hospitalizations and at substantially higher costs in the state of NC. A substantial portion of the adjusted difference was related to the hospital treating the patient. However, even after controlling for the hospital, the differences remained clinically and statistically significant. Copyright © 2017 Elsevier B.V. All rights reserved.

Momentum distribution of charged particles in jets in dijet events and ...

Indian Academy of Sciences (India)

2016-07-19

Jul 19, 2016 ... Momentum distribution of charged particles in jets in dijet events and comparison to perturbative QCD predictions. M E ZOMORRODIAN1,∗, M HASHEMINIA1,4, S M ZABIHINPOUR2 and A MIRJALILI3. 1Department of Physics, Ferdowsi University of Mashhad, 91775-1436, Mashhad, Iran. 2Department of ...

Use of transabdominal ultrasound in the diagnosis of gastroesophageal junction diseases, comparison with conventional barium study and endoscopy, referred to Ghaem Hospital, Mashhad, North East of Iran

International Nuclear Information System (INIS)

Rahrouh, M.; Khosravi, A.

2003-01-01

Over the past two decades, the incidence of adenocarcinoma of the esophagus and gastric cardia has increased at a rate exceeding that of any other cancer. Ultrasound imaging of gastroesophageal junction is valuable part of diagnostics and identifies abnormalities may be helpful in establishing the etiology and choosing the treatment method. We compared transabdominal sonography with upper gastrointestinal tract x-ray series (barium study) for evaluating gastroesophageal junction disease .To demonstrate the gastroesophageal junction with a real-time, transabdominal sonography, the patient in a supine position, the transducer was placed under the xiphoid and the ultrasound beam was directed cephalad through the window of the left lobe of the liver. In 84 cases (50 men, 34 women; age range, 31-70 years) underwent abdominal sonography. Normal findings were verified by esophagoscopy or by clinical follow-up. The intraabdominal esophagus was demonstrated satisfactorily, and all abnormal findings were verified by biopsy and correlated with endoscopy or barium study and surgery. The normal sonographic pattern and the thickness of the wall of abdominal esophagus were determined. The detection rate of the normal pattern in 42 control subjects was 95%, the normal thickness of the wall (range 3-mm to 4 mm). In 28 patients with severe acute esophageal inflammation, the thickness was (range 4 mm to 8 mm). In 14 patients with an invading lesion in the gastroesophageal junction due to malignancy, the thickness of the wall was more than 10 mm in each case (range 9 mm to 17 mm). Because sonography identifies abnormalities of the gastroesophageal junction, is a good screening method with a high sensitivity in the majority of patients for changes in wall architecture and it provides information on disorders of structure and motility. This study indicates that the sonographic detection of gastroesophageal junction through the liver window can be included in routine abdominal sonography

Inpatient child mortality by travel time to hospital in a rural area of Tanzania.

Science.gov (United States)

Manongi, Rachel; Mtei, Frank; Mtove, George; Nadjm, Behzad; Muro, Florida; Alegana, Victor; Noor, Abdisalan M; Todd, Jim; Reyburn, Hugh

2014-05-01

To investigate the association, if any, between child mortality and distance to the nearest hospital. The study was based on data from a 1-year study of the cause of illness in febrile paediatric admissions to a district hospital in north-east Tanzania. All villages in the catchment population were geolocated, and travel times were estimated from availability of local transport. Using bands of travel time to hospital, we compared admission rates, inpatient case fatality rates and child mortality rates in the catchment population using inpatient deaths as the numerator. Three thousand hundred and eleven children under the age of 5 years were included of whom 4.6% died; 2307 were admitted from time between admission and death. Assuming uniform mortality in the catchment population, the predicted number of deaths not benefiting from hospital admission prior to death increased by 21.4% per hour of travel time to hospital. If the same admission and death rates that were found at <3 h from the hospital applied to the whole catchment population and if hospital care conferred a 30% survival benefit compared to home care, then 10.3% of childhood deaths due to febrile illness in the catchment population would have been averted. The mortality impact of poor access to hospital care in areas of high paediatric mortality is likely to be substantial although uncertainty over the mortality benefit of inpatient care is the largest constraint in making an accurate estimate. © 2014 The Authors Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

Strategy. North-Korean nuclear: endgame?

International Nuclear Information System (INIS)

Mirandol, Guylain de

2017-01-01

As North Korea performed new ballistic missile tests in February 2017, and thus violated UN resolutions, this article proposes an overview of the evolutions from nuclear sanctions to economic sanctions. Initially, UN sanctions aimed at struggling against nuclear programmes and proliferation through embargo on arms and materials. After a nuclear test in 2016, South Korea withdrew from a North Korean industrial complex. International sanctions now aim at economically isolating North Korea, at increasing its trade deficit, and at reducing the sending of currencies by North-Korean expatriates. The author notices that these sanctions do not alter manufacturing activities, and that North Korea thus keeps on developing and being integrated into the international division of labour. The last part briefly discusses how North Korea could be able to get around sanctions

North Korea Conundrum

Energy Technology Data Exchange (ETDEWEB)

Samore, G

2002-07-01

Proliferation has become an important political issue over the last decades, marked simultaneously by the nuclearization of South Asia, the strengthening of international regimes (TNP, CW, MTCR) and the discovery of fraud and trafficking. This paper presents the motivations and strategy of North Korea in violating existing agreements and developing an alternative source of weapons grade material. Then it analyses the US gradual economical and political strategy to pressure North Korea to eliminate its nuclear weapons program. The future position of the US will depend on the Iraq outcome and on the results of its pressure policy on North Korea. (J.S.)

North Korea Conundrum

International Nuclear Information System (INIS)

Samore, G.

2002-01-01

Proliferation has become an important political issue over the last decades, marked simultaneously by the nuclearization of South Asia, the strengthening of international regimes (TNP, CW, MTCR) and the discovery of fraud and trafficking. This paper presents the motivations and strategy of North Korea in violating existing agreements and developing an alternative source of weapons grade material. Then it analyses the US gradual economical and political strategy to pressure North Korea to eliminate its nuclear weapons program. The future position of the US will depend on the Iraq outcome and on the results of its pressure policy on North Korea. (J.S.)

Assessing Injury and Violence Prevention in North Carolina's Local Health Departments.

Science.gov (United States)

Mouw, Mary S; Counts, Jennifer; Fordham, Corinne; Francis, Molly Merrill; Bach, Laura E; Maman, Suzanne; Proescholdbell, Scott K

2016-01-01

Injury and violence-related morbidity and mortality present a major public health problem in North Carolina. However, the extent to which local health departments (LHDs) engage in injury and violence prevention (IVP) has not been well described. One objective of the current study is to provide a baseline assessment of IVP in the state's LHDs, describing capacity, priorities, challenges, and the degree to which programs are data-driven and evidence-based. The study will also describe a replicable, cost-effective method for systematic assessment of regional IVP. This is an observational, cross-sectional study that was conducted through a survey of North Carolina's 85 LHDs. Representatives from 77 LHDs (91%) responded. Nearly one-third (n = 23; 30%) reported that no staff members were familiar with evidence-based interventions in IVP, and over one-third (n = 29; 38%) reported that their LHD did not train staff in IVP. Almost one-half (n = 37; 48%) had no dedicated funding for IVP. On average, respondents said that about half of their programs were evidence-based; however, there was marked variation (mean, 52%; standard deviation = 41). Many collaborated with diverse partners including law enforcement, hospitals, and community-based organizations. There was discordance between injury and violence burden and programming. Overall, 53% of issues listed as top local problems were not targeted in their LHDs' programs. Despite funding constraints, North Carolina's LHDs engaged in a broad range of IVP activities. However, programming did not uniformly address state injury and violence priorities, nor local injury and violence burden. Staff members need training in evidence-based strategies that target priority areas. Multisector partnerships were common and increased LHDs' capacity. These findings are actionable at the state and local level. ©2016 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.

31 CFR 500.559 - Accounts of North Korean, North Vietnamese, Cambodian or South Vietnamese sole proprietorships.

Science.gov (United States)

2010-07-01

... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Accounts of North Korean, North Vietnamese, Cambodian or South Vietnamese sole proprietorships. 500.559 Section 500.559 Money and Finance... Licensing Policy § 500.559 Accounts of North Korean, North Vietnamese, Cambodian or South Vietnamese sole...

Energy policy of North Korea

International Nuclear Information System (INIS)

Rueth, G.

2006-01-01

Since the year 1990, North Korea suffers internal-policy problems as well as foreign-political problems. The gross domestic investment decreased by 3.8% yearly between the years 1990 and 1998. Many actual problems of North Korea correspond with the energy crisis in this land affecting nearly all sectors of economy and society. This energy crisis was released by the fact, that the former Soviet Union has stopped the supply of primary energy in the year 1991. In the contribution under consideration, the author reports on the energy policy of North Korea. The main themes of this contribution are: (a) Development and characteristics of the energy sector; (b) Crisis of the energy sector; (c) Consequences of the energy crisis in North Korea; (d) Possibilities of the solution of the energy crisis. For the U.S.A. and the international community, the energy crisis offers the possibility to turn North Korea to negotiations by means of remedial measures in the energy sector. In response, North Korea should drop its nuclear energy program. Apart from such positive incentives, the threat of sanctions is conceivable. North Korea imports nearly 70 % of its oil demand from the People's Republic of China. Therefore, China has an great influence on North Korea. The energy crisis of North Korea shows the fatal consequences of a falsely performed energy policy with respect to the population of this land and with respect to the stability and disposing capacity of the political leadership

Infant feeding experiences among teen mothers in North Carolina: Findings from a mixed-methods study

Directory of Open Access Journals (Sweden)

Samandari Ghazaleh

2011-09-01

Full Text Available Abstract Background Adolescent mothers in the U.S. are much less likely to initiate breastfeeding than older mothers, and teens who do initiate breastfeeding tend to breastfeed for shorter durations. The purpose of this mixed-methods study is to investigate breastfeeding practices, barriers and facilitators among adolescent mothers ages 17 and younger. Methods Quantitative descriptive analyses are conducted using data from the North Carolina Pregnancy Risk Assessment Monitoring System (PRAMS. The population-based sample comprises 389 teens ages 13-17 giving birth to a live born infant in North Carolina in 2000 - 2005 and in 2007. Qualitative analyses are based on in-depth interviews with 22 Black, White and Hispanic teen mothers residing in rural and urban areas of North Carolina conducted between November 2007 and February 2009. Results In quantitative analyses, 52% (196 of 389 of North Carolina teen mothers initiated breastfeeding, but half of those who initiated breastfeeding (92/196 stopped within the first month postpartum. Hispanic teens (44/52 or 89% were much more likely than Black (61/159 or 41% or White teens (87/164 or 52% to initiate breastfeeding and to continue for a longer duration. Nearly sixty two percent (29/52 of Hispanic respondents breastfed for greater than four weeks as compared to 16% (29/159 of Black respondents and 26% (39/164 of White respondents. Common barriers to breastfeeding initiation and continuation included not liking breastfeeding, returning to school, nipple pain, and insufficient milk. Qualitative data provided context for the quantitative findings, elucidating the barriers and facilitators to breastfeeding from the teens' perspective and insight into the ways in which breastfeeding support to teens could be enhanced. Conclusions The large number of adolescents ceasing breastfeeding within the first month points to the need for more individualized follow-up after hospital discharge in the first few days

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.

Retinoblastoma: experience of a referral center in the North Region of Portugal

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Rocha-Bastos R

2014-05-01

Full Text Available RA da Rocha-Bastos,1 JR Araújo,1 RS Silva,2 MJ Gil-da-Costa,2 E Brandão,1 NJ Farinha,2,3 F Falcão-Reis,1,4 T Dinah-Bragança1 1Department of Ophthalmology, Hospital São João, 2Hematology and Oncology Unit, Pediatric Hospital, Hospital São João, 3Pediatrics Department, Faculty of Medicine, University of Porto, 4Department of Sense Organs, Faculty of Medicine, University of Porto, Porto, Portugal Purpose: To describe the experience of the Ophthalmology Department of Hospital São João (HSJ, a tertiary health care center in North Region, Portugal, in terms of the diagnosis, treatment, and follow-up of retinoblastoma. Methods: This was a retrospective study of patients diagnosed with retinoblastoma in Hospital São João, between 1978 and 2012. Results: Fifty patients with retinoblastoma were evaluated in our institution between 1978 and 2012. Four patients were excluded due to loss of follow-up. Among the 46 retinoblastoma cases, 33 (71.7% were unilateral and 13 (28.3% bilateral, with a mean age at diagnosis of 22.19 months and 6.92 months, respectively (P<0.001. Leukocoria was the most common presenting sign (36.9%, followed by strabismus (19.6%, a combination of leukocoria and strabismus (8.7%, and buphthalmia (2.2%. Between 1978 and 1992, nine retinoblastoma cases were referred to our hospital, all of them unilateral, and, in each case, enucleation was performed, with or without salvage therapy. Between 1993 and 2012, 18 eyes with retinoblastoma were successfully managed with conservative treatment. Conclusion: Demographic results were generally coincident with previous reports. It is crucial to screen leukocoria in pediatric practice, even in asymptomatic children. The outcome of retinoblastoma treatment in our hospital is similar to other series in developed countries. Keywords: retinoblastoma, leukocoria, strabismus, enucleation, pediatric cancer

Quality of paediatric blood transfusions in two district hospitals in Tanzania: a cross-sectional hospital based study

DEFF Research Database (Denmark)

Mosha, Dominic; Poulsen, Anja; Reyburn, Hugh

2009-01-01

respectively, prior to the BT decision. Pre-transfusion haemoglobin and body temperature were recorded in 2/3 of the patients, but respiratory rate and pulse rate were not routinely recorded. In 40% of BTs, the transfusion time exceeded the recommended 4 hours. The zonal blood bank (ZBB) and local donors......BACKGROUND: Blood transfusion (BT) can be lifesaving for children; however, monitoring the quality of BT is important. The current study describes the quality of paediatric BT delivered in two district hospitals in north-east Tanzania in order to identify areas for quality assurance and improvement...... in the administration of BT. METHODS: All 166 children admitted in the paediatric wards and receiving BT through April to June 2007 were prospectively observed. Medical records, request forms and registers in the laboratories were reviewed to identify blood source, blood screening and indications for BT. BT...

Burden of rotavirus gastroenteritis in the Middle Eastern and North African pediatric population.

Science.gov (United States)

Khoury, Hanane; Ogilvie, Isla; El Khoury, Antoine C; Duan, Yinghui; Goetghebeur, Mireille M

2011-01-07

Rotavirus gastroenteritis (RVGE) is the most common cause of severe childhood diarrhea worldwide. Objectives were to estimate the burden of RVGE among children less than five years old in the Middle East (Bahrain, Iran, Iraq, Israel, Jordan, Kuwait, Oman, Qatar, Saudi Arabia, Syria, UAE, Yemen), North Africa (Algeria, Egypt, Libya, Morocco, Tunisia) and Turkey. A comprehensive literature search was conducted in major databases on the epidemiology and burden of rotavirus among children less than five years old between 1999 and 2009. Data from each country was extracted and compared. The search identified 43 studies. RVGE was identified in 16-61% of all cases of acute gastroenteritis, with a peak in the winter. RVGE-related hospitalization rates ranged from 14% to 45%, compared to 14%-28% for non-RVGE. Annually, RVGE caused up to 112 fatalities per 100,000 in certain countries in the region. Hospitalization costs ranged from $1.8 to $4.6 million annually, depending on the country. The most recent literature available showed that G1P[8] was the most prevalent genotype combination in 8 countries (range 23%-56%). G2P[4] was most prevalent in 4 countries (26%-48%). G9P[8] and G4P[8] were also frequently detected. RVGE is a common disease associated with significant morbidity, mortality, and economic burden. Given the variety and diverse rotavirus types in the region, use of a vaccine with broad and consistent serotype coverage would be important to help decrease the burden of RVGE in the Middle East and North Africa.

North Korean Relationships

Science.gov (United States)

2012-12-18

partner, holding 18 percent of all trade. North Korea’s leading export items to Japan were men’s suits, mushrooms , and coal. Japan’s main export items...credited with providing resources to North Korea in efforts to help establish and cultivate a much stronger military force as well as begin to

Disaster metrics: quantitative benchmarking of hospital surge capacity in trauma-related multiple casualty events.

Science.gov (United States)

Bayram, Jamil D; Zuabi, Shawki; Subbarao, Italo

2011-06-01

Hospital surge capacity in multiple casualty events (MCE) is the core of hospital medical response, and an integral part of the total medical capacity of the community affected. To date, however, there has been no consensus regarding the definition or quantification of hospital surge capacity. The first objective of this study was to quantitatively benchmark the various components of hospital surge capacity pertaining to the care of critically and moderately injured patients in trauma-related MCE. The second objective was to illustrate the applications of those quantitative parameters in local, regional, national, and international disaster planning; in the distribution of patients to various hospitals by prehospital medical services; and in the decision-making process for ambulance diversion. A 2-step approach was adopted in the methodology of this study. First, an extensive literature search was performed, followed by mathematical modeling. Quantitative studies on hospital surge capacity for trauma injuries were used as the framework for our model. The North Atlantic Treaty Organization triage categories (T1-T4) were used in the modeling process for simplicity purposes. Hospital Acute Care Surge Capacity (HACSC) was defined as the maximum number of critical (T1) and moderate (T2) casualties a hospital can adequately care for per hour, after recruiting all possible additional medical assets. HACSC was modeled to be equal to the number of emergency department beds (#EDB), divided by the emergency department time (EDT); HACSC = #EDB/EDT. In trauma-related MCE, the EDT was quantitatively benchmarked to be 2.5 (hours). Because most of the critical and moderate casualties arrive at hospitals within a 6-hour period requiring admission (by definition), the hospital bed surge capacity must match the HACSC at 6 hours to ensure coordinated care, and it was mathematically benchmarked to be 18% of the staffed hospital bed capacity. Defining and quantitatively benchmarking the

Effects of Irrigation and Nitrogen Application Rates on Yield and Yield Components of Corn, Sesame and Sugar beet in Mashhad Climatic Condition

Directory of Open Access Journals (Sweden)

R Heydari Pour

2015-07-01

Full Text Available In many crops, incorrect management of nitrogen and water is one of the most important factors in the resources productivity such as water and nitrogen. In order to evaluate the effects of different nitrogen levels (zero, 50, 100 and 150 kg ha-1 and irrigation application rates (100, 75 and 50% of water requirement per species on corn, sesame and sugar beet, three separate experiments was conducted in Agricultural Research Station of Ferdowsi University of Mashhad, Iran, in 2009-2010 growing season. Three separate experiments were arranged by strip plots in randomized complete block design, with three replications. The results showed that effect of irrigation application rates on biological yield and grain number per ear and interaction effects of water × nitrogen on plant height, 100 grain weight and grain yield of corn was significant. With decreasing irrigation over 25 % water requirements, the highest grain yield (4.93 ton ha-1 in corn observed by applying nitrogen equal to 50 kg.ha-1. In addition, the highest maize yield (9.41 ton.ha-1 in mentioned was obtained by supplying 100 % water requirements. Effects of Irrigation levels on plant height and the interaction effects of water × nitrogen on 1000 grain weight in sesame was significant. Under no water stress, the highest grain yield (1.22 ton ha-1 in sesame was obtained with applying 50kg nitrogen per ha. With supplying 75% water requirements plus 50 kg nitrogen per hactar, maximum yield of sesame (820 kg ha-1 was obtained. Results of this study indicated that interaction between studied factors had insignificant effect on economic and biological yield in sugar beet. With supplying 25% water requirements plus 50 kg nitrogen per ha, maximum yield of sugar beet (58.37 ton ha-1 was achieved. It seems that suitable nitrogen management can be considered as approach in optimize the water consuming.

Effect of Mycorrhiza Symbiosis on Yield, Yield Components and Water Use Efficiency of Sesame (Sesamum indicum L. Affected by Different Irrigation Regimes in Mashhad Condition

Directory of Open Access Journals (Sweden)

A Koocheki

2016-02-01

Full Text Available Introduction Plant association with mycorrhiza has been considered as one of the options to improve input efficiency particularly for water and nutrient - (Allen and Musik, 1993; Bolan, 1991. This has been due to kncreasing the absorbing area of the root and therefore better contact with water and nutrients. Inoculation with mycorrhiza enhances nutrient uptake with low immobility such as phosphorus and solphur-, improve association and could be an option to drought and other environmental abnormalities such as salinity (Rice et al., 2002. Moreover, higher water use efficiency (WUE for crops -has been reported in the literatures (Sekhara and Reddy, 1993.The sustainable use of scarce water resources in Iran is a priority for agricultural development. The pressure of using water in agriculture sector is increasing, so creating ways to improve water-use efficiency and taking a full advantage of available water are crucial. Water stress reduce crop yield by impairing the growth of crop canopy and biomass. Scheduling water application is very crucial for efficient use of drip irrigation system, as excessive irrigation reduces yield, while inadequate irrigation causes water stress and reduces production. The aim of present study was to evaluate the symbiotic effect of mycorrhiza on yield, yield components and water use efficiency of sesame under different irrigation regimes in Mashhad. Material and Methods In order to investigate the impact of inoculation with two species of Arbuscular mycorrhiza fungi on yield, yield components and water use efficiency (WUE of sesame (Sesamum indicum L. under different irrigation regimes, an experiment was conducted as split plot based on a randomized complete block design with three replications during two growing seasons 2009-2010 and 2010-2011 at the Agricultural Research Station, College of Agriculture, Ferdowsi University of Mashhad.. The experimental factors were three irrigation regimes include 2000, 3000 and

Data for decision making: strategic information tools for hospital management during a pandemic.

Science.gov (United States)

Farias, Daniel R; Raffo, Lucrecia; Bacigalupo, Silvia; Cremaschi, Maria; Vence, Liliana; Ramos, Susana; Salguero, Ana; Claudio, Martin; Meites, Elissa; Cubito, Alejandro

2010-10-01

During the 2009 influenza A (H1N1) pandemic, Argentina's Hospital Nacional Profesor Alejandro Posadas, a referral center in the capital province of Buenos Aires, treated a large urban patient population. Beginning in April, after severe influenza had been reported in North America but before any suspected cases of H1N1 had been reported in Argentina, the authors formed a pandemic planning committee to direct our hospital's response. An important strategy of the management team was to create a single daily monitoring tool that could integrate multiple information sources. We describe our pandemic planning strategy so that it may serve as a template for other hospitals. We describe our integrated data management system and the indicators it measured. We also describe the iterative process used to develop these tools and the current versions we use in surveillance for possible new waves of pandemic influenza. We present 3 examples of strategic decision making applied to data from our integrated information system. Daily pandemic surveillance data motivated the planning committee to reallocate hospital resources to care for patients during the peak pandemic period. This report illustrates the importance of pandemic planning and advanced integrated information tools for management of a health care facility during a pandemic.

Subtypes of dissociative (conversion) disorder in two tertiary hospitals in Bangladesh.

Science.gov (United States)

Ahsan, M S; Mullick, S I; Sobhan, M A; Khanam, M; Nahar, J S; Salam, M A; Ali, R; Islam, M; Kabir, M S

2010-01-01

Dissociative (conversion) disorders are common among the patients attending in and out patients of Psychiatry Department of tertiary hospitals in Bangladesh. This study was done to see the subtypes of dissociative (conversion) disorder according to International Classification of Diseases, Tenth Revision (ICD-10). This is a descriptive, cross sectional study done on 100 consecutive patients from the Departments of Psychiatry, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka and Dhaka Medical College Hospital (DMCH). Study period was July 2005 to June 2006. Among the patients of dissociative (conversion) disorder, mixed dissociative (conversion) disorder was found highest 34%, followed by dissociative convulsion 33%, dissociative motor disorders 19%, dissociative anaesthesia and sensory loss 5%, dissociative amnesia 4%, dissociative fugue 3%. However, the researcher did not find any multiple personality disorder which is relatively common in North America. This finding reflected that there are differences in prevalence of sub types of dissociative disorders in Bangladesh and Western countries.

Prevalence of cleft lip and palate among four provinces in the West and North-West of Iran

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Nahid Jalilevand

2015-01-01

Full Text Available Background: One of the most common anomalies in newborn infants is cleft lip and/or cleft palate (CL/P. In spite of several studies about the prevalence of this, no investigation evaluated this prevalence in the West and North-West of Iran. With due attention to different ethnic groups in this area, the aim of this study is to investigate whether the distribution of CL/P live births varies regionally in this area of Iran. Materials and Methods: A cross-sectional study was conducted using hospital registry records to identify all children born with CL/P. The hospitals with a maternity unit were selected in the capital cities of four provinces in the West and North-West of Iran, East Azarbaijan, Kurdestan, Gilan, and Markazi. The population under study included all infants born alive from 2008 to 2012. Results: During the study period, 107,317 live births were registered in the hospitals with a maternity unit of four cities, and 52 infants (0.485/1000 live births were born with CL/P. The prevalence in Rasht, Arak, Sanandaj, and Tabriz cities was 0.557, 0.352, 0.503, and 0.559/1000 live births, respectively (P 0.05, whereas the prevalence of CL/P based on sex was statistically different among the four provinces (P < 0.05. Conclusion: This study shows regional variations in the birth prevalence of clefts and various cleft types. The different effects of gender on the birth prevalence of CL/P from city-to-city may be explained environmentally and/or by genetic factors affecting the development of oral clefts.

Five years review of cases of adult tetanus managed at Gondar University Hospital, North West Ethiopia (Gondar, Sep. 2003-Aug. 2008).

Science.gov (United States)

Tadesse, Abilo; Gebre-Selassie, Samuel

2009-10-01

Tetanus is a life threatening preventable infection relatively uncommon in the developed world but occurs frequently in developing countries with case fatality rate of 40-60%. We conducted the study as there is no recent review regarding adult tetanus in Ethiopia which looked at the predisposing factors, presenting features and case fatality rate. The study aims to evaluate clinical characteristics of adult tetanus as related to predisposing factors, presenting features and treatment outcome. This is a retrospective review of adult tetanus cases admitted to medical ward of Gondar University Hospital, North West Ethiopia, over a period of 5-years. A total of 29 adults were admitted with the diagnosis of generalized tetanus during the study period. There were more male then female patients (sex ratio 1.9:1) with rural dwellers constituting the majority. The mean age of patients was 35 +/- 14 yrs (range, 18-70 yrs. Majority of patients (72.4%) sustained acute injury preceding symptom onset, often on lower extremity. Three rural mothers, who denied history of trauma, developed puerperal tetanus with in 2 weeks of delivery, genital tract thought to be the portal of entry. Almost all patients, who had sustained acute injury, did not seek medical help for their wounds and missed the chance to receive prophylaxis for tetanus. Over all, 48.3% had severe, 37.9% moderate, and 13.8% mild form of tetanus at presentation. The most common clinical presentation was trismus (100%), followed by stiff neck and back (93.1%) and neck rigidity (86.2).Over all mortality rate was 41.4%. Respiratory failure requiring ventilatory support (66.7%) was the major cause of death. The study recommends a need for tetanus immunization in those who had acute injury and planning to educate individuals at risk to recognise symptoms early, and seek medical care to combat this fatal disease.

Orthopedic Implant Value Drivers: A Qualitative Survey Study of Hospital Purchasing Administrators.

Science.gov (United States)

Li, Chuan Silvia; Vannabouathong, Christopher; Sprague, Sheila; Bhandari, Mohit

2015-01-01

Osteoarthritis (OA) is a chronic, degenerative disease that is highly prevalent in the population, yet the factors that affect purchasing decisions related to this condition are poorly understood. A questionnaire was developed and administered to hospital executives across North America to determine the factors that affect purchasing decisions related to OA. Thirty-four individuals participated in the survey. Clinical evidence and cost effectiveness were deemed to be the most important factors in the process of making purchasing decisions. The most important considerations for adopting new technology were whether there was sufficient evidence in the literature, followed by thoughts of key opinion leaders, and cost of intervention/device. Ongoing research is still needed, but the current study allowed us to identify some trends in the data, providing new insight on how hospital purchasing decisions are made, which could have an immediate impact on those currently involved with making these decisions.

Trends in viral meningitis hospitalisations and notifications in the North Eastern Health Board (1997 - 2001): a cause for concern?

LENUS (Irish Health Repository)

Brabazon, E D

2004-01-01

This study aimed to compare trends in both hospital admissions and notifications of viral meningitis in the North Eastern Health Board (NEHB). Hospital admissions from 1997 to 2001, involving NEHB residents with an infectious disease diagnosis, were examined and viral meningitis cases were analyzed. During this period 265 NEHB residents were admitted to hospital with viral meningitis--an increase of 429% between 1997 and 2001 with the bulk of this increase during 2000 and 2001. A total of 1,234 bed days were taken up by this cohort and the mean length of stay was 4.5 days (95% CI 4.2 - 4.9). The number of viral meningitis notifications in the NEHB was 38 (ranging from 4 in 1997 to 11 in 2001). This number is much lower than expected given the corresponding number of hospital admissions for the same period. Thus, most cases were not notified which means that current surveillance systems under-estimate the disease burden of viral meningitis. Such under-reporting has implications for infectious disease policy in Ireland.

Does cultural and linguistic diversity affect health-related outcomes for people with stroke at discharge from hospital?

Science.gov (United States)

Davies, Sarah E; Dodd, Karen J; Hill, Keith D

2017-04-01

Primary purpose to determine if cultural and linguistic diversity affects health-related outcomes in people with stroke at discharge from hospital and secondary purpose to explore whether interpreter use alters these outcomes. Systematic search of: Cochrane, PEDro, CINAHL, Medline, Pubmed, Embase, PsycINFO and Ageline databases. Publications were classified into whether they examined the impact of diversity in culture, or language or culture and language combined. Quality of evidence available was summarized using Best Evidence Synthesis. Eleven studies met inclusion criteria and were reviewed. Best Evidence Synthesis indicated conflicting evidence about the impact of culture alone and language barriers alone on health-related outcomes. There was strong evidence that hospital length of stay does not differ between groups when the combined impact of culture and language was investigated. Conflicting evidence was found for other outcomes including admission, discharge and change in FIM scores, and post-hospital discharge living arrangements. It is unknown if interpreter use alters health-related outcomes, because this was infrequently reported. The current limited research suggests that cultural and linguistic diversity does not appear to impact on health-related outcomes at discharge from hospital for people who have had a stroke, however further research is needed to address identified gaps. Implications for Rehabilitation The different language, culture and beliefs about health demonstrated by patients with stroke from minority groups in North America do not appear to significantly impact on their health-related outcomes during their admission to hospital. It is not known whether interpreter use influences outcomes in stroke rehabilitation because there is insufficient high quality research in this area. Clinicians in countries with different health systems and different cultural and linguistic groups within their communities need to view the results with caution

Jurassic domes in the North Sea - northern North Atlantic region

Energy Technology Data Exchange (ETDEWEB)

Surlyk, F. [Univ. of Copenhagen, Geological Inst., Copenhagen (Denmark)

1996-12-31

The stratigraphic and tectonic evolution of the Jurassic of East Greenland, the Norwegian Shelf and the North Sea is remarkably similar. A major Middle Jurassic unconformity occurs in all three areas. In the North Sea it is commonly termed the `Mid-Cimmerian Unconformity` and is characterized by progressive truncation of the underlying section towards a centre at the triple junction between the Central Graben, Viking Graben and Moray Firth. Strata above the unconformity show a progressive Late Aalenian-Early Kimmeridgian onlap in the same direction. These relations have been interpreted as caused by Early Jurassic uplift and of a major thermal dome in the central North Sea, followed by Medial and Late Jurassic rifting, erosion, deflation and transgression of the dome. The East Greenland unconformity shows progressive truncation of underlying strata from south to north, and Bajocian to Callovian onlap in the same direction. The same pattern seems to be developed on the conjugate Norwegian margin. This suggests the possibility that the three unconformities have similar causes for their development. It is proposed that major rift domes formed in the Central North Sea and in the Greenland-Norway seaway in Early Jurassic times. The domes were eroded and gradually deflated during Medial Jurassic times and were finally submerged by the Late Oxfordian-Kimmeridgian. They were associated with volcanism and rifting which was delayed with respect to dome initiation. Roughly contemperaneous domes were present west of Britain, north of the Porcupine Seabight, and in Scania, southern Sweden, as reflected by development of asymmetrical unconformities showing progressive truncation of underlying strata, onlap of overlying Jurassic strata, and associated intrusive and extrusive volcanism. The domes are related to impingement of the heads of transient mantle plumes at the base of the lithosphere. The associated unconformities are thus of non-eustatic nature. Domal uplift and

The Value Proposition of Prevention: The Impacts of Pure North S’Energy Foundation’s Preventive Care Program on Acute Care Utilization in Alberta

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J.C. Herbert Emery

2016-04-01

Full Text Available This analysis of Pure North S’Energy Foundation’s preventive health services shows that the acute health care cost savings of being pro-active, rather than reactive, and averting chronic disease, are significant, immediate and worth pursuing further. Chronic disease, such as cardiovascular maladies, diabetes, cancer and other long-term illnesses, represents the leading cause of disability and death in Canada. An estimated 25 per cent of expenditures in the public health system go towards treating these frequently avoidable diseases. This health-care cost curve, which sees more money expended on fighting the increase of chronic disease, can be bent, so to speak, through prevention services that offer long-term benefits to people’s health. Preventing disease is not just good for individuals, but for the health system in general, as prevention frees up acute care beds for more timely access by those who need them. The concern for health care decision makers struggling to find dollars to meet current health care needs is that investment in prevention is risky compared spending on medical treatment. It is often expressed that the health cost savings of prevention are too far off in the future and there is a lack of convincing evidence that preventive services and interventions will achieve the health gains expected. Pure North offers participants in its eight-year-old program access to a variety of healthcare practitioners, including doctors, naturopaths, nurses, nurse practitioners and dentists. Participants receive lifestyle counselling and dietary supplements aimed at combating vitamin D insufficiency, obesity, insulin resistance and other problems that can lead to chronic disease. Our study found that participants who stay with the program for two years demonstrate significant reductions in their number of visits to emergency rooms and hospitals. Indeed, after just one year in the program, the number of hospital visits was down 27 per cent

Características clínicas e epidemiológicas da leishmaniose visceral em crianças internadas em um hospital universitário de referência no norte de Minas Gerais, Brasil Clinical and epidemiological characteristics of visceral leishmaniasis in children hospitalized at a reference university hospital in the north of Minas Gerais, Brazil

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Ludmila Mourão Xavier-Gomes

2009-12-01

12 years admitted with a diagnosis of VL at the University Hospital Clemente de Faria, Montes Claros, MG. Records for the period between January 2006 and December 2007 were analyzed. RESULTS: We identified 51 children with VL, of which 51% were female, and 74.5% were under 5 years of age. Children came from Montes Claros (31%, 20 municipalities in the north of the state of Minas Gerais (69%, urban areas (72.5%, and rural areas (21.6%. The main clinical manifestation was fever (96.1% and major clinical findings at admission were splenomegaly (98% and hepatomegaly (94%. The treatment of choice was Glucantime (70.6%, Conventional Amphotericin B (13.7%, Liposomal Amphotericin B (2%, and Glucantime associated with Amphotericin B (15.7%. Infections developed during hospitalization in 35.4% of cases, and of those, 11.8% were skin infections. The average length of hospitalization was 19 days (SD = ± 5.4; 96.1% children received medical discharge and 3.9% progressed to death. CONCLUSIONS: From the clinical and epidemiological characteristics identified in the study, more effective monitoring by healthcare workers is recommended, aiming at early recognition and appropriate treatment of the disease and its complications.

Domestic violence shelter partnerships and veterinary student attitudes at North American veterinary schools and colleges.

Science.gov (United States)

Creevy, Kate E; Shaver, Stephanie L; Cornell, Karen K

2013-01-01

Animal abuse and domestic violence are linked issues, and pet ownership is reported to play a crucial role in the choice to leave an abusive situation. Although veterinarians witness the effects of abuse and violence over the course of their careers, they have limited training regarding these issues. One mechanism for educating veterinary students while providing a service for victims of domestic violence is the creation of partnerships between domestic violence shelters and veterinary schools. These extracurricular programs can provide both care for pets belonging to victims of domestic violence and an educational platform for student participants. The goals of this study were to determine the prevalence and characteristics of domestic violence shelter partnerships (DVSPs) at North American veterinary teaching hospitals and to determine whether the presence of a DVSP was associated with increased awareness among veterinary students regarding animal abuse and domestic violence. Nine of 33 veterinary schools surveyed described a DVSP program. Students at schools with DVSPs associated with their veterinary teaching hospitals were significantly more likely to indicate that their awareness of the link between animal abuse and domestic violence had increased during veterinary school. Most veterinary students reported that they felt poorly prepared to handle domestic violence and animal abuse issues in the workplace. This study indicates that extracurricular DVSPs are a viable means of educating veterinary students regarding domestic violence and animal abuse. A need for improved education on these topics in veterinary schools across North America is identified.

Oesophageal carcinoma in jordanian field hospital in afghanistan

International Nuclear Information System (INIS)

Ajlouni, Y.M.

2007-01-01

Mazzar-I-Shariff in Afghanistan, is a poor wartorn city with only one gastrointestinal endoscopist in the region. It was noticed by previous gastroenterologists working in Jordanian Field Hospital in Afghanistan that oesophageal carcinoma is seen more frequant than that in Jordan. The objectives of the study were to determine the spectrum of upper gastrointestinal diseases in patients who undergone upper endoscopy in the Jordanian Field Hospital in Afghanistan and to estimate the incidence,age of diagnosis, clinical presentations and the endoscopic appearance of the oesophageal carcinoma. Between 20 December 2003 and March 3, 2004, 289 gastroscopies were performed in Jordanian field Hospital/Afghanistan on patients aged 16 years or more. Biopsies were taken from any suspected lesion. Data for each patient were kept to correlate with the histopathological results. Thirty three (11.4%) endoscopies gave normal results. The most common major single findings in the other 256 were oseophageal carcinoma (22.5%) duodenal ulcers (13.5%), and oesophagitis (13%). About one third of the patients had more than one endoscopic finding. Oseophageal carcinoma was found in 22.5% of patients and it was more common in men than women. The most common presenting symptom for oseophageal carcinoma were dysphagia and weight loss. It was more frequent in age group of 60-72 years. The most common endoscopic findings were mass or ulcerative lesion. Oesophageal carcinoma is a common finding in patients who had upper endoscopy in the Jordanian Field Hospital in the north of Afghanistan.Mazzar-I-Sharif needs well equiped gastrointestinal unit and a multi disciplinary team (Gastroenterologist, Histopathologist,Surgeon and Dietitian) to deal with patients with oesophageal carcinoma and more research is needed to establish the possible etiology. (author)

North Korea: a mercenary proliferator?

International Nuclear Information System (INIS)

Hemez, Remy

2015-01-01

After having recalled that North Korea possesses a rather advanced ballistic programme which has been started in the 1970 with the Chinese support, that North Korea is the fourth world producer of ballistic missiles, the author outlines that this country has become a major proliferator as it exports this production to different States and non-State actors. He recalls the long history of relationships between North Korea and terrorist organisations (even during the Cold War), comments the current and major support of North Korea to Hamas and Hezbollah in Gaza and in Lebanon. These relationships are then related with those these both organisations have with Syria and Iran who are in fact the relays between them and North Korea. The author explains why Hamas and Hezbollah must buy their weapons to such a far country: Iran is submitted to international sanctions, Iran and Syria want to avoid being banned from the international community for selling weapon to a terrorist (or so-said) organisation, and prices are rather competitive. If North Korea is also submitted to international sanctions, weapon smuggling seems to be institutional in this country. The author finally briefly evokes the issue of chemical weapons: North Korea possesses few thousand tonnes of these weapons, and could export them to non-state organisations

North-South precipitation patterns in western North America on interannual-to-decadal timescales

Science.gov (United States)

Dettinger, M.D.; Cayan, D.R.; Diaz, Henry F.; Meko, D.M.

1998-01-01

The overall amount of precipitation deposited along the West Coast and western cordillera of North America from 25??to 55??N varies from year to year, and superimposed on this domain-average variability are varying north-south contrasts on timescales from at least interannual to interdecadal. In order to better understand the north-south precipitation contrasts, their interannual and decadal variations are studied in terms of how much they affect overall precipitation amounts and how they are related to large-scale climatic patterns. Spatial empirical orthogonal functions (EOFs) and spatial moments (domain average, central latitude, and latitudinal spread) of zonally averaged precipitation anomalies along the westernmost parts of North America are analyzed, and each is correlated with global sea level pressure (SLP) and sea surface temperature series, on interannual (defined here as 3-7 yr) and decadal (>7 yr) timescales. The interannual band considered here corresponds to timescales that are particularly strong in tropical climate variations and thus is expected to contain much precipitation variability that is related to El Nino-Southern Oscillation; the decadal scale is defined so as to capture the whole range of long-term climatic variations affecting western North America. Zonal EOFs of the interannual and decadal filtered versions of the zonal-precipitation series are remarkably similar. At both timescales, two leading EOFs describe 1) a north-south seesaw of precipitation pivoting near 40??N and 2) variations in precipitation near 40??N, respectively. The amount of overall precipitation variability is only about 10% of the mean and is largely determined by precipitation variations around 40??-45??N and most consistently influenced by nearby circulation patterns; in this sense, domain-average precipitation is closely related to the second EOF. The central latitude and latitudinal spread of precipitation distributions are strongly influenced by precipitation

North by north-west: climate change and directions of density shifts in birds.

Science.gov (United States)

Lehikoinen, Aleksi; Virkkala, Raimo

2016-03-01

There is increasing evidence that climate change shifts species distributions towards poles and mountain tops. However, most studies are based on presence-absence data, and either abundance or the observation effort has rarely been measured. In addition, hardly any studies have investigated the direction of shifts and factors affecting them. Here, we show using count data on a 1000 km south-north gradient in Finland, that between 1970-1989 and 2000-2012, 128 bird species shifted their densities, on average, 37 km towards the north north-east. The species-specific directions of the shifts in density were significantly explained by migration behaviour and habitat type. Although the temperatures have also moved on average towards the north north-east (186 km), the species-specific directions of the shifts in density and temperature did not correlate due to high variation in density shifts. Findings highlight that climate change is unlikely the only driver of the direction of species density shifts, but species-specific characteristics and human land-use practices are also influencing the direction. Furthermore, the alarming results show that former climatic conditions in the north-west corner of Finland have already moved out of the country. This highlights the need for an international approach in research and conservation actions to mitigate the impacts of climate change. © 2015 John Wiley & Sons Ltd.

Causes of decadal climate variability over the North Pacific and North America

International Nuclear Information System (INIS)

Latif, M.; Barnett, T.P.

1994-01-01

The cause of decadal climate variability over the North Pacific and North America is investigated by analyzing data from a multi-decadal integration with a state of the art coupled ocean-atmosphere model and observations. About one third of the low-frequency climate variability in the region of interest can be attributed to a cycle involving unstable air-sea interactions between the subtropical gyre circulation in the North Pacific and the Aleutian low pressure system. The existence of this cycle provides a basis for long-range climate forecasting over the western United States at decadal time scales. (orig.)

Evaluation of prophylactic antibiotic administration in general surgery division of a teaching hospital in north of Iran

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Paniz Yousefi

2016-01-01

Full Text Available Surgical site infections are one of the most important post-surgery complications. Antimicrobial prophylaxis has been used routinely in surgeries to reduce infection incidence. However, inappropriate selection of antimicrobial agents or dosing can develop antimicrobial resistance, serious adverse reactions and prolong hospitalization. Current study aimed to examine prophylactic antibiotic prescription in surgeries in a teaching hospital in Sari, Mazandaran and evaluate level of adherence to the international guidelines. Between January 2015 to May 2015, 104 patients in general surgery ward were selected and enrolled in the study. The prophylactic antibiotics, dosage, timing and duration of administration were collected by reviewing patients’ records and compared to the existing guidelines. Prophylactic antibiotic was given to 85.5% of patients. Prescribed antibiotics were cefazolin (46.1%, metronidazole (24%, ceftriaxone (12.5%, ciprofloxacin (1.9% and vancomycin (0.96%. Most of the patients (62.9% received an inappropriate and delayed timing. Proper antibiotic dosage was seen in 45.2% of patients. All patients received post-operative prophylactic antibiotic. Main antibiotics include cefazolin (41.3%, metronidazole (33.7%, ceftriaxone (31.7% and clindamycin (20.2%. Only 10 (21.9% patients received cefazolin or vancomycin for a total duration of 48 hours or less. Surgical wound infection occurred in 17 (16.3% patients during hospital stay. Adherence to antimicrobial prophylaxis guidelines was completely achieved in 14.4% of cases. Results of this study signified that adherence to existing guidelines was poor and the most common mistakes were over usage, inappropriate dosage and choosing of antibiotics.

North-south interdependence

Energy Technology Data Exchange (ETDEWEB)

Norse, D

1979-01-01

The sound eco-development of agriculture can help to establish a cooperative and harmonious north-south interdependence. The interdependence pattern is seen when the major agricultural suppliers (energy, fertilizers, and pesticides) are examined in the context of commodity transfers of grain and rubber. The consumers of either the north or south would be unable to find alternative sources without major production or social disruption. The Organization of Economic Co-operation and Development (OECD) INTERFUTURES study examines the chain of dependencies between raw materials and markets and the implications for economic development, employment, and environmental hazards. If interdependence is to benefit both the north and the south, technological fixes will not be adequate or appropriate to deal with the potential hazards. (DCK)

The Asian-Bering-North American teleconnection: seasonality, maintenance, and climate impact on North America

Science.gov (United States)

Yu, Bin; Lin, H.; Wu, Z. W.; Merryfield, W. J.

2018-03-01

The Asian-Bering-North American (ABNA) teleconnection index is constructed from the normalized 500-hPa geopotential field by excluding the Pacific-North American pattern contribution. The ABNA pattern features a zonally elongated wavetrain originating from North Asia and flowing downstream across Bering Sea and Strait towards North America. The large-scale teleconnection is a year-round phenomenon that displays strong seasonality with the peak variability in winter. North American surface temperature and temperature extremes, including warm days and nights as well as cold days and nights, are significantly controlled by this teleconnection. The ABNA pattern has an equivalent barotropic structure in the troposphere and is supported by synoptic-scale eddy forcing in the upper troposphere. Its associated sea surface temperature anomalies exhibit a horseshoe-shaped structure in the North Pacific, most prominent in winter, which is driven by atmospheric circulation anomalies. The snow cover anomalies over the West Siberian plain and Central Siberian Plateau in autumn and spring and over southern Siberia in winter may act as a forcing influence on the ABNA pattern. The snow forcing influence in winter and spring can be traced back to the preceding season, which provides a predictability source for this teleconnection and for North American temperature variability. The ABNA associated energy budget is dominated by surface longwave radiation anomalies year-round, with the temperature anomalies supported by anomalous downward longwave radiation and damped by upward longwave radiation at the surface.

Third North Korean nuclear test: what is the state of the North's programme?

International Nuclear Information System (INIS)

Sitt, Bernard

2013-02-01

Two months ago, following North Korea's Unha-3 launch, which put a small satellite into orbit, this publication discussed the possibility of a third North Korean nuclear test. As expected, Pyongyang remained true to its traditional policy of provocation. With carefully calculated timing, it carried out a third nuclear test on 12 February, just hours after Barack Obama's State of the Union address, four days before former leader Kim Jong-il's birthday, and on the eve of the investiture of the new South Korean president on the 25 February. Moreover, the North Korean regime is billing this test as a riposte to the new round of sanctions adopted on by the Security Council on 22 January following the Unha-3 launch in December, as it announced on the 24 January. Yet, aside from the associated posturing, this test confirms, if more confirmation were needed, the North's determination to develop an effective nuclear deterrent. The use of the term miniaturisation is certainly in part a propaganda exercise (can actual miniaturisation be achieved after three nuclear tests, one or two of whose success is highly doubtful?). Nonetheless, North Korea has clearly made progress in developing a nuclear weapon and an intercontinental ballistic missile derived from the Taepodong-2, and has promised to carry out further ballistic launches. Without a doubt, even if the North is a long way from possessing what we would consider an operational nuclear capability, its determination has helped it to make progress, and the country shows no signs of wanting to change course. In light of this fact, what can the international community do beyond existing and future sanctions regimes? Doubtless very little. China, which continues to support the North and which has been known in the past to exert influence on Pyongyang, has expressed its firm displeasure as to the North's activities but appears to have no leverage over Kim Jong-un. The Six-Party talks have little chance of being revived, as North

Hospital waste management in nonteaching hospitals of Lucknow City, India

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Manish Kumar Manar

2014-01-01

Full Text Available Objective: To assess hospital waste management in nonteaching hospitals of Lucknow city. Materials and Methods: A cross-sectional, descriptive study was conducted on the staffs of nonteaching hospitals of Lucknow from September 2012 to March 2013. A total of eight hospitals were chosen as the study sample size. Simple random sampling technique was used for the selection of the nonteaching hospitals. A pre-structured and pre-tested interview questionnaire was used to collect necessary information regarding the hospitals and biomedical waste (BMW management of the hospitals. The general information about the selected hospitals/employees of the hospitals was collected. Results: Mean hospital waste generated in the eight nonteaching hospitals of Lucknow was 0.56 kg/bed/day. About 50.5% of the hospitals did not have BMW department and colored dustbins. In 37.5% of the hospitals, there were no BMW records and segregation at source. Incinerator was used only by hospital A for treatment of BMW. Hospital G and hospital H had no facilities for BMW treatment. Conclusion: There is a need for appropriate training of staffs, strict implementation of rules, and continuous surveillance of the hospitals of Lucknow to improve the BMW management and handling practices.

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.

Change in Vascular Access and Hospitalization Risk in Long-Term Hemodialysis Patients

Science.gov (United States)

Wang, Weiling; Lazarus, J. Michael; Hakim, Raymond M.

2010-01-01

Background and objectives: Conversion from central venous catheters to a graft or a fistula is associated with lower mortality risk in long-term hemodialysis (HD) patients; however, a similar association with hospitalization risk remains to be elucidated. Design, setting, participants, & measurements: We conducted a prospective observational study all maintenance in-center HD patients who were treated in Fresenius Medical Care, North America legacy facilities; were alive on January 1, 2007; and had baseline laboratory data from December 2006. Access conversion (particularly from a catheter to a fistula or a graft) during the 4-month period from January 1 through April 30, 2007, was linked using Cox models to hospitalization risk during the succeeding 1-year follow-up period (until April 30, 2008). Results: The cohort (N = 79,545) on January 1, 2007 had 43% fistulas, 29% catheters, and 27% grafts. By April 30, 2007, 70,852 patients were still on HD, and among 19,792 catheters initially, only 10.3% (2045 patients) converted to either a graft or a fistula. With catheters as reference, patients who converted to grafts/fistulas had similar adjusted hazard ratios (0.69) as patients on fistulas (0.71), while patients with fistulas/grafts who converted to catheters did worse (1.22), all P < 0.0001. Conclusions: Catheters remain associated with the greatest hospitalization risk. Conversion from a catheter to either graft or fistula had significantly lower hospitalization risk relative to keeping the catheter. Prospective studies are needed to determine whether programs that reduce catheters will decrease hospitalization risk in HD patients. PMID:20884778

Unplanned readmission after hospital discharge in burn patients in Iran.

Science.gov (United States)

Jafaryparvar, Zakiyeh; Adib, Masoomeh; Ghanbari, Atefeh; Leyli, Ehsan Kazemnezhad

2018-02-21

Burns are considered as one of the most serious health problems throughout the world. They may lead to adverse consequences and outcomes. One of these outcomes is unplanned readmission. Unplanned readmission has been commonly used as a quality indicator by hospitals and governments. This study aimed to determine the predictors of unplanned readmission in patients with burns hospitalized in a burn center in the North of Iran (Guilan province, Rasht). This retrospective analytic study has been done on the medical records of hospitalized patients with burns in Velayat Sub-Specialty Burn and Plastic Surgery Center, Rasht, Iran during 2008-2013. In general, 703 medical records have been reviewed but statistical analysis was performed on 626 medical records. All data were entered in SPSS (version 16) and analyzed by descriptive and inferential statistics. Among 626 patients with burns, the overall readmission rate was 5.1%. Predictors of readmission included total body surface area (OR 1.030, CI 1.011-1.049), hypertension (OR 2.923, CI 1.089-7.845) and skin graft (OR 7.045, CI 2.718-18.258). Considering the outcome, predictors following burn have a crucial role in the allocation of treatment cost for patients with burns and they can be used as one of the quality indicators for health care providers and governments.

The incidence of gastroenteritis diagnosis among sick dogs presented to the Onderstepoort Veterinary Academic Hospital correlated with meteorological data : research communication

Directory of Open Access Journals (Sweden)

A.S. Shakespeare

1999-07-01

Full Text Available The number of sick dogs diagnosed with and without gastroenteritis presented to the Onderstepoort Veterinary Academic Hospital situated north of Pretoria is reported from counts extracted from the records of the Outpatients clinic for 6 years, 1988 to 1993. The average percentage of sick dogs diagnosed with gastroenteritis was 11.51 % and the average percentage of sick dogs that were admitted to the parvovirus isolation hospital ward was 2.8 %. A strong correlation exists between the number of dogs admitted to the parvovirus ward and average monthly wind speed and inverse humidity values.

The Impact of Hospital Size on CMS Hospital Profiling.

Science.gov (United States)

Sosunov, Eugene A; Egorova, Natalia N; Lin, Hung-Mo; McCardle, Ken; Sharma, Vansh; Gelijns, Annetine C; Moskowitz, Alan J

2016-04-01

The Centers for Medicare & Medicaid Services (CMS) profile hospitals using a set of 30-day risk-standardized mortality and readmission rates as a basis for public reporting. These measures are affected by hospital patient volume, raising concerns about uniformity of standards applied to providers with different volumes. To quantitatively determine whether CMS uniformly profile hospitals that have equal performance levels but different volumes. Retrospective analysis of patient-level and hospital-level data using hierarchical logistic regression models with hospital random effects. Simulation of samples including a subset of hospitals with different volumes but equal poor performance (hospital effects=+3 SD in random-effect logistic model). A total of 1,085,568 Medicare fee-for-service patients undergoing 1,494,993 heart failure admissions in 4930 hospitals between July 1, 2005 and June 30, 2008. CMS methodology was used to determine the rank and proportion (by volume) of hospitals reported to perform "Worse than US National Rate." Percent of hospitals performing "Worse than US National Rate" was ∼40 times higher in the largest (fifth quintile by volume) compared with the smallest hospitals (first quintile). A similar gradient was seen in a cohort of 100 hospitals with simulated equal poor performance (0%, 0%, 5%, 20%, and 85% in quintiles 1 to 5) effectively leaving 78% of poor performers undetected. Our results illustrate the disparity of impact that the current CMS method of hospital profiling has on hospitals with higher volumes, translating into lower thresholds for detection and reporting of poor performance.

Fracturas orbitocigomáticas, valor de la clasificación de Knight y North en su terapéutica Orbitozygomatic fractures and the value of Knight and North´s classification.

Directory of Open Access Journals (Sweden)

Oscar N. García-Roco Pérez

2006-08-01

Full Text Available Se realizó un estudio observacional descriptivo de 230 pacientes intervenidos quirúrgicamente por fracturas orbitocigomáticas en el Servicio de Cirugía Maxilofacial del Hospital Provincial Docente "Manuel Ascunce Domenech" de Camagüey, en el período de enero 1999 a diciembre 2003, con el propósito de describir el valor de la clasificación de Knight y North en la selección de variantes quirúrgicas terapéuticas de las fracturas orbitocigomáticas, a través de la experiencia del servicio. Se utilizó la clasificación de Knight y North para la selección de las variantes de tratamiento, determinándose las variables edad, sexo, clasificación, terapéutica quirúrgica, complicaciones y resultados posoperatorios. Se observó un predominio del sexo masculino con el 75,7 %, y dicha cirugía se realizó con mayor frecuencia entre los 25-34 años (34,3 %. La clase III de Knight y North fue la más frecuente (45,6 %, seguida por la II y IV, con el 31,6 y 10,1 %, respectivamente. Basados en esta clasificación y teniendo en cuenta el grado de inestabilidad posreducción esperado, se seleccionó adecuadamente la variante terapéutica a emplear en el 98,8 % de los casos. Se llega a la conclusión de que la incidencia de fracturas orbitocigomáticas es alta, y dentro de ellas, la clase III de Knight y North es la más frecuente. Se recomienda esta clasificación para su tratamiento, ya que permite seleccionar la variante de tratamiento más adecuada de acuerdo con el grado de inestabilidad posreducción esperado, lográndose resultados estéticos y funcionales adecuados con escasas complicaciones posoperatorias no inherentes a esta.A descriptive observational study of 250 patients, who were operated on from orbitozygomatic fractures at the Maxillofacial Surgery Service of “Manuel Ascunce Domenech” provincial teaching hospital in Camaguey from January 1999 to December 2003, was conducted . The objective was to describe the importance of Knight

Burden of rotavirus gastroenteritis in the Middle Eastern and North African pediatric population

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Duan Yinghui

2011-01-01

Full Text Available Abstract Background Rotavirus gastroenteritis (RVGE is the most common cause of severe childhood diarrhea worldwide. Objectives were to estimate the burden of RVGE among children less than five years old in the Middle East (Bahrain, Iran, Iraq, Israel, Jordan, Kuwait, Oman, Qatar, Saudi Arabia, Syria, UAE, Yemen, North Africa (Algeria, Egypt, Libya, Morocco, Tunisia and Turkey. Methods A comprehensive literature search was conducted in major databases on the epidemiology and burden of rotavirus among children less than five years old between 1999 and 2009. Data from each country was extracted and compared. Results The search identified 43 studies. RVGE was identified in 16-61% of all cases of acute gastroenteritis, with a peak in the winter. RVGE-related hospitalization rates ranged from 14% to 45%, compared to 14%-28% for non-RVGE. Annually, RVGE caused up to 112 fatalities per 100,000 in certain countries in the region. Hospitalization costs ranged from $1.8 to $4.6 million annually, depending on the country. The most recent literature available showed that G1P[8] was the most prevalent genotype combination in 8 countries (range 23%-56%. G2P[4] was most prevalent in 4 countries (26%-48%. G9P[8] and G4P[8] were also frequently detected. Conclusions RVGE is a common disease associated with significant morbidity, mortality, and economic burden. Given the variety and diverse rotavirus types in the region, use of a vaccine with broad and consistent serotype coverage would be important to help decrease the burden of RVGE in the Middle East and North Africa.

Thrombolytic therapy in acute Myocardial Infarction: Experience in auniversity hospital in Kuwait

International Nuclear Information System (INIS)

Rashed, Wafa A.; Singh, S.; Constandi, Jamal N.; Memon, A.; Al-Kandari, F.; Zubaid, M.

1998-01-01

There is conclusive evidence from large clinical trials that thrombolytictherapy reduces mortality and morbidity in myocardial infarction (AMI).However, only a small proportion of patients receive thrombolytic treatment.Estimates have varied from 20%-50% in North America and Europe. Data from theArab Middle East is sparse. The purpose of our study was to determine the useof thrombolytic therapy in our hospital. We conducted a retrospectiveanalysis of 343 patients (358 incidents of AMI), who were either dischargedfrom or died at the coronary care unit of the Mubarak Al-Kabeer Hospitalduring the one-year period between June 1994 to May 1995. Our patients wererelatively younger (63% were 65 years) were also less likely to be thrombolyzedthan younger patients (42% vs. 66%; P=0.0006). We conclude that the use ofthrombolytic therapy in this university hospital in Kuwait is appropriate.However, as observed in other reports as well, the underutilization ofthrombolytic therapy in women and elderly needs to be addressed in futurestudies. (author)

Linguatula serrata (Porocephalida: Linguatulidae) Infection among Client-Owned Dogs in Jalingo, North Eastern Nigeria: Prevalence and Public Health Implications

OpenAIRE

Oluwasina, Oseni Saheed; ThankGod, Onyiche Emmanuel; Augustine, Omonuwa Omojefe; Gimba, Fufa Ido

2014-01-01

Pentastomiasis is a parasitic zoonosis endemic to western and central Africa. This study was undertaken to determine the prevalence and public health implications of Linguatulosis in client-owned dogs in Jalingo, North Eastern Nigeria. Seven hundred and seventy seven (777) dogs brought for treatment at the hospital were subjected to buccal (sublingual) examination for pentastomiasis. Parameters such as age, sex, and breeds were determined. Also, the months of the year were taken into consider...

Individual and hospital-related determinants of potentially inappropriate admissions emerging from administrative records.

Science.gov (United States)

Fusco, Marco; Buja, Alessandra; Piergentili, Paolo; Golfetto, Maria Teresa; Serafin, Gianni; Gallo, Silvia; Dalla Barba, Livio; Baldo, Vincenzo

2016-11-01

The appropriate use of health care is an important issue in developed countries. The purpose of this study was to ascertain the extent of potentially inappropriate hospital admissions and their individual, clinical and hospital-related determinants. Medical records were analyzed for the year 2014 held by the Local Heath Unit n. 13 in the Veneto Region of north-east Italy (19,000 records). The outcomes calculated were: admissions for conditions amenable to day hospital care; brief medical admissions; outlier lengths of stay for elderly patients' medical admissions; and medical admissions to surgical wards. Univariate analyses and logistic regression models were used to test associations with demographic, clinical and hospital ward covariates, including organizational indicators. Inappropriate reliance on acute care beds ranged from 6% to 28%, depending on the type of quality indicator analyzed. Some individual features, and wards' specific characteristics were associated with at least one of the phenomena of inappropriate hospital resource usage. In particular, male gender, younger age and transferals seemed to affect inappropriate admissions to surgical wards. Potentially avoidable admissions featuring inpatients amenable to day hospital care were associated with subjects with fewer comorbidities and lower case-mix wards, while inappropriately short medical stays were influenced by patients' higher functional status and local residency and by lower bed occupancy rates. In conclusion, inappropriately long hospital stays for elderly cases were associated with patients with multiple pathologies in wards with a low bed-occupancy. Education level and citizenship did not seem to influence inappropriate admissions. Some individual, clinical ad structural characteristics of patients and wards emerging from administrative records could be associated with inappropriate reliance on acute hospital beds. Analyzing the indicators considered in this study could generate

Increases in Intravenous Magnesium Use among Hospitalized Patients: An Institution Cross-Sectional Experience

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Bryce A. Kiberd

2015-06-01

Full Text Available Background: Among hospitalized patients, indications for the measurement of magnesium levels and treatment of hypomagnesemia with intravenous magnesium are not well defined. Recently, there have been reports of worldwide shortages of intravenous magnesium sulphate. Objective: To examine secular trends in the administration of intravenous magnesium on hospital wards at a tertiary care institution. The secondary objective is to identify factors associated with magnesium use among admitted patients. Methods: Retrospective cross-section review of hospitalized patients at a single Canadian tertiary care center. Utilization of non-parental nutrition intravenous magnesium from 2003 to 2013 stratified by hospital ward was examined. In addition, patient level data from select wards (including medical and surgical services was examined at early and more recent time period (4/2006 versus 4/2013. Results: Among the 248,329 hospitalized patients, intravenous magnesium use increased by 2.86 fold from 2003 to 2013. Not all wards had an increase whereas some had nearly a 10 fold increase in use. In the sample ( n = 769, (adjusting for admission magnesium level, presence of an indication for intravenous magnesium, ward location, comorbidity and demographics intravenous magnesium administration was higher (25.8 % versus 5.5 % in 2013 versus 2006 (OR 13.91 (95 % CI, 6.21–31.17, p < 0.001. Despite this increase in intravenous magnesium administration, <3 % of patients were admitted on oral magnesium in 2006 and 2013. For patients receiving intravenous magnesium only a minority were discharged on oral therapy despite low levels. Conclusions: This center has witnessed a considerable increase in the use of in-hospital intravenous magnesium over the last 6 years that cannot be explained for by medical indications. The risks and benefits of this therapy deserve further study. If this change in practice is representative of other North American hospitals, it may be

Comparing the odds of postpartum haemorrhage in planned home birth against planned hospital birth: results of an observational study of over 500,000 maternities in the UK

OpenAIRE

Nove, Andrea; Berrington, Ann; Matthews, Zo?

2012-01-01

Abstract Background The aim of this study is to compare the odds of postpartum haemorrhage among women who opt for home birth against the odds of postpartum haemorrhage for those who plan a hospital birth. It is an observational study involving secondary analysis of maternity records, using binary logistic regression modelling. The data relate to pregnancies that received maternity care from one of fifteen hospitals in the former North West Thames Regional Health Authority Area in England, an...

A detailed gravimetric geoid of North America, the North Atlantic, Eurasia, and Australia

Science.gov (United States)

Marsh, J. G.

1973-01-01

A computer program was developed for the calculation of a goid based upon a combination of satellite and surface gravity data. A detailed gravimetric geoid of North America, the North Atlantic, Eurasia, and Australia was derived by using this program.

31 CFR 500.560 - Bank accounts of official representatives of foreign governments in North Korea, North Viet-Nam...

Science.gov (United States)

2010-07-01

... representatives of foreign governments in North Korea, North Viet-Nam, Cambodia, or South Viet-Nam. 500.560... governments in North Korea, North Viet-Nam, Cambodia, or South Viet-Nam. Specific licenses are issued... Viet-Nam, Cambodia, or South Viet-Nam for transactions which are not inconsistent with the purposes of...

Incidence of nutritional anaemia among the under five children attending Ahmed Gasim hospital

International Nuclear Information System (INIS)

Mohamed, Hager Elrasheed Ali

1998-11-01

A survey was carried out in Khartoum North Ahmed Gasim specialist Hospital for children to identify aetiological factors that lead to incidence of nutritional anaemia among children under under five years of age. The sample consists of 192 patients taken from the hospital wards (experimental group), and 60 healthy children taken from out patient vaccination department of same hospital. A questionnaire was used as a tool for collection data regarding children and their families with emphasis to general information, socio-economic information, dietary information, anthropometric information, medical history and laboratory investigations including haemoglobin, hematocrit (PCV)%, peripheral blood picture, serum ferritin, serum folate and serum B 12 . Results show no correlation between anaemia and age R(0.1048) p 1 2 deficiency. Some children affected had mixed deficiency anaemia (3.182). Iron deficiency without anaemia was common among healthy children (control) 22.8%. Some recommendations were set for the improvement of the existing situation e.g. health education, nutrition education with emphasis on intake of supplements and weaning diets rich in iron and folate. Follow up and surveillance program to compact nutritional anaemia should be adopted.(Author)

Impact of organizational climate on organizational commitment and perceived organizational performance: empirical evidence from public hospitals.

Science.gov (United States)

Berberoglu, Aysen

2018-06-01

Extant literature suggested that positive organizational climate leads to higher levels of organizational commitment, which is an important concept in terms of employee attitudes, likewise, the concept of perceived organizational performance, which can be assumed as a mirror of the actual performance. For healthcare settings, these are important matters to consider due to the fact that the service is delivered thoroughly by healthcare workers to the patients. Therefore, attitudes and perceptions of the employees can influence how they deliver the service. The aim of this study was to evaluate healthcare employees' perceptions of organizational climate and test the hypothesized impact of organizational climate on organizational commitment and perceived organizational performance. The study adopted a quantitative approach, by collecting data from the healthcare workers currently employed in public hospitals in North Cyprus, utilizing a self-administered questionnaire. Collected data was analyzed with the help of Statistical Package for Social Sciences, and ANOVA and Linear Regression analyses were used to test the hypothesis. Results revealed that organizational climate is highly correlated with organizational commitment and perceived organizational performance. Simple linear regression outcomes indicated that organizational climate is significant in predicting organizational commitment and perceived organizational performance. There was a positive and linear relationship between organizational climate with organizational commitment and perceived organizational performance. Results from the regression analysis suggested that organizational climate has an impact on predicting organizational commitment and perceived organizational performance of the employees in public hospitals of North Cyprus. Organizational climate was found to be statistically significant in determining the organizational commitment of the employees. The results of the study provided some critical

Spatio-Temporal Variation and Prediction of Ischemic Heart Disease Hospitalizations in Shenzhen, China

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Yanxia Wang

2014-05-01

Full Text Available Ischemic heart disease (IHD is a leading cause of death worldwide. Urban public health and medical management in Shenzhen, an international city in the developing country of China, is challenged by an increasing burden of IHD. This study analyzed the spatio-temporal variation of IHD hospital admissions from 2003 to 2012 utilizing spatial statistics, spatial analysis, and space-time scan statistics. The spatial statistics and spatial analysis measured the incidence rate (hospital admissions per 1,000 residents and the standardized rate (the observed cases standardized by the expected cases of IHD at the district level to determine the spatio-temporal distribution and identify patterns of change. The space-time scan statistics was used to identify spatio-temporal clusters of IHD hospital admissions at the district level. The other objective of this study was to forecast the IHD hospital admissions over the next three years (2013–2015 to predict the IHD incidence rates and the varying burdens of IHD-related medical services among the districts in Shenzhen. The results show that the highest hospital admissions, incidence rates, and standardized rates of IHD are in Futian. From 2003 to 2012, the IHD hospital admissions exhibited similar mean centers and directional distributions, with a slight increase in admissions toward the north in accordance with the movement of the total population. The incidence rates of IHD exhibited a gradual increase from 2003 to 2012 for all districts in Shenzhen, which may be the result of the rapid development of the economy and the increasing traffic pollution. In addition, some neighboring areas exhibited similar temporal change patterns, which were also detected by the spatio-temporal cluster analysis. Futian and Dapeng would have the highest and the lowest hospital admissions, respectively, although these districts have the highest incidence rates among all of the districts from 2013 to 2015 based on the prediction

NORTH CAROLINA GROUNDWATER RECHARGE RATES 1994

Science.gov (United States)

North Carolina Groundwater Recharge Rates, from Heath, R.C., 1994, Ground-water recharge in North Carolina: North Carolina State University, as prepared for the NC Department of Environment, Health and Natural Resources (NC DEHNR) Division of Enviromental Management Groundwater S...

The North Dakota lignite partnership

International Nuclear Information System (INIS)

Porter, C.R.

1998-01-01

The State of North Dakota and the Lignite Energy Council have formed a government/industry partnership to promote the use of North Dakota lignite. The partnership provides funding and management for the Lignite Research, Development and Marketing Program. The program funds activities which preserve and enhance jobs and lignite production; ensure economic growth, stability and opportunity; and maintain a stable and competitive tax base. Funding is provided for activities in three areas: marketing feasibility studies, small research projects, and demonstration projects. Funding is derived from the state coal severance tax. Approximately $3,000,000 annually is appropriated from coal severance revenues for program activities. North Dakota is the ninth largest coal producing state, with lignite as the only rank of coal found in the state. Energy is the second largest economic sector in North Dakota, and it currently comprises over 12% of the state's total economic base. This paper reviews the North Dakota lignite industry and describes studies and projects which have received funding from the program

What is the impact of chronic kidney disease stage and cardiovascular disease on the annual cost of hospital care in moderate-to-severe kidney disease?

DEFF Research Database (Denmark)

Kent, Seamus; Schlackow, Iryna; Lozano-Kühne, Jingky

2015-01-01

BACKGROUND: Reliable estimates of the impacts of chronic kidney disease (CKD) stage, with and without cardiovascular disease, on hospital costs are needed to inform health policy. METHODS: The Study of Heart and Renal Protection (SHARP) randomized trial prospectively collected information on kidney...... disease progression, serious adverse events and hospital care use in a cohort of patients with moderate-to-severe CKD. In a secondary analysis of SHARP data, the impact of participants' CKD stage, non-fatal cardiovascular events and deaths on annual hospital costs (i.e. all hospital admissions, routine...... dialysis treatments and recorded outpatient/day-case attendances in United Kingdom 2011 prices) were estimated using linear regression. RESULTS: 7,246 SHARP patients (2,498 on dialysis at baseline) from Europe, North America, and Australasia contributed 28,261 years of data. CKD patients without diabetes...

Steering patients to safer hospitals? The effect of a tiered hospital network on hospital admissions.

Science.gov (United States)

Scanlon, Dennis P; Lindrooth, Richard C; Christianson, Jon B

2008-10-01

To determine if a tiered hospital benefit and safety incentive shifted the distribution of admissions toward safer hospitals. A large manufacturing company instituted the hospital safety incentive (HSI) for union employees. The HSI gave union patients a financial incentive to choose hospitals that met the Leapfrog Group's three patient safety "leaps." The analysis merges data from four sources: claims and enrollment data from the company, the American Hospital Association, the AHRQ HCUP-SID, and a state Office of the Insurance Commissioner. Changes in hospital admissions' patterns for union and nonunion employees using a difference-in-difference design. We estimate the probability of choosing a specific hospital from a set of available alternatives using conditional logistic regression. Patients affiliated with the engineers' union and admitted for a medical diagnosis were 2.92 times more likely to select a hospital designated as safer in the postperiod than in the preperiod, while salaried nonunion (SNU) patients (not subject to the financial incentive) were 0.64 times as likely to choose a compliant hospital in the post- versus preperiod. The difference-in-difference estimate, which is based on the predictions of the conditional logit model, is 0.20. However, the machinists' union was also exposed to the incentive and they were no more likely to choose a safer hospital than the SNU patients. The incentive did not have an effect on patients admitted for a surgical diagnosis, regardless of union status. All patients were averse to travel time, but those union patients selecting an incentive hospital were less averse to travel time. Patient price incentives and quality/safety information may influence hospital selection decisions, particularly for medical admissions, though the optimal incentive level for financial return to the plan sponsor is not clear.

Near-Death Experiences in a Multi-religious Hospital Population in Sri Lanka.

Science.gov (United States)

Chandradasa, Miyuru; Wijesinghe, Chamara; Kuruppuarachchi, K A L A; Perera, Mahendra

2017-07-01

Near-death experiences (NDEs) are a wide range of experiences that occur in association with impending death. There are no published studies on NDEs in general hospital populations, and studies have been mainly conducted on critically ill patients. We assessed the prevalence of NDEs and its associations in a multi-religious population in a general hospital in Sri Lanka. A randomised sample of patients admitted to the Colombo North Teaching Hospital was assessed using the Greyson NDE scale and clinical assessment. Out of total 826 participants, NDEs were described by 3%. Compared to the NDE-negative participants, the NDE-positive group had a significantly higher mean for age and a ratio of men. Women reported deeper NDEs. Patients of theistic religions (Christianity, Islam and Hinduism) reported significantly more NDEs compared to patients from the non-theistic religious group (Buddhism). NDE-positive patient group had significantly higher reporting of a feeling 'that they are about to die', the presence of loss of consciousness and a higher percentage of internal medical patients. This is the first time that NDEs are assessed in a general hospital population and NDEs being reported from Sri Lanka. We also note for the first time that persons with theistic religious beliefs reported more NDEs than those with non-theistic religious beliefs. Medical professionals need to be aware of these phenomena to be able to give an empathic hearing to patients who have NDE.

North Korea, Quo Vadis?

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Karl H. Stingeder

2014-03-01

Full Text Available North Korean politics appears neither irrational nor unpredictable: the logic of its actions may at first seem opaque, but it nonetheless displays its own rationale and patterns. – North Korea: a ruthless political actor, now under the leadership of Kim Jong-Un who inherited the regime’s leadership from his father and "Supreme Leader", Kim Jong-Il, in 2011. The country’s policy is based on its ongoing political agenda of (nuclear brinkmanship, a true threat to the world – or at least that's how the Western hemisphere sees it. Yet our factual knowledge of this post-Leninist and totalitarian regime is extremely limited and relatively distorted; it is largely circumstantial evidence and judgmental speculation that accounts for our perception of this East Asian state. Northeast Asia (China, Japan, South and North Korea, Taiwan is a region dominated by the legacy of the Cold War. The North Korean leadership has indeed established its priorities, primarily its isolationist orientation, but in the long term the regime cannot survive without external stimulus. Most importantly, even in a long-term, non-violent and gradual transformation of North Korea considerable danger can ultimately result in the demise of the regime. Apart from few signs of a North Korean "civil society", currently only the army might have the resources to see through a regime change. In the meantime, the strategies of isolationism as well as tight control of the media remain as fundamental cornerstones of the regime. A close-knit network of social control has been established and access to the internet for the most part is limited to the regime’s entrusted cadre.

Estimating North Dakota's Economic Base

OpenAIRE

Coon, Randal C.; Leistritz, F. Larry

2009-01-01

North Dakota’s economic base is comprised of those activities producing a product paid for by nonresidents, or products exported from the state. North Dakota’s economic base activities include agriculture, mining, manufacturing, tourism, and federal government payments for construction and to individuals. Development of the North Dakota economic base data is important because it provides the information to quantify the state’s economic growth, and it creates the final demand sectors for the N...

The North Korean nuclear dilemma

International Nuclear Information System (INIS)

Hecker, Siegfried S.

2004-01-01

The current nuclear crisis, the second one in ten years, erupted when North Korea expelled international nuclear inspectors in December 2002, then withdrew from the Nuclear Nonproliferation Treaty (NPT), and claimed to be building more nuclear weapons with the plutonium extracted from the spent fuel rods heretofore stored under international inspection. These actions were triggered by a disagreement over U.S. assertions that North Korea had violated the Agreed Framework (which froze the plutonium path to nuclear weapons to end the first crisis in 1994) by clandestinely developing uranium enrichment capabilities providing an alternative path to nuclear weapons. With Stanford University Professor John Lewis and three other Americans, I was allowed to visit the Yongbyon Nuclear Center on Jan. 8, 2004. We toured the 5 MWe reactor, the 50 MWe reactor construction site, the spent fuel pool storage building, and the radiochemical laboratory. We concluded that North Korea has restarted its 5 MWe reactor (which produces roughly 6 kg of plutonium annually), it removed the 8000 spent fuel rods that were previously stored under IAEA safeguards from the spent fuel pool, and that it most likely extracted the 25 to 30 kg of plutonium contained in these fuel rods. Although North Korean officials showed us what they claimed was their plutonium metal product from this reprocessing campaign, we were not able to conclude definitively that it was in fact plutonium metal and that it came from the most recent reprocessing campaign. Nevertheless, our North Korean hosts demonstrated that they had the capability, the facility and requisite capacity, and the technical expertise to produce plutonium metal. On the basis of our visit, we were not able to address the issue of whether or not North Korea had a 'deterrent' as claimed - that is, we were not able to conclude that North Korea can build a nuclear device and that it can integrate nuclear devices into suitable delivery systems. However

Nursing magnet hospitals have better CMS hospital compare ratings

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Robbins RA

2017-11-01

Full Text Available Background: There has been conflicting data on whether Nursing Magnet Hospitals (NMH provide better care. Methods: NMH in the Southwest USA (Arizona, California, Colorado, Hawaii, Nevada, and New Mexico were compared to hospitals not designated as NMH using the Centers for Medicare and Medicaid (CMS hospital compare star designation. Results: NMH had higher star ratings than non-NMH hospitals (3.34 + 0.78 vs. 2.86 + 0.83, p<0.001. The hospitals were mostly large, urban non-critical access hospitals. Academic medical centers made up a disproportionately large portion of the NMH. Conclusions: Although NMH had higher hospital ratings, the data may favor non-critical access academic medical centers which are known to have better outcomes.

Prescribing errors during hospital inpatient care: factors influencing identification by pharmacists.

Science.gov (United States)

Tully, Mary P; Buchan, Iain E

2009-12-01

To investigate the prevalence of prescribing errors identified by pharmacists in hospital inpatients and the factors influencing error identification rates by pharmacists throughout hospital admission. 880-bed university teaching hospital in North-west England. Data about prescribing errors identified by pharmacists (median: 9 (range 4-17) collecting data per day) when conducting routine work were prospectively recorded on 38 randomly selected days over 18 months. Proportion of new medication orders in which an error was identified; predictors of error identification rate, adjusted for workload and seniority of pharmacist, day of week, type of ward or stage of patient admission. 33,012 new medication orders were reviewed for 5,199 patients; 3,455 errors (in 10.5% of orders) were identified for 2,040 patients (39.2%; median 1, range 1-12). Most were problem orders (1,456, 42.1%) or potentially significant errors (1,748, 50.6%); 197 (5.7%) were potentially serious; 1.6% (n = 54) were potentially severe or fatal. Errors were 41% (CI: 28-56%) more likely to be identified at patient's admission than at other times, independent of confounders. Workload was the strongest predictor of error identification rates, with 40% (33-46%) less errors identified on the busiest days than at other times. Errors identified fell by 1.9% (1.5-2.3%) for every additional chart checked, independent of confounders. Pharmacists routinely identify errors but increasing workload may reduce identification rates. Where resources are limited, they may be better spent on identifying and addressing errors immediately after admission to hospital.

The Degree of Accessibility to Health Care – Issues Concerning the North-Eastern Population of Romania

Directory of Open Access Journals (Sweden)

Alina Mareci

2008-05-01

Full Text Available This study is analysing the population accessibly to the sanitary infrastructure in the North-East region of Romania, namely the six component counties of Bacu, Botoani, Iai, Neam, Suceava and Vaslui. Due to lack of basic sanitary infrastructure when it comes to regional general medical centres (called dispensaries, the population is forced to travel large distances in order to benefit of medical assistance. The hospital infrastructure is unbalanced in terms of territorial distribution. The highly populated urban settlements are usually equipped with one or more hospital unit(s being located along the national road E85 and the adjacent national roads, fulfilling in most cases municipal roles or holding vital social and economic importance for the region. The longer distances the patients are forced to travel for medical assistance the higher health costs due to the additional travel costs the person has to undertake. One direct result of this travelling is overcrowded hospitals in the targeted areas which in its turn may have negative impacts on the quality of services provided and on the amount of time the people need to spend in that facility.

Avaliação da preceptoria na residência médica em cirurgia geral, no centro cirúrgico, comparação entre um hospital universitário e um hospital não universitário Assessment of preceptorship in general surgery residency in the operating room, comparison between a teaching hospital and a non teaching hospital

Directory of Open Access Journals (Sweden)

Elizabeth Gomes Santos

2012-12-01

questionnaire. At the NTH, 11 preceptors were evaluated by 13 residents. The comparison of the distribution of responses between hospitals was analyzed using the chi-squared test for trend. Significance level was set at 5%. The statistical analysis was processed by the statistical software SAS® System version 6.11 (SAS Institute, Inc., Cary, North Carolina. The NTH showed a greater trend for discordant and indifferent responses than the TH. Only one question resulted in statistical significance between the hospitals. No significant difference was found between hospitals in the comparison of the responses to the remaining CONCLUSION: Only question 4 ("Keeps focused on the operation" showed a significant difference (p=0.010 in the distribution of responses. The two hospitals exhibited similar preceptorship quality.

Ethnic group variations in alcohol-related hospital admissions in England: does place matter?

Science.gov (United States)

Barry, Eleanor; Laverty, Anthony A; Majeed, Azeem; Millett, Christopher

2015-01-01

The health burden of alcohol use is socially and geographically patterned in many countries. Less is known about variations in this burden between ethnic groups and whether this differs across place of residence. National cross-sectional study using hospital admission data in England. Alcohol-related admission rates, where an alcohol-related condition was either the primary diagnosis (considered as the reason for admission) or a comorbidity, were calculated using ethnic group specific rates for English regions. In 2010/11 there were a total of 264,870 alcohol-related admissions in England. Admission rates were higher in the North of England than elsewhere (e.g. for primary diagnosis 161 per 100,000 population in the North vs. 62 per 100,000 in the South). These patterns were not uniform across ethnic groups however. For example, admission rates for alcohol-related comorbidity were four times higher among White Irish in London compared with those in the South of England (306 to 76 per 100,000) and four times higher in Indians living in the Midlands compared with those in the South of England (128 to 29 per 100,000). These patterns were similar for admissions with a comorbid alcohol-related condition. Geographical location may be an important determinant of within and between ethnic group variations in alcohol-related hospital admissions in England. While a number of factors were not examined here, this descriptive analysis suggests that this heterogeneity should be taken into account when planning interventions and services for the prevention and management of alcohol misuse.

The North Korean Nuclear Crisis: Outcome and Resolution

International Nuclear Information System (INIS)

Lee, Seung-Keun

2011-01-01

This paper focuses on the North Korean nuclear crisis and how to find the best method of dismantling the North's nuclear facilities. From empirical studies of North Korean negotiating behavior, strategy, intentions and future of the regime, North Korea seems unlikely to abandon its nuclear program, if left unconstrained. This paper analyzes North Korean nuclear strategy and discusses problems concerned with the North Korean nuclear issues. It will propose some resolutions for a comprehensive approach in order to find a solution to the North Korean nuclear threat: restarting the six-party talks; preparation of a sophisticated nuclear elimination road-map; encouraging the gradual transformation of North Korea and its integration into the international community. In the long run, when North Korean nuclear strategy is considered, dialogue and engagement combined with international pressure or proper sanctions is needed

40 CFR 81.335 - North Dakota.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 17 2010-07-01 2010-07-01 false North Dakota. 81.335 Section 81.335... AREAS FOR AIR QUALITY PLANNING PURPOSES Section 107 Attainment Status Designations § 81.335 North Dakota. North Dakota—SO2 Designated area Does not meet primary standards Does not meet secondary standards...

Women in perfusion: a survey of North American female perfusionists.

Science.gov (United States)

Brewer, Stacey L; Mongero, Linda B

2013-09-01

Perfusion as a career has long been dominated by men (American Board of Cardiovascular Perfusion, Booklet of information since 1975). Women represent 33.3% of the present workforce in North America (1187 certified women). In the 1900s, fewer than 20% of women participated in the labor force compared with 75% today and growing (1). In addition women make only 77 cents for every dollar that men earn and the more education a woman has, the greater the disparity in her wages (2). Only 53% of employers provide at least some replacement pay during periods of maternity leave (2). The purpose of this survey was to poll women in perfusion to evaluate concerns and opinions in their careers and to compare this with the female labor force. In October 2011, a 40-question survey (surveymonkey.com) was made available to all female perfusionists in North American by postcard mailing through the American Board of Cardiovascular Perfusion. There were 538 responses to the survey, which is 45% of all female certified perfusionists in North America. A total of 32.6% of the survey participants have been in perfusion for more than 20 years and 75% are staff perfusionists, working for a hospital (59.5%) rather than a contract group (36.7%). A total of 44.7% of women who had children during their employment were out on leave 10 weeks or less. A total of 95.9% feel they miss important family functions as a result of their work schedules and 63% consider themselves under moderate stress. Direct supervision of the participants by men occurred in 76.5% of cases, and 68.2% felt that they were treated with the same respect as male coworkers. Nonetheless, 50.9% felt discriminated against because of gender. This survey suggests that the female perfusionists in North America share the same difficulties as women in the labor force. The role of women in society in general is clearly changing. Female perfusionists will be part of that change. Seventy percent of those surveyed would recommend perfusion

Seasonal climate prediction for North Eurasia

International Nuclear Information System (INIS)

Kryjov, Vladimir N

2012-01-01

An overview of the current status of the operational seasonal climate prediction for North Eurasia is presented. It is shown that the performance of existing climate models is rather poor in seasonal prediction for North Eurasia. Multi-model ensemble forecasts are more reliable than single-model ones; however, for North Eurasia they tend to be close to climatological ones. Application of downscaling methods may improve predictions for some locations (or regions). However, general improvement of the reliability of seasonal forecasts for North Eurasia requires improvement of the climate prediction models. (letter)

Trauma in Guilan (North of Iran: An Epidemiologic Study

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Dehnadimoghadam Anoosh

2009-10-01

Full Text Available Injuries, especially traffic accidents are so important causes of death, disability, hospital expenses, economic damages to the society which World Health Organization selected them as the main subjects for investigation and research. We have done an epidemiologic study about trauma in Guilan, a province in north of Iran. This is  a descriptive study carried out on patients with traumatic injuries, admitted in Poursina Teaching Hospital, during September 2005 to July 2006. Data were collected prospectively using a data collection form including demographic information, mechanism of trauma, anatomical site of injuries, according to AIS90 and severity of head trauma according to glasgow coma scale (GCS. Data were processed by SPSS 11.5 and are shown in tables and figures. Overall 3598 patients admitted. Mean age was 31.85 ± 17.76 years with male to female ratio  about 3.5:1. Most of patients were 25-44 years old (33.9%. Traffic accidents were the leading  cause of injuries (73.84% and then fall (15.7%. Motorcycle was the most common mode of transport in our patients (47.07% after that car (24.3%. Occurrence of traffic accidents increased through evening. Forty six percent of patients transported to hospital by people or came themselves (46.42%. Head and neck were the most common injured part of body (82.4 %, however about in 81.66% of patients were mild and then limb and pelvis (34.7%. Finally about 2.8% of them died. A trauma especially traffic accidents are an important public health issue in Guilan, we recommend conducting other studies focusing on risk factors in details, and considering injury prevention in local decision making.

Molecular epidemiology of clinical and carrier strains of methicillin resistant Staphylococcus aureus (MRSA in the hospital settings of north India

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Dar Mohammad J

2006-09-01

Full Text Available Abstract Background The study was conducted between 2000 and 2003 on 750 human subjects, yielding 850 strains of staphylococci from clinical specimens (575, nasal cultures of hospitalized patients (100 and eye & nasal sources of hospital workers (50 & 125 respectively in order to determine their epidemiology, acquisition and dissemination of resistance genes. Methods Organisms from clinical samples were isolated, cultured and identified as per the standard routine procedures. Susceptibility was measured by the agar diffusion method, as recommended by the Nat ional Committee for Clinical Laboratory Standards (NCCLS. The modified method of Birnboin and Takahashi was used for isolation of plasmids from staphylococci. Pulsed-field gel electrophoresis (PFGE typing of clinical and carrier Methicillin resistant Staphylococcus aureus (MRSA strains isolated during our study was performed as described previously. Results It was shown that 35.1% of Staphylococcus aureus and 22.5% of coagulase-negative staphylococcal isolates were resistant to methicillin. Highest percentage of MRSA (35.5% was found in pus specimens (n = 151. The multiple drug resistance of all MRSA (n = 180 and Methicillin resistant Coagulase-negative Staphylococcus aureus (MRCNS (n = 76 isolates was detected. In case of both methicillin-resistant as well as methicillin-sensitive Saphylococcal isolates zero resistance was found to vancomycin where as highest resistance was found to penicillin G followed by ampicillin. It was shown that the major reservoir of methicillin resistant staphylococci in hospitals are colonized/infected inpatients and colonized hospital workers, with carriers at risk for developing endogenous infection or transmitting infection to health care workers and patients. The results were confirmed by molecular typing using PFGE by SmaI-digestion. It was shown that the resistant markers G and T got transferred from clinical S. aureus (JS-105 to carrier S. aureus (JN-49

Library Programs in North Carolina

Data.gov (United States)

Town of Chapel Hill, North Carolina — Count of programs offered and program attendance numbers at public libraries in North CarolinaData is from the 2014-15 NC Statistical Report of NC Public Libraries:...

North Dakota Native American Essential Understandings

Science.gov (United States)

North Dakota Department of Public Instruction, 2015

2015-01-01

In the spring of 2015, the North Dakota Department of Public Instruction brought together tribal Elders from across North Dakota to share stories, memories, songs, and wisdom in order to develop the North Dakota Native American Essential Understandings (NDNAEU) to guide the learning of both Native and non-Native students across the state. They…

HCAHPS - Hospital

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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...

North American oil demand outlook

International Nuclear Information System (INIS)

Stewart, M.B.

1995-01-01

An understanding of the relationship of economic growth and potential petroleum product demand is needed to forecast the potential for North American oil demand growth as well as knowledge of world supply and price. The bullish expectations for economic growth in the US and Canada auger well for North American refiners and marketeers. The growth in world economic output forecast, however, means a larger oil demand and an increase in OPEC's pricing power. Such price increases could depress North American oil demand growth. (author)

Study of Germination Characteristics of Fenugreek (Trigonella foenum-graecum L. population under Salinity and Drought Stress

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hassan Farhadi

2017-10-01

Full Text Available Introduction: Fenugreek (Trigonalla foenum-graecum L., an annual herbaceous plant belonging to the Coleoidea (Fabaceae family, has numerous medicinal properties such as decreasing blood glucose, laxative, appetizer, mucus, antipyretic and increasing the amount of milk during lactation . Among the most important problems in arid and semi-arid regions, drought stress or water shortage will have negative effects on plant growth. Drought stress occurs mostly because of reducing water availability in the soil. This may be due to excessive water loss or absorption problems, or both of them. One of the major factors limiting germination, which occurs in more arid and semi-arid regions, is salt stress. The study was done to evaluate germination of four Iranian population of fenugreek (Amol, Tabriz, Sari and Mashhad under drought and salinity stresses. Materials and methods: To investigate the effect of salinity and drought stresses on germination and seedling growth characteristics of native landrace fenugreek, two separate experiments were conducted in a Completely Randomized Design with three replications in Seed Laboratory of University of Mashhad in 2014. The experiment treatments consisted of four levels of salinity (0, 60, 120, 180 mM that was induced by different concentrations of sodium chloride and drought stress induced by polyethylene glycol 6000 (PEG 6000 at four levels (0, -3, -6 and -9 Bar with three replications. The drought stress levels were simulation by polyethylene glycol 6000 and using the Michel and Kaufmann formula. Distilled water was applied as control. Iranian seed population of fenugreek were purchased from the city of Amol, Tabriz, Sari and Mashhad then the seeds were washed with sodium hypochlorite (3 % v/v for two minutes for disinfestation and washed three times with distilled water. On the twelfth day of experiment, seedling traits such as plumule and root length and weight in Petri dishes were measured. Results and

Hospital Compare

Data.gov (United States)

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...

Immunological Response of Hiv-Infected Children to Highly Active Antiretoviral Therapy at Gondar University Hospital, North-Western Ethiopia.

Science.gov (United States)

Kokeb, Mehretie; Degu, Getu

2016-01-01

The effectiveness of highly active antiretroviral therapy (HAART) in children has not been well studied specially in developing countries where the burden of HIV is high. This study was aimed to assess the immunologic response of HIV-infected children to HAART at Pediatric ART Clinic Gondar University Hospital. Institution based cross-sectional study was conducted at the Pediatric ART Clinic Gondar University Hospital from March 01-April 30, 2014. The study included 283 HIV-infected children who were on HAART for 6 months and above. Medical records of HIV-infected children were reviewed using pre-tested questionnaire. CD4 count/percent was collected every 6 months retrospectively. For all statistical significance tests, the cut-off value was pimmunological response. The study revealed that there was good Immunological response to ART, and that the maximum response was in the 1(st) 6 months of ART. Low CD4 count at initiation, undisclosed HIV status and lack of good adherence were found to cause low immunological response to HAART.

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

Science.gov (United States)

Anbäcken, O

1994-01-01

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

The management of hospital waste products in hospitals of Bushehr Province

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kamran Mirzaie

2008-02-01

Full Text Available Background: Hospital waste contains a large quantity of dangerous pathogenic agents, which are hazardous to the health of man, animal, plant and the environment. In Iran, like many other developing countries, not enough attention is paid to this matter and available information regarding the generation and disposal of medical wastes are low. The existing information about production and disposal of wastes in our hospitals is little and incomplete. In this study, a survey on hospital waste management system in Bushehr province hospitals was conducted. Methods: In this cross-sectional study, 8 hospitals in Bushehr province were investigated during a period of 6 months using a questionnaire, interviews and direct observations. The questionnaire had 93 questions (open and closed about general information on the hospitals and about various systems of managing hospital waste according to the World Health Organization suggested survey questionnaire for hospital waste management in developing countries. Results: In hospitals of bushehr province, waste generation rate was 2615 kg/day, including domestic waste (51.7%, infectious waste (20.8%, sharps (15.2% and chemical and drugs wastes (12.3%. In almost all hospitals, segregation of infectious waste from domestic waste at the place of origin and putting them in special containers had been done but this segregation wasn’t complete and sometimes some hazardous waste were disposed of in domestic waste containers. All hospitals used a color coding system for waste containers, 75 % of hospitals had incinerators. In others, waste was carried out by municipal service daily. In all hospitals, all workers were trained about hospital waste management. In none of the surveyed hospitals, there was an obvious policy and plan for purchasing equipment and necessary facilities in order to dispose hospital waste correctly and also no clear budget was allocated for hospital waste management. In none of these hospitals

Hospitals

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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...

Genomic Analysis of Multidrug-Resistant Escherichia coli from North Carolina Community Hospitals: Ongoing Circulation of CTX-M-Producing ST131-H30Rx and ST131-H30R1 Strains.

Science.gov (United States)

Kanamori, Hajime; Parobek, Christian M; Juliano, Jonathan J; Johnson, James R; Johnston, Brian D; Johnson, Timothy J; Weber, David J; Rutala, William A; Anderson, Deverick J

2017-08-01

Escherichia coli sequence type 131 (ST131) predominates globally among multidrug-resistant (MDR) E. coli strains. We used whole-genome sequencing (WGS) to investigate 63 MDR E. coli isolates from 7 North Carolina community hospitals (2010 to 2015). Of these, 39 (62%) represented ST131, including 37 (95%) from the ST131- H 30R subclone: 10 (27%) from its H 30R1 subset and 27 (69%) from its H 30Rx subset. ST131 core genomes differed by a median of 15 (range, 0 to 490) single-nucleotide variants (SNVs) overall versus only 7 within H 30R1 (range, 3 to 12 SNVs) and 11 within H 30Rx (range, 0 to 21). The four isolates with identical core genomes were all H 30Rx. Epidemiological and clinical characteristics did not vary significantly by strain type, but many patients with MDR E. coli or H 30Rx infection were critically ill and had poor outcomes. H 30Rx isolates characteristically exhibited fluoroquinolone resistance and CTX-M-15 production, had a high prevalence of trimethoprim-sulfamethoxazole resistance (89%), sul1 (89%), and dfrA17 (85%), and were enriched for specific virulence traits, and all qualified as extraintestinal pathogenic E. coli The high overall prevalence of CTX-M-15 appeared to be possibly attributable to its association with the ST131- H 30Rx subclone and IncF[F2:A1:B-] plasmids. Some phylogenetically clustered non-ST131 MDR E. coli isolates also had distinctive serotypes/ fimH types, fluoroquinolone mutations, CTX-M variants, and IncF types. Thus, WGS analysis of our community hospital source MDR E. coli isolates suggested ongoing circulation and differentiation of E. coli ST131 subclones, with clonal segregation of CTX-M variants, other resistance genes, Inc-type plasmids, and virulence genes. Copyright © 2017 American Society for Microbiology.

The relationship between food frequency and menstrual distress in high school females

OpenAIRE

Mohamadirizi, Soheila; Kordi, Masoumeh

2015-01-01

Background: Nutrition pattern is one of the important factors predicting menstrual distress, which varies among different cultures and countries. The purpose of this study is to determine the relationship between food frequency and menstrual distress in high school girls from Mashhad. Materials and Methods: This cross-sectional study was conducted in 2012 using a two-stage sampling method on 407 high school female students from Mashhad who met the inclusion criteria. Subjects completed que...

Hospitals - HOSPITALS_HAZUS_IN: Hospitals and Clinics in Indiana, Derived from HAZUS (Federal Emergency Management Agency, Point Shapefile)

Data.gov (United States)

NSGIC State | GIS Inventory — HOSPITALS_HAZUS_IN is a point shapefile that shows locations of hospitals and clinics in Indiana. HOSPITALS_HAZUS_IN was derived from the shapefile named "HOSPITAL."...

Patient Survey (PCH - HCAHPS) PPS-exempt Cancer Hospital - 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...

CLIL in the North: finding true north?

NARCIS (Netherlands)

Smit, Nienke

CLIL teaching in the Netherlands is very popular: roughly 130 secondary schools offer CLIL education. But did you know that only nine secondary schools in the north of the Netherlands currently offer bilingual education? This means that CLIL education is still not at cycling distance for every

Doripenem in hospital infections: a focus on nosocomial pneumonia, complicated intra-abdominal infections, and complicated urinary tract infections

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Tze Shien Lo

2009-06-01

Full Text Available Tze Shien Lo,1 Stephanie M Borchardt,2 Justin M Welch,3 Melissa A Rohrich,3 Augusto M Alonto,4 Anne V Alonto51Infectious Diseases Service, Veterans Administration Medical Center, Fargo, North Dakota, USA; 2Research Service, Veterans Administration Medical Center, Fargo, North Dakota, USA; 3Pharmacy Service, Veterans Administration Medical Center, Fargo, North Dakota, USA; 4Infectious Diseases Department, MeritCare Medical Center, Fargo, North Dakota, USA; 5Department of Internal Medicine, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USAAbstract: Doripenem is the latest carbapenem on the market to date. Although not an antibiotic in a new class, it offers a glimmer of hope in combating serious infections secondary to multidrug-resistant Gram-negative bacteria when we have not seen a new class of antibacterial, particularly for Gram-negative bacteria, for more than 10 years. In vitro, doripenem exhibits a broad spectrum of activity against Gram-positive and Gram-negative bacteria, including extended-spectrum β-lactamase (ESBL and Amp-C β-lactamase producing Enterobacteriaceae and anaerobes. Doripenem also exhibits better in vitro activity against Pseudomonas aeruginosa compared to other anti-pseudomonal carbapenems. It combines the desirable activities of both imipenem and meropenem. It has similar activity to imipenem against Gram-positive pathogens and has the antimicrobial spectrum of meropenem against Gram-negative organisms. Several randomized clinical trials have demonstrated that doripenem is non-inferior to meropenem, imipenem, piperacillin/tazobactam, or levofloxacin in its efficacy and safety profile in treating a wide range of serious bacterial infections including intra-abdominal infection, complicated urinary tract infection, and nosocomial pneumonia. Due to its wide spectrum of activity and good safety profile it is susceptible to misuse leading to increasing rates of resistance

Health care inequities in north India: role of public sector in universalizing health care.

Science.gov (United States)

Prinja, Shankar; Kanavos, Panos; Kumar, Rajesh

2012-09-01

Income inequality is associated with poor health. Inequities exist in service utilization and financing for health care. Health care costs push high number of households into poverty in India. We undertook this study to ascertain inequities in health status, service utilization and out-of-pocket (OOP) health expenditures in two States in north India namely, Haryana and Punjab, and Union Territory of Chandigarh. Data from National Sample Survey 60 th Round on Morbidity and Health Care were analyzed by mean consumption expenditure quintiles. Indicators were devised to document inequities in the dimensions of horizontal and vertical inequity; and redistribution of public subsidy. Concentration index (CI), and equity ratio in conjunction with concentration curve were computed to measure inequity. Reporting of morbidity and hospitalization rate had a pro-rich distribution in all three States indicating poor utilization of health services by low income households. Nearly 57 and 60 per cent households from poorest income quintile in Haryana and Punjab, respectively faced catastrophic OOP hospitalization expenditure at 10 per cent threshold. Lower prevalence of catastrophic expenditure was recorded in higher income groups. Public sector also incurred high costs for hospitalization in selected three States. Medicines constituted 19 to 47 per cent of hospitalization expenditure and 59 to 86 per cent OPD expenditure borne OOP by households in public sector. Public sector hospitalizations had a pro-poor distribution in Haryana, Punjab and Chandigarh. Our analysis indicates that public sector health service utilization needs to be improved. OOP health care expenditures at public sector institutions should to be curtailed to improve utilization of poorer segments of population. Greater availability of medicines in public sector and regulation of their prices provide a unique opportunity to reduce public sector OOP expenditure.

Patients' perceptions of interactions with hospital staff are associated with hospital readmissions: a national survey of 4535 hospitals.

Science.gov (United States)

Yang, Lianping; Liu, Chaojie; Huang, Cunrui; Mukamel, Dana B

2018-01-29

Reducing 30-day hospital readmissions has become a focus of the current national payment policies. Medicare requires that hospitals collect and report patients' experience with their care as a condition of payment. However, the extent to which patients' experience with hospital care is related to hospital readmission is unknown. We established multivariate regression models in which 30-day risk-adjusted readmission rates were the dependent variables and patients' perceptions of the responsiveness of the hospital staff and communication (as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores) were the independent variables of interest. We selected six different clinical conditions for analyses, including acute myocardial infarction (AMI), chronic obstructive pulmonary disease (COPD), heart failure, hip/knee surgery, pneumonia, and stroke. Data included all acute care hospitals reporting in Hospital Compare in 2014. The number of hospitals with reported readmissions ranged from 2234 hospitals for AMI to 3758 hospitals for pneumonia. The average 30-day readmission rates ranged from 5.19% for knee/hip surgery to 22.7% for COPD. Patient experience of hospital-staff responsiveness as "top-box" ranged from 64% to 67% across the six clinical conditions, communication with nurses ranged from 77% to 79% and communication with doctors ranged from 80% to 81% (higher numbers are better). Our finding suggests that hospitals with better staff responsiveness were significantly more likely to have lower 30-day readmissions for all conditions. The effect size depended on the baseline readmission rates, with the largest effect on hospitals in the upper 75th quartile. A ten-percentage-point increase in staff responsiveness led to a 0.03-0.18 percentage point decrease in readmission rates. We found that neither communication with physicians nor communication with nurses was significantly associated with hospital readmissions. Our findings

Performance of in-hospital mortality prediction models for acute hospitalization: Hospital Standardized Mortality Ratio in Japan

Directory of Open Access Journals (Sweden)

Motomura Noboru

2008-11-01

Full Text Available Abstract Objective In-hospital mortality is an important performance measure for quality improvement, although it requires proper risk adjustment. We set out to develop in-hospital mortality prediction models for acute hospitalization using a nation-wide electronic administrative record system in Japan. Methods Administrative records of 224,207 patients (patients discharged from 82 hospitals in Japan between July 1, 2002 and October 31, 2002 were randomly split into preliminary (179,156 records and test (45,051 records groups. Study variables included Major Diagnostic Category, age, gender, ambulance use, admission status, length of hospital stay, comorbidity, and in-hospital mortality. ICD-10 codes were converted to calculate comorbidity scores based on Quan's methodology. Multivariate logistic regression analysis was then performed using in-hospital mortality as a dependent variable. C-indexes were calculated across risk groups in order to evaluate model performances. Results In-hospital mortality rates were 2.68% and 2.76% for the preliminary and test datasets, respectively. C-index values were 0.869 for the model that excluded length of stay and 0.841 for the model that included length of stay. Conclusion Risk models developed in this study included a set of variables easily accessible from administrative data, and still successfully exhibited a high degree of prediction accuracy. These models can be used to estimate in-hospital mortality rates of various diagnoses and procedures.

North American refining

International Nuclear Information System (INIS)

Osten, James; Haltmaier, Susan

2000-01-01

This article examines the current status of the North American refining industry, and considers the North American economy and the growth in demand in the petroleum industry, petroleum product demand and quality, crude oil upgrading to meet product standards, and changes in crude oil feedstocks such as the use of heavier crudes and bitumens. Refining expansion, the declining profits in refining, and changes due to environmental standards are discussed. The Gross Domestic Product and oil demand for the USA, Canada, Mexico, and Venezuela for the years 1995-2020 are tabulated

Developing IT Infrastructure for Rural Hospitals: A Case Study of Benefits and Challenges of Hospital-to-Hospital Partnerships.

Science.gov (United States)

Reddy, Madhu C; Purao, Sandeep; Kelly, Mary

2008-01-01

This article presents a study identifying benefits and challenges of a novel hospital-to-hospital information technology (IT) outsourcing partnership (HHP). The partnership is an innovative response to the problem that many smaller, rural hospitals face: to modernize their IT infrastructure in spite of a severe shortage of resources. The investigators studied three rural hospitals that outsourced their IT infrastructure, through an HHP, to a larger, more technologically advanced hospital in the region. The study design was based on purposive sampling and interviews of senior managers from the four hospitals. The results highlight the HHP's benefits and challenges from both the rural hospitals' and vendor hospital's perspectives. The HHP was considered a success: a key outcome was that it has improved the rural hospitals' IT infrastructure at an affordable cost. The investigators discuss key elements for creating a successful HHP and offer preliminary answers to the question of what it takes for an HHP to be successful.

Seasonal Climate Associated with Major Shipping Routes in the North Pacific and North Atlantic

Directory of Open Access Journals (Sweden)

Jau-Ming Chen

2014-01-01

Full Text Available The major shipping routes in the North Pacific (NP and North Atlantic (NA are analyzed via ship-reported records compiled by the International Comprehensive Ocean-Atmosphere Data Set (ICOADS. The shipping route seasonal characteristics and associated climatic features are also examined. In the NP, the dominant cross-basin route takes a great-circle path between East Asia and North America along 54°N north of the Aleutian Islands throughout the year. This route penetrates the Aleutian low center where ocean waves and winds are relatively weaker than those in the low¡¦s southern section south of 50°N. Moreover, the Earth¡¦s spherical shape makes a higher-latitude route shorter in navigational distance across the NP than a lower-latitude route. Two additional mid-latitude routes through the 40° - 50°N region appear in summer when the Aleutian low vanishes. In the NA, the major shipping routes form an X-shaped pattern in the oceans south of 40°N to connect North America/the Panama Canal and the Mediterranean Sea/the British Isles and Europe. These major shipping routes are far from the influence of the Icelandic low and thus are used throughout the year due to the stability in marine conditions and their general efficiency. A third and more zonal route appears to the north of the X-shaped routes in the 40° - 50°N region. Weak influence from the Icelandic low on marine conditions during summer and spring means that more ships take this route in summer and spring than in winter and fall.

Meanwhile, North Korea

International Nuclear Information System (INIS)

Hautecouverture, Benjamin

2014-08-01

The progress regarding weapons of mass destruction (WMD) programmes in North Korea and the instability on the Korean Peninsula have taken a back seat in the international community's analysis and perhaps its concerns for more than a year. The last event to provoke a wave of protest and tangible renewed interest occurred on 12 February 2013 when Pyongyang carried out its third nuclear test with an estimated yield of 6 to 8 kilo-tonnes. The United Nations Security Council condemned the test on 7 March (Resolution 2094). With the exception of several recent Security Council declarations, it is clear that activity on the part of the international community has been sparse. The same can be said with regard to the European Union and the United States. This state of affairs is not surprising. The analysis takes note of it by ceasing, there or thereabouts, to produce new material. Firstly, the North Korean crisis is a long-term one and the diplomatic process that is meant to lead to its resolution has been interrupted; the Six-Party Talks have been at a standstill since the end of 2008. A agreement between the United States and North Korea, concluded on 29 February 2012 under which the North Korean regime accepted the principle of a moratorium on long-range missile tests, nuclear tests, and all activity at the Yongbyon nuclear complex lastly barely a few days. Many actors involved in the management of this crisis are suffering from a weariness whose acknowledgement is politically incorrect: with regard to Pyongyang's launch of missiles and rockets last spring, the U.S. admiral Samuel Locklear told the Associated Press in July 'you become somewhat numb, you start to say, well, it's not so much of a big deal'. Moreover, since 2013, the focus of international security with regard to WMD and beyond has also largely shifted from North-East Asia to the Middle East and Eastern Europe. Pell-mell, the worsening and broadening of the war in Syria, the terrorist surge in Iraq, the

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...

Prevalence of metabolic syndrome in a north Indian hospital-based population with obstructive sleep apnoea

Science.gov (United States)

Agrawal, Swastik; Sharma, Surendra K.; Sreenivas, Vishnubhatla; Lakshmy, Ramakrishnan

2011-01-01

Background & objectives: Obstructive sleep apnoea (OSA) is known to be associated with cardiovascular risk factors and metabolic syndrome (MS). The burden of MS in patients with OSA in India is unknown. We investigated the prevalence of MS and its components in a cross-sectional study in patients with and without OSA in a hospital-based population of a tertiary health care centre in New Delhi, India. Methods: Consecutive patients undergoing overnight polysomnography in the Sleep Laboratory of the Department of Internal Medicine of All India Institute of Medical Sciences (AIIMS) hospital, New Delhi, were studied. Anthropometry and body composition analysis, blood pressure (BP), fasting blood glucose, insulin resistance by homeostasis model assessment (HOMA-IR) and fasting blood lipid profile were measured. MS was defined using the National Cholesterol Education Program Adult treatment panel III criteria, with Asian cut-off values for abdominal obesity. Results: Of the 272 subjects recruited, 187 (82%) had OSA [apnoea-hypopnoea index (AHI)>5 events/h] while 40 (18%) had a normal sleep study. Prevalence of MS in OSA patients was 79 per cent compared to 48 per cent in non-OSA individuals [OR 4.15, (2.05-8.56), P<0.001]. Prevalence of OSA in mild, moderate and severe OSA was 66, 72 and 86 per cent, respectively (P<0.001). Patients with OSA were more likely to have higher BP [OR: 1.06 (1.02-1.11)], fasting insulin [OR: 1.18 (1.05-1.32)], HOMA-IR [OR: 1.61 (1.11-2.33)] and waist circumference [OR: 1.20 (1.13-1.27)]. Interpretation & conclusions: Our findings suggest that OSA is associated with a 4-fold higher occurrence of MS than patients without OSA. The prevalence of MS increases with increasing severity of OSA, therefore, early detection will be beneficial. PMID:22199102

Economic Impact of Higher Education in North Dakota. North Dakota Economic Studies, No. 10.

Science.gov (United States)

Dobesh, Larry J.; Henry, Mark S.

Besides their primary mission of providing education to the students of North Dakota, the 11 colleges and universities in the state represent an important "industry" which generates substantial income to the businesses and people of the state. Total college-related spending in North Dakota was $76 million during the 1973-1974 school…

Assessment of pharmacists' delivery of public health services in rural and urban areas in Iowa and North Dakota.

Science.gov (United States)

Scott, David M; Strand, Mark; Undem, Teri; Anderson, Gabrielle; Clarens, Andrea; Liu, Xiyuan

2016-01-01

The profession of pharmacy is expanding its involvement in public health, but few studies have examined pharmacists' delivery of public health services. To assess Iowa and North Dakota pharmacists' practices, frequency of public health service delivery, level of involvement in achieving the essential services of public health, and barriers to expansion of public health services in rural and urban areas. This study implemented an on-line survey sent to all pharmacists currently practicing pharmacy in Iowa and North Dakota. Overall, 602 valid responses were analyzed, 297 in rural areas and 305 in urban areas. Three practice settings (chain stores [169, 28.2%], independent community pharmacies [162, 27.0%], and hospital pharmacies [156, 26.0%]) comprised 81.2% of the sample. Both chain and independent community pharmacists were more commonly located in rural areas than in urban areas (PDakota. These findings should be interpreted to be primarily due to differences in the role of the rural pharmacist and the quest for certain opportunities that rural pharmacists are seeking.

Hospitals look to hospitality service firms to meet TQM goals.

Science.gov (United States)

Hard, R

1992-05-20

Hospitals that hire contract service firms to manage one or all aspects of their hospitality service departments increasingly expect those firms to help meet total quality management goals as well as offer the more traditional cost reduction, quality improvement and specialized expertise, finds the 1992 Hospital Contract Services Survey conducted by Hospitals.

[Food and beverages available in automatic food dispensers in health care facilities of the Portugal North Health Region].

Science.gov (United States)

Rodrigues, Filipa Gomes; Ramos, Elisabete; Freitas, Mário; Neto, Maria

2010-01-01

Patients and health staff frequently need to stay in health care facilities for quite a long time. Therefore, it's necessary to create the conditions that allow the ingestion of food during those periods, namely through the existence of automatic food dispensers. However, the available food and beverages might not always be compatible with a healthy diet. The aim of this work was to evaluate if the food and beverages available in automatic food dispensers in public Ambulatory Care Facilities (ACF) and Hospitals of the Portugal North Health Region were contributing to a healthy diet, during the year of 2007. A questionnaire was elaborated and sent to the Coordinators of the Health Sub-Regions and to the Hospital Administrators. The questionnaire requested information about the existence of automatic food dispensers in the several departments of each health care facility, as well as which food and beverages were available and most sold. Afterwards, the pre-processing of the results involved the classification of the food and beverages in three categories: recommended, sometimes recommended and not recommended. The questionnaire reply ratio was 71% in ACF and 83% in Hospitals. Automatic food dispensers were available in all the Hospitals and 86.5% of ACF. It wasn't possible to acquire food in 37% of the health facility departments. These departments were all located in ACF. The more frequently available beverages in departments with automatic food dispensers were coffee, still water, tea, juices and nectars and soft drinks. Still water, coffee, yogurt, juices and nectars and soft drinks were reported as the most sold. The more frequently avaliable food items were chocolate, recommended cookies, not recommended cakes, recommended sandwiches and sometimes recommended croissants. The food items reported as being the most sold were recommended sandwiches, chocolate, recommended cookies, sometimes recommended croissants and not recommended cookies. The beverages in the

Do HMO penetration and hospital competition impact quality of hospital care?

Science.gov (United States)

Rivers, P A; Fottler, M D

2004-11-01

This study examines the impact of HMO penetration and competition on hospital markets. A modified structure-conduct-performance paradigm was applied to the health care industry in order to investigate the impact of HMO penetration and competition on risk-adjusted hospital mortality rates (i.e. quality of hospital care). Secondary data for 1957 acute care hospitals in the USA from the 1991 American Hospital Association's Annual Survey of Hospitals were used. The outcome variables were risk-adjusted mortality rates in 1991. Predictor variables were market characteristics (i.e. managed care penetration and hospital competition). Control variables were environmental, patient, and institutional characteristics. Associations between predictor and outcome variables were investigated using statistical regression techniques. Hospital competition had a negative relationship with risk-adjusted mortality rates (a negative indicator of quality of care). HMO penetration, hospital competition, and an interaction effect of HMO penetration and competition were not found to have significant effects on risk-adjusted mortality rates. These findings suggest that when faced with intense competition, hospitals may respond in ways associated with reducing their mortality rates.

Aestheticized politics : the workings of North Korean art

NARCIS (Netherlands)

Yoon, Min-Kyung

2014-01-01

My dissertation is a study of North Korean art as a site where politics, history, and culture meet. Art in North Korea fulfills a clear purpose. This is most apparent in the depiction of historical themes in North Korean art. History serves the political legitimization of the North Korean state and

Moving farther north

International Nuclear Information System (INIS)

Boswell, R.

2000-01-01

According to predictions by the National Petroleum Council, North American demand for natural gas is likely to increase from 20 Tcf currently to 29 Tcf by the year 2010 and could increase to beyond 31 Tcf by 2015. In view of this and other similar predictions it is prudent to examine the potential sources of supply and to assess their capacity to meet this ever increasing demand. This paper provides an overview of North America's gas potential, proved reserves and current production. One of the sources much depended upon to meet future demand is the deepwater Gulf of Mexico which, however, would have to grow at the compounded rate of 21 per cent annually to meet expectations of 4.5 Tcf per year by 2010, a staggering rate of growth that would require 250 to 300 completions per year (current rate is about 100 per year) and two to three times the number of rigs currently working in the Gulf. If the deepwater Gulf of Mexico cannot meet this target, the incremental supply will most likely come from the North, namely the Fort Liard, Norman Wells, and the Mackenzie Delta/Beaufort Sea regions of Canada and Alaska's Cook Inlet, Copper River, North Slope and Susitna Basin. The economics of developing each of these regions is examined, using field size, reserves per well, exploration and development costs and cycle time as the bases for comparison. Obstacles to development such as access to pipelines, government regulations, and opposition by environmental groups are also discussed

The role of culture in perceptual learning styles

OpenAIRE

حسینی فاطمی ، پیشقدم حسینی فاطمی ، پیشقدم

2009-01-01

The major aim of this article is to determine the role of culture in perceptual learning style (PLS) preferences of Iranian English learners, in order to minimize teacher-student style conflict in the classroom. To do this, 400 university students from different fields of study were selected from Allameh Tabatabaee University in Tehran, Ferdowsi University of Mashhad and Mashhad University of Medical Sciences. The subjects were asked to answer Reid’s questionnaire (1987) which was designed to...

Histopathological Study of Protective Effects of Honey on Subacute Toxicity of Acrylamide-Induced Tissue Lesions in Rats’ Brain and Liver

OpenAIRE

Parichehr Ahrari Roodi; Zahra Moosavi*; Amir Afkhami Goli; Mohammad Azizzadeh; Hossein Hosseinzadeh

2018-01-01

Background: The therapeutic potential of honey is related to antioxidant activity against reactive oxygen species because it contains compounds such as polyphenols; therefore, we evaluated the potential protective effect of honey on subacute toxicity of ACR by histopathologic study on tissue lesions in rat. Methods: In Ferdowsi University of Mashhad, Mashhad, Iran, 2016, male Wistar rats were divided into 7 groups. To induce toxicity, ACR was injected (50 mg/kg for 11 d) to rats in 5 group...

Carolina Care at University of North Carolina Health Care: Implementing a Theory-Driven Care Delivery Model Across a Healthcare System.

Science.gov (United States)

Tonges, Mary; Ray, Joel D; Herman, Suzanne; McCann, Meghan

2018-04-01

Patient satisfaction is a key component of healthcare organizations' performance. Providing a consistent, positive patient experience across a system can be challenging. This article describes an organization's approach to achieving this goal by implementing a successful model developed at the flagship academic healthcare center across an 8-hospital system. The Carolina Care at University of North Carolina Health Care initiative has resulted in substantive qualitative and quantitative benefits including higher patient experience scores for both overall rating and nurse communication.

West Nile virus: North American experience

Science.gov (United States)

Hofmeister, Erik K.

2011-01-01

West Nile virus, a mosquito-vectored flavivirus of the Japanese encephalitis serogroup, was first detected in North America following an epizootic in the New York City area in 1999. In the intervening 11 years since the arrival of the virus in North America, it has crossed the contiguous USA, entered the Canadian provinces bordering the USA, and has been reported in the Caribbean islands, Mexico, Central America and, more recently, South America. West Nile virus has been reported in over 300 species of birds in the USA and has caused the deaths of thousands of birds, local population declines of some avian species, the clinical illness and deaths of thousands of domestic horses, and the clinical disease in over 30 000 Americans and the deaths of over 1000. Prior to the emergence of West Nile virus in North America, St. Louis encephalitis virus and Dengue virus were the only other known mosquito-transmitted flaviviruses in North America capable of causing human disease. This review will discuss the North American experience with mosquito-borne flavivirus prior to the arrival of West Nile virus, the entry and spread of West Nile virus in North America, effects on wild bird populations, genetic changes in the virus, and the current state of West Nile virus transmission.

Psychoemotional state of patients 60+ years old with chronic cerebrovascular insufficiency relocating with their family from the far north

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Liudmila G. Klimatckaia

2016-12-01

Full Text Available Background. In the Soviet period, people came to work in the Far North of the Krasnoyarsk Territory. Now they are retired. Remaining retired in the North is not economically feasible. Resettlement of unemployed elderly people to the more favorable southern climatic zones of central Siberia is connected with a demographic situation. For families 60+ years old, the “From the Extreme North to the South” program was created. The article presents the results of studies on the psychoemotional state of migrants 60+ years old. Objectives . To study the psychoemotional state of patients 60+ years old with chronic cerebrovascular insufficiency when adapting from the North to the South. Material and methods. 98 migrants from the North to the South were examined. These were people with a chronic insufficiency of brain blood circulation at the age of 60+ years old. Patients were tested utilizing the G. Eysenck and A.S. Zigmond, R.P. Snaith. Hospital Anxiety and Depression Scale. Results . Various types of personality were revealed: extroverts – 60.2% (59 people, introverts – 39.8% (39 people. Emotionally stable migrants 60+ years old – 25.5% (28 people. Emotionally unstable – 74.5% (70 people. The sociability combination with impulsiveness was characteristic with a high level of emotional instability (17.27 ± 0.26 points. At very high level (19.5 ± 0.31 points, low self-esteem and an emotional block were revealed. Conclusions . 1. Emotionally stable migrants 60+ years old readapt fairly. 2. High and very high levels of neuroticism demonstrate the formation of anxiety disorders and restriction of adaptive opportunities in migrants 60+ years old. Treatment and prophylactic actions are provided to them.

The Hospital Information Planning Study at Groote Schuur Hospital ...

African Journals Online (AJOL)

Information is an increasingly important resource in an academic hospital. Effective planning and control of this resource are essential in order to maximize its usefulness. Tile HOspital Information Planning Study (HIPS) undertaken at Groote Schuur Hospital, and based on. the Business Systems Planning (BSP) ...

Exploring hospitality within hospital meals by means of visual methodologies

DEFF Research Database (Denmark)

Justesen, Lise

2016-01-01

ABSTRACT This paper reflects the application of visual methodologies adapted in an explorative study on hospitality and hospital meals. It takes point of departure in a multi-sited ethnographic fieldwork placed at a general hospital in 2012. Visual methodologies were applied in multiple ways....... This includes visual methodologies as part of observation and interview strategies. The paper presents and discusses how the application of different visual methodologies can contribute to the construction of ethnographical knowledge on hospitality and hospital meals. Finally ethical considerations as well...

On Hospital Design – Identifying Building Attributes of Hospital Design

DEFF Research Database (Denmark)

Holst, Malene Kirstine; Kirkegaard, Poul Henning; Christoffersen, Lars D.

The present paper surveys the input parameters in hospital design and describes them formally as building attributes in preparation for facilitating planning and designing of hospitals with the aim of a more optimal design process. The overview of the hospital functionalities, bonds, logistics...... and needs is based on an approach of understanding the complexity of the hospital functionalities based on capacities, qualities and times beforehand specific department or units are described. This approach attempts to create an overview of the hospital functionalities respecting capacities, qualities...

Hospital prices and market structure in the hospital and insurance industries.

Science.gov (United States)

Moriya, Asako S; Vogt, William B; Gaynor, Martin

2010-10-01

There has been substantial consolidation among health insurers and hospitals, recently, raising questions about the effects of this consolidation on the exercise of market power. We analyze the relationship between insurer and hospital market concentration and the prices of hospital services. We use a national US dataset containing transaction prices for health care services for over 11 million privately insured Americans. Using three years of panel data, we estimate how insurer and hospital market concentration are related to hospital prices, while controlling for unobserved market effects. We find that increases in insurance market concentration are significantly associated with decreases in hospital prices, whereas increases in hospital concentration are non-significantly associated with increases in prices. A hypothetical merger between two of five equally sized insurers is estimated to decrease hospital prices by 6.7%.

Impact of North America on the aerosol composition in the North Atlantic free troposphere

Directory of Open Access Journals (Sweden)

M. I. García

2017-06-01

Full Text Available In the AEROATLAN project we study the composition of aerosols collected over  ∼  5 years at Izaña Observatory (located at  ∼  2400 m a.s.l. in Tenerife, the Canary Islands under the prevailing westerly airflows typical of the North Atlantic free troposphere at subtropical latitudes and midlatitudes. Mass concentrations of sub-10 µm aerosols (PM10 carried by westerly winds to Izaña, after transatlantic transport, are typically within the range 1.2 and 4.2 µg m−3 (20th and 80th percentiles. The main contributors to background levels of aerosols (PM10 within the 1st–50th percentiles  =  0.15–2.54 µg m−3 are North American dust (53 %, non-sea-salt sulfate (14 % and organic matter (18 %. High PM10 events (75th–95th percentiles  ≈  4.0–9.0 µg m−3 are prompted by dust (56 %, organic matter (24 % and non-sea-salt sulfate (9 %. These aerosol components experience a seasonal evolution explained by (i their spatial distribution in North America and (ii the seasonal shift of the North American outflow, which migrates from low latitudes in winter (∼  32° N, January–March to high latitudes in summer (∼  52° N, August–September. The westerlies carry maximum loads of non-sea-salt sulfate, ammonium and organic matter in spring (March–May, of North American dust from midwinter to mid-spring (February–May and of elemental carbon in summer (August–September. Our results suggest that a significant fraction of organic aerosols may be linked to sources other than combustion (e.g. biogenic; further studies are necessary for this topic. The present study suggests that long-term evolution of the aerosol composition in the North Atlantic free troposphere will be influenced by air quality policies and the use of soils (potential dust emitter in North America.

Bacteriological profile and antibiotic sensitivity pattern of neonatal septicaemia in a rural tertiary care hospital in North India

Directory of Open Access Journals (Sweden)

S Thakur

2016-01-01

Full Text Available Background: There is not much published literature on neonatal septicemia available for the Sub-Himalayan region of North India. Hence, we undertook this study to find out the bacteriological profile and antibiotic sensitivity pattern of neonatal septicemia in the neonatal Intensive Care Unit. Material and Methods: Blood cultures were performed for all clinically suspected neonatal septicemia cases for 1-year. Identification of all pathogenic isolates was followed by antibiotic sensitivity testing. Results: We did blood cultures for 450 neonates and 42% were culture positive. Early onset sepsis were 92 (49% and 96 (51% were late onset sepsis. Gram-positive isolates were 60% and 40% were Gram-negative. Staphylococcus aureus (40%, coagulase negative Staphylococcus species (16%, non-fermenter group of organisms (NFGOs (15%, and Klebsiella pneumoniae (10% were the main isolates. Nasal cannula 101 (54%, birth asphyxia 91 (48%, and prematurity 73 (38% were the prominent risk factors associated with septicemia. Gram-positive organisms were highly resistant to penicillin (87% whereas Gram-negative isolates showed high resistance to third generation cephalosporins (53–89% and aminoglycosides (50–67%. The S. aureus isolates were methicillin-resistant in 41% whereas extended spectrum beta lactamase production was seen in 48% Gram-negative isolates.Conclusion: Our study highlights the recent emergence of Gram-positive organisms as predominant cause of neonatal septicemia in this part of Sub-Himalayan region, along with the review of literature which shows similar results from North India and rest of the world too. Though Gram-negative bacteria still remain the main cause of mortality in neonatal septicemia, we want to dispel the common notion among practitioners that they are the predominant isolates in neonatal septicemia.

Performance evaluation of nonhomogeneous hospitals: the case of Hong Kong hospitals.

Science.gov (United States)

Li, Yongjun; Lei, Xiyang; Morton, Alec

2018-02-14

Throughout the world, hospitals are under increasing pressure to become more efficient. Efficiency analysis tools can play a role in giving policymakers insight into which units are less efficient and why. Many researchers have studied efficiencies of hospitals using data envelopment analysis (DEA) as an efficiency analysis tool. However, in the existing literature on DEA-based performance evaluation, a standard assumption of the constant returns to scale (CRS) or the variable returns to scale (VRS) DEA models is that decision-making units (DMUs) use a similar mix of inputs to produce a similar set of outputs. In fact, hospitals with different primary goals supply different services and provide different outputs. That is, hospitals are nonhomogeneous and the standard assumption of the DEA model is not applicable to the performance evaluation of nonhomogeneous hospitals. This paper considers the nonhomogeneity among hospitals in the performance evaluation and takes hospitals in Hong Kong as a case study. An extension of Cook et al. (2013) [1] based on the VRS assumption is developed to evaluated nonhomogeneous hospitals' efficiencies since inputs of hospitals vary greatly. Following the philosophy of Cook et al. (2013) [1], hospitals are divided into homogeneous groups and the product process of each hospital is divided into subunits. The performance of hospitals is measured on the basis of subunits. The proposed approach can be applied to measure the performance of other nonhomogeneous entities that exhibit variable return to scale.

Pediatric out-of-hospital deaths following hospital discharge: a ...

African Journals Online (AJOL)