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Sample records for hospital outpost comprehensive

  1. First lunar outpost

    Science.gov (United States)

    Andino, Aureo F.; Silva, Daniel; Ortiz, Nelson; Alvarez, Omar; Colon, Julio A.; Colon, Myrelle; Diaz, Alicia; Escobar, Xochiquetzal Y.; Garcia, Alberto; Gonzalez, Isabel C.

    1992-01-01

    Design and research efforts at the University of Puerto Rico have focused on the evaluation and refinement of the Habitability Criteria for a prolonged human presence in space during the last four years. Living quarters for a Mars mission and a third generation lunar base concept were proposed. This academic year, 1991-92, work on further refinement of the habitability criteria and design of partial gravity furniture was carried on. During the first semester, design alternatives for furniture necessary in a habitat design optimized for lunar and Martian environments were developed. Designs are based on recent research data from lunar and Mars gravity simulations, and current NASA standards. Artifacts will be submitted to NASA architects to be tested in KC-135 flights. Test findings will be submitted for incorporation in future updates to NASA habitat design standards. Second semester work was aimed at integrating these findings into the First Lunar Outpost (FLO), a mission scenario currently being considered by NASA. The mission consists of a manned return to the moon by crews of four astronauts for periods of 45 days. The major hardware components of the mission are as follows: (1) a Crew Module for the delivery of the crew and their supplies, and (2) the Habitat Module, which will arrive on the Moon unmanned. Our design efforts concentrated on this Habitat Module and on application of habitability criteria. Different geometries for the pressure vessel and their impact on the interior architecture were studied. Upon the selection of a geometry, a more detailed analysis of the interior design was performed, taking into consideration the reduced gravity, and the protection against radiation, micrometeorites, and the extreme temperature variation. A proposal for a FLO was submitted by the students, consisting essentially of a 24-feet (7.3 m.) by 35-feet (10.67 m) high vertical cylinder with work areas, crew quarters, galley, wardroom, leisure facilities, health

  2. [Comprehensive quality management in hospitals--experience and recommendations].

    Science.gov (United States)

    Schubert, H J

    1999-03-01

    Total quality management concepts, increasingly being introduced into hospitals, offer opportunities for integrative leadership concepts because of their multidimensional character viewed from the aspects of results and from the standpoint of organisational design. Customized for leadership and organisation of hospitals in Germany, questions of introduction strategies as well as recommendations for the integration of total quality understanding into the daily practice of management and employees are discussed. The active support of top and middle management and a combination of radical change in selected problem areas and continual incremental improvements on a broad base have been proven as significant factors for the success in the introductory phase. For a lasting integration of the principles of a comprehensive quality management concept in a hospital, it will be necessary to carry out regularly relevant measurements of success. The results become an important part of agreements with management.

  3. Comprehensive Outpatient Rehabilitation Program: Hospital-Based Stroke Outpatient Rehabilitation.

    Science.gov (United States)

    Rice, Danielle; Janzen, Shannon; McIntyre, Amanda; Vermeer, Julianne; Britt, Eileen; Teasell, Robert

    2016-05-01

    Few studies have considered the effectiveness of outpatient rehabilitation programs for stroke patients. The objective of this study was to assess the effectiveness of a hospital-based interdisciplinary outpatient stroke rehabilitation program with respect to physical functioning, mobility, and balance. The Comprehensive Outpatient Rehabilitation Program provides a hospital-based interdisciplinary approach to stroke rehabilitation in Southwestern Ontario. Outcome measures from physiotherapy and occupational therapy sessions were available at intake and discharge from the program. A series of paired sample t-tests were performed to assess patient changes between time points for each outcome measure. A total of 271 patients met the inclusion criteria for analysis (56.1% male; mean age = 62.9 ± 13.9 years). Significant improvements were found between admission and discharge for the Functional Independence Measure, grip strength, Chedoke-McMaster Stroke Assessment, two-minute walk test, maximum walk test, Timed Up and Go, Berg Balance Scale, and one-legged stance (P rehabilitation program was effective at improving the physical functioning, mobility, and balance of individuals after a stroke. A hospital-based, stroke-specific rehabilitation program should be considered when patients continue to experience deficits after inpatient rehabilitation. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  4. Interior design of the lunar outpost

    Science.gov (United States)

    Kennedy, Kriss J.

    1990-01-01

    This paper is part of an ongoing study on the interior design of a lunar outpost habitat facility. The concept presented represents the work done up to and including August 1989. This concept is part of NASA's ongoing effort to explore alternative options for planet surface systems habitation. Results of a volume analog study to determine the required pressurized volume are presented along with an internal layout of the habitat facility. The concept presented in this paper is a constructible lunar habitat that provides a living and working environment for a crew of 12. It is a 16-m diameter spherical pneumatic structure which contains 2145 cubic meters of volume. Five levels of living and working areas make up the 742 sq m of floor space. A 2-m vertical circulation shaft at the center allows for transfer of crew and equipment.

  5. Sample Curation at a Lunar Outpost

    Science.gov (United States)

    Allen, Carlton C.; Lofgren, Gary E.; Treiman, A. H.; Lindstrom, Marilyn L.

    2007-01-01

    The six Apollo surface missions returned 2,196 individual rock and soil samples, with a total mass of 381.6 kg. Samples were collected based on visual examination by the astronauts and consultation with geologists in the science back room in Houston. The samples were photographed during collection, packaged in uniquely-identified containers, and transported to the Lunar Module. All samples collected on the Moon were returned to Earth. NASA's upcoming return to the Moon will be different. Astronauts will have extended stays at an out-post and will collect more samples than they will return. They will need curation and analysis facilities on the Moon in order to carefully select samples for return to Earth.

  6. Comprehensive geriatric assessment for older adults admitted to hospital.

    Science.gov (United States)

    Ellis, Graham; Whitehead, Martin A; O'Neill, Desmond; Langhorne, Peter; Robinson, David

    2011-07-06

    Comprehensive geriatric assessment (CGA) is a multidimensional, interdisciplinary diagnostic process to determine the medical, psychological and functional capabilities of a frail elderly person in order to develop a co-ordinated and integrated plan for treatment and long-term follow up. We sought to evaluate the effectiveness of CGA in hospital for older adults admitted as an emergency. We searched the Cochrane Effective Practice and Organisation of Care (EPOC) Group Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library), the Database of Abstracts of Reviews of Effects (DARE), MEDLINE, EMBASE, CINAHL and AARP Ageline, and handsearched high-yield journals. We searched for randomised controlled trials comparing CGA (whether by mobile teams or in designated wards) to usual care. Two review authors initially assessed eligibility and trial quality and extracted published data. Twenty-two trials evaluating 10,315 participants in six countries were identified. Patients in receipt of CGA were more likely to be alive and in their own homes at up to six months (OR 1.25, 95% CI 1.11 to 1.42, P = 0.0002) and at the end of scheduled follow up (median 12 months) (OR 1.16, 95% CI 1.05 to 1.28, P = 0.003) when compared to general medical care. In addition, patients were less likely to be institutionalised (OR 0.79, 95% CI 0.69 to 0.88, P P = 0.001), and were more likely to experience improved cognition in the CGA group (OR 1.11, 95% CI 0.20 to 2.01, P = 0.02). Subgroup interaction in the primary outcomes suggests that the effects of CGA are primarily the result of CGA wards. Comprehensive geriatric assessment increases a patient's likelihood of being alive and in their own home at up to 12 months.

  7. The Making of a Lunar Outpost - Exploring a Future Case Study

    Science.gov (United States)

    Lewis, Ruthan; Micheels, Kurt; Dankewicz, Cathy

    2007-01-01

    Buildup and development of a lunar outpost / base will be an incremental and alternated process of crew, logistics, hardware, and science payload deliveries. To better plan the resources and technological objectives for each increment, one may examine the operational and technological requirements for a ``midterm'' phase and project backwards to derive and strategize requirements and resources for each stage of the development. This comprehensive characterization of the midterm phase will ultimately provide the waypoint by which later development phases can be more effectively planned. A unique and critical engineering and architectural view of a midterm waypoint and the roadmap to achieve the goals and capabilities at that milestone was generated. Data to derive the process and midterm outpost design was acquired during a recent comprehensive National Aeronautics and Space Administration (NASA) research project. Current and soon to be state-of-the-art, viable, proven technologies to support an effective and resourceful outpost design including rigidizable, inflatable structures, hybridized in-situ and imported materials utilization, and environmentally-responsive structures considering thermal, radiation, topographical, low-gravity, crew and transport mobility, habitability, and logistics aspects were investigated and applied. Adjacency analyses were performed to optimize the arrangement of spaces. Additionally, an inventive, internal, organizational architectural system that maps and coordinates lunar and Earth contingency planning configurations and activities, and assists fabrication and layout processes and techniques was derived.

  8. First MARS Outpost: Development Considerations and Concepts

    Science.gov (United States)

    Bell, L.

    2002-01-01

    The Sasakawa International Center for Space Architecture (SICSA) is undertaking a multi-year research and design study that is exploring near and long-term commercial space development opportunities. The central goal of this activity is to conceptualize a scenario of sequential, integrated private enterprise initiatives that can carry humankind forward to Mars. This presentation highlights planning considerations and design concepts for establishing a first settlement on Mars. The outpost would support surface missions lasting up to about 500 days and would serve as the initial stage of a larger and continuously operational development which would utilize Mars resources to be less reliant on materials from Earth. Key elements of this first stage mission development sequence include a new heavy-lift Earth-to-orbit launch vehicle; a plasma- drive Mars transit vehicle; habitat modules for crews in transit to and from Mars; "hard" and "inflatable" surface habitats and laboratories; a mobile power unit; a spacecraft to assist orbital assembly; and vehicles to lift crews off the Mars surface and land them safely back on Earth from LEO. SICSA's space development approach differs in fundamental ways from conventional NASA-sponsored initiatives. First, virtually all baseline planning assumptions are influenced by the private sector-driven nature of an approach that aims to avoid all possible reliance upon government financing, agendas and schedules. In this regard, any involvements with NASA or the space agencies of other countries would be premised upon mutual public-corporate partnership benefits rather than upon federal contract awards, management and control. Another potential difference relates to program philosophy. Unlike Apollo Program "sprint" missions which culminated with footprints and flagpoles on the Moon, the aim is to realize sustainable and continuing planetary exploration and development progress. This goal can be advanced through approaches that

  9. Comprehensive geriatric assessment for older adults admitted to hospital: meta-analysis of randomised controlled trials

    OpenAIRE

    Ellis, G.; Whitehead, M.A.; Robinson, D.; O'Neill, D.; Langhorne, P.

    2011-01-01

    Objective - To evaluate the effectiveness of comprehensive geriatric assessment in hospital for older adults admitted as an emergency.\\ud \\ud Search strategy - We searched the EPOC Register, Cochrane’s Controlled Trials Register, the Database of Abstracts of Reviews of Effects (DARE), Medline, Embase, CINAHL, AARP Ageline, and handsearched high yield journals.\\ud \\ud Selection criteria - Randomised controlled trials of comprehensive geriatric assessment (whether by mobile teams or in designat...

  10. Technological innovations for human outposts on planetary bodies

    Science.gov (United States)

    Clark, Benton C.

    1988-01-01

    Technology developments which have applications for establishing man-tended outposts on the moon and Mars are reviewed. The development of pressurized rovers and computer-aided control, repair, and manufacturing is discussed. The possibility of utilizing aerodynamic drag by optimizing dynamic pressure to accomplish the necessary spacecraft velocity reduction for planetary orbital capture is considered and research in the development of artificial gravity is examined.

  11. Testing a Mars science outpost in the Antarctic dry valleys

    Science.gov (United States)

    Andersen, D. T.; Mckay, C. P.; Wharton, R. A.; Rummel, J. D.

    1992-01-01

    Field research conducted in the Antarctic has been providing insights about the nature of Mars in the science disciplines of exobiology and geology. Located in the McMurdo Dry Valleys of southern Victoria Land (160 deg and 164 deg E longitude and 76 deg 30 min and 78 deg 30 min S latitude), research outposts are inhabited by teams of 4-6 scientists. It is proposed that the design of these outposts be expanded to enable meaningful tests of many of the systems that will be needed for the successful conduct of exploration activities on Mars. Although there are some important differences between the environment in the Antarctic dry valleys and on Mars, the many similarities and particularly the field science activities, make the dry valleys a useful terrestrial analog to conditions on Mars. Three areas have been identified for testing at a small science outpost in the dry valleys: (1) studying human factors and physiology in an isolated environment; (2) testing emerging technologies (e.g. innovative power management systems, advanced life support facilities including partial bioregenerative life support systems for water recycling and food growth, telerobotics, etc.); and (3) conducting basic scientific research that will enhance understanding of Mars while contributing to the planning for human exploration. It is suggested that an important early result of a Mars habitat program will be the experience gained by interfacing humans and their supporting technology in a remote and stressful environment.

  12. AN AMBIVALENT CONRAD IN AN OUTPOST OF PROGRESS

    Directory of Open Access Journals (Sweden)

    Majid SADEGHZADEGAN

    2017-06-01

    Full Text Available The present paper aims to portray the racist and anti-racist dimensions of Joseph Conrad in his short story “An Outpost of Progress” (1897. Conrad’s alleged racist status espoused by thinkers such as Chinua Achebe and Edward Said, particularly in Heart of Darkness, has constantly been the subject of heated debates in literature. A myriad of analogous traces in the short story “An Outpost of Progress” lend Conrad’s voice to a highly racist position while many other anti-racist traces observed in the story could lower the resonance of the same voice, hence an inconclusive ambivalence or a liminal position in Conrad’s tone. This paper is thus divided into two sections. The first section has the racist traces of Conrad in the short story on top of its agenda whereas the second section ventures into the anti-racist footprints of Conrad’s voice in the story. In so doing, this paper sets out to turn to Achebe and Said in arguing for the racist position of Conrad; however, the anti-racist facets of the story will be substantiated via relying on the arguments developed by thinkers such as D. C. R. A. Goonetilleke and Benita Parry. An ironic ambivalence swaying from a racist tone to an anti-racist tone in Conrad’s voice in “An Outpost of Progress” is the conclusive maxim.

  13. A Comprehensive Evaluation System for Military Hospitals' Response Capability to Bio-terrorism.

    Science.gov (United States)

    Wang, Hui; Jiang, Nan; Shao, Sicong; Zheng, Tao; Sun, Jianzhong

    2015-05-01

    The objective of this study is to establish a comprehensive evaluation system for military hospitals' response capacity to bio-terrorism. Literature research and Delphi method were utilized to establish the comprehensive evaluation system for military hospitals' response capacity to bio-terrorism. Questionnaires were designed and used to survey the status quo of 134 military hospitals' response capability to bio-terrorism. Survey indicated that factor analysis method was suitable to for analyzing the comprehensive evaluation system for military hospitals' response capacity to bio-terrorism. The constructed evaluation system was consisted of five first-class and 16 second-class indexes. Among them, medical response factor was considered as the most important factor with weight coefficient of 0.660, followed in turn by the emergency management factor with weight coefficient of 0.109, emergency management consciousness factor with weight coefficient of 0.093, hardware support factor with weight coefficient of 0.078, and improvement factor with weight coefficient of 0.059. The constructed comprehensive assessment model and system are scientific and practical.

  14. Effects of Comprehensive Risk Management Program on the Preparedness of Rofeide Rehabilitation Hospital in Disasters and Incidents

    Directory of Open Access Journals (Sweden)

    Samira Rajabi

    2017-07-01

    Conclusion: Considering the positive impact of the implementation of the risk management program on the preparedness of Rofeide Rehabilitation Hospital and promotion of its preparedness level from poor to moderate, as well as relatively high vulnerability of hospitals against internal and external risks, national hospitals are recommended to use the comprehensive hospital risk management model to be more prepared for disasters.

  15. Comprehensive geriatric assessment for older adults admitted to hospital: meta-analysis of randomised controlled trials.

    Science.gov (United States)

    Ellis, Graham; Whitehead, Martin A; Robinson, David; O'Neill, Desmond; Langhorne, Peter

    2011-10-27

    To evaluate the effectiveness of comprehensive geriatric assessment in hospital for older adults admitted as an emergency. We searched the EPOC Register, Cochrane's Controlled Trials Register, the Database of Abstracts of Reviews of Effects (DARE), Medline, Embase, CINAHL, AARP Ageline, and handsearched high yield journals. Randomised controlled trials of comprehensive geriatric assessment (whether by mobile teams or in designated wards) compared with usual care. Comprehensive geriatric assessment is a multidimensional interdisciplinary diagnostic process used to determine the medical, psychological, and functional capabilities of a frail elderly person to develop a coordinated and integrated plan for treatment and long term follow-up. Three independent reviewers assessed eligibility and trial quality and extracted published data. Two additional reviewers moderated. Twenty two trials evaluating 10,315 participants in six countries were identified. For the primary outcome "living at home," patients who underwent comprehensive geriatric assessment were more likely to be alive and in their own homes at the end of scheduled follow-up (odds ratio 1.16 (95% confidence interval 1.05 to 1.28; P = 0.003; number needed to treat 33) at a median follow-up of 12 months versus 1.25 (1.11 to 1.42; P P P = 0.001) and were more likely to experience improved cognition (standardised mean difference 0.08, 0.01 to 0.15; P = 0.02) in the comprehensive geriatric assessment group. Comprehensive geriatric assessment increases patients' likelihood of being alive and in their own homes after an emergency admission to hospital. This seems to be especially true for trials of wards designated for comprehensive geriatric assessment and is associated with a potential cost reduction compared with general medical care.

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

    Science.gov (United States)

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

    2009-01-01

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

  17. Evaluation of a comprehensive slip, trip and fall prevention programme for hospital employees.

    Science.gov (United States)

    Bell, Jennifer L; Collins, James W; Wolf, Laurie; Gronqvist, Raoul; Chiou, Sharon; Chang, Wen-Ruey; Sorock, Gary S; Courtney, Theodore K; Lombardi, David A; Evanoff, Bradley

    2008-12-01

    In 2007, the Bureau of Labor Statistics reported that the incidence rate of lost workday injuries from slips, trips and falls (STFs) on the same level in hospitals was 35.2 per 10,000 full-time equivalents (FTE), which was 75% greater than the average rate for all other private industries combined (20.2 per 10,000 FTEs). The objectives of this 10-year (1996-2005) longitudinal study were to: 1) describe occupational STF injury events in hospitals; 2) evaluate the effectiveness of a comprehensive programme for reducing STF incidents among hospital employees. The comprehensive prevention programme included analysis of injury records to identify common causes of STFs, on-site hazard assessments, changes to housekeeping procedures and products, introduction of STF preventive products and procedures, general awareness campaigns, programmes for external ice and snow removal, flooring changes and slip-resistant footwear for certain employee subgroups. The hospitals' total STF workers' compensation claims rate declined by 58% from the pre-intervention (1996-1999) rate of 1.66 claims per 100 FTE to the post-intervention (2003-2005) time period rate of 0.76 claims per 100 FTE (adjusted rate ratio = 0.42, 95% CI: 0.33-0.54). STFs due to liquid contamination (water, fluid, slippery, greasy and slick spots) were the most common cause (24%) of STF claims for the entire study period 1996-2005. Food services, transport/emergency medical service and housekeeping staff were at highest risk of a STF claim in the hospital environment. Nursing and office administrative staff generated the largest numbers of STF claims. STF injury events in hospitals have a myriad of causes and the work conditions in hospitals are diverse. This research provides evidence that implementation of a broad-scale prevention programme can significantly reduce STF injury claims.

  18. Development of a comprehensive hospital-based elder abuse intervention: an initial systematic scoping review.

    Directory of Open Access Journals (Sweden)

    Janice Du Mont

    Full Text Available Elder abuse, a universal human rights problem, is associated with many negative consequences. In most jurisdictions, however, there are no comprehensive hospital-based interventions for elder abuse that address the totality of needs of abused older adults: psychological, physical, legal, and social. As the first step towards the development of such an intervention, we undertook a systematic scoping review.Our primary objective was to systematically extract and synthesize actionable and applicable recommendations for components of a multidisciplinary intersectoral hospital-based elder abuse intervention. A secondary objective was to summarize the characteristics of the responses reviewed, including methods of development and validation.The grey and scholarly literatures were systematically searched, with two independent reviewers conducting the title, abstract and full text screening. Documents were considered eligible for inclusion if they: 1 addressed a response (e.g., an intervention to elder abuse, 2 contained recommendations for responding to abused older adults with potential relevance to a multidisciplinary and intersectoral hospital-based elder abuse intervention; and 3 were available in English.The extracted recommendations for care were collated, coded, categorized into themes, and further reviewed for relevancy to a comprehensive hospital-based response. Characteristics of the responses were summarized using descriptive statistics.649 recommendations were extracted from 68 distinct elder abuse responses, 149 of which were deemed relevant and were categorized into 5 themes: Initial contact; Capacity and consent; Interview with older adult, caregiver, collateral contacts, and/or suspected abuser;physical/forensic, mental, psychosocial, and environmental/functional; and care plan. Only 6 responses had been evaluated, suggesting a significant gap between development and implementation of recommendations.To address the lack of evidence to

  19. Development of a Comprehensive Hospital-Based Elder Abuse Intervention: An Initial Systematic Scoping Review

    Science.gov (United States)

    Du Mont, Janice; Macdonald, Sheila; Kosa, Daisy; Elliot, Shannon; Spencer, Charmaine; Yaffe, Mark

    2015-01-01

    Introduction Elder abuse, a universal human rights problem, is associated with many negative consequences. In most jurisdictions, however, there are no comprehensive hospital-based interventions for elder abuse that address the totality of needs of abused older adults: psychological, physical, legal, and social. As the first step towards the development of such an intervention, we undertook a systematic scoping review. Objectives Our primary objective was to systematically extract and synthesize actionable and applicable recommendations for components of a multidisciplinary intersectoral hospital-based elder abuse intervention. A secondary objective was to summarize the characteristics of the responses reviewed, including methods of development and validation. Methods The grey and scholarly literatures were systematically searched, with two independent reviewers conducting the title, abstract and full text screening. Documents were considered eligible for inclusion if they: 1) addressed a response (e.g., an intervention) to elder abuse, 2) contained recommendations for responding to abused older adults with potential relevance to a multidisciplinary and intersectoral hospital-based elder abuse intervention; and 3) were available in English. Analysis The extracted recommendations for care were collated, coded, categorized into themes, and further reviewed for relevancy to a comprehensive hospital-based response. Characteristics of the responses were summarized using descriptive statistics. Results 649 recommendations were extracted from 68 distinct elder abuse responses, 149 of which were deemed relevant and were categorized into 5 themes: Initial contact; Capacity and consent; Interview with older adult, caregiver, collateral contacts, and/or suspected abuser; Assessment: physical/forensic, mental, psychosocial, and environmental/functional; and care plan. Only 6 responses had been evaluated, suggesting a significant gap between development and implementation of

  20. An Antarctic research outpost as a model for planetary exploration.

    Science.gov (United States)

    Andersen, D T; McKay, C P; Wharton, R A; Rummel, J D

    1990-01-01

    During the next 50 years, human civilization may well begin expanding into the solar system. This colonization of extraterrestrial bodies will most likely begin with the establishment of small research outposts on the Moon and/or Mars. In all probability these facilities, designed primarily for conducting exploration and basic science, will have international participation in their crews, logistical support and funding. High fidelity Earth-based simulations of planetary exploration could help prepare for these expensive and complex operations. Antarctica provides one possible venue for such a simulation. The hostile and remote dry valleys of southern Victoria Land offer a valid analog to the Martian environment but are sufficiently accessible to allow routine logistical support and to assure the relative safety of their inhabitants. An Antarctic research outpost designed as a planetary exploration simulation facility would have great potential as a testbed and training site for the operation of future Mars bases and represents a near-term, relatively low-cost alternative to other precursor activities. Antarctica already enjoys an international dimension, an aspect that is more than symbolically appropriate to an international endeavor of unprecedented scientific and social significance--planetary exploration by humans. Potential uses of such a facility include: 1) studying human factors in an isolated environment (including long-term interactions among an international crew); 2) testing emerging technologies (e.g., advanced life support facilities such as a partial bioregenerative life support system, advanced analytical and sample acquisition instrumentation and equipment, etc.); and 3) conducting basic scientific research similar to the research that will be conducted on Mars, while contributing to the planning for human exploration. (Research of this type is already ongoing in Antarctica).

  1. International benchmarking of specialty hospitals. A series of case studies on comprehensive cancer centres

    Science.gov (United States)

    2010-01-01

    Background Benchmarking is one of the methods used in business that is applied to hospitals to improve the management of their operations. International comparison between hospitals can explain performance differences. As there is a trend towards specialization of hospitals, this study examines the benchmarking process and the success factors of benchmarking in international specialized cancer centres. Methods Three independent international benchmarking studies on operations management in cancer centres were conducted. The first study included three comprehensive cancer centres (CCC), three chemotherapy day units (CDU) were involved in the second study and four radiotherapy departments were included in the final study. Per multiple case study a research protocol was used to structure the benchmarking process. After reviewing the multiple case studies, the resulting description was used to study the research objectives. Results We adapted and evaluated existing benchmarking processes through formalizing stakeholder involvement and verifying the comparability of the partners. We also devised a framework to structure the indicators to produce a coherent indicator set and better improvement suggestions. Evaluating the feasibility of benchmarking as a tool to improve hospital processes led to mixed results. Case study 1 resulted in general recommendations for the organizations involved. In case study 2, the combination of benchmarking and lean management led in one CDU to a 24% increase in bed utilization and a 12% increase in productivity. Three radiotherapy departments of case study 3, were considering implementing the recommendations. Additionally, success factors, such as a well-defined and small project scope, partner selection based on clear criteria, stakeholder involvement, simple and well-structured indicators, analysis of both the process and its results and, adapt the identified better working methods to the own setting, were found. Conclusions The improved

  2. Health literacy and English language comprehension among elderly inpatients at an urban safety-net hospital.

    Science.gov (United States)

    Cordasco, Kristina M; Asch, Steven M; Franco, Idalid; Mangione, Carol M

    2009-01-01

    To evaluate the relationship between health literacy and age in chronically-ill inpatients at a safety-net hospital. We recruited 399 English- and Spanish-speaking inpatients being evaluated or treated for Congestive Heart Failure or Coronary Artery Disease at a large, urban safety-net teaching hospital in Southern California. Participants were interviewed to ascertain education, English comprehension, and in-home language use. Health literacy was assessed using The Test of Functional Health Literacy in Adults (TOFHLA). We compared by age (aged 65 or more, 51 to 64 years of age, and less than age 50) levels of health literacy, educational attainment, English comprehension, and language use. Prevalence of inadequate health literacy significantly increased with increasing age (87.2% in > or = 65, 48.9% for 51-64, and 26.3% in immigration status. Additionally, older patients were more likely to have never learned to read (34.9% in > or = 65, 6.5% for 51-64, and 1.5% in or = 65, 9.0% for 51-64, and 0.8% in or = 65, 43.5% for 51-64, and 35.8% in language at home (82.3% in > or = 65, 70.2% for 51-64, and 62.2% in < or = 50, p=0.015). To prepare to meet the chronic disease needs of a growing older patient population, and ameliorate the negative health effects of associated low literacy, safety-net hospital leaders and providers need to prioritize the development and implementation of low-literacy educational materials, programs, and services.

  3. Use of a Lunar Outpost for Developing Space Settlement Technologies

    Science.gov (United States)

    Purves, Lloyd R.

    2008-01-01

    The type of polar lunar outpost being considered in the NASA Vision for Space Exploration (VSE) can effectively support the development of technologies that will not only significantly enhance lunar exploration, but also enable long term crewed space missions, including space settlement. The critical technologies are: artificial gravity, radiation protection, Closed Ecological Life Support Systems (CELSS) and In-Situ Resource Utilization (ISRU). These enhance lunar exploration by extending the time an astronaut can remain on the moon and reducing the need for supplies from Earth, and they seem required for space settlement. A polar lunar outpost provides a location to perform the research and testing required to develop these technologies, as well as to determine if there are viable countermeasures that can reduce the need for Earth-surface-equivalent gravity and radiation protection on long human space missions. The types of spinning space vehicles or stations envisioned to provide artificial gravity can be implemented and tested on the lunar surface, where they can create any level of effective gravity above the 1/6 Earth gravity that naturally exists on the lunar surface. Likewise, varying degrees of radiation protection can provide a natural radiation environment on the lunar surface less than or equal to 1/2 that of open space at 1 AU. Lunar ISRU has the potential of providing most of the material needed for radiation protection, the centrifuge that provides artificial gravity; and the atmosphere, water and soil for a CELSS. Lunar ISRU both saves the cost of transporting these materials from Earth and helps define the requirements for ISRU on other planetary bodies. Biosphere II provides a reference point for estimating what is required for an initial habitat with a CELSS. Previous studies provide initial estimates of what would be required to provide such a lunar habitat with the gravity and radiation environment of the Earth s surface. While much preparatory

  4. Providing Oxygen for the Crew of a Lunar Outpost

    Science.gov (United States)

    Ewert, Michael K.; Jeng, Frank; Conger, Bruce; Anderson, Molly S.

    2009-01-01

    Oxygen (O2) is obviously essential for human space missions, but it is important to examine all the different ways it will be used and the potential sources that it may come from. This effort will lead to storage and delivery requirements and help to determine the optimum architecture from an overall systems engineering point of view. Accounting for all the oxygen in a Lunar Outpost mission includes meeting the metabolic needs of the crew while in the surface Habitat, leakage through the Habitat or Pressurized Rover walls, recharge of the space suit backpack and emergency situations. Current plans indicate that both primary and secondary O2 bottles for the space suit will be filled to a pressure of 20.7 MPa (3000 psia). Other uses of O2 require much lower pressure. Sources of O2 at a Lunar Outpost include compressed or liquefied O2 brought along specifically for life support, scavenged O2 from the Lander propulsion system, recovered O2 from waste water or exhaled carbon dioxide and O2 mined from the moon itself. Previously, eight technology options were investigated to provide the high pressure space suit O2. High pressure O2 storage was treated as the baseline technology and compared to the other seven. The other seven were cryogenic storage followed by high pressure vaporization, scavenging liquid oxygen (LOX) from Lander followed by vaporization, LOX delivery followed by sorption compression, low pressure water electrolysis followed by mechanical compression, high pressure water electrolysis, sharing a high pressure electrolyzer with a regenerative fuel cell power system, and making use of In- Situ Resource Utilization (ISRU). This system-level analysis was conducted by comparing equivalent system mass of the eight technologies in open and closed loop life support architectures. The most promising high pressure O2 generation technologies were recommended for development. Updates and an expansion of the earlier study have been made and the results are reported in

  5. Creating Methane from Plastics: Recycling at a Lunar Outpost

    Science.gov (United States)

    Captain, Janine; Santiago, Eddie; Wheeler, Ray; Strayer, RIchard; Garland, Jay; Parrish, Clyde

    2010-01-01

    The high cost of re-supply from Earth demands resources to be utilized to the fullest extent for exploration missions. Recycling is a key technology that maximizes the available resources by converting waste products into useful commodities. One example of this is to convert crew member waste such as plastic packaging, food scraps, and human waste, into fuel. The ability to refuel on the lunar surface would reduce the vehicle mass during launch and provide excess payload capability. The goal of this project is to determine the feasibility of recycling waste into methane on the lunar outpost by performing engineering assessments and lab demonstrations of the technology. The first goal of the project was to determine how recycling could influence lunar exploration. Table I shows an estimation of the typical dried waste stream generated each day for a crew of four. Packaging waste accounts for nearly 86% of the dry waste stream and is a significant source of carbon on the lunar surface. This is important because methane (CH4) can be used as fuel and no other source of carbon is available on the lunar surface. With the initial assessment indicating there is sufficient resources in the waste stream to provide refueling capabilities, the project was designed to examine the conversion of plastics into methane.

  6. A comprehensive palliative care center implementation in S.B. Ulus State Hospital

    Directory of Open Access Journals (Sweden)

    Ayla Kabalak

    2012-06-01

    Every people wants to best care and to die painless in their end-stage of life. This is a human right. Therefore, end-of-life care is considered an indicator of health quality all over the world. The ultimate goal of palliative care is to relieve the suffering of patients and their families by the comprehensive assessment and treatment of physical, psychosocial, and spiritual symptoms experienced by patients. After the patient\\s death, palliative care focuses primarily on bereavement of the family. T.C. Ministry of Health to find a solution of this important issue as a first step, the preparations for the establishment of palliative care centers and units, training of health personnel started. S.B. Ulus State Hospital as a team we have set out to open a comprehensive palliative care center. Our goal is to contribute on take place of palliative care organization in health system and to the spread across the country. [J Contemp Med 2012; 2(2.000: 122-126

  7. Automation of Health Management, Troubleshooting and Recovery in Lunar Outpost, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — NASA's Lunar and other future extraterrestrial outposts will be built for long duration missions that are likely to experience significant number of faults and...

  8. Axiomatic Design of a Framework for the Comprehensive Optimization of Patient Flows in Hospitals

    Directory of Open Access Journals (Sweden)

    Gabriele Arcidiacono

    2017-01-01

    Full Text Available Lean Management and Six Sigma are nowadays applied not only to the manufacturing industry but also to service industry and public administration. The manifold variables affecting the Health Care system minimize the effect of a narrow Lean intervention. Therefore, this paper aims to discuss a comprehensive, system-based approach to achieve a factual holistic optimization of patient flows. This paper debates the efficacy of Lean principles applied to the optimization of patient flows and related activities, structures, and resources, developing a theoretical framework based on the principles of the Axiomatic Design. The demand for patient-oriented and efficient health services leads to use these methodologies to improve hospital processes. In the framework, patients with similar characteristics are clustered in families to achieve homogeneous flows through the value stream. An optimization checklist is outlined as the result of the mapping between Functional Requirements and Design Parameters, with the right sequence of the steps to optimize the patient flow according to the principles of Axiomatic Design. The Axiomatic Design-based top-down implementation of Health Care evidence, according to Lean principles, results in a holistic optimization of hospital patient flows, by reducing the complexity of the system.

  9. Axiomatic Design of a Framework for the Comprehensive Optimization of Patient Flows in Hospitals

    Science.gov (United States)

    Arcidiacono, Gabriele; Matt, Dominik T.; Rauch, Erwin

    2017-01-01

    Lean Management and Six Sigma are nowadays applied not only to the manufacturing industry but also to service industry and public administration. The manifold variables affecting the Health Care system minimize the effect of a narrow Lean intervention. Therefore, this paper aims to discuss a comprehensive, system-based approach to achieve a factual holistic optimization of patient flows. This paper debates the efficacy of Lean principles applied to the optimization of patient flows and related activities, structures, and resources, developing a theoretical framework based on the principles of the Axiomatic Design. The demand for patient-oriented and efficient health services leads to use these methodologies to improve hospital processes. In the framework, patients with similar characteristics are clustered in families to achieve homogeneous flows through the value stream. An optimization checklist is outlined as the result of the mapping between Functional Requirements and Design Parameters, with the right sequence of the steps to optimize the patient flow according to the principles of Axiomatic Design. The Axiomatic Design-based top-down implementation of Health Care evidence, according to Lean principles, results in a holistic optimization of hospital patient flows, by reducing the complexity of the system. © 2017 Gabriele Arcidiacono et al.

  10. Blurring the boundaries of space: shaping nursing lives at the Red Cross outposts in Ontario, 1922-1945.

    Science.gov (United States)

    Elliott, Jayne

    2004-01-01

    Historians and other scholars interested in the history of hospitals have investigated the links between medical architecture and the organization of space with the evolution of modern medicine. The transformation over time in the architectural for of medical institutions has tended to reflect developments in medical science and therapeutic efficiency as well as elements in the broader social climate. Some authors, however, have argued for the agency of structure and spatial organization, to consider that they are not just containers with which human activities take place, but which also actively construct or constitute social practices and relations. Most studies of this nature have centred on large medical buildings especially in urban areas, and have examined the impact of architectural arrangement in relation to administrators and architects, physicians and patients. Fe have considered the interconnections of form and space with nurses, despite the prominence of institutional nursing labour since the late 19th-century. The following discussion begins an exploration of these concepts within the rural environment. Between 1922 and 1984, the Ontario Division of the Canadian Red Cross Society administered an outpost program in which it operated small hospitals and nursing stations in isolated communities throughout the northern reaches of the province. This article will focus primarily o n the one-nurse stations that the Division managed during the interwar years and the nurses that it hired to staff them. The interior spatial organization of these outposts, which led in particular to their multiple functions as tiny hospitals, community health centres and nurses' homes, not only shaped both the professional practice and the social or private lives of the Red Cross nurses but also contributed to the diffusion of contemporary precepts in health and medical care throughout a remote population.

  11. A comprehensive approach to improving patient flow in our hospitals--the 'left to right, over and under' concept.

    Science.gov (United States)

    Ardagh, Michael

    2015-08-21

    It is essential we manage the capacity of our hospitals so that acute demand can be accommodated without developing queues for care and backlogs of work. This paper presents a comprehensive model for improving patient flow in our hospitals by attending carefully to both the demand and capacity states of the hospital and maximising efficient flow of our acute patient journeys. The model includes attention to the patient journey as the central focus, with an overarching governance structure and an underpinning sophisticated operations structure.

  12. Comprehensive cardiopulmonary life support (CCLS for cardiopulmonary resuscitation by trained paramedics and medics inside the hospital

    Directory of Open Access Journals (Sweden)

    Rakesh Garg

    2017-01-01

    Full Text Available The cardiopulmonary resuscitation (CPR guideline of comprehensive cardiopulmonary life support (CCLS for management of the patient with cardiopulmonary arrest in adults provides an algorithmic step-wise approach for optimal outcome of the patient inside the hospital by trained medics and paramedics. This guideline has been developed considering the infrastructure of healthcare delivery system in India. This is based on evidence in the international and national literature. In the absence of data from the Indian population, the extrapolation has been made from international data, discussed with Indian experts and modified accordingly to ensure their applicability in India. The CCLS guideline emphasise the need to recognise patients at risk for cardiac arrest and their timely management before a cardiac arrest occurs. The basic components of CPR include chest compressions for blood circulation; airway maintenance to ensure airway patency; lung ventilation to enable oxygenation and defibrillation to convert a pathologic 'shockable' cardiac rhythm to one capable to maintaining effective blood circulation. CCLS emphasises incorporation of airway management, drugs, and identification of the cause of arrest and its correction, while chest compression and ventilation are ongoing. It also emphasises the value of organised team approach and optimal post-resuscitation care.

  13. Navigating Return to Work and Breastfeeding in a Hospital with a Comprehensive Employee Lactation Program.

    Science.gov (United States)

    Froh, Elizabeth B; Spatz, Diane L

    2016-11-01

    The Surgeon General's Call to Action to Support Breastfeeding details the need for comprehensive employer lactation support programs. Our institution has an extensive employee lactation program, and our breastfeeding initiation and continuation rates are statistically significantly higher than state and national data, with more than 20% of our employees breastfeeding for more than 1 year. The objective of this research was complete secondary data analysis of qualitative data collected as part of a larger study on breastfeeding outcomes. In the larger study, 545 women who returned to work full or part time completed an online survey with the ability to provide free text qualitative data and feedback regarding their experiences with breastfeeding after return to work. Qualitative data were pulled from the online survey platform. The responses to these questions were analyzed using conventional content analysis by the research team (2 PhD-prepared nurse researchers trained and experienced in qualitative methodologies and 1 research assistant) in order to complete a thematic analysis of the survey data. Analysis of the data yielded 5 major themes: (1) positive reflections, (2) nonsupportive environment/work culture, (3) supportive environment/work culture, (4) accessibility of resources, and (5) internal barriers. The themes that emerged from this research clearly indicate that even in a hospital with an extensive employee lactation program, women have varied experiences-some more positive than others. Returning to work while breastfeeding requires time and commitment of the mother, and a supportive employee lactation program may ease that transition of return to work.

  14. A comprehensive database of Duchenne and Becker muscular dystrophy patients in Children's Hospital of Fudan University

    Directory of Open Access Journals (Sweden)

    Xi-hua LI

    2015-05-01

    Full Text Available Background China is one of the countries that have the largest number of patients suffering from Duchenne and Becker muscular dystrophy (DMD/BMD. Although the building of international DMD/BMD databases has laid a foundation for clinical drug development and clinical trials, it has not yet been carried out in China. In this study, a modified registry form of Remudy was applied to 229 DMD/BMD patients in order to establish a comprehensive database, which will lay the groundwork for international cooperation.  Methods A total of 229 DMD/BMD patients diagnosed by genetic testing or muscle biopsy admitted in Children's Hospital of Fudan University (CHFU during the period of August 2011 to December 2013 were enrolled in this study. The data included sex, age, age at diagnosis, geographic distribution of patients, DMD gene mutation types, family history, walking capability, cardiac and respiratory function, steroid treatment and rehabilitation intervention.  Results There were 194 DMD and 35 BMD male patients who were diagnosed at the age of 0-18 years, and among them, most patients were diagnosed at the age of > 3-4 (16.59%, 38/229 and > 7-8 (14.85%, 34/229 years. Exon deletion was the most frequent genetic mutations for DMD/BMD [65.46% (127/194 and 74.29% (26/35], respectively. Patients with a family history accounted for 23.14% (53/229. The rate of DMD registrants losing walking capability was 17.53% (34/194, and all the BMD registrants were able to walk. Cardiac functions were examined in 46.29% (106/229 DMD/BMD boys and respiratory functions were examined in 17.90% (41/229 DMD/BMD boys. The proportion of DMD patients receiving prednisone with dosage of 0.75 mg/(kg·d was 26.29% (51/194.  Conclusions This database describes in detail the genotype, clinical manifestation, diagnosis and treatment and rehabilitation status of 229 DMD/BMD patients in China. The database not only provides comprehensive information for DMD/BMD patient management

  15. International benchmarking of specialty hospitals. A series of case studies on comprehensive cancer centres

    NARCIS (Netherlands)

    van Lent, W.A.M.; de Beer, Relinde; van Harten, Willem H.

    2010-01-01

    Background Benchmarking is one of the methods used in business that is applied to hospitals to improve the management of their operations. International comparison between hospitals can explain performance differences. As there is a trend towards specialization of hospitals, this study examines the

  16. A Comprehensive Program to Reduce Rates of Hospital-Acquired Pressure Ulcers in a System of Community Hospitals.

    Science.gov (United States)

    Englebright, Jane; Westcott, Ruth; McManus, Kathryn; Kleja, Kacie; Helm, Colleen; Korwek, Kimberly M; Perlin, Jonathan B

    2018-03-01

    The prevention of hospital-acquired pressure ulcers (PrUs) has significant consequences for patient outcomes and the cost of care. Providers are challenged with evaluating available evidence and best practices, then implementing programs and motivating change in various facility environments. In a large system of community hospitals, the Reducing Hospital Acquired-PrUs Program was developed to provide a toolkit of best practices, timely and appropriate data for focusing efforts, and continuous implementation support. Baseline data on PrU rates helped focus efforts on the most vulnerable patients and care situations. Facilities were empowered to use and adapt available resources to meet local needs and to share best practices for implementation across the system. Outcomes were measured by the rate of hospital-acquired PrUs, as gathered from patient discharge records. The rate of hospital-acquired stage III and IV PrUs decreased 66.3% between 2011 and 2013. Of the 149 participating facilities, 40 (27%) had zero hospital-acquired stage III and IV PrUs and 77 (52%) had a reduction in their PrU rate. Rates of all PrUs documented as present on admission did not change during this period. A comparison of different strategies used by the most successful facilities illustrated the necessity of facility-level flexibility and recognition of local workflows and patient demographics. Driven by the combination of a repository of evidence-based tools and best practices, readily available data on PrU rates, and local flexibility with processes, the Reducing Hospital Acquired-PrUs Program represents the successful operationalization of improvement in a wide variety of facilities.

  17. Cost and Predictors of Hospitalizations for Ambulatory Care - Sensitive Conditions Among Medicaid Enrollees in Comprehensive Managed Care Plans

    Directory of Open Access Journals (Sweden)

    William N. Mkanta

    2016-09-01

    Full Text Available Introduction: Preventable hospitalizations are responsible for increasing the cost of health care and reflect ineffectiveness of the health services in the primary care setting. The objective of this study was to assess expenditure for hospitalizations and utilize expenditure differentials to determine factors associated with ambulatory care - sensitive conditions (ACSCs hospitalizations. Methods: A cross-sectional study of hospitalizations among Medicaid enrollees in comprehensive managed care plans in 2009 was conducted. A total of 25 581 patients were included in the analysis. Expenditures on hospitalizations were examined at the 50th, 75th, 90th, and 95th expenditure percentiles both at the bivariate level and in the logistic regression model to determine the impact of differing expenditure on ACSC hospitalizations. Results: Compared with patients without ACSC admissions, a larger proportion of patients with ACSC hospitalizations required advanced treatment or died on admission. Overall mean expenditures were higher for the ACSC group than for non-ACSC group (US$18 070 vs US$14 452. Whites and blacks had higher expenditures for ACSC hospitalization than Hispanics at all expenditure percentiles. Patient’s age remained a consistent predictor of ACSC hospitalization across all expenditure percentiles. Patients with ACSC were less likely to have a procedure on admission; however, the likelihood decreased as expenditure percentiles increased. At the median expenditure, blacks and Hispanics were more likely than other race/ethnic groups to have ACSC hospitalizations (odds ratio [OR]: 1.307, 95% confidence interval [CI]: 1.013-1.686 and OR 1.252, 95% CI: 1.060-1.479, respectively. Conclusion: Future review of delivery and monitoring of services at the primary care setting should include managed care plans in order to enhance access and overall quality of care for optimal utilization of the resources.

  18. Hospital admissions for acute myocardial infarction before and after implementation of a comprehensive smoke-free policy in Uruguay

    Science.gov (United States)

    Sebrié, Ernesto Marcelo; Sandoya, Edgardo; Hyland, Andrew; Bianco, Eduardo; Glantz, Stanton A; Cummings, K Michael

    2012-01-01

    Background Stimulated by the WHO Framework Convention on Tobacco Control, many countries in Latin America adopted comprehensive smoke-free policies. In March 2006, Uruguay became the first Latin American country to adopt 100% smoke-free national legislation, which ended smoking in all indoor public places and workplaces, including restaurants and bars. The objective of this study was to evaluate trends in hospital admissions for cardiovascular disease 2 years before and 2 years after the policy was implemented in Uruguay. Methods Reports of hospital admissions for acute myocardial infarction (AMI) (International Classification of Disease-10 I21) from 37 hospitals (79% of all hospital admissions in the country), representing the period 2 years before and 2 years after the adoption of a nationwide smoke-free policy in Uruguay (between 1 March 2004 and 29 February 2008), were reviewed. A time series analysis was undertaken to compare the average monthly number of events of hospital admission for AMI before and after the smoke-free law. Results A total of 7949 hospital admissions for AMI were identified during the 4-year study period. Two years after the smoke-free policy was enacted, hospital admissions for AMI fell by 22%. The same pattern and roughly the same magnitude of reduction in AMI admissions were observed for patients seen in public and private hospitals, men, women and people aged 40–65 years and older than 65 years. Conclusions The national smoke-free policy implemented in Uruguay in 2006 was associated with a significant reduction in hospital admissions for AMI. PMID:22337557

  19. Hospital admissions for acute myocardial infarction before and after implementation of a comprehensive smoke-free policy in Uruguay.

    Science.gov (United States)

    Sebrié, Ernesto Marcelo; Sandoya, Edgardo; Hyland, Andrew; Bianco, Eduardo; Glantz, Stanton A; Cummings, K Michael

    2013-05-01

    Stimulated by the WHO Framework Convention on Tobacco Control, many countries in Latin America adopted comprehensive smoke-free policies. In March 2006, Uruguay became the first Latin American country to adopt 100% smoke-free national legislation, which ended smoking in all indoor public places and workplaces, including restaurants and bars. The objective of this study was to evaluate trends in hospital admissions for cardiovascular disease 2 years before and 2 years after the policy was implemented in Uruguay. Reports of hospital admissions for acute myocardial infarction (AMI) (International Classification of Disease-10 I21) from 37 hospitals (79% of all hospital admissions in the country), representing the period 2 years before and 2 years after the adoption of a nationwide smoke-free policy in Uruguay (between 1 March 2004 and 29 February 2008), were reviewed. A time series analysis was undertaken to compare the average monthly number of events of hospital admission for AMI before and after the smoke-free law. A total of 7949 hospital admissions for AMI were identified during the 4-year study period. Two years after the smoke-free policy was enacted, hospital admissions for AMI fell by 22%. The same pattern and roughly the same magnitude of reduction in AMI admissions were observed for patients seen in public and private hospitals, men, women and people aged 40-65 years and older than 65 years. The national smoke-free policy implemented in Uruguay in 2006 was associated with a significant reduction in hospital admissions for AMI.

  20. Analysis of a Moon outpost for Mars enabling technologies through a Virtual Reality environment

    Science.gov (United States)

    Casini, Andrea E. M.; Maggiore, Paolo; Viola, Nicole; Basso, Valter; Ferrino, Marinella; Hoffman, Jeffrey A.; Cowley, Aidan

    2018-02-01

    The Moon is now being considered as the starting point for human exploration of the Solar System beyond low-Earth orbit. Many national space agencies are actively advocating to build up a lunar surface habitat capability starting from 2030 or earlier: according to ESA Technology Roadmaps for Exploration this should be the result of a broad international cooperation. Taking into account an incremental approach to reduce risks and costs of space missions, a lunar outpost can be considered as a test bed towards Mars, allowing to validate enabling technologies, such as water processing, waste management, power generation and storage, automation, robotics and human factors. Our natural satellite is rich in resources that could be used to pursue such a goal through a necessary assessment of ISRU techniques. The aim of this research is the analysis of a Moon outpost dedicated to the validation of enabling technologies for human space exploration. The main building blocks of the outpost are identified and feasible evolutionary scenarios are depicted, to highlight the incremental steps to build up the outpost. Main aspects that are dealt with include outpost location and architecture, as well as ISRU facilities, which in a far term future can help reduce the mass at launch, by producing hydrogen and oxygen for consumables, ECLSS, and propellant for Earth-Moon sorties and Mars journeys. A test outpost is implemented in a Virtual Reality (VR) environment as a first proof-of-concepts, where the elements are computer-based mock-ups. The VR facility has a first-person interactive perspective, allowing for specific in-depth analyses of ergonomics and operations. The feedbacks of these analyses are crucial to highlight requirements that might otherwise be overlooked, while their general outputs are fundamental to write down procedures. Moreover, the mimic of astronauts' EVAs is useful for pre-flight training, but can also represent an additional tool for failures troubleshooting

  1. Budget Impact of a Comprehensive Nutrition-Focused Quality Improvement Program for Malnourished Hospitalized Patients.

    Science.gov (United States)

    Sulo, Suela; Feldstein, Josh; Partridge, Jamie; Schwander, Bjoern; Sriram, Krishnan; Summerfelt, Wm Thomas

    2017-07-01

    Nutrition interventions can alleviate the burden of malnutrition by improving patient outcomes; however, evidence on the economic impact of medical nutrition intervention remains limited. A previously published nutrition-focused quality improvement program targeting malnourished hospitalized patients showed that screening patients with a validated screening tool at admission, rapidly administering oral nutritional supplements, and educating patients on supplement adherence result in significant reductions in 30-day unplanned readmissions and hospital length of stay. To assess the potential cost-savings associated with decreased 30-day readmissions and hospital length of stay in malnourished inpatients through a nutrition-focused quality improvement program using a web-based budget impact model, and to demonstrate the clinical and fiscal value of the intervention. The reduction in readmission rate and length of stay for 1269 patients enrolled in the quality improvement program (between October 13, 2014, and April 2, 2015) were compared with the pre-quality improvement program baseline and validation cohorts (4611 patients vs 1319 patients, respectively) to calculate potential cost-savings as well as to inform the design of the budget impact model. Readmission rate and length-of-stay reductions were calculated by determining the change from baseline to post-quality improvement program as well as the difference between the validation cohort and the post-quality improvement program, respectively. As a result of improved health outcomes for the treated patients, the nutrition-focused quality improvement program led to a reduction in 30-day hospital readmissions and length of stay. The avoided hospital readmissions and reduced number of days in the hospital for the patients in the quality improvement program resulted in cost-savings of $1,902,933 versus the pre-quality improvement program baseline cohort, and $4,896,758 versus the pre-quality improvement program in the

  2. Franz Josef Land: extreme northern outpost for Arctic fishes

    Directory of Open Access Journals (Sweden)

    Natalia V. Chernova

    2014-12-01

    Full Text Available The remote Franz Josef Land (FJL Archipelago is the most northerly land in Eurasia and its fish fauna, particularly in nearshore habitats, has been poorly studied. An interdisciplinary expedition to FJL in summer 2013 used scuba, seines, and plankton nets to comprehensively study the nearshore fish fauna of the archipelago. We present some of the first underwater images for many of these species in their natural habitats. In addition, deep water drop cameras were deployed between 32 and 392 m to document the fish fauna and their associated habitats at deeper depths. Due to its high latitude (79°–82°N, extensive ice cover, and low water temperatures (<0 °C much of the year, the fish diversity at FJL is low compared to other areas of the Barents Sea. Sixteen species of fishes from seven families were documented on the expedition, including two species previously unknown to the region. One Greenland shark, Somniosus microcephalus (Somniosidae, ca. 2 m in length, was recorded by drop camera near Hayes Island at 211 m, and Esipov’s pout, Gymnelus esipovi (Zoarcidae, was collected at Wilton Island at 15 m in a kelp forest. Including the tape-body pout, Gymnelus taeniatus, described earlier from the sub-littoral zone of Kuhn Island, 17 fish species are now known from FJL’s nearshore waters. Species endemic to the Arctic accounted for 75% of the nearshore species observed, followed by species with wider ranges. A total of 43 species from 15 families are known from FJL with the majority of the records from offshore trawl surveys between 110 and 620 m. Resident species have mainly high Arctic distributions, while transient species visit the archipelago to feed (e.g., Greenland shark, and others are brought by currents as larvae and later migrate to spawn grounds in the south (e.g., Atlantic cod Gadus morhua, Capelin Mallotus villosus, Beaked redfish Sebastes mentella. Another species group includes warmer-water fishes that are rare waifs (e

  3. Surgical informed consent in obstetric and gynecologic surgeries: experience from a comprehensive teaching hospital in Southern Ethiopia.

    Science.gov (United States)

    Teshome, Million; Wolde, Zenebe; Gedefaw, Abel; Tariku, Mequanent; Asefa, Anteneh

    2018-05-24

    Surgical Informed Consent (SIC) has long been recognized as an important component of modern medicine. The ultimate goals of SIC are to improve clients' understanding of the intended procedure, increase client satisfaction, maintain trust between clients and health providers, and ultimately minimize litigation issues related to surgical procedures. The purpose of the current study is to assess the comprehensiveness of the SIC process for women undergoing obstetric and gynecologic surgeries. A hospital-based cross-sectional study was undertaken at Hawassa University Comprehensive Specialized Hospital (HUCSH) in November and December, 2016. A total of 230 women who underwent obstetric and/or gynecologic surgeries were interviewed immediately after their hospital discharge to assess their experience of the SIC process. Thirteen components of SIC were used based on international recommendations, including the Royal College of Surgeon's standards of informed consent practices for surgical procedures. Descriptive summaries are presented in tables and figures. Forty percent of respondents were aged between 25 and 29 years. Nearly a quarter (22.6%) had no formal education. More than half (54.3%) of respondents had undergone an emergency surgical procedure. Only 18.4% of respondents reported that the surgeon performing the operation had offered SIC, while 36.6% of respondents could not recall who had offered SIC. All except one respondent provided written consent to undergo a surgical procedure. However, 8.3% of respondents received SIC service while already on the operation table for their procedure. Only 73.9% of respondents were informed about the availability (or lack thereof) of alternative treatment options. Additionally, a majority of respondents were not informed about the type of anesthesia to be used (88.3%) and related complications (87.4%). Only 54.2% of respondents reported that they had been offered at least six of the 13 SIC components used by the

  4. Statecraft and expansionary dynamics: A Virú outpost at Huaca Prieta, Chicama Valley, Peru.

    Science.gov (United States)

    Millaire, Jean-François; Prieto, Gabriel; Surette, Flannery; Redmond, Elsa M; Spencer, Charles S

    2016-10-11

    Interpolity interaction and regional control were central features of all early state societies, taking the form of trade-embedded in political processes to varying degrees-or interregional conquest strategies meant to expand the polity's control or influence over neighboring territories. Cross-cultural analyses of early statecraft suggest that territorial expansion was an integral part of the process of primary state formation, closely associated with the delegation of authority to subordinate administrators and the construction of core outposts of the state in foreign territories. We report here on a potential case of a core outpost, associated with the early Virú state, at the site of Huaca Prieta in the Chicama Valley, located 75 km north of the Virú state heartland on the north coast of Peru. This site is discussed in the context of other possible Virú outposts in the Moche Valley, Pampa La Cruz, and Huaca Las Estrellas, and as part of a broader reflection on expansionary dynamics and statecraft.

  5. Statecraft and expansionary dynamics: A Virú outpost at Huaca Prieta, Chicama Valley, Peru

    Science.gov (United States)

    Millaire, Jean-François; Prieto, Gabriel; Surette, Flannery; Redmond, Elsa M.; Spencer, Charles S.

    2016-01-01

    Interpolity interaction and regional control were central features of all early state societies, taking the form of trade—embedded in political processes to varying degrees—or interregional conquest strategies meant to expand the polity’s control or influence over neighboring territories. Cross-cultural analyses of early statecraft suggest that territorial expansion was an integral part of the process of primary state formation, closely associated with the delegation of authority to subordinate administrators and the construction of core outposts of the state in foreign territories. We report here on a potential case of a core outpost, associated with the early Virú state, at the site of Huaca Prieta in the Chicama Valley, located 75 km north of the Virú state heartland on the north coast of Peru. This site is discussed in the context of other possible Virú outposts in the Moche Valley, Pampa La Cruz, and Huaca Las Estrellas, and as part of a broader reflection on expansionary dynamics and statecraft. PMID:27671633

  6. Work ability among hospital food service professionals: multiple associated variables require comprehensive intervention.

    Science.gov (United States)

    Fischer, Frida Marina; Martinez, Maria Carmen

    2012-01-01

    The work of hospital food service is characterized by demands that can be associated with work ability--WA. The aim of this study was to evaluate factors associated with WA among hospital food service professionals and recommend intervention measures. This is a cross sectional study carried out in 2009, conducted in a hospital of São Paulo, Brazil. Participants were 76 (96.2%) of the eligible. They filled out a questionnaire including socio-demographic data, life styles, working conditions and WA. Multivariate linear regression analyses were performed. Factors associated with WA were age (p = 0.051), over commitment (p = 0.011), effort-reward ratio (p = 0.002) and work injuries (p work injuries is consistent with the theoretical model that demonstrated that health status is the basis to maintain the WA. The association of effort-reward imbalance shows that issues related with work organization are relevant for these workers. The association of overcommittment suggests that workers recognize their responsibility with the therapeutic processes of patients. Results showed a number of features of different nature that should be taken into account when implementing measures to improve the WA, to be applied at different levels: individual, task and institutional.

  7. The impact of the Cyprus comprehensive smoking ban on air quality and economic business of hospitality venues

    Directory of Open Access Journals (Sweden)

    Christophi Costas A

    2013-01-01

    Full Text Available Abstract Background Several countries, including Cyprus, have passed smoke-free legislations in recent years. The goal of this study was to assess the indoor levels of particulate matter in hospitality venues in Cyprus before and after the implementation of the law on 1/1/2010, evaluate the role of enforcement, and examine the legislation’s effect on revenue and employment. Methods Several hospitality venues (n = 35 were sampled between April 2007 and January 2008, and 21 of those were re-sampled after the introduction of the smoking ban, between March and May 2010. Data on enforcement was provided by the Cyprus Police whereas data on revenue and employment within the hospitality industry of Cyprus were obtained from the Cyprus Statistical Service; comparisons were made between the corresponding figures before and after the implementation of the law. Results The median level of PM2.5 associated with secondhand smoking was 161 μg/m3 pre-ban and dropped to 3 μg/m3 post-ban (98% decrease, p  Conclusion Smoke free legislations, when enforced, are highly effective in improving the air quality and reducing the levels of indoor PM2.5. Strict enforcement plays a key role in the successful implementation of smoking bans. Even in nations with high smoking prevalence comprehensive smoking laws can be effectively implemented and have no negative effect on accommodation, food, and beverage services.

  8. COMPREHENSIVE STUDY OF HYDATID DISEASE OF LIVER AND MANAGEMENT AT PERIPHERAL TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Karunaharan Thomas

    2017-04-01

    Full Text Available BACKGROUND Hydatid Disease (HD is a zoonotic disease caused by the larvae of Echinococcosis granulosus, now become a rare clinical entity in teaching medical college hospitals. This is due to the public education about the disease, mode of spread and treatment available. The aim of the study is to review the epidemiology, clinical presentation, diagnostic methods available, organs affected and treatment available in the tertiary hospitals and outcome. MATERIALS AND METHODS Data Collection- Patients with upper right abdominal pain with radiological and ultrasound findings are included in the study. About twenty patients are taken for this study. Medical managements, surgical procedure done and outcomes are recorded, tabulated and analysed. Research Design- Prospective Study, Research Setting- KAPV Govt. Medical College and Mahatma Gandhi Memorial Govt. Hospital, Trichy, Tamilnadu. Duration- 7 yrs. (2009 to 2016 Sample Size- Twenty. Inclusion CriteriaPatients between 12 to 70 years of age of both sexes. Patient having right upper abdomen or epigastric pain with positive radiological and ultrasound findings. Patient willing to participate in the study. Exclusion Criteria- Patients more than 70 years not willing to participate in the study patients absconded in between the management. RESULTS Liver is a commonest solid organ affected by the hydatid disease. Most of the diagnosis are made accidentally when the patients are investigated for some other diseases. The commonest clinical presentation is right abdominal or epigastric pain with hepatomegaly. The average age group is 45 years. X-ray abdomen, ultrasound abdomen are the most useful investigations. Asymptomatic uncomplicated small cyst less than 5 cms are managed with medical treatment. Symptomatic large cysts are submitted for surgical intervention. CONCLUSION The main source of income in majority of rural population is agriculture and sheep and cattle grazing. WHO is working towards the

  9. Comprehensive analysis of prognostic factors in hospitalized patients with pneumonia occurring outside hospital: Serum albumin is not less important than pneumonia severity assessment scale.

    Science.gov (United States)

    Miyazaki, Hiroyuki; Nagata, Nobuhiko; Akagi, Takanori; Takeda, Satoshi; Harada, Taishi; Ushijima, Shinichiro; Aoyama, Takashi; Yoshida, Yuji; Yatsugi, Hiroshi; Fujita, Masaki; Watanabe, Kentaro

    2018-08-01

    This study aimed to elucidate factors related to 30-day mortality of pneumonia occurring outside hospital by comprehensively analyzing data considered relevant to prognosis. Data considered relevant to prognosis were retrospectively examined from clinical charts and chest X-ray images of all patients with pneumonia occurring outside hospital admitted to our hospital from 2010 to 2016. The primary outcome was 30-day mortality. Data were collected from 534 patients (317 community-acquired pneumonia and 217 nursing- and healthcare associated pneumonia patients; 338 men (63.3%); mean age, 76.2 years-old). Eighty-three patients (9.9%) died from pneumonia within 30 days from the date of admission. The numbers of patients with pneumonia severity index (PSI) classes of I/II/III/IV/V and age, dehydration, respiratory failure, orientation disturbance, pressure (A-DROP) scores of 0/1/2/3/4/5 were 29/66/127/229/83, and 71/107/187/132/30/7, respectively. Mean (standard deviation) body mass index (BMI), serum albumin, blood procalcitonin, white blood cell and C-reactive protein were 20.00 (4.12) kg/m 2 , 3.16 (0.60) g/dL, 3.69 (13.15) ng/mL, 11559.4 (5656.9)/mm 3 , and 10.92 (8.75) mg/dL, respectively. Chest X-ray images from 152 patients exhibited a pneumonia shadow over a quarter of total lung field. Logistic regression analysis revealed that PSI class or A-DROP score, BMI, serum albumin, and extent of pneumonia shadow were related to 30-day mortality. Receiver operating characteristics curve analysis revealed that serum albumin was superior to PSI class or A-DROP score for predicting 30-day mortality. Serum albumin is not less important than PSI class or A-DROP score for predicting 30-day mortality in hospitalized patients with pneumonia occurring outside hospital. Copyright © 2018 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  10. Country Outposts

    Science.gov (United States)

    McCollum, Sean

    2010-01-01

    Being an LGBT youth in America has never been a Gay Pride Parade, no matter the community setting. But most rural schools prove an especially unhappy and dispiriting place for kids whose sexuality or gender expression does not fit within community expectations. Those are the findings of researchers for the Gay, Lesbian and Straight Education…

  11. What Are the Perceptions, Experiences, and Behaviors of Health Care Providers After Implementation of a Comprehensive Smoke-Free Hospital Policy?

    Science.gov (United States)

    Luck, Kerrie E; Doucet, Shelley

    2018-01-01

    The aim of this study was to explore the perceptions, experiences, and behaviors of health care providers (HCPs) after the implementation of a comprehensive smoke-free policy. This qualitative descriptive study, using semi-structured interviews, was conducted with 28 HCPs working in a Canadian hospital. Four overarching themes emerged from the analysis including (a) greater support for tobacco reduction, (b) enhanced patient care and interactions, (c) improved staff morale, and (d) some barriers still exist. The main findings suggest a comprehensive smoke-free hospital environment can strengthen the tobacco-free workplace culture within a hospital setting among HCPs where support for tobacco reduction is amplified, patient care and interactions regarding tobacco dependence are improved, and staff morale is enhanced. While there are still some challenging barriers as well as opportunities for improvements, the implementation of a comprehensive smoke-free policy heightened the call-to-action among HCPs to take a more active role in tobacco reduction.

  12. The impact of the Cyprus comprehensive smoking ban on air quality and economic business of hospitality venues.

    Science.gov (United States)

    Christophi, Costas A; Paisi, Martha; Pampaka, Despina; Kehagias, Martha; Vardavas, Constantine; Connolly, Gregory N

    2013-01-27

    Several countries, including Cyprus, have passed smoke-free legislations in recent years. The goal of this study was to assess the indoor levels of particulate matter in hospitality venues in Cyprus before and after the implementation of the law on 1/1/2010, evaluate the role of enforcement, and examine the legislation's effect on revenue and employment. Several hospitality venues (n = 35) were sampled between April 2007 and January 2008, and 21 of those were re-sampled after the introduction of the smoking ban, between March and May 2010. Data on enforcement was provided by the Cyprus Police whereas data on revenue and employment within the hospitality industry of Cyprus were obtained from the Cyprus Statistical Service; comparisons were made between the corresponding figures before and after the implementation of the law. The median level of PM2.5 associated with secondhand smoking was 161 μg/m3 pre-ban and dropped to 3 μg/m3 post-ban (98% decrease, p < 0.0001). Furthermore, in the year following the ban, the hotel turnover rate increased by 4.1% and the restaurant revenue by 6.4%; employment increased that same year by 7.2% and 1.0%, respectively. Smoke free legislations, when enforced, are highly effective in improving the air quality and reducing the levels of indoor PM2.5. Strict enforcement plays a key role in the successful implementation of smoking bans. Even in nations with high smoking prevalence comprehensive smoking laws can be effectively implemented and have no negative effect on accommodation, food, and beverage services.

  13. Integrated Bio-ISRU and Life Support Systems at the Lunar Outpost: Concept and Preliminary Results

    Science.gov (United States)

    Brown, I. I.; Garrison, D. H.; Allen, C. C.; Pickering, K.; Sarkisova, S. A.; Galindo, C., Jr.; Pan, D.; Foraker, E.; Mckay, D. S.

    2009-01-01

    We continue the development of our concept of a biotechnological loop for in-situ resource extraction along with propellant and food production at a future lunar outpost, based on the cultivation of litholytic cyanobacteria (LCB) with lunar regolith (LR) in a geobioreactor energized by sunlight. Our preliminary studies have shown that phototropic cultivation of LCB with simulants of LR in a low-mineralized medium supplemented with CO2 leads to rock dissolution (bioweathering) with the resulting accumulation of Fe, Mg and Al in cyanobacterial cells and in the medium. LCB cultivated with LR simulants produces more O2 than the same organisms cultivated in a high-mineralized medium. The loss of rock mass after bioweathering with LCB suggests the release of O from regolith. Further studies of chemical pathways of released O are required. The bioweathering process is limited by the availability of CO2, N, and P. Since lunar regolith is mainly composed of O, Si, Ca, Al and Mg, we propose to use organic waste to supply a geobioreactor with C, N and P. The recycling of organic waste, including urine, through a geobioreactor will allow for efficient element extraction as well as oxygen and biomass production. The most critical conclusion is that a biological life support system tied to a geobioreactor might be more efficient for supporting an extraterrestrial outpost than a closed environmental system.

  14. Interplanetary outpost the human and technological challenges of exploring the outer planets

    CERN Document Server

    Seedhouse, Erik

    2012-01-01

    Water has been discovered on the Saturnian moon, Enceladus, and on Jupiter's moons, Europa, Ganymede, and Callisto. Where there is water, could there be life? Could this tantalizing possibility result in a manned mission to the outer planets? But how will such a mission be designed, what propulsion system will be used, and what hazards will the crewmembers face? Interplanetary Outpost describes step by step how the mission architecture will evolve, how crews will be selected and trained, and what the mission will entail from launch to landing. It addresses the effects that exteneded duration, radiation, communication, and isolation will have on the human body, and how not only performance but behavior might be affected.

  15. Hospitals

    Data.gov (United States)

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

  16. Comprehensive evaluation of electronic medical record system use and user satisfaction at five low-resource setting hospitals in ethiopia.

    Science.gov (United States)

    Tilahun, Binyam; Fritz, Fleur

    2015-05-25

    Electronic medical record (EMR) systems are increasingly being implemented in hospitals of developing countries to improve patient care and clinical service. However, only limited evaluation studies are available concerning the level of adoption and determinant factors of success in those settings. The objective of this study was to assess the usage pattern, user satisfaction level, and determinants of health professional's satisfaction towards a comprehensive EMR system implemented in Ethiopia where parallel documentation using the EMR and the paper-based medical records is in practice. A quantitative, cross-sectional study design was used to assess the usage pattern, user satisfaction level, and determinant factors of an EMR system implemented in Ethiopia based on the DeLone and McLean model of information system success. Descriptive statistical methods were applied to analyze the data and a binary logistic regression model was used to identify determinant factors. Health professionals (N=422) from five hospitals were approached and 406 responded to the survey (96.2% response rate). Out of the respondents, 76.1% (309/406) started to use the system immediately after implementation and user training, but only 31.7% (98/309) of the professionals reported using the EMR during the study (after 3 years of implementation). Of the 12 core EMR functions, 3 were never used by most respondents, and they were also unaware of 4 of the core EMR functions. It was found that 61.4% (190/309) of the health professionals reported over all dissatisfaction with the EMR (median=4, interquartile range (IQR)=1) on a 5-level Likert scale. Physicians were more dissatisfied (median=5, IQR=1) when compared to nurses (median=4, IQR=1) and the health management information system (HMIS) staff (median=2, IQR=1). Of all the participants, 64.4% (199/309) believed that the EMR had no positive impact on the quality of care. The participants indicated an agreement with the system and information

  17. Effect of a comprehensive health education program on pre-hospital delay intentions in high-risk stroke population and caregivers.

    Science.gov (United States)

    Yang, Li; Zhao, Qiuli; Zhu, Xuemei; Shen, Xiaoying; Zhu, Yulan; Yang, Liu; Gao, Wei; Li, Minghui

    2017-08-01

    Many factors influence pre-hospital delays in the event of stroke. This study aimed to develop and evaluate a comprehensive educational program for decreasing pre-hospital delays in high-risk stroke population. We enrolled 220 high-risk stroke population and caregivers from six urban communities in Harbin from May 2013 to May 2015, and randomly divided them into intervention and control groups. We implemented a comprehensive educational program (intervention group), comprising public lectures, instructional brochures, case videos, simulations, and role-playing from May 2013 to May 2015. We delivered conventional oral education in the control group. We compared stroke pre-hospital delay behavioral intention (SPDBI), pre-hospital stroke symptom coping test (PSSCT), and stroke pre-symptoms alert test (SPSAT) results between the groups before and 6, 12, and 18 months after health intervention. There were significant differences between before and after intervention (P educational program was significantly effective in decreasing SPDBI, improving knowledge, enhancing stroke pre-symptoms alert, and reducing the possibility of pre-hospital delays.

  18. Medicare Program; Comprehensive Care for Joint Replacement Payment Model for Acute Care Hospitals Furnishing Lower Extremity Joint Replacement Services. Final rule.

    Science.gov (United States)

    2015-11-24

    This final rule implements a new Medicare Part A and B payment model under section 1115A of the Social Security Act, called the Comprehensive Care for Joint Replacement (CJR) model, in which acute care hospitals in certain selected geographic areas will receive retrospective bundled payments for episodes of care for lower extremity joint replacement (LEJR) or reattachment of a lower extremity. All related care within 90 days of hospital discharge from the joint replacement procedure will be included in the episode of care. We believe this model will further our goals in improving the efficiency and quality of care for Medicare beneficiaries with these common medical procedures.

  19. Effects of comprehensive stroke care capabilities on in-hospital mortality of patients with ischemic and hemorrhagic stroke: J-ASPECT study.

    Science.gov (United States)

    Iihara, Koji; Nishimura, Kunihiro; Kada, Akiko; Nakagawara, Jyoji; Ogasawara, Kuniaki; Ono, Junichi; Shiokawa, Yoshiaki; Aruga, Toru; Miyachi, Shigeru; Nagata, Izumi; Toyoda, Kazunori; Matsuda, Shinya; Miyamoto, Yoshihiro; Suzuki, Akifumi; Ishikawa, Koichi B; Kataoka, Hiroharu; Nakamura, Fumiaki; Kamitani, Satoru

    2014-01-01

    The effectiveness of comprehensive stroke center (CSC) capabilities on stroke mortality remains uncertain. We performed a nationwide study to examine whether CSC capabilities influenced in-hospital mortality of patients with ischemic and hemorrhagic stroke. Of the 1,369 certified training institutions in Japan, 749 hospitals responded to a questionnaire survey regarding CSC capabilities that queried the availability of personnel, diagnostic techniques, specific expertise, infrastructure, and educational components recommended for CSCs. Among the institutions that responded, data on patients hospitalized for stroke between April 1, 2010 and March 31, 2011 were obtained from the Japanese Diagnosis Procedure Combination database. In-hospital mortality was analyzed using hierarchical logistic regression analysis adjusted for age, sex, level of consciousness on admission, comorbidities, and the number of fulfilled CSC items in each component and in total. Data from 265 institutions and 53,170 emergency-hospitalized patients were analyzed. Mortality rates were 7.8% for patients with ischemic stroke, 16.8% for patients with intracerebral hemorrhage (ICH), and 28.1% for patients with subarachnoid hemorrhage (SAH). Mortality adjusted for age, sex, and level of consciousness was significantly correlated with personnel, infrastructural, educational, and total CSC scores in patients with ischemic stroke. Mortality was significantly correlated with diagnostic, educational, and total CSC scores in patients with ICH and with specific expertise, infrastructural, educational, and total CSC scores in patients with SAH. CSC capabilities were associated with reduced in-hospital mortality rates, and relevant aspects of care were found to be dependent on stroke type.

  20. Automation of a Versatile Crane (the LSMS) for Lunar Outpost Construction, Maintenance and Inspection

    Science.gov (United States)

    Doggett, William R.; Roithmayr, Carlos M.; Dorsey, John T.; Jones, Thomas C.; Shen, Haijun; Seywald, Hans; King, Bruce D.; Mikulas, Martin M., Jr.

    2009-01-01

    Devices for lifting, translating and precisely placing payloads are critical for efficient Earth-based construction operations. Both recent and past studies have demonstrated that devices with similar functionality will be needed to support lunar outpost operations. Although several designs have been developed for Earth based applications, these devices lack unique design characteristics necessary for transport to and use on the harsh lunar surface. These design characteristics include: a) lightweight components, b) compact packaging for launch, c) automated deployment, d) simple in-field reconfiguration and repair, and e) support for tele-operated or automated operations. Also, because the cost to transport mass to the lunar surface is very high, the number of devices that can be dedicated to surface operations will be limited. Thus, in contrast to Earth-based construction, where many single-purpose devices dominate a construction site, a lunar outpost will require a limited number of versatile devices that provide operational benefit from initial construction through sustained operations. The first generation test-bed of a new high performance device, the Lunar Surface Manipulation System (LSMS) has been designed, built and field tested. The LSMS has many unique features resulting in a mass efficient solution to payload handling on the lunar surface. Typically, the LSMS device mass is estimated at approximately 3% of the mass of the heaviest payload lifted at the tip, or 1.8 % of the mass of the heaviest mass lifted at the elbow or mid-span of the boom for a high performance variant incorporating advanced structural components. Initial operational capabilities of the LSMS were successfully demonstrated during field tests at Moses Lake, Washington using a tele-operated approach. Joint angle sensors have been developed for the LSMS to improve operator situational awareness. These same sensors provide the necessary information to support fully automated operations

  1. Golgi Outpost Synthesis Impaired by Toxic Polyglutamine Proteins Contributes to Dendritic Pathology in Neurons

    Directory of Open Access Journals (Sweden)

    Chang Geon Chung

    2017-07-01

    Full Text Available Dendrite aberration is a common feature of neurodegenerative diseases caused by protein toxicity, but the underlying mechanisms remain largely elusive. Here, we show that nuclear polyglutamine (polyQ toxicity resulted in defective terminal dendrite elongation accompanied by a loss of Golgi outposts (GOPs and a decreased supply of plasma membrane (PM in Drosophila class IV dendritic arborization (da (C4 da neurons. mRNA sequencing revealed that genes downregulated by polyQ proteins included many secretory pathway-related genes, including COPII genes regulating GOP synthesis. Transcription factor enrichment analysis identified CREB3L1/CrebA, which regulates COPII gene expression. CrebA overexpression in C4 da neurons restores the dysregulation of COPII genes, GOP synthesis, and PM supply. Chromatin immunoprecipitation (ChIP-PCR revealed that CrebA expression is regulated by CREB-binding protein (CBP, which is sequestered by polyQ proteins. Furthermore, co-overexpression of CrebA and Rac1 synergistically restores the polyQ-induced dendrite pathology. Collectively, our results suggest that GOPs impaired by polyQ proteins contribute to dendrite pathology through the CBP-CrebA-COPII pathway.

  2. Life support systems analysis and technical trades for a lunar outpost

    Science.gov (United States)

    Ferrall, J. F.; Ganapathi, G. B.; Rohatgi, N. K.; Seshan, P. K.

    1994-01-01

    The NASA/JPL life support systems analysis (LISSA) software tool was used to perform life support system analysis and technology trades for a Lunar Outpost. The life support system was modeled using a chemical process simulation program on a steady-state, one-person, daily basis. Inputs to the LiSSA model include metabolic balance load data, hygiene load data, technology selection, process operational assumptions and mission parameter assumptions. A baseline set of technologies has been used against which comparisons have been made by running twenty-two cases with technology substitutions. System, subsystem, and technology weights and powers are compared for a crew of 4 and missions of 90 and 600 days. By assigning a weight value to power, equivalent system weights are compared. Several less-developed technologies show potential advantages over the baseline. Solid waste treatment technologies show weight and power disadvantages but one could have benefits associated with the reduction of hazardous wastes and very long missions. Technology development towards reducing the weight of resupplies and lighter materials of construction was recommended. It was also recommended that as technologies are funded for development, contractors should be required to generate and report data useful for quantitative technology comparisons.

  3. A historical-archaeological investigation of an Anglo-Boer War British outpost in the Kruger National Park

    Directory of Open Access Journals (Sweden)

    Anton C. Van Vollenhoven

    1998-08-01

    Full Text Available During the Anglo-Boer War (1899-1902 a voluntary British military unit called Steinaecker's Horse, operated in the Lowveld and Swaziland. The commander of the unit, colonel Ludwig von Steinaecker, was an important historical figure in this area. The unit established a number of outposts in an area today known as the Kruger National Park. One of these outposts was archaeologically investigated in order to recover any remains that may be associated with this unit and to form some idea of their lifestyle. Although no historical information on this particular outpost was found, the archaeological excavations revealed some interesting evidence. The disturbance of the site and the number of visible cultural material, indicated that it was used in recent times. The large refuse middens show that a reasonably large number of people occupied the site. Most of the artifacts found can be linked to the diet and articles of everyday use of the inhabitants. The conclusion is that the site was probably occupied by both a garrison of the Steinaecker's Horse military unit and some troops of the Native Police unit. Based on the distribution of different types of artifacts on the site a social differ- entiation between the members of these two units is assumed.

  4. [Introduction of computerized anesthesia-recording systems and construction of comprehensive medical information network for patients undergoing surgery in the University of Tokyo Hospital].

    Science.gov (United States)

    Kitamura, Takayuki; Hoshimoto, Hiroyuki; Yamada, Yoshitsugu

    2009-10-01

    The computerized anesthesia-recording systems are expensive and the introduction of the systems takes time and requires huge effort. Generally speaking, the efficacy of the computerized anesthesia-recording systems on the anesthetic managements is focused on the ability to automatically input data from the monitors to the anesthetic records, and tends to be underestimated. However, once the computerized anesthesia-recording systems are integrated into the medical information network, several features, which definitely contribute to improve the quality of the anesthetic management, can be developed; for example, to prevent misidentification of patients, to prevent mistakes related to blood transfusion, and to protect patients' personal information. Here we describe our experiences of the introduction of the computerized anesthesia-recording systems and the construction of the comprehensive medical information network for patients undergoing surgery in The University of Tokyo Hospital. We also discuss possible efficacy of the comprehensive medical information network for patients during surgery under anesthetic managements.

  5. Hospitals

    DEFF Research Database (Denmark)

    Mullins, Michael

    2013-01-01

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

  6. ''Fast track'' lunar NTR systems assessment for NASA's first lunar outpost and its evolvability to Mars

    International Nuclear Information System (INIS)

    Borowski, S.K.; Alexander, S.W.

    1993-01-01

    Integrated systems and missions studies are presented for an evolutionary lunar-to-Mars space transportion system (STS) based on nuclear thermal rocket (NTR) technology. A ''standardized'' set of engine and stage components are identified and used in a ''building block'' fashion to configure a variety of piloted and cargo, lunar and Mars vehicles. The reference NTR characteristics include a thrust of 50 thousand pounds force (klbf), specific impulse (I sp ) of 900 seconds, and an engine thrust-to-weight ratio of 4.3. For the National Aeronautics and Space Administration's (NASA) First Lunar Outpost (FLO) mission, an expendable NTR stage powered by two such engines can deliver ∼96 metric tonnes (t) to trans-lunar injection (TLI) conditions for an initial mass in low Earth orbit (IMLEO) of ∼198 t compared to 250 t for a cryogenic chemical system. The stage liquid hydrogen (LH 2 ) tank has a diameter, length, and capacity of 10 m, 14.5 m and 66 t, respectively. By extending the stage length and LH 2 capacity to ∼20 m and 96 t, a single launch Mars cargo vehicle could deliver to an elliptical Mars parking orbit a 63 t Mars excursion vehicle (MEV) with a 45 t surface payload. Three 50 klbf engines and the two standardized LH 2 tanks developed for the lunar and Mars cargo vehicles are used to configure the vehicles supporting piloted Mars missions as early as 2010. The ''modular'' NTR vehicle approach forms the basis for an efficient STS able to handle the needs of a wide spectrum of lunar and Mars missions

  7. Effects of Comprehensive Stroke Care Capabilities on In-Hospital Mortality of Patients with Ischemic and Hemorrhagic Stroke: J-ASPECT Study

    Science.gov (United States)

    Iihara, Koji; Nishimura, Kunihiro; Kada, Akiko; Nakagawara, Jyoji; Ogasawara, Kuniaki; Ono, Junichi; Shiokawa, Yoshiaki; Aruga, Toru; Miyachi, Shigeru; Nagata, Izumi; Toyoda, Kazunori; Matsuda, Shinya; Miyamoto, Yoshihiro; Suzuki, Akifumi; Ishikawa, Koichi B.; Kataoka, Hiroharu; Nakamura, Fumiaki; Kamitani, Satoru

    2014-01-01

    Background The effectiveness of comprehensive stroke center (CSC) capabilities on stroke mortality remains uncertain. We performed a nationwide study to examine whether CSC capabilities influenced in-hospital mortality of patients with ischemic and hemorrhagic stroke. Methods and Results Of the 1,369 certified training institutions in Japan, 749 hospitals responded to a questionnaire survey regarding CSC capabilities that queried the availability of personnel, diagnostic techniques, specific expertise, infrastructure, and educational components recommended for CSCs. Among the institutions that responded, data on patients hospitalized for stroke between April 1, 2010 and March 31, 2011 were obtained from the Japanese Diagnosis Procedure Combination database. In-hospital mortality was analyzed using hierarchical logistic regression analysis adjusted for age, sex, level of consciousness on admission, comorbidities, and the number of fulfilled CSC items in each component and in total. Data from 265 institutions and 53,170 emergency-hospitalized patients were analyzed. Mortality rates were 7.8% for patients with ischemic stroke, 16.8% for patients with intracerebral hemorrhage (ICH), and 28.1% for patients with subarachnoid hemorrhage (SAH). Mortality adjusted for age, sex, and level of consciousness was significantly correlated with personnel, infrastructural, educational, and total CSC scores in patients with ischemic stroke. Mortality was significantly correlated with diagnostic, educational, and total CSC scores in patients with ICH and with specific expertise, infrastructural, educational, and total CSC scores in patients with SAH. Conclusions CSC capabilities were associated with reduced in-hospital mortality rates, and relevant aspects of care were found to be dependent on stroke type. PMID:24828409

  8. Effects of comprehensive stroke care capabilities on in-hospital mortality of patients with ischemic and hemorrhagic stroke: J-ASPECT study.

    Directory of Open Access Journals (Sweden)

    Koji Iihara

    Full Text Available BACKGROUND: The effectiveness of comprehensive stroke center (CSC capabilities on stroke mortality remains uncertain. We performed a nationwide study to examine whether CSC capabilities influenced in-hospital mortality of patients with ischemic and hemorrhagic stroke. METHODS AND RESULTS: Of the 1,369 certified training institutions in Japan, 749 hospitals responded to a questionnaire survey regarding CSC capabilities that queried the availability of personnel, diagnostic techniques, specific expertise, infrastructure, and educational components recommended for CSCs. Among the institutions that responded, data on patients hospitalized for stroke between April 1, 2010 and March 31, 2011 were obtained from the Japanese Diagnosis Procedure Combination database. In-hospital mortality was analyzed using hierarchical logistic regression analysis adjusted for age, sex, level of consciousness on admission, comorbidities, and the number of fulfilled CSC items in each component and in total. Data from 265 institutions and 53,170 emergency-hospitalized patients were analyzed. Mortality rates were 7.8% for patients with ischemic stroke, 16.8% for patients with intracerebral hemorrhage (ICH, and 28.1% for patients with subarachnoid hemorrhage (SAH. Mortality adjusted for age, sex, and level of consciousness was significantly correlated with personnel, infrastructural, educational, and total CSC scores in patients with ischemic stroke. Mortality was significantly correlated with diagnostic, educational, and total CSC scores in patients with ICH and with specific expertise, infrastructural, educational, and total CSC scores in patients with SAH. CONCLUSIONS: CSC capabilities were associated with reduced in-hospital mortality rates, and relevant aspects of care were found to be dependent on stroke type.

  9. Multi-physics design and analyses of long life reactors for lunar outposts

    Science.gov (United States)

    Schriener, Timothy M.

    Future human exploration of the solar system is likely to include establishing permanent outposts on the surface of the Moon. These outposts will require reliable sources of electrical power in the range of 10's to 100's of kWe to support exploration and resource utilization activities. This need is best met using nuclear reactor power systems which can operate steadily throughout the long ˜27.3 day lunar rotational period, irrespective of location. Nuclear power systems can potentially open up the entire lunar surface for future exploration and development. Desirable features of nuclear power systems for the lunar surface include passive operation, the avoidance of single point failures in reactor cooling and the integrated power system, moderate operating temperatures to enable the use of conventional materials with proven irradiation experience, utilization of the lunar regolith for radiation shielding and as a supplemental neutron reflector, and safe post-operation decay heat removal and storage for potential retrieval. In addition, it is desirable for the reactor to have a long operational life. Only a limited number of space nuclear reactor concepts have previously been developed for the lunar environment, and these designs possess only a few of these desirable design and operation features. The objective of this research is therefore to perform design and analyses of long operational life lunar reactors and power systems which incorporate the desirable features listed above. A long reactor operational life could be achieved either by increasing the amount of highly enriched uranium (HEU) fuel in the core or by improving the neutron economy in the reactor through reducing neutron leakage and parasitic absorption. The amount of fuel in surface power reactors is constrained by the launch safety requirements. These include ensuring that the bare reactor core remains safely subcritical when submerged in water or wet sand and flooded with seawater in the unlikely

  10. Evolution of the concept of avoidable hospitalization through the selections of causes and codes: evidence from a comprehensive review.

    NARCIS (Netherlands)

    Pelone, F.; Basso, D.; Lilli, S.; Belvis, A.G. de; Rosano, A.; Zee, J. van der; Ricciardi, W.

    2010-01-01

    Background: Ambulatory care sensitive conditions (ACSCs) are diseases where the provision of primary health care (PHC) interventions may affect the severity of the disease and prevent hospitalization. This study aimed at exploring changes of different definitions and classification of ACSCs and the

  11. Effect of in-hospital comprehensive geriatric assessment (CGA in older people with hip fracture. The protocol of the Trondheim Hip Fracture Trial

    Directory of Open Access Journals (Sweden)

    Taraldsen Kristin

    2011-04-01

    Full Text Available Abstract Background Hip fractures in older people are associated with high morbidity, mortality, disability and reduction in quality of life. Traditionally people with hip fracture are cared for in orthopaedic departments without additional geriatric assessment. However, studies of postoperative rehabilitation indicate improved efficiency of multidisciplinary geriatric rehabilitation as compared to traditional care. This randomized controlled trial (RCT aims to investigate whether an additional comprehensive geriatric assessment of hip fracture patients in a special orthogeriatric unit during the acute in-hospital phase may improve outcomes as compared to treatment as usual in an orthopaedic unit. Methods/design The intervention of interest, a comprehensive geriatric assessment is compared with traditional care in an orthopaedic ward. The study includes 401 home-dwelling older persons >70 years of age, previously able to walk 10 meters and now treated for hip fracture at St. Olav Hospital, Trondheim, Norway. The participants are enrolled and randomised during the stay in the Emergency Department. Primary outcome measure is mobility measured by the Short Physical Performance Battery (SPPB at 4 months after surgery. Secondary outcomes measured at 1, 4 and 12 months postoperatively are place of residence, activities of daily living, balance and gait, falls and fear of falling, quality of life and depressive symptoms, as well as use of health care resources and survival. Discussion We believe that the design of the study, the randomisation procedure and outcome measurements will be of sufficient strength and quality to evaluate the impact of comprehensive geriatric assessment on mobility and other relevant outcomes in hip fracture patients. Trials registration ClinicalTrials.gov, NCT00667914

  12. [Comprehensive study on the prevention of food poisoning through the investigation of an affected hospital food service facility].

    Science.gov (United States)

    Kubota, Satoshi; Kawai, Hiromi

    2015-01-01

    In Japan, more than 20,000 people suffer from various types of food poisoning annually. In this paper, we discuss the prevention of food poisoning in hospital food service facilities from the perspective of hygiene management and organizational behavior. We inspected the kitchen environment and the meal preparation process in a hospital food service facility in Japan that had been the site of a food poisoning incident. To clarify the present state of hygiene management, interviews were conducted with both the head of the nutrition and food service section and the administrative manager. In addition, questionnaires were distributed to the food service staff to assess their level of satisfaction with the working environment. The facility had been built about 10 years previously and was well maintained. Meal preparations were performed according to the operation manual, and education and training for the food service staff were carried out daily. No problems were evident regarding hygiene management. However, concerning organizational behavior, the satisfaction level of the staff was found to be relatively low, which may have led to a reduction in their organizational commitment and a decrease in their performance. To aid in the prevention of food poisoning incidents in hospital food service facilities, it is essential not only to conduct standard hygiene management and training, but also to consider the organizational behavior of the food service staff.

  13. Highways and outposts: economic development and health threats in the central Brazilian Amazon region

    Directory of Open Access Journals (Sweden)

    Damacena Giseli N

    2010-06-01

    economic and demographic growth increases the risk of AIDS transmission and violence. Highways connect secluded localities and may threaten local populations. This region has been undergoing rapid localized development booms, thus creating outposts of rapid and temporary migration, which may introduce health risks to remote areas.

  14. Highways and outposts: economic development and health threats in the central Brazilian Amazon region.

    Science.gov (United States)

    Barcellos, Christovam; Feitosa, Patrícia; Damacena, Giseli N; Andreazzi, Marco A

    2010-06-17

    transmission and violence. Highways connect secluded localities and may threaten local populations. This region has been undergoing rapid localized development booms, thus creating outposts of rapid and temporary migration, which may introduce health risks to remote areas.

  15. Comprehensive genetic testing for primary immunodeficiency disorders in a tertiary hospital: 10-year experience in Auckland, New Zealand.

    Science.gov (United States)

    Woon, See-Tarn; Ameratunga, Rohan

    2016-01-01

    New Zealand is a developed geographically isolated country in the South Pacific with a population of 4.4 million. Genetic diagnosis is the standard of care for most patients with primary immunodeficiency disorders (PIDs). Since 2005, we have offered a comprehensive genetic testing service for PIDs and other immune-related disorders with a published sequence. Here we present results for this program, over the first decade, between 2005 and 2014. We undertook testing in 228 index cases and 32 carriers during this time. The three most common test requests were for X-linked lymphoproliferative (XLP), tumour necrosis factor receptor associated periodic syndrome (TRAPS) and haemophagocytic lymphohistiocytosis (HLH). Of the 32 suspected XLP cases, positive diagnoses were established in only 2 patients. In contrast, genetic defects in 8 of 11 patients with suspected X-linked agammaglobulinemia (XLA) were confirmed. Most XLA patients were initially identified from absence of B cells. Overall, positive diagnoses were made in about 23% of all tests requested. The diagnostic rate was lowest for several conditions with locus heterogeneity. Thorough clinical characterisation of patients can assist in prioritising which genes should be tested. The clinician-driven customised comprehensive genetic service has worked effectively for New Zealand. Next generation sequencing will play an increasing role in disorders with locus heterogeneity.

  16. Readmission after treatment of Grade 3 and 4 renal injuries at a Level I trauma center: Statewide assessment using the Comprehensive Hospital Abstract Reporting System.

    Science.gov (United States)

    Winters, Brian; Wessells, Hunter; Voelzke, Bryan B

    2016-03-01

    One criticism of the existing renal trauma research is the limited outpatient follow-up after index hospitalization. We assessed readmission rates following treatment for American Association for the Surgery of Trauma (AAST) Grade 3 and 4 renal injury using the Comprehensive Hospital Abstract Reporting System (CHARS). We evaluated all patients with AAST Grade 3 and 4 renal injuries admitted to Harborview Medical Center (HMC) between 1998 and 2010, the only Level 1 trauma center in Washington state. Grade 4 renal injuries were stratified by collecting system laceration (CSL) or segmental vascular injury. Data were abstracted from the CHARS database for readmissions to any Washington state hospital within 6 months of renal injury. Clinical variables, diagnoses, and procedures were queried based on DRG International Classification of Diseases-9th Rev. codes. A total of 477 Grade 3 and 159 Grade 4 renal injuries were initially treated at HMC. On admission, 111 patients required intervention: 75 (16%) of 477 Grade 3 and 36 (23%) of 159 Grade 4 injuries. Within 6 months of index hospitalization, 86 (18%) of 477 Grade 3 and 38 (24%) of 159 Grade 4 patients were readmitted to any Washington state hospital. Eighty percent of Grade 3 injuries and 66% of Grade 4 injuries returned to HMC compared with secondary hospitals (p = 0.08). At readmission, 19 (22%) of 86 Grade 3 and 16 (42%) of 38 Grade 4 injuries had a urologic diagnosis. Subsequent procedural intervention was required on readmission in 6 (7%) of 86 Grade 3 and 5 (13%) of 38 Grade 4 renal injuries (all CSL injuries). A subset of patients treated for Grade 3 and 4 renal trauma will be readmitted for further management. While urologic diagnoses and additional procedures may be low overall, readmission to outside hospitals may preclude accurate determination of renal trauma outcomes. Based on these data, patients with Grade 4 CSL injuries seem to be at the highest risk for readmission and to require a subsequent

  17. Comprehensive Molecular Characterization of Escherichia coli Isolates from Urine Samples of Hospitalized Patients in Rio de Janeiro, Brazil

    Directory of Open Access Journals (Sweden)

    Ana Carolina C. Campos

    2018-02-01

    Full Text Available Urinary tract infections (UTIs are often caused by Escherichia coli. Their increasing resistance to broad-spectrum antibiotics challenges the treatment of UTIs. Whereas, E. coli ST131 is often multidrug resistant (MDR, ST69 remains susceptible to antibiotics such as cephalosporins. Both STs are commonly linked to community and nosocomial infections. E. coli phylogenetic groups B2 and D are associated with virulence and resistance profiles making them more pathogenic. Little is known about the population structure of E. coli isolates obtained from urine samples of hospitalized patients in Brazil. Therefore, we characterized E. coli isolated from urine samples of patients hospitalized at the university and three private hospitals in Rio de Janeiro, using whole genome sequencing. A high prevalence of E. coli ST131 and ST69 was found, but other lineages, namely ST73, ST648, ST405, and ST10 were also detected. Interestingly, isolates could be divided into two groups based on their antibiotic susceptibility. Isolates belonging to ST131, ST648, and ST405 showed a high resistance rate to all antibiotic classes tested, whereas isolates belonging to ST10, ST73, ST69 were in general susceptible to the antibiotics tested. Additionally, most ST69 isolates, normally resistant to aminoglycosides, were susceptible to this antibiotic in our population. The majority of ST131 isolates were ESBL-producing and belonged to serotype O25:H4 and the H30-R subclone. Previous studies showed that this subclone is often associated with more complicated UTIs, most likely due to their high resistance rate to different antibiotic classes. Sequenced isolates could be classified into five phylogenetic groups of which B2, D, and F showed higher resistance rates than groups A and B1. No significant difference for the predicted virulence genes scores was found for isolates belonging to ST131, ST648, ST405, and ST69. In contrast, the phylogenetic groups B2, D and F showed a higher

  18. Effect of comprehensive breast care on breast cancer outcomes: a community hospital based study from Mumbai, India.

    Science.gov (United States)

    Gadgil, Anita; Roy, Nobhojit; Sankaranarayanan, Rengaswamy; Muwonge, Richard; Sauvaget, Catherine

    2012-01-01

    Breast cancer is the second most common cancer in women in India and the disease burden is increasing annually. The lack of awareness initiatives, structured screening, and affordable treatment facilities continue to result in poor survival. We present a breast cancer survival scenario, in urban population in India, where standardised care is distributed equitably and free of charge through an employees' healthcare scheme. We studied 99 patients who were treated at our hospital during the period 2005 to 2010 and our follow-up rates were 95.95%. Patients received evidence-based standardised care in line with the tertiary cancer centre in Mumbai. One-, three- and five-year survival rates were calculated using Kaplan-Meier method. Socio-demographic, reproductive and tumor factors, relevant to survival, were analysed. Mortality hazard ratios (HR) were calculated using Cox proportional hazard method. Survival in this series was compared to that in registries across India and discrepancies were discussed. Patients mean age was 56 years, mean tumor size was 3.2 cms, 85% of the tumors belonged to T1 and T2 stages, and 45% of the patients belonged to the composite stages I and IIA. Overall 5-year survival was 74.9%. Patients who presented with large-sized tumors (HR 3.06; 95% CI 0.4-9.0), higher composite stage (HR 1.91; 0.55-6.58) and undergone mastectomy (HR 2.94; 0.63- 13.62) had a higher risk of mortality than women who had higher levels of education (HR 0.25; 0.05-1.16), although none of these results reached the significant statistical level. We observed 25% better survival compared to other Indian populations. Our results are comparable to those from the European Union and North America, owing to early presentation, equitable access to standardised free healthcare and complete follow-up ensured under the scheme. This emphasises that equitable and affordable delivery of standardised healthcare can translate into early presentation and better survival in India.

  19. Building a Dangerous Outpost in the Green Mountain State: A Case Study of Educator Preparation Policymaking

    Science.gov (United States)

    McGough, David J.; Bedell, Claudine; Tinkler, Barri

    2018-01-01

    Poised at a bifurcation, the educator preparation community in Vermont faced either the adoption of a generic product for the assessment of initial educator licensure candidates or the comprehensive revision of a longstanding state-based assessment portfolio. Using a case study approach and narrative methods, specifically the Narrative Policy…

  20. Building components for an outpost on the Lunar soil by means of a novel 3D printing technology

    Science.gov (United States)

    Cesaretti, Giovanni; Dini, Enrico; De Kestelier, Xavier; Colla, Valentina; Pambaguian, Laurent

    2014-01-01

    3D-printing technologies are receiving an always increasing attention in architecture, due to their potential use for direct construction of buildings and other complex structures, also of considerable dimensions, with virtually any shape. Some of these technologies rely on an agglomeration process of inert materials, e.g. sand, through a special binding liquid and this capability is of interest for the space community for its potential application to space exploration. In fact, it opens the possibility for exploiting in-situ resources for the construction of buildings in harsh spatial environments. The paper presents the results of a study aimed at assessing the concept of 3D printing technology for building habitats on the Moon using lunar soil, also called regolith. A particular patented 3D-printing technology - D-shape - has been applied, which is, among the existing rapid prototyping systems, the closest to achieving full scale construction of buildings and the physical and chemical characteristics of lunar regolith and terrestrial regolith simulants have been assessed with respect to the working principles of such technology. A novel lunar regolith simulant has also been developed, which almost exactly reproduces the characteristics of the JSC-1A simulant produced in the US. Moreover, tests in air and in vacuum have been performed to demonstrate the occurrence of the reticulation reaction with the regolith simulant. The vacuum tests also showed that evaporation or freezing of the binding liquid can be prevented through a proper injection method. The general requirements of a Moon outpost have been specified, and a preliminary design of the habitat has been developed. Based on such design, a section of the outpost wall has been selected and manufactured at full scale using the D-shape printer and regolith simulant. Test pieces have also been manufactured and their mechanical properties have been assessed.

  1. Comprehensive Care

    Science.gov (United States)

    ... Comprehensive Care Share this page Facebook Twitter Email Comprehensive Care Understand the importance of comprehensive MS care ... In this article A complex disease requires a comprehensive approach Today multiple sclerosis (MS) is not a ...

  2. [Designing and Operating a Comprehensive Mental Health Management System to Support Faculty at a University That Contains a Medical School and University Hospital].

    Science.gov (United States)

    Kawanishi, Chiaki

    2016-01-01

    In Japan, healthcare professionals and healthcare workers typically practice a culture of self-assessment when it comes to managing their own health. Even where this background leads to instances of mental health disorders or other serious problems within a given organization, such cases are customarily addressed by the psychiatrists or psychiatric departments of the facilities affected. Organized occupational mental health initiatives for professionals and workers within the healthcare system are extremely rare across Japan, and there is little recognition of the need for such initiatives even among those most directly affected. The author has some experience designing and operating a comprehensive health management system to support students and faculty at a university in the Tokyo Metropolitan Area that contains a medical school and university hospital. At this university, various mental health-related problems were routinely being allowed to develop into serious cases, while the fundamental reforms required by the health management center and the mental health management scheme organized through the center had come to represent a challenge for the entire university. From this initial situation, we undertook several successive initiatives, including raising the number of staff in the health management center and its affiliated organizations, revising and drafting new health management rules and regulations, launching an employment support and management system, implementing screenings to identify people with mental ill-health, revamping and expanding a counselling response system, instituting regular collaboration meetings with academic affairs staff, and launching educational and awareness-raising activities. This resulted in the possibility of intervention in all cases of mental health crisis, such as suicidal ideation. We counted more than 2,400 consultations (cumulative total number; more than half of consultations was from the medical school, postgraduate

  3. A Study to Ascertain the Feasibility of Joint Efforts to Establish a Comprehensive Health Care Delivery System Utilizing Hill-Burton Constructed Hospital,

    Science.gov (United States)

    1978-12-15

    Utilization Review Procedures ................ 22 Reduced Philanthropy ......................... 22 Lack of Incentives ........................... 23 Reductions...challenges are made on hospitals in the form of status of technology, elite physician compliments, and increased specialization of labor which ccnstantly...construction are now marginally subsidized by philanthropy . Third party reimbursement is now the dominant source of hospital revenue with cost based formula

  4. Comprehensive Early Stimulation Program for Infants. Instruction Manual [and] Early Interventionist's Workbook [and] Parent/Caregiver Workbook. William Beaumont Hospital Speech and Language Pathology Series.

    Science.gov (United States)

    Santana, Altagracia A.; Bottino, Patti M.

    This early intervention kit includes a Comprehensive Early Stimulation Program for Infants (CESPI) instruction manual, an early interventionist workbook, and ten parent/caregiver workbooks. The CESPI early intervention program is designed to provide therapists, teachers, other health professionals, and parents with a common-sense, practical guide…

  5. A comprehensive psychiatric service

    DEFF Research Database (Denmark)

    Wang, A G

    1984-01-01

    A comprehensive psychiatric service was established in 1969 in the Faroe Islands. This service was created as a department of a general hospital. The spheres covered by this department, operating in the midst of the community were: acute and chronic patients, a liaison-psychiatric service...

  6. Awareness of radiation protection and dose levels of imaging procedures among medical students, radiography students, and radiology residents at an academic hospital: Results of a comprehensive survey.

    Science.gov (United States)

    Faggioni, Lorenzo; Paolicchi, Fabio; Bastiani, Luca; Guido, Davide; Caramella, Davide

    2017-01-01

    To evaluate the awareness of radiation protection issues and the knowledge of dose levels of imaging procedures among medical students, radiology residents, and radiography students at an academic hospital. A total of 159 young doctors and students (including 60 radiology residents, 56 medical students, and 43 radiography students) were issued a questionnaire consisting of 16 multiple choice questions divided into three separated sections (i.e., demographic data, awareness about radiation protection issues, and knowledge about radiation dose levels of common radiological examinations). Medical students claimed to have at least a good knowledge of radiation protection issues more frequently than radiology residents and radiography students (94.4% vs 55% and 35.7%, respectively; Pradiological procedures was significantly worse among medical students than radiology residents and radiography students (Pradiology residents as to knowledge of radiation protection issues (PRadiology residents, radiography students and medical students have a limited awareness about radiation protection, with a specific gap of knowledge concerning real radiation doses of daily radiological examinations. Both undergraduate and postgraduate teaching needs to be effectively implemented with radiation safety courses. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  7. [Development and Implementation of a Comprehensive Health Management System (Fit for Work and Life) for Employees of a University Hospital - A Practice Report].

    Science.gov (United States)

    Gutenbrunner, C; Egen, C; Kahl, K G; Briest, J; Tegtbur, U; Miede, J; Born, M

    2017-07-01

    Background: Due to the increase of sick leave, prolonging working life and the prediction of shortage of skilled workers in the future, health management systems are continuously gaining importance. Employees in a University Hospital are exposed to particular stress factors, which are also reflected in a higher than average amount of sick leave. Against this background, the project "Fit for Work and Life" (FWL) was developed and implemented by the Hannover Medical School (MHH). Aims: FWL aims to maintain, improve or recover the work ability of employees by offering both preventive and rehabilitative treatments. A second goal is to significantly reduce the days of sick leave. Methods: The project was jointly developed and implemented by five MHH departments and the DRV Braunschweig-Hannover (DRV BS-H) according to previously defined principles. It was scientifically evaluated by the following outcomes: average days of sick leave, work ability (WAI), quality of life (SF-36, WHOQOL), coping strategies (FERUS) and effort-reward imbalance (ERI). Results and Conclusions: So far, this project is unique in its concept. It has been successfully implemented in the organisational structures of the MHH. 376 employees have registered during the first project year. Up to now, 182 participants have completed their individual programmes. The results show that 60.4% of employees have moderate to poor WAI values. The average of the mental summary scale of the SF-36 was 44.9, indicating a high workload. © Georg Thieme Verlag KG Stuttgart · New York.

  8. EGFR mutation testing in patients with advanced non-small cell lung cancer: a comprehensive evaluation of real-world practice in an East Asian tertiary hospital.

    Science.gov (United States)

    Choi, Yoon-La; Sun, Jong-Mu; Cho, Juhee; Rampal, Sanjay; Han, Joungho; Parasuraman, Bhash; Guallar, Eliseo; Lee, Genehee; Lee, Jeeyun; Shim, Young Mog

    2013-01-01

    Guidelines for management of non-small cell lung cancer (NSCLC) strongly recommend EGFR mutation testing. These recommendations are particularly relevant in Asians that have higher EGFR mutation prevalence. This study aims to explore current testing practices, logistics of testing, types of EGFR mutation, and prevalence of EGFR mutations in patients with advanced NSCLC in a large comprehensive cancer center in Korea. Our retrospective cohort included 1,503 NSCLC patients aged ≥18 years, with stage IIIB/IV disease, who attended the Samsung Medical Center in Seoul, Korea, from January 2007 through July 2010. Trained oncology nurses reviewed and abstracted data from electronic medical records. This cohort had a mean age (SD) of 59.6 (11.1) years, 62.7% were males, and 52.9% never-smokers. The most common NSCLC histological types were adenocarcinoma (70.5%) and squamous cell carcinoma (18.0%). Overall, 39.5% of patients were tested for EGFR mutations. The proportion of patients undergoing EGFR testing during January 2007 through July 2008, August 2008 through September 2009, and October 2009 through July 2010 were 23.3%, 38.3%, and 63.5%, respectively (Pwomen, younger patients, stage IV disease, non-smokers, and adenocarcinoma histology. Of 586 cases successfully tested for EGFR mutations, 209 (35.7%) were positive, including 118 cases with exon 19 deletions and 62 with L858R mutations. EGFR mutation positive patients were more likely to be female, never-smokers, never-drinkers and to have adenocarcinoma. In a large cancer center in Korea, the proportion of EGFR testing increased from 2007 through 2010. The high frequency of EGFR mutation positive cases warrants the need for generalized testing in Asian NSCLC patients.

  9. Comprehensive in-hospital monitoring in acute heart failure: applications for clinical practice and future directions for research. A statement from the Acute Heart Failure Committee of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC).

    Science.gov (United States)

    Harjola, Veli-Pekka; Parissis, John; Brunner-La Rocca, Hans-Peter; Čelutkienė, Jelena; Chioncel, Ovidiu; Collins, Sean P; De Backer, Daniel; Filippatos, Gerasimos S; Gayat, Etienne; Hill, Loreena; Lainscak, Mitja; Lassus, Johan; Masip, Josep; Mebazaa, Alexandre; Miró, Òscar; Mortara, Andrea; Mueller, Christian; Mullens, Wilfried; Nieminen, Markku S; Rudiger, Alain; Ruschitzka, Frank; Seferovic, Petar M; Sionis, Alessandro; Vieillard-Baron, Antoine; Weinstein, Jean Marc; de Boer, Rudolf A; Crespo Leiro, Maria G; Piepoli, Massimo; Riley, Jillian P

    2018-04-30

    This paper provides a practical clinical application of guideline recommendations relating to the inpatient monitoring of patients with acute heart failure, through the evaluation of various clinical, biomarker, imaging, invasive and non-invasive approaches. Comprehensive inpatient monitoring is crucial to the optimal management of acute heart failure patients. The European Society of Cardiology heart failure guidelines provide recommendations for the inpatient monitoring of acute heart failure, but the level of evidence underpinning most recommendations is limited. Many tools are available for the in-hospital monitoring of patients with acute heart failure, and each plays a role at various points throughout the patient's treatment course, including the emergency department, intensive care or coronary care unit, and the general ward. Clinical judgment is the preeminent factor guiding application of inpatient monitoring tools, as the various techniques have different patient population targets. When applied appropriately, these techniques enable decision making. However, there is limited evidence demonstrating that implementation of these tools improves patient outcome. Research priorities are identified to address these gaps in evidence. Future research initiatives should aim to identify the optimal in-hospital monitoring strategies that decrease morbidity and prolong survival in patients with acute heart failure. © 2018 The Authors. European Journal of Heart Failure © 2018 European Society of Cardiology.

  10. Parental involvement in their school-aged children's post-operative pain management in the hospital setting: a comprehensive systematic review.

    Science.gov (United States)

    Hoon, Lim Siew; Hong-Gu, He; Mackey, Sandra

    Paediatric pain management remains a challenge in clinical settings. Parents can contribute to the effective and accurate pain assessment and management of their child. No systematic reviews regarding the parental involvement in their child's post-operative pain management have been published. To determine the best available evidence regarding parental involvement in managing their children's post-operative pain in the hospital setting. The review considered studies that included parents of all ethnic groups with children aged between 6 to 12 years old who were hospitalised and undergone surgery of any kind with post-operative surgical or incision site pain where care was provided in acute hospital settings. The phenomena of interest were the experiences of parents in managing their children's post-operative pain. A three-step search strategy was utilised in each component of this review. Major databases searched included: MEDLINE, CINAHL, Scopus, ScienceDirect, the Cochrane library, PubMed as well as Google Scholar. The search included published studies and papers in English from 1990 to 2009. Each included study was assessed by two independent reviewers using the appropriate appraisal checklists developed by the Joanna Briggs Institute (JBI). Quantitative and qualitative data were extracted from the included papers using standardised data extraction tools from the JBI, Meta-analysis Statistics Assessment and Review Instrument data extraction tool for descriptive/case series and the JBI-Qualitative Assessment and Review Instrument data extraction tool for interpretive and critical research. The five quantitative studies included in this review were not suitable for meta-analysis due to clinical and methodological heterogeneity and therefore the findings are presented in a narrative form. The two qualitative studies were from the same study, therefore meta-synthesis was not possible. Hence the results of the studies were presented in a narrative format. Seven

  11. Awareness of radiation protection and dose levels of imaging procedures among medical students, radiography students, and radiology residents at an academic hospital: Results of a comprehensive survey

    International Nuclear Information System (INIS)

    Faggioni, Lorenzo; Paolicchi, Fabio; Bastiani, Luca; Guido, Davide; Caramella, Davide

    2017-01-01

    Highlights: • Medical students tend to overstate their knowledge of radiation protection (RP). • Overall RP knowledge of young doctors and students is suboptimal. • RP teaching to undergraduates and postgraduates needs to be substantially improved. - Abstract: Purpose: To evaluate the awareness of radiation protection issues and the knowledge of dose levels of imaging procedures among medical students, radiology residents, and radiography students at an academic hospital. Material and methods: A total of 159 young doctors and students (including 60 radiology residents, 56 medical students, and 43 radiography students) were issued a questionnaire consisting of 16 multiple choice questions divided into three separated sections (i.e., demographic data, awareness about radiation protection issues, and knowledge about radiation dose levels of common radiological examinations). Results: Medical students claimed to have at least a good knowledge of radiation protection issues more frequently than radiology residents and radiography students (94.4% vs 55% and 35.7%, respectively; P < 0.05), with no cases of perceived excellent knowledge among radiography students. However, the actual knowledge of essential radiation protection topics such as regulations, patient and tissue susceptibility to radiation damage, professional radiation risk and dose optimisation, as well as of radiation doses delivered by common radiological procedures was significantly worse among medical students than radiology residents and radiography students (P < 0.05). Those latter significantly outperformed radiology residents as to knowledge of radiation protection issues (P < 0.01). Overall, less than 50% of survey respondents correctly answered all questions of the survey. Conclusions: Radiology residents, radiography students and medical students have a limited awareness about radiation protection, with a specific gap of knowledge concerning real radiation doses of daily radiological

  12. Awareness of radiation protection and dose levels of imaging procedures among medical students, radiography students, and radiology residents at an academic hospital: Results of a comprehensive survey

    Energy Technology Data Exchange (ETDEWEB)

    Faggioni, Lorenzo, E-mail: lfaggioni@sirm.org [Department of Diagnostic and Interventional Radiology, University of Pisa, Via Roma 67, 56100, Pisa (Italy); Paolicchi, Fabio [Department of Diagnostic and Interventional Radiology, University of Pisa, Via Roma 67, 56100, Pisa (Italy); Bastiani, Luca [Institute of Clinical Physiology, National Research Council, Via Moruzzi 1, 56124, Pisa (Italy); Guido, Davide [Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Forlanini 2, 27100, Pavia (Italy); Caramella, Davide [Department of Diagnostic and Interventional Radiology, University of Pisa, Via Roma 67, 56100, Pisa (Italy)

    2017-01-15

    Highlights: • Medical students tend to overstate their knowledge of radiation protection (RP). • Overall RP knowledge of young doctors and students is suboptimal. • RP teaching to undergraduates and postgraduates needs to be substantially improved. - Abstract: Purpose: To evaluate the awareness of radiation protection issues and the knowledge of dose levels of imaging procedures among medical students, radiology residents, and radiography students at an academic hospital. Material and methods: A total of 159 young doctors and students (including 60 radiology residents, 56 medical students, and 43 radiography students) were issued a questionnaire consisting of 16 multiple choice questions divided into three separated sections (i.e., demographic data, awareness about radiation protection issues, and knowledge about radiation dose levels of common radiological examinations). Results: Medical students claimed to have at least a good knowledge of radiation protection issues more frequently than radiology residents and radiography students (94.4% vs 55% and 35.7%, respectively; P < 0.05), with no cases of perceived excellent knowledge among radiography students. However, the actual knowledge of essential radiation protection topics such as regulations, patient and tissue susceptibility to radiation damage, professional radiation risk and dose optimisation, as well as of radiation doses delivered by common radiological procedures was significantly worse among medical students than radiology residents and radiography students (P < 0.05). Those latter significantly outperformed radiology residents as to knowledge of radiation protection issues (P < 0.01). Overall, less than 50% of survey respondents correctly answered all questions of the survey. Conclusions: Radiology residents, radiography students and medical students have a limited awareness about radiation protection, with a specific gap of knowledge concerning real radiation doses of daily radiological

  13. EGFR Mutation Testing in Patients with Advanced Non-Small Cell Lung Cancer: A Comprehensive Evaluation of Real-World Practice in an East Asian Tertiary Hospital

    Science.gov (United States)

    Cho, Juhee; Rampal, Sanjay; Han, Joungho; Parasuraman, Bhash; Guallar, Eliseo; Lee, Genehee; Lee, Jeeyun; Shim, Young Mog

    2013-01-01

    Introduction Guidelines for management of non-small cell lung cancer (NSCLC) strongly recommend EGFR mutation testing. These recommendations are particularly relevant in Asians that have higher EGFR mutation prevalence. This study aims to explore current testing practices, logistics of testing, types of EGFR mutation, and prevalence of EGFR mutations in patients with advanced NSCLC in a large comprehensive cancer center in Korea. Methods Our retrospective cohort included 1,503 NSCLC patients aged ≥18 years, with stage IIIB/IV disease, who attended the Samsung Medical Center in Seoul, Korea, from January 2007 through July 2010. Trained oncology nurses reviewed and abstracted data from electronic medical records. Results This cohort had a mean age (SD) of 59.6 (11.1) years, 62.7% were males, and 52.9% never-smokers. The most common NSCLC histological types were adenocarcinoma (70.5%) and squamous cell carcinoma (18.0%). Overall, 39.5% of patients were tested for EGFR mutations. The proportion of patients undergoing EGFR testing during January 2007 through July 2008, August 2008 through September 2009, and October 2009 through July 2010 were 23.3%, 38.3%, and 63.5%, respectively (P<0.001). The median time elapsed between cancer diagnoses and receiving EGFR testing results was 21 days. EGFR testing was most frequently ordered by oncologists (57.7%), pulmonologists (31.9%), and thoracic surgeons (6.6%). EGFR testing was more commonly requested for women, younger patients, stage IV disease, non-smokers, and adenocarcinoma histology. Of 586 cases successfully tested for EGFR mutations, 209 (35.7%) were positive, including 118 cases with exon 19 deletions and 62 with L858R mutations. EGFR mutation positive patients were more likely to be female, never-smokers, never-drinkers and to have adenocarcinoma. Conclusions In a large cancer center in Korea, the proportion of EGFR testing increased from 2007 through 2010. The high frequency of EGFR mutation positive cases warrants

  14. EGFR mutation testing in patients with advanced non-small cell lung cancer: a comprehensive evaluation of real-world practice in an East Asian tertiary hospital.

    Directory of Open Access Journals (Sweden)

    Yoon-La Choi

    Full Text Available INTRODUCTION: Guidelines for management of non-small cell lung cancer (NSCLC strongly recommend EGFR mutation testing. These recommendations are particularly relevant in Asians that have higher EGFR mutation prevalence. This study aims to explore current testing practices, logistics of testing, types of EGFR mutation, and prevalence of EGFR mutations in patients with advanced NSCLC in a large comprehensive cancer center in Korea. METHODS: Our retrospective cohort included 1,503 NSCLC patients aged ≥18 years, with stage IIIB/IV disease, who attended the Samsung Medical Center in Seoul, Korea, from January 2007 through July 2010. Trained oncology nurses reviewed and abstracted data from electronic medical records. RESULTS: This cohort had a mean age (SD of 59.6 (11.1 years, 62.7% were males, and 52.9% never-smokers. The most common NSCLC histological types were adenocarcinoma (70.5% and squamous cell carcinoma (18.0%. Overall, 39.5% of patients were tested for EGFR mutations. The proportion of patients undergoing EGFR testing during January 2007 through July 2008, August 2008 through September 2009, and October 2009 through July 2010 were 23.3%, 38.3%, and 63.5%, respectively (P<0.001. The median time elapsed between cancer diagnoses and receiving EGFR testing results was 21 days. EGFR testing was most frequently ordered by oncologists (57.7%, pulmonologists (31.9%, and thoracic surgeons (6.6%. EGFR testing was more commonly requested for women, younger patients, stage IV disease, non-smokers, and adenocarcinoma histology. Of 586 cases successfully tested for EGFR mutations, 209 (35.7% were positive, including 118 cases with exon 19 deletions and 62 with L858R mutations. EGFR mutation positive patients were more likely to be female, never-smokers, never-drinkers and to have adenocarcinoma. CONCLUSIONS: In a large cancer center in Korea, the proportion of EGFR testing increased from 2007 through 2010. The high frequency of EGFR mutation positive

  15. Heroines of lonely outposts or tools of the empire? British nurses in Britain's model colony: Ceylon, 1878-1948.

    Science.gov (United States)

    Jones, Margaret

    2004-09-01

    In 1878 two 'Nightingale' nurses arrived in the British colony of Ceylon to initiate a training programme for indigenous women in the skills and values of what was then termed 'scientific nursing'. These two women were the first of a succession of British women who went to the colony to nurse in its hospitals and to train Ceylonese women for the profession. Using the official records of the colonial government held in the National Archives, Kew and the records of the Overseas Nursing Association in the Rhodes House Collection, Oxford, this paper explores both the professional and social experiences of these women. This paper also analyses the role that these representatives of the colonial state played in the development of an indigenous nursing profession and concludes that their presence in the colony ultimately left an ambiguous legacy. In their role as trainers of indigenous women, they furthered the development and spread of a Western nursing profession in the colony's hospitals. At the same time, however, their continuing dominance of training and the positions of responsibility was an inhibiting factor in the ability of indigenous nurses to organise and professionalise. Whereas the doctors, trained in the colony's Medical College, achieved registration as early as 1905, the nurses had to wait until 1949, a year after independence, before their qualification was recognised and protected. Nursing remained throughout the colonial period therefore, even more so than at the metropolitan centre, the 'Cinderella' of the medical professions.

  16. VT Hospital Site Locations

    Data.gov (United States)

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

  17. Financial planning on a comprehensive scale.

    Science.gov (United States)

    Mishra, Simita

    2013-04-01

    Hospitals and health systems that wish to explore the shift to comprehensive care management should: Assess the investments in infrastructure necessary to support comprehensive care management, Gauge the financial implications and set quality and financial goals, Monitor performance using metrics such as patient satisfaction, avoidable admissions, out-of-group referrals, and average length of stay.

  18. Comprehensive Psychiatric Evaluation

    Science.gov (United States)

    ... Facts for Families Guide Facts for Families - Vietnamese Comprehensive Psychiatric Evaluation No. 52; Updated October 2017 Evaluation ... with serious emotional and behavioral problems need a comprehensive psychiatric evaluation. Comprehensive psychiatric evaluations usually require a ...

  19. Children's hypertext comprehension

    NARCIS (Netherlands)

    Segers, P.C.J.; Segers, E.; Broek, P. van den

    2017-01-01

    The present chapter gives an overview of the literature on hypertext comprehension, children's hypertext comprehension and individual variation therein, ending with a perspective for future research. Hypertext comprehension requires the reader to make bridging inferences between the different parts

  20. Hospitals; hospitals13

    Data.gov (United States)

    University of Rhode Island Geospatial Extension Program — Hospital Facilities information was compiled from several various sources. Main source was the RI Department of Health Facilities Regulation database, License 2000....

  1. Comprehensive metabolic panel

    Science.gov (United States)

    Metabolic panel - comprehensive; Chem-20; SMA20; Sequential multi-channel analysis with computer-20; SMAC20; Metabolic panel 20 ... Chernecky CC, Berger BJ. Comprehensive metabolic panel (CMP) - blood. In: ... Tests and Diagnostic Procedures . 6th ed. St Louis, MO: ...

  2. 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...

  3. HCAHPS - Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of hospital ratings for the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). HCAHPS is a national, standardized survey of hospital...

  4. A randomized clinical trial of hospital-based, comprehensive cardiac rehabilitation versus usual care for patients with congestive heart failure, ischemic heart disease, or high risk of ischemic heart disease (the DANREHAB trial) - design, intervention, and population

    DEFF Research Database (Denmark)

    Zwisler, A.D.O.; Schou, O.; Soja, A.M.B.

    2005-01-01

    , or readmissions due to heart disease based on linkage to public registries. The CR was an individually tailored, multidisciplinary program (6 weeks of intensive CR and 12 months of follow-up) including patient education, exercise training, dietary counseling, smoking cessation, psychosocial support, risk factor...... that a large-scale, centrally randomized clinical trial on comprehensive CR can be conducted among a broadly defined patient group, but reaching the stipulated number of 1800 patients was difficult. Although the study included relatively many women and older people, elderly patients and patients with high...

  5. A randomized clinical trial of hospital-based, comprehensive cardiac rehabilitation versus usual care for patients with congestive heart failure, ischemic heart disease, or high risk of ischemic heart disease (the DANREHAB trial)--design, intervention, and population

    DEFF Research Database (Denmark)

    Zwisler, Ann-Dorthe Olsen; Soja, Anne Merete Boas; Brønnum-Hansen, Henrik

    2005-01-01

    , or readmissions due to heart disease based on linkage to public registries. The CR was an individually tailored, multidisciplinary program (6 weeks of intensive CR and 12 months of follow-up) including patient education, exercise training, dietary counseling, smoking cessation, psychosocial support, risk factor...... that a large-scale, centrally randomized clinical trial on comprehensive CR can be conducted among a broadly defined patient group, but reaching the stipulated number of 1800 patients was difficult. Although the study included relatively many women and older people, elderly patients and patients with high...

  6. College Student Utilization of a Comprehensive Psychiatric Emergency Program

    Science.gov (United States)

    Mitchell, Sharon L.; Kader, Mahrin; Haggerty, Melinda Z.; Bakhai, Yogesh D.; Warren, Calvert G.

    2013-01-01

    The authors sought to identify college students at risk for experiencing a mental health crisis that warranted a psychiatric evaluation at a hospital and/or a psychiatric hospitalization. A retrospective chart review of college students evaluated at a comprehensive psychiatric emergency program during a 1-year period was conducted. Demographic…

  7. Case in Language Comprehension

    NARCIS (Netherlands)

    Bader, Markus; Lamers, Monique

    2012-01-01

    Research on human language comprehension has been heavily influenced by properties of the English language. Since case plays only a minor role in English, its role for language comprehension has only recently become a topic for extensive research on psycholinguistics. In the psycholinguistic

  8. Spectrum of Physics Comprehension

    Science.gov (United States)

    Blasiak, W.; Godlewska, M.; Rosiek, R.; Wcislo, D.

    2012-01-01

    The paper presents the results of research on the relationship between self-assessed comprehension of physics lectures and final grades of junior high school students (aged 13-15), high school students (aged 16-18) and physics students at the Pedagogical University of Cracow, Poland (aged 21). Students' declared level of comprehension was measured…

  9. Short-Term Impact of a Comprehensive Smoke-Free Law Following a Partial Smoke-Free Law on PM2.5 Concentration Levels at Hospitality Venues on the Peripheries of College Campuses

    Directory of Open Access Journals (Sweden)

    Sol Yu

    2015-11-01

    Full Text Available Tobacco-free policies on college campuses are spreading in Korea. However, the impact of the smoking ban legislation at venues on the boundary of a college campus is still limited. This study aimed to assess short-term changes in PM2.5 concentrations before and after the enactment of the smoking ban legislation to evaluate the impact. In this cross-sectional study, PM2.5 measurements (pre-ban: n = 99, post-ban: n = 64 were conducted in randomly selected billiards, pubs, and computer game rooms on the peripheries of college campuses in October 2013, prior to implementation of the smoking ban, and in May 2014, after the ban. The median (interquartile range, IQR of the PM2.5 concentration for all venues was 31 μg/m3 (0–80 μg/m3 in the pre-ban period and 11 μg/m3 (0–36 μg/m3 in the post-ban period implying indoor PM2.5 concentration levels of the peripheries of college campuses likely decreased one year after implementation of the ban. However, the differences were not significant yet. The results support the introduction of more rigorous monitoring of SHS exposure levels toward the ultimate goal of encouraging a complete smoking ban in hospitality venues, including billiards, pubs, and computer game rooms located on the peripheries of college campuses.

  10. Short-Term Impact of a Comprehensive Smoke-Free Law Following a Partial Smoke-Free Law on PM2.5 Concentration Levels at Hospitality Venues on the Peripheries of College Campuses

    Science.gov (United States)

    Yu, Sol; Yang, Wonho; Lee, Kiyoung; Kim, Sungcheon; Ha, Kwonchul; Kim, Sungroul

    2015-01-01

    Tobacco-free policies on college campuses are spreading in Korea. However, the impact of the smoking ban legislation at venues on the boundary of a college campus is still limited. This study aimed to assess short-term changes in PM2.5 concentrations before and after the enactment of the smoking ban legislation to evaluate the impact. In this cross-sectional study, PM2.5 measurements (pre-ban: n = 99, post-ban: n = 64) were conducted in randomly selected billiards, pubs, and computer game rooms on the peripheries of college campuses in October 2013, prior to implementation of the smoking ban, and in May 2014, after the ban. The median (interquartile range, IQR) of the PM2.5 concentration for all venues was 31 μg/m3 (0–80 μg/m3) in the pre-ban period and 11 μg/m3 (0–36 μg/m3) in the post-ban period implying indoor PM2.5 concentration levels of the peripheries of college campuses likely decreased one year after implementation of the ban. However, the differences were not significant yet. The results support the introduction of more rigorous monitoring of SHS exposure levels toward the ultimate goal of encouraging a complete smoking ban in hospitality venues, including billiards, pubs, and computer game rooms located on the peripheries of college campuses. PMID:26540063

  11. Short-Term Impact of a Comprehensive Smoke-Free Law Following a Partial Smoke-Free Law on PM₂.₅ Concentration Levels at Hospitality Venues on the Peripheries of College Campuses.

    Science.gov (United States)

    Yu, Sol; Yang, Wonho; Lee, Kiyoung; Kim, Sungcheon; Ha, Kwonchul; Kim, Sungroul

    2015-11-02

    Tobacco-free policies on college campuses are spreading in Korea. However, the impact of the smoking ban legislation at venues on the boundary of a college campus is still limited. This study aimed to assess short-term changes in PM2.5 concentrations before and after the enactment of the smoking ban legislation to evaluate the impact. In this cross-sectional study, PM2.5 measurements (pre-ban: n = 99, post-ban: n = 64) were conducted in randomly selected billiards, pubs, and computer game rooms on the peripheries of college campuses in October 2013, prior to implementation of the smoking ban, and in May 2014, after the ban. The median (interquartile range, IQR) of the PM2.5 concentration for all venues was 31 μg/m³ (0-80 μg/m³) in the pre-ban period and 11 μg/m³ (0-36 μg/m³) in the post-ban period implying indoor PM2.5 concentration levels of the peripheries of college campuses likely decreased one year after implementation of the ban. However, the differences were not significant yet. The results support the introduction of more rigorous monitoring of SHS exposure levels toward the ultimate goal of encouraging a complete smoking ban in hospitality venues, including billiards, pubs, and computer game rooms located on the peripheries of college campuses.

  12. Quotient-Comprehension Chains

    Directory of Open Access Journals (Sweden)

    Kenta Cho

    2015-11-01

    Full Text Available Quotients and comprehension are fundamental mathematical constructions that can be described via adjunctions in categorical logic. This paper reveals that quotients and comprehension are related to measurement, not only in quantum logic, but also in probabilistic and classical logic. This relation is presented by a long series of examples, some of them easy, and some also highly non-trivial (esp. for von Neumann algebras. We have not yet identified a unifying theory. Nevertheless, the paper contributes towards such a theory by introducing the new quotient-and-comprehension perspective on measurement instruments, and by describing the examples on which such a theory should be built.

  13. Comprehensive cardiac rehabilitation

    DEFF Research Database (Denmark)

    Kruse, Marie; Hochstrasser, Stefan; Zwisler, Ann-Dorthe O

    2006-01-01

    OBJECTIVES: The costs of comprehensive cardiac rehabilitation are established and compared to the corresponding costs of usual care. The effect on health-related quality of life is analyzed. METHODS: An unprecedented and very detailed cost assessment was carried out, as no guidelines existed...... and may be as high as euro 1.877. CONCLUSIONS: Comprehensive cardiac rehabilitation is more costly than usual care, and the higher costs are not outweighed by a quality of life gain. Comprehensive cardiac rehabilitation is, therefore, not cost-effective....

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

    Science.gov (United States)

    Aiura, Hiroshi

    2013-06-01

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

  15. Comprehensive geriatric assessment

    African Journals Online (AJOL)

    2007-09-14

    Sep 14, 2007 ... i.e. difficulty performing simple physical and mental tasks necessary for daily life. ... Definition. Comprehensive geriatric assessment (CGA) is a multidimensional .... The formation of a programme of therapy is decided on.

  16. Spectrum of physics comprehension

    International Nuclear Information System (INIS)

    Blasiak, W; Godlewska, M; Rosiek, R; Wcislo, D

    2012-01-01

    The paper presents the results of research on the relationship between self-assessed comprehension of physics lectures and final grades of junior high school students (aged 13-15), high school students (aged 16-18) and physics students at the Pedagogical University of Cracow, Poland (aged 21). Students' declared level of comprehension was measured during a physics lecture on a prearranged scale of 1-10 with the use of a personal response system designed for the purpose of this experiment. Through the use of this tool, we obtained about 2000 computer records of students' declared comprehension of a 45 min lecture, which we named ‘the spectrum of comprehension’. In this paper, we present and analyse the correlation between students' declared comprehension of the content presented in the lecture and their final learning results. (paper)

  17. 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%.

  18. Radiation protection in hospitals

    International Nuclear Information System (INIS)

    MOuld, R.F.

    1985-01-01

    A book on radiation protection in hospitals has been written to cater for readers with different backgrounds, training and needs by providing an elementary radiation physics text in Part I and an advanced, comprehensive Part II relating to specific medical applications of X-rays and of radioactivity. Part I includes information on basic radiation physics, radiation risk, radiation absorption and attenuation, radiation measurement, radiation shielding and classification of radiation workers. Part II includes information on radiation protection in external beam radiotherapy, interstitial source radiotherapy, intracavitary radiotherapy, radioactive iodine-131 radiotherapy, nuclear medicine diagnostics and diagnostic radiology. (U.K.)

  19. THE NATURE OF COMPREHENSION.

    Science.gov (United States)

    CLELAND, DONALD L.

    THE NATURE OF COMPREHENSION IS DEFINED AND CLARIFIED. THE LITERATURE IS SURVEYED TO SHOW THAT THE DEVELOPMENT OF CONCEPTS IS IMPORTANT IN INTELLECTUAL ACTIVITIES. IT IS POINTED OUT THAT CONCEPTS ARE BUILT FROM PERCEPTS, IMAGES, SENSATION, AND MEMORIES, AND THAT THE STEPS WHICH ARE EMPLOYED AS CONCEPTS ARE BUILT AND REFINED AND INCLUDE PERCEIVING,…

  20. Comprehension Strategy Gloves.

    Science.gov (United States)

    Newman, Gayle

    2002-01-01

    Describes the idea of creating a glove for each of the comprehension strategies for use with different text structures. Notes that the gloves serve as a multisensory approach by providing visual clues through icons on each finger and the palm. Discusses three different gloves: the prereading glove, the narrative text structure glove, and the…

  1. Painless reading comprehension

    CERN Document Server

    Jones, EdD, Darolyn "Lyn"

    2016-01-01

    Reading comprehension gets easier as students learn what kind of reader they are, discover how to keep facts in their head, and much more. Bonus Online Component: includes additional games, including Beat the Clock, a line match game, and a word scramble.

  2. Comprehensive Environmental Management Process

    International Nuclear Information System (INIS)

    Hjeresen, D.L.; Roybal, S.L.

    1994-01-01

    This report contains information about Los Alamos National Laboratory's Comprehensive Environmental Management Plan. The topics covered include: waste minimization, waste generation, environmental concerns, public relations of the laboratory, and how this plan will help to answer to the demands of the laboratory as their mission changes

  3. Cognitive Correlates of Listening Comprehension

    Science.gov (United States)

    Kim, Young-Suk; Phillips, Beth

    2014-01-01

    In an effort to understand cognitive foundations of oral language comprehension (i.e., listening comprehension), we examined how inhibitory control, theory of mind, and comprehension monitoring are uniquely related to listening comprehension over and above vocabulary and age. A total of 156 children in kindergarten and first grade from…

  4. Hospital Inspections

    Data.gov (United States)

    U.S. Department of Health & Human Services — Welcome to hospitalinspections.org, a website run by the Association of Health Care Journalists (AHCJ) that aims to make federal hospital inspection reports easier...

  5. Hospital marketing.

    Science.gov (United States)

    Carter, Tony

    2003-01-01

    This article looks at a prescribed academic framework for various criteria that serve as a checklist for marketing performance that can be applied to hospital marketing organizations. These guidelines are drawn from some of Dr. Noel Capon of Columbia University's book Marketing Management in the 21st Century and applied to actual practices of hospital marketing organizations. In many ways this checklist can act as a "marketing" balanced scorecard to verify performance effectiveness and develop opportunities for innovation.

  6. Comprehensive hard materials

    CERN Document Server

    2014-01-01

    Comprehensive Hard Materials deals with the production, uses and properties of the carbides, nitrides and borides of these metals and those of titanium, as well as tools of ceramics, the superhard boron nitrides and diamond and related compounds. Articles include the technologies of powder production (including their precursor materials), milling, granulation, cold and hot compaction, sintering, hot isostatic pressing, hot-pressing, injection moulding, as well as on the coating technologies for refractory metals, hard metals and hard materials. The characterization, testing, quality assurance and applications are also covered. Comprehensive Hard Materials provides meaningful insights on materials at the leading edge of technology. It aids continued research and development of these materials and as such it is a critical information resource to academics and industry professionals facing the technological challenges of the future. Hard materials operate at the leading edge of technology, and continued res...

  7. 501 reading comprehension questions

    CERN Document Server

    2014-01-01

    This updated edition offers the most extensive and varied practice for all types of questions students might face on standardized and in-class tests. With this guide, students will learn to develop expert reading strategies, understand how to read faster and with greater comprehension, overcome reading anxiety, and increase appreciation of reading for pleasure. This book's step-by-step approach provides graduated coverage that moves from the basics to more advanced reading.

  8. Planning Combat Outposts to Maximize Population Security

    Science.gov (United States)

    2010-06-01

    Abraham Maslow defined incremental layers of needs that require fulfillment and that can explain people’s motivations in life [12]. The needs at a lower...Hildebrant I ,e Certified by: The Charles Stark Draper Laboratory, Inc. Technical Supervisor Stephen C. Graves Professor, Abraham J. Siegel...22 Figure 2-4: Maslow Hierarchy of Needs ................................................................................. 27 Figure 3-1

  9. A comprehensive French grammar

    CERN Document Server

    Price, Glanville

    2013-01-01

    Characterized by clear and accessible explanations, numerous examples and sample sentences, a new section on register and tone, and useful appendices covering topics including age and time, A Comprehensive French Grammar, Sixth Edition is an indispensable tool for advanced students of French language and literature.A revised edition of this established, bestselling French grammarIncludes a new section on register and medium and offers expanded treatment of French punctuationFeatures numerous examples and sample sentences, and useful appendices covering topics including age, time, and dimension

  10. Comprehensive multiplatform collaboration

    Science.gov (United States)

    Singh, Kundan; Wu, Xiaotao; Lennox, Jonathan; Schulzrinne, Henning G.

    2003-12-01

    We describe the architecture and implementation of our comprehensive multi-platform collaboration framework known as Columbia InterNet Extensible Multimedia Architecture (CINEMA). It provides a distributed architecture for collaboration using synchronous communications like multimedia conferencing, instant messaging, shared web-browsing, and asynchronous communications like discussion forums, shared files, voice and video mails. It allows seamless integration with various communication means like telephones, IP phones, web and electronic mail. In addition, it provides value-added services such as call handling based on location information and presence status. The paper discusses the media services needed for collaborative environment, the components provided by CINEMA and the interaction among those components.

  11. Academic Hospitality

    Science.gov (United States)

    Phipps, Alison; Barnett, Ronald

    2007-01-01

    Academic hospitality is a feature of academic life. It takes many forms. It takes material form in the hosting of academics giving papers. It takes epistemological form in the welcome of new ideas. It takes linguistic form in the translation of academic work into other languages, and it takes touristic form through the welcome and generosity with…

  12. Comprehensive overview of prostatitis.

    Science.gov (United States)

    Khan, Farhan Ullah; Ihsan, Awais Ullah; Khan, Hidayat Ullah; Jana, Ruby; Wazir, Junaid; Khongorzul, Puregmaa; Waqar, Muhammad; Zhou, Xiaohui

    2017-10-01

    Prostatitis is a common urinary tract syndrome that many doctors find problematic to treat effectively. It is the third most commonly found urinary tract disease in men after prostate cancer and Benign Prostate Hyperplasia (BPH). Prostatitis may account for 25% of all office visits made to the urological clinics complaining about the genital and urinary systems all over the world. In the present study, we classified prostatitis and comprehensively elaborated the etiology, pathogenesis, diagnosis, and treatment of acute bacterial prostatitis (category I), chronic bacterial prostatitis (category II), chronic pelvic pain syndrome (CPPS) (category III), and asymptomatic prostatitis (category IV). In addition, we also tried to get some insights about other types of prostatitis-like fungal, viral and gonococcal prostatitis. The aim of this review is to present the detail current perspective of prostatitis in a single review. To the best of our knowledge currently, there is not a single comprehensive review, which can completely elaborate this important topic in an effective way. Furthermore, this review will provide a solid platform to conduct future studies on different aspects such as risk factors, mechanism of pathogenesis, proper diagnosis, and rational treatment plans for fungal, viral, and gonococcal prostatitis. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  13. Comprehensive national energy strategy

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-04-01

    This Comprehensive National Energy Strategy sets forth a set of five common sense goals for national energy policy: (1) improve the efficiency of the energy system, (2) ensure against energy disruptions, (3) promote energy production and use in ways that respect health and environmental values, (4) expand future energy choices, and (5) cooperate internationally on global issues. These goals are further elaborated by a series of objectives and strategies to illustrate how the goals will be achieved. Taken together, the goals, objectives, and strategies form a blueprint for the specific programs, projects, initiatives, investments, and other actions that will be developed and undertaken by the Federal Government, with significant emphasis on the importance of the scientific and technological advancements that will allow implementation of this Comprehensive National Energy Strategy. Moreover, the statutory requirement of regular submissions of national energy policy plans ensures that this framework can be modified to reflect evolving conditions, such as better knowledge of our surroundings, changes in energy markets, and advances in technology. This Strategy, then, should be thought of as a living document. Finally, this plan benefited from the comments and suggestions of numerous individuals and organizations, both inside and outside of government. The Summary of Public Comments, located at the end of this document, describes the public participation process and summarizes the comments that were received. 8 figs.

  14. Hospitality and hostility in hospitals

    DEFF Research Database (Denmark)

    Jensen, Tina Blegind; Aanestad, Margunn

    2007-01-01

    The purpose of this paper is to discuss the adoption of healthcare information systems (HIS) from a user perspective. Our case study concerns how a group of orthopaedic surgeons experienced and reacted to the adoption and mandatory use of an Electronic Patient Record system in a Danish hospital. We...... propose to use the concepts of hospitality and hostility to turn our attention to the interaction between the host (the surgeons) and the guest (the information system) and consider how the boundaries between them evolved in the everyday work practices. As an alternative to previous studies on technology...

  15. Psychodermatology: A comprehensive review

    Directory of Open Access Journals (Sweden)

    Savita Yadav

    2013-01-01

    Full Text Available Psychodermatology is an interesting domain of dermatology that overlaps with psychiatry. This arena in dermatology has received limited diligence, partly due to lack of training in this realm. We present here a comprehensive review of salient features and treatment updates in primary psychiatric dermatoses and have also discussed the role of psyche in psychophysiological cutaneous disorders. Secondary psychiatric morbidity is relatively common among patients visiting the dermatologists but often overlooked and uncared for. Dermatologist should be able to initiate basic pharmacotherapy, should be knowledgeable about various non-pharmacological treatments and know the right time to refer the patient to the psychiatrist. Awareness and pertinent treatment of psychodermatological disorders among dermatologists will lead to a more holistic treatment approach and better prognosis in this unique group of patients.

  16. Comprehensive Environmental Management Plan

    International Nuclear Information System (INIS)

    Hjeresen, D.L.

    1994-01-01

    The Environmental Management Program at Los Alamos National Laboratory is in the process of initiating and then implementing a Comprehensive Environmental Management Plan (CEMP). There are several environmental impact and compliance drivers for this initiative. The Los Alamos CEMP is intended to be a flexible, long-range process that predicts, minimizes, treats, and disposes of any waste generated in execution of the Los Alamos mission - even if that mission changes. The CEMP is also intended to improve stakeholder and private sector involvement and access to environmental information. The total quality environmental management (TQEM) process will benchmark Los Alamos to private sector and DOE operations, identify opportunities for improvement, prioritize among opportunities, implement projects, measure progress, and spur continuous improvement in Environmental Management operations

  17. Comprehensive nuclear materials

    CERN Document Server

    Allen, Todd; Stoller, Roger; Yamanaka, Shinsuke

    2012-01-01

    Comprehensive Nuclear Materials encapsulates a panorama of fundamental information on the vast variety of materials employed in the broad field of nuclear technology. The work addresses, in five volumes, 3,400 pages and over 120 chapter-length articles, the full panorama of historical and contemporary international research in nuclear materials, from Actinides to Zirconium alloys, from the worlds' leading scientists and engineers. It synthesizes the most pertinent research to support the selection, assessment, validation and engineering of materials in extreme nuclear environments. The work discusses the major classes of materials suitable for usage in nuclear fission, fusion reactors and high power accelerators, and for diverse functions in fuels, cladding, moderator and control materials, structural, functional, and waste materials.

  18. Hospital Malnutrition

    OpenAIRE

    Asumadu-Sarkodie, Samuel

    2012-01-01

    Malnutrition seen in hospitals usually occurs as some form of protein-energy malnutrition (PEM). Primary PEM results from an acute or chronic deficiency of both protein and calories. Secondary PEM, or cachexia, results from a disease or medical condition such as cancer or gastrointestinal disease that alters requirements or impairs utilization of nutrients. This record was migrated from the OpenDepot repository service in June, 2017 before shutting down.

  19. A New Comprehensive Short-form Health Literacy Survey Tool for Patients in General

    Directory of Open Access Journals (Sweden)

    Tuyen Van Duong, RN, MSN, PhD

    2017-03-01

    Conclusion: The comprehensive HL-SF12 was a valid and easy to use tool for assessing patients’ health literacy in the hospitals to facilitate healthcare providers in enhancing patients’ health literacy and healthcare qualities.

  20. Comprehensive stroke units: a review of comparative evidence and experience.

    Science.gov (United States)

    Chan, Daniel K Y; Cordato, Dennis; O'Rourke, Fintan; Chan, Daniel L; Pollack, Michael; Middleton, Sandy; Levi, Chris

    2013-06-01

    Stroke unit care offers significant benefits in survival and dependency when compared to general medical ward. Most stroke units are either acute or rehabilitation, but comprehensive (combined acute and rehabilitation) model (comprehensive stroke unit) is less common. To examine different levels of evidence of comprehensive stroke unit compared to other organized inpatient stroke care and share local experience of comprehensive stroke units. Cochrane Library and Medline (1980 to December 2010) review of English language articles comparing stroke units to alternative forms of stroke care delivery, different types of stroke unit models, and differences in processes of care within different stroke unit models. Different levels of comparative evidence of comprehensive stroke units to other models of stroke units are collected. There are no randomized controlled trials directly comparing comprehensive stroke units to other stroke unit models (either acute or rehabilitation). Comprehensive stroke units are associated with reduced length of stay and greatest reduction in combined death and dependency in a meta-analysis study when compared to other stroke unit models. Comprehensive stroke units also have better length of stay and functional outcome when compared to acute or rehabilitation stroke unit models in a cross-sectional study, and better length of stay in a 'before-and-after' comparative study. Components of stroke unit care that improve outcome are multifactorial and most probably include early mobilization. A comprehensive stroke unit model has been successfully implemented in metropolitan and rural hospital settings. Comprehensive stroke units are associated with reductions in length of stay and combined death and dependency and improved functional outcomes compared to other stroke unit models. A comprehensive stroke unit model is worth considering as the preferred model of stroke unit care in the planning and delivery of metropolitan and rural stroke services

  1. Reinternação em hospital psiquiátrico: a compreensão do processo saúde/doença na vivência do cotidiano Reinternamiento en hospital psiquiátrico: la comprensión del proceso salud/enfermedad en la vivencia del cotidiano Readmission to a psychiatric hospital: the comprehension of the health/illness process through the experience of daily life

    Directory of Open Access Journals (Sweden)

    Mariana Moraes Salles

    2007-03-01

    Full Text Available Este trabalho é recorte de uma investigação que buscou identificar o cotidiano de pessoas com transtornos mentais, que sofrem reinternações psiquiátricas. Nesse percurso foi possível evidenciar que esses sujeitos expressam diversas concepções do processo saúde/doença mental e que caracterizam as formas de tratamento que se utilizam. Utilizou-se como metodologia a abordagem qualitativa fundamentada no conceito de cotidiano da autora Agnes Heller. As entrevistas de pacientes e familiares foram submetidas à análise de discurso que, entre outros resultados, revelou que essa população passou a ter novas ferramentas e possibilidades para compreender a loucura e a assistência ao doente mental.Este trabajo es recorte de una investigación que buscó identificar el cotidiano de personas con trastornos mentales, que sufren reinternamientos psiquiátricos. En este recorrido fue posible evidenciar que esos sujetos expresan diversas concepciones del proceso salud/enfermedad mental y que caracterizan las formas de tratamiento utilizados. En la metodología se utilizó el abordaje cualitativo fundamentado en el concepto de cotidiano de la autora Agnes Heller. Las entrevistas de pacientes y familiares fueron sometidas al análisis de discurso que, entre otros resultados, reveló que esa población pasó a tener nuevas herramientas y posibilidades para comprender la locura y la asistencia al enfermo mental.This study is part of a research that aimed at identifying the daily life of people with mental disruptions who are re-admitted to psychiatric hospitals. It was possible to pinpoint that these individuals express several conceptions of the health/mental illness process and that they also distinguish the kinds of treatment they go through. As far as methodology is concerned the study used the qualitative approach based on Agnes Heller's concept of daily life. The interviews with patients and their relatives were submitted to speech analysis

  2. The 2001 Comprehensive Review

    CERN Multimedia

    Åkesson, T

    A new approach for CERN to monitor the LHC-experiments' technical and scientific progress was introduced last year: The Comprehensive Reviews. A significant fraction of the full LHCC committee is mobilized during two days to review the complete project status. This event took place for ATLAS during 2-3 of July this year. With a rather exhaustive program we presented our status in 39 talks. It was a demanding and close to impossible task for the referees to comprehend the ATLAS status by listening to this massive amount of information, but from the ATLAS point-of-view we judged it important that the referees were exposed to both the progress and the remaining problem areas. The referees were satisfied with our status; probably more so this year than last year. They judged the main critical issues to be: The schedules of the barrel toroid, the end-cap TRT, the LAr barrel and end-cap A, and the MDTs. The procurement of radiation hard electronics was also thought to be a critical issue. They were informed of ...

  3. Comprehensive facilities plan

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-09-01

    The Ernest Orlando Lawrence Berkeley National Laboratory`s Comprehensive Facilities Plan (CFP) document provides analysis and policy guidance for the effective use and orderly future development of land and capital assets at the Berkeley Lab site. The CFP directly supports Berkeley Lab`s role as a multiprogram national laboratory operated by the University of California (UC) for the Department of Energy (DOE). The CFP is revised annually on Berkeley Lab`s Facilities Planning Website. Major revisions are consistent with DOE policy and review guidance. Facilities planing is motivated by the need to develop facilities for DOE programmatic needs; to maintain, replace and rehabilitate existing obsolete facilities; to identify sites for anticipated programmatic growth; and to establish a planning framework in recognition of site amenities and the surrounding community. The CFP presents a concise expression of the policy for the future physical development of the Laboratory, based upon anticipated operational needs of research programs and the environmental setting. It is a product of the ongoing planning processes and is a dynamic information source.

  4. Comprehensive eye evaluation algorithm

    Science.gov (United States)

    Agurto, C.; Nemeth, S.; Zamora, G.; Vahtel, M.; Soliz, P.; Barriga, S.

    2016-03-01

    In recent years, several research groups have developed automatic algorithms to detect diabetic retinopathy (DR) in individuals with diabetes (DM), using digital retinal images. Studies have indicated that diabetics have 1.5 times the annual risk of developing primary open angle glaucoma (POAG) as do people without DM. Moreover, DM patients have 1.8 times the risk for age-related macular degeneration (AMD). Although numerous investigators are developing automatic DR detection algorithms, there have been few successful efforts to create an automatic algorithm that can detect other ocular diseases, such as POAG and AMD. Consequently, our aim in the current study was to develop a comprehensive eye evaluation algorithm that not only detects DR in retinal images, but also automatically identifies glaucoma suspects and AMD by integrating other personal medical information with the retinal features. The proposed system is fully automatic and provides the likelihood of each of the three eye disease. The system was evaluated in two datasets of 104 and 88 diabetic cases. For each eye, we used two non-mydriatic digital color fundus photographs (macula and optic disc centered) and, when available, information about age, duration of diabetes, cataracts, hypertension, gender, and laboratory data. Our results show that the combination of multimodal features can increase the AUC by up to 5%, 7%, and 8% in the detection of AMD, DR, and glaucoma respectively. Marked improvement was achieved when laboratory results were combined with retinal image features.

  5. Cultural Knowledge in News Comprehension

    DEFF Research Database (Denmark)

    Mathieu, David

    2009-01-01

    This paper presents the main lines of the design and the findings of a reception study on news comprehension. This empirical study is a comparison of the comprehension processes of Danes and French Canadians over a set of news texts from both countries. Comprehension is explored from a cultural...... perspective, through the lens of cognition and pragmatics, revealing the role played by cultural knowledge in comprehension and the underlying relationship between a text and its intended audience. It is argued that recipients ‘problematise’ the news texts, a process by which the texts answer questions...

  6. SITE COMPREHENSIVE LISTING (CERCLIS) (Superfund)

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Comprehensive Environmental Response, Compensation and Liability Information System (CERCLIS) (Superfund) Public Access Database contains a selected set of...

  7. An ideal hospital.

    Science.gov (United States)

    Chandrasiri, Singithi Sidney

    2017-07-03

    Purpose The purpose of this paper is to explore a novel overarching strategy in tackling the key issues raised by the recent inquiry into bullying, harassment and discrimination in surgical practice and surgical training in Australian and New Zealand hospitals. Design/methodology/approach The approach taken is an analysis of the available evidence-based literature to inform the proposed viewpoint. The theoretical subject scope presented is a discussion of how and why the various strategies put forward in this paper should be integrated into and led from an overarching workforce engagement platform. Findings The key themes isolated from the Inquiry into Australian and New Zealand surgical practice ranged from abuse of power by those in leadership positions, gender inequity in the surgical workforce, opaque and corrupt complaints handling processes, excessive surgical trainee working hours to bystander silence secondary to a fear of reprisal. A workforce engagement perspective has elicited the potential to counter various impacts, that of clinical ineffectiveness, substandard quality and safety, inefficient medical workforce management outcomes, adverse economic implications and the operational profitability of a hospital. Generic strategies grounded in evidence-based literature were able to then be aligned with specific action areas to provide a new leadership framework for addressing these impacts. Originality/value To the author's knowledge, this is one of the first responses providing a framework on how medical managers and hospital executives can begin to lead a comprehensive and practical strategy for changing the existing culture of bullying, harassment and discrimination in surgical practice by using a staff engagement framework.

  8. Hospital CRM: unexplored frontier of revenue growth?

    Science.gov (United States)

    Young, Thomas

    2007-10-01

    Customer relationship management (CRM) has a less-than-stellar reputation, in large part because efforts to implement it have been piecemeal and not well funded. The technologies now exist to make CRM much more effective than it has been in the past. Many hospitals today are demonstrating a substantial ROI from implementing a comprehensive CRM program.

  9. Pragmatic Comprehension Development through Telecollaboration

    Science.gov (United States)

    Rafieyan, Vahid; Sharafi-Nejad, Maryam; Khavari, Zahra; Eng, Lin Siew; Mohamed, Abdul Rashid

    2014-01-01

    Pragmatic comprehension can be ideally developed through contact with target language speakers. This contact can be provided in English as Foreign Language contexts through telecollaboration. To test the actual effect of telecollaboration on the development of pragmatic comprehension, 30 Iranian undergraduates of English as a Foreign Language…

  10. Reading comprehension in Parkinson's disease.

    Science.gov (United States)

    Murray, Laura L; Rutledge, Stefanie

    2014-05-01

    Although individuals with Parkinson's disease (PD) self-report reading problems and experience difficulties in cognitive-linguistic functions that support discourse-level reading, prior research has primarily focused on sentence-level processing and auditory comprehension. Accordingly, the authors investigated the presence and nature of reading comprehension in PD, hypothesizing that (a) individuals with PD would display impaired accuracy and/or speed on reading comprehension tests and (b) reading performances would be correlated with cognitive test results. Eleven adults with PD and 9 age- and education-matched control participants completed tests that evaluated reading comprehension; general language and cognitive abilities; and aspects of attention, memory, and executive functioning. The PD group obtained significantly lower scores on several, but not all, reading comprehension, language, and cognitive measures. Memory, language, and disease severity were significantly correlated with reading comprehension for the PD group. Individuals in the early stages of PD without dementia or broad cognitive deficits can display reading comprehension difficulties, particularly for high- versus basic-level reading tasks. These reading difficulties are most closely related to memory, high-level language, and PD symptom severity status. The findings warrant additional research to delineate further the types and nature of reading comprehension impairments experienced by individuals with PD.

  11. [Operation directions by comparing financial ratio of 22 provincial hospitals].

    Science.gov (United States)

    Wang, J Y; Ko, Y C; Wang, J W; Jan, L C; Chang, F M; Lin, K C

    1996-12-01

    Even more restrictive regulations and reimbursement limits seem to be a very heavy burden and stress for most provincial hospitals, especially after the National Health Insurance System has been introduced. The purpose of this project to find a better, universal direction for these hospitals through three steps: 1) Using different financial and accounting ratio indexes to evaluate the general business performance of each hospital. 2) Taking a comprehensive questionnaire with senior managers of each hospital to know their concepts and attitudes concerning external environment and internal operation. 3) Comparing data's correlation and differentiation to ascertain better trends for future operation for all hospitals. The database for this project comes from two resources: 1) Government finance and budget reports of 22 provincial hospitals for the 1994 accounting calendar year. 2) The results of questionnaires returned by 274 senior managers of hospitals, and analysis of these by chi-square test. Through statistical comparison, a number of conclusions can be made: 1) Most hospitals have better operation efficiency if any professional hospital administrator is working for them. 2) The hospital with more comprehensive personnel system shows better business performance. 3) The hospital with routine and formal financial analysis reports always has better business performance. 4) The hospital with poor operational efficiency tends to get rid of restriction or limitation from government's system. 5) The hospital with good operational efficiency has more confidence and desire to improve and change. 6) The hospital with poor operational efficiency is more dependent on outside support from government. 7) The hospital with better business performance has more concern about the impact of malpractice around the hospital. In short, a hospital with poor business efficiency always has more pessimistic attitude and tends to rely on outside resource support. On the other hand, a

  12. The marketing of partial hospitalization.

    Science.gov (United States)

    Millsap, P; Brown, E; Kiser, L; Pruitt, D

    1987-09-01

    Health-care professionals are currently operating in the context of a rapidly changing health-care delivery system, including the move away from inpatient services to outpatient services in order to control costs. Those who practice in partial-hospital settings are in a position to offer effective, cost-efficient services; however, there continue to be obstacles which hinder appropriate utilization of the modality. The development and use of a well-designed marketing plan is one strategy for removing these obstacles. This paper presents a brief overview of the marketing process, ideas for developing a marketing plan, and several examples of specific marketing strategies as well as ways to monitor their effectiveness. Partial-hospital providers must take an active role in answering the calls for alternative sources of psychiatric care. A comprehensive, education-oriented marketing approach will increase the public's awareness of such alternatives and enable programs to survive in a competitive environment.

  13. Comprehensive Error Rate Testing (CERT)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Centers for Medicare and Medicaid Services (CMS) implemented the Comprehensive Error Rate Testing (CERT) program to measure improper payments in the Medicare...

  14. Pediatric blunt splenic trauma: a comprehensive review

    Energy Technology Data Exchange (ETDEWEB)

    Lynn, Karen N.; Werder, Gabriel M.; Callaghan, Rachel M.; Jafri, Zafar H. [William Beaumont Hospital, Department of Diagnostic Radiology, Royal Oak, MI (United States); Sullivan, Ashley N. [St. George' s University School of Medicine, Grenada, West Indies (Grenada); Bloom, David A. [William Beaumont Hospital, Department of Diagnostic Radiology, Royal Oak, MI (United States); William Beaumont Hospital, Section of Pediatric Radiology, Department of Radiology, Royal Oak, MI (United States)

    2009-09-15

    Abdominal trauma is a leading cause of death in children older than 1 year of age. The spleen is the most common organ injured following blunt abdominal trauma. Pediatric trauma patients present unique clinical challenges as compared to adults, including different mechanisms of injury, physiologic responses, and indications for operative versus nonoperative management. Splenic salvage techniques and nonoperative approaches are preferred to splenectomy in order to decrease perioperative risks, transfusion needs, duration/cost of hospitalization, and risk of overwhelming postsplenectomy infection. Early and accurate detection of splenic injury is critical in both adults and children; however, while imaging findings guide management in adults, hemodynamic stability is the primary determinant in pediatric patients. After initial diagnosis, the primary role of imaging in pediatric patients is to determine the level and duration of care. We present a comprehensive literature review regarding the mechanism of injury, imaging, management, and complications of traumatic splenic injury in pediatric patients. Multiple patients are presented with an emphasis on the American Association for the Surgery of Trauma organ injury grading system. Clinical practice guidelines from the American Pediatric Surgical Association are discussed and compared with our experience at a large community hospital, with recommendations for future practice guidelines. (orig.)

  15. Pediatric blunt splenic trauma: a comprehensive review

    International Nuclear Information System (INIS)

    Lynn, Karen N.; Werder, Gabriel M.; Callaghan, Rachel M.; Jafri, Zafar H.; Sullivan, Ashley N.; Bloom, David A.

    2009-01-01

    Abdominal trauma is a leading cause of death in children older than 1 year of age. The spleen is the most common organ injured following blunt abdominal trauma. Pediatric trauma patients present unique clinical challenges as compared to adults, including different mechanisms of injury, physiologic responses, and indications for operative versus nonoperative management. Splenic salvage techniques and nonoperative approaches are preferred to splenectomy in order to decrease perioperative risks, transfusion needs, duration/cost of hospitalization, and risk of overwhelming postsplenectomy infection. Early and accurate detection of splenic injury is critical in both adults and children; however, while imaging findings guide management in adults, hemodynamic stability is the primary determinant in pediatric patients. After initial diagnosis, the primary role of imaging in pediatric patients is to determine the level and duration of care. We present a comprehensive literature review regarding the mechanism of injury, imaging, management, and complications of traumatic splenic injury in pediatric patients. Multiple patients are presented with an emphasis on the American Association for the Surgery of Trauma organ injury grading system. Clinical practice guidelines from the American Pediatric Surgical Association are discussed and compared with our experience at a large community hospital, with recommendations for future practice guidelines. (orig.)

  16. 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...

  17. 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.

  18. Help prevent hospital errors

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000618.htm Help prevent hospital errors To use the sharing features ... in the hospital. If You Are Having Surgery, Help Keep Yourself Safe Go to a hospital you ...

  19. Association of Hospitalization for Neurosurgical Operations in Magnet Hospitals With Mortality and Length of Stay.

    Science.gov (United States)

    Missios, Symeon; Bekelis, Kimon

    2018-03-01

    The association of Magnet hospital status with improved surgical outcomes remains an issue of debate. To investigate whether hospitalization in a Magnet hospital is associated with improved outcomes for patients undergoing neurosurgical operations. A cohort study was executed using all patients undergoing neurosurgical operations in New York registered in the Statewide Planning and Research Cooperative System database from 2009 to 2013. We examined the association of Magnet status hospitalization after neurosurgical operations with inpatient case fatality and length of stay (LOS). We employed an instrumental variable analysis to simulate a randomized trial. Overall, 190 787 patients underwent neurosurgical operations. Of these, 68 046 (35.7%) were hospitalized in Magnet hospitals, and 122 741 (64.3%) in non-Magnet institutions. Instrumental variable analysis demonstrated that hospitalization in Magnet hospitals was associated with decreased case fatality (adjusted difference, -0.8%; -95% confidence interval, -0.7% to -0.6%), and LOS (adjusted difference, -1.9; 95% confidence interval, -2.2 to -1.5) in comparison to non-Magnet hospitals. These associations were also observed in propensity score adjusted mixed effects models. These associations persisted in prespecified subgroups of patients undergoing spine surgery, craniotomy for tumor resection, or neurovascular interventions. We identified an association of Magnet hospitals with lower case fatality, and shorter LOS in a comprehensive New York State patient cohort undergoing neurosurgical procedures. Copyright © 2017 by the Congress of Neurological Surgeons

  20. Memory mechanisms supporting syntactic comprehension.

    Science.gov (United States)

    Caplan, David; Waters, Gloria

    2013-04-01

    Efforts to characterize the memory system that supports sentence comprehension have historically drawn extensively on short-term memory as a source of mechanisms that might apply to sentences. The focus of these efforts has changed significantly in the past decade. As a result of changes in models of short-term working memory (ST-WM) and developments in models of sentence comprehension, the effort to relate entire components of an ST-WM system, such as those in the model developed by Baddeley (Nature Reviews Neuroscience 4: 829-839, 2003) to sentence comprehension has largely been replaced by an effort to relate more specific mechanisms found in modern models of ST-WM to memory processes that support one aspect of sentence comprehension--the assignment of syntactic structure (parsing) and its use in determining sentence meaning (interpretation) during sentence comprehension. In this article, we present the historical background to recent studies of the memory mechanisms that support parsing and interpretation and review recent research into this relation. We argue that the results of this research do not converge on a set of mechanisms derived from ST-WM that apply to parsing and interpretation. We argue that the memory mechanisms supporting parsing and interpretation have features that characterize another memory system that has been postulated to account for skilled performance-long-term working memory. We propose a model of the relation of different aspects of parsing and interpretation to ST-WM and long-term working memory.

  1. Measurment and Reporting of Comprehensive Income: Search ...

    African Journals Online (AJOL)

    Measurment and Reporting of Comprehensive Income: Search, Challenges, ... of periods of stable and unstable economic situation and satisfies varied users' ... Keywords: Historical accounting; comprehensive income; asset valuation model.

  2. Nursing supervision for care comprehensiveness

    Directory of Open Access Journals (Sweden)

    Lucieli Dias Pedreschi Chaves

    Full Text Available ABSTRACT Objective: To reflect on nursing supervision as a management tool for care comprehensiveness by nurses, considering its potential and limits in the current scenario. Method: A reflective study based on discourse about nursing supervision, presenting theoretical and practical concepts and approaches. Results: Limits on the exercise of supervision are related to the organization of healthcare services based on the functional and clinical model of care, in addition to possible gaps in the nurse training process and work overload. Regarding the potential, researchers emphasize that supervision is a tool for coordinating care and management actions, which may favor care comprehensiveness, and stimulate positive attitudes toward cooperation and contribution within teams, co-responsibility, and educational development at work. Final considerations: Nursing supervision may help enhance care comprehensiveness by implying continuous reflection on including the dynamics of the healthcare work process and user needs in care networks.

  3. Conceptual Combination During Sentence Comprehension

    Science.gov (United States)

    Swinney, David; Love, Tracy; Walenski, Matthew; Smith, Edward E.

    2008-01-01

    This experiment examined the time course of integration of modifier-noun (conceptual) combinations during auditory sentence comprehension using cross-modal lexical priming. The study revealed that during ongoing comprehension, there is initial activation of features of the noun prior to activation of (emergent) features of the entire conceptual combination. These results support compositionality in conceptual combination; that is, they indicate that features of the individual words constituting a conceptual combination are activated prior to combination of the words into a new concept. PMID:17576278

  4. Hospital marketing revisited.

    Science.gov (United States)

    Costello, M M

    1987-05-01

    With more hospitals embracing the marketing function in their organizational management over the past decade, hospital marketing can no longer be considered a fad. However, a review of hospital marketing efforts as reported in the professional literature indicates that hospitals must pay greater attention to the marketing mix elements of service, price and distribution channels as their programs mature.

  5. Hospital Library Administration.

    Science.gov (United States)

    Cramer, Anne

    The objectives of a hospital are to improve patient care, while the objectives of a hospital library are to improve services to the staff which will support their efforts. This handbook dealing with hospital administration is designed to aid the librarian in either implementing a hospital library, or improving services in an existing medical…

  6. Target marketing for the hospital-based wellness center.

    Science.gov (United States)

    Cangelosi, J D

    1997-01-01

    The American population is aging, medical technology is advancing, and life expectancies are on the rise. At the same time hospitals are looking for additional sources of income due to the pressures of government regulations and managed care. One of the options for hospitals looking for additional sources of income is the hospital-based but free-standing comprehensive wellness and fitness center. Such centers go beyond the facilities, programs and services offered by traditional health and fitness centers. In addition to physical fitness programs, hospital-based wellness centers offer programs in CPR, nutrition, weight control and many other programs of interest to an aging but active American populace. This research documents the hospital industry, wellness industry and the prospects of success or failure for he hospital attempting such a venture. The focus of the research is the experience of a particular hospital with regard to the programs, facilities and services deemed most important by its target market.

  7. Comprehensive dictionary of electrical engineering

    CERN Document Server

    Laplante, Philip A

    1998-01-01

    The Comprehensive Dictionary of Electrical Engineering is a complete lexicon covering all the fields of electrical engineering.Areas examined include:applied electrical engineeringmicrowave engineeringcontrol engineeringpower engineeringdigital systems engineeringdevice electronicsand much more! The book provides workable definitions for practicing engineers, serves as a reference and research tool for students, and offers practical information for scientists and engineers in other disciplines.

  8. Children's Comprehension of Live Theatre.

    Science.gov (United States)

    Klein, Jeanne; Fitch, Marguerite

    Two studies investigate the way in which children make sense of a play and the visual, aural, and psychological components of theatre which contribute to this comprehension. In the first study, 32 fifth graders saw "Don Quixote of La Mancha." In the second study, 45 third graders saw "Monkey, Monkey" (about the Chinese Monkey King). The day after…

  9. Listening Comprehension: Approach, Design, Procedure.

    Science.gov (United States)

    Richards, Jack C.

    1983-01-01

    Three dimensions in the teaching of listening comprehension are outlined: (1) a theory is presented that takes account of the cognitive processes used (approach); (2) listeners' needs are analyzed and a taxonomy of microskills and objectives for teaching them are proposed (design); and (3) classroom exercises and activities are suggested…

  10. Comprehensive School Alienation Program, Guidelines.

    Science.gov (United States)

    Hawaii State Dept. of Education, Honolulu. Office of Instructional Services.

    This document presents guidelines developed by the Hawaii State Department of Education's Comprehensive School Alienation Program to consolidate and strengthen the delivery of services to alienated students. It is intended to assist district staff, school administrators, and project personnel in planning and implementing program activities and…

  11. A Comprehensive General Chemistry Demonstration

    Science.gov (United States)

    Sweeder, Ryan D.; Jeffery, Kathleen A.

    2013-01-01

    This article describes the use of a comprehensive demonstration suitable for a high school or first-year undergraduate introductory chemistry class. The demonstration involves placing a burning candle in a container adjacent to a beaker containing a basic solution with indicator. After adding a lid, the candle will extinguish and the produced…

  12. Electroconvulsive Therapy: A Comprehensive Assessment

    Directory of Open Access Journals (Sweden)

    Tayfun Zeren

    2003-08-01

    Full Text Available Electroconvulsive therapy (ECT is one of the most important discoveries of psychiatric treatments. This article comprehensively assesses historical progress, mechanism of actions, practical methods, indications, side effects, complications, drug interactions of ECT and attitudes towards ECT. [Archives Medical Review Journal 2003; 12(4.000: 340-377

  13. Innovation Learning in Comprehensive Education?

    Science.gov (United States)

    Lindfors, Eila; Hilmola, Antti

    2016-01-01

    The goal of this article is to clarify the concept of innovation and by presenting a research on the basic education outcome assessment data from an innovation learning perspective, answer to a question: Do students learn innovation in comprehensive education? The empirical information in this research is based on data collected in the national…

  14. Prediction during natural language comprehension

    NARCIS (Netherlands)

    Willems, R.M.; Frank, S.L.; Nijhof, A.D.; Hagoort, P.; Bosch, A.P.J. van den

    2016-01-01

    The notion of prediction is studied in cognitive neuroscience with increasing intensity. We investigated the neural basis of 2 distinct aspects of word prediction, derived from information theory, during story comprehension. We assessed the effect of entropy of next-word probability distributions as

  15. Comprehensive School Safety Initiative Report

    Science.gov (United States)

    National Institute of Justice, 2014

    2014-01-01

    The National Institute of Justice (NIJ) developed the Comprehensive School Safety Initiative in consultation with federal partners and Congress. It is a research-focused initiative designed to increase the safety of schools nationwide through the development of knowledge regarding the most effective and sustainable school safety interventions and…

  16. Glosses, Comprehension, and Strategy Use

    Science.gov (United States)

    Ko, Myong Hee

    2005-01-01

    This study, using both qualitative and quantitative measures, investigates how different types of gloss conditions affect Korean college students' reading comprehension. One hundred and six undergraduates at a university in Korea participated in the study. Twelve were assigned to think aloud, and the rest (ninety-four) took part in the main study…

  17. Constraint Programming for Context Comprehension

    DEFF Research Database (Denmark)

    Christiansen, Henning

    2014-01-01

    A close similarity is demonstrated between context comprehension, such as discourse analysis, and constraint programming. The constraint store takes the role of a growing knowledge base learned throughout the discourse, and a suitable con- straint solver does the job of incorporating new pieces...

  18. Neuroimaging Evidence of Comprehension Monitoring

    Directory of Open Access Journals (Sweden)

    Linda Baker

    2014-04-01

    Full Text Available The purpose of this article is to synthesize the emerging neuroimaging literature that reveals how the brain responds when readers and listeners encounter texts that demand monitoring of their ongoing comprehension processes. Much of this research has been undertaken by cognitive scientists who do not frame their work in metacognitive terms, and therefore it is less likely to be familiar to psychologists who study metacognition in educational contexts. The important role of metacognition in the development and use of academic skills is widely recognized. Metacognition is typically defined as the awareness and control of one's own cognitive processes. In the domain of reading, the most important metacognitive skill is comprehension monitoring, the evaluation and regulation of comprehension. Readers who monitor their understanding realize when they have encountered difficulty making sense of the text, and they apply error correction procedures to attempt to resolve the difficulty. Metacognition depends on executive control skills that continue to develop into early adulthood, in parallel with the maturation of the executive control regions of the prefrontal cortex. Functional magnetic resonance imaging (fMRI and event-related potentials (ERP have been used for some time to study neural correlates of basic reading processes such as word identification, but it is only within recent years that researchers have turned to the higher-level processes of text comprehension. The article describes illustrative studies that reveal changes in neural activity when adults apply lexical, syntactic, or semantic standards to evaluate their understanding.

  19. A Strategic Framework for Improving the Patient Experience in Hospitals.

    Science.gov (United States)

    Birkelien, Natalie L

    Hospitals are taking new approaches to satisfy consumers and deliver on customer expectations by enhancing their patients' comprehensive experience. The HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) survey and value-based purchasing initiatives have tied reimbursement to patient satisfaction scores, bringing patient perspectives on care to the forefront of hospitals' strategic priorities. This essay reviews the patient experience literature and argues that hospitals should adopt an expanded approach beyond HCAHPS measures to enhance the patient experience. Such an approach allows providers to deliver quality outcomes that satisfy patients' wants and needs.

  20. Attempted suicides in India: a comprehensive look.

    Science.gov (United States)

    Saddichha, Sahoo; Prasad, M N V; Saxena, Mukul Kumar

    2010-01-01

    Suicide continues to be one of the biggest killers in the world, with suicide rates varying between 8.1 and 58.3/100,000 population for different parts of India. Andhra Pradesh, the fourth largest state in India, is responsible for more than 11% of these. Unfortunately, most suicides are under-reported and there is scant data on attempted suicides. This study aimed to comprehensively study the characteristics of attempted suicides in Andhra Pradesh and using the primary data, make secondary projections for the forthcoming years. Using Patient Care Record (PCR) forms of all emergencies serviced by 108, the first comprehensive emergency service in India, an analysis of all cases was done to detect possible suicides during the period January-December 2007. A follow up 48 hours later was then done to confirm status and diagnosis. A total of 1007 cases were recorded as confirmed suicides. Hanging and insecticide poisoning (72%) were the most common methods used. Males preferred hanging and insecticide poisoning while females preferred self-immolation and hanging as common methods. Self-immolation and insecticide poisoning had the highest mortality (41.6%). Estimates of attempted suicides for the year 2008 revealed a mean of 3.2-3.8 per 1000 population for males, 3.3-3.7 per 1000 population for females and 6.4-7.6 per 1000 population combined. A serious epidemic of suicides seems to be in store in the coming years unless preventive steps in the form of policy changes are undertaken. Restricting access to poisonous substances or prescription drugs and taking into consideration the prevailing social, economic and cultural factors could help in reducing numbers. Starting tele-help services or offering brief interventions during hospital stays are other programs which may be considered.

  1. Lean in healthcare: A comprehensive review.

    Science.gov (United States)

    D'Andreamatteo, Antonio; Ianni, Luca; Lega, Federico; Sargiacomo, Massimo

    2015-09-01

    Lean seems to be the next revolution for a better, improved, value-based healhcare. In the last 15 years Lean has been increasingly adapted and adopted in healthcare. Accordingly, Lean healthcare has been developing into a major strand of research since the early 2000s. The aim of this work is to present a comprehensive overview of the main issues highlighted by research on implementation of Lean in a complex contest such as the healthcare one. Comprehensive literature review was conducted in order to identify empirical and theoretical articles published up to September 2013. Thematic analysis was performed in order to extract and synthesis data. 243 articles were selected for analysis. Lean is best understood as a means to increase productivity. Hospital is the more explored setting, with emergency and surgery as the pioneer departments. USA appears to be the leading country for number of applications. The theoretical works have been focused mainly on barriers, challenges and success factors. Sustainability, framework for measurement and critical appraisal remain underestimated themes. Evaluations of "system wide approach" are still low in number. Even though Lean results appear to be promising, findings so far do not allow to draw a final word on its positive impacts or challenges when introduced in the healthcare sector. Scholars are called to explore further the potentiality and the weaknesses of Lean, above all as for the magnitude of investments required and for the engagement of the whole organization it represents increasingly strategic choice, whilst health professionals, managers and policy makers could and should learn from research how to play a pivotal role for a more effective implementation of lean in different health contexts. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  2. Hospitalization of abused and neglected children.

    Science.gov (United States)

    Marshall, W N

    1997-03-01

    To describe the use of inpatient hospitalization for abused and neglected children living in a metropolitan area. Retrospective record review of abused and neglected children admitted in 1992 and 1993 to hospitals with 87% of metropolitan area pediatric admissions; comparison of these data with population, crisis nursery, and child protective services data. Thirty-four abused and neglected children were admitted to hospital, representing 0.3% (34/11,066; 95% confidence interval, 0%-1.2%) of pediatric admissions and 0.2% (34/19,950; 95% confidence interval, 0%-0.6%) of child protective services reports. This represents a rate of hospitalization for child abuse of 10 children (95% confidence interval, 0-46) per 100,000 child population per year. Seven hundred fifteen children were admitted to the crisis nursery by child protective services. Of those admitted to the hospital, 12 needed intensive care, 5 of whom died. Only 3 of 34 hospital-admitted children had private health insurance; 19 of 34 were younger than 1 year. Inpatient hospitalization for abuse represented a small fraction of total pediatric admissions and of child protective services reports. Comprehensive medical care for most abused children and medical education about child abuse must occur in outpatient settings.

  3. ELEMENTAL FORMS OF HOSPITALITY

    OpenAIRE

    Maximiliano Emanuel Korstanje

    2010-01-01

    Modern studies emphasized on the needs of researching the hospitality as relevant aspects of tourism and hospitality fields. Anyway, these approaches are inextricably intertwined to the industry of tourism and do not take seriously the anthropological and sociological roots of hospitality. In fact, the hotel seems to be a partial sphere of hospitality at all. Under this context, the present paper explores the issue of hospitality enrooted in the political and economic indo-European principle ...

  4. Development and validation of a score for evaluating comprehensive stroke care capabilities: J-ASPECT Study

    OpenAIRE

    Kada, Akiko; Nishimura, Kunihiro; Nakagawara, Jyoji; Ogasawara, Kuniaki; Ono, Junichi; Shiokawa, Yoshiaki; Aruga, Toru; Miyachi, Shigeru; Nagata, Izumi; Toyoda, Kazunori; Matsuda, Shinya; Suzuki, Akifumi; Kataoka, Hiroharu; Nakamura, Fumiaki; Kamitani, Satoru

    2017-01-01

    Background Although the Brain Attack Coalition recommended establishing centers of comprehensive care for stroke and cerebrovascular disease patients, a scoring system for such centers was lacking. We created and validated a comprehensive stroke center (CSC) score, adapted to Japanese circumstances. Methods Of the selected 1369 certified training institutions in Japan, 749 completed an acute stroke care capabilities survey. Hospital performance was determined using a 25-item score, evaluating...

  5. Hospitable Classrooms: Biblical Hospitality and Inclusive Education

    Science.gov (United States)

    Anderson, David W.

    2011-01-01

    This paper contributes to a Christian hermeneutic of special education by suggesting the biblical concept of hospitality as a necessary characteristic of classroom and school environments in which students with disabilities and other marginalized students can be effectively incorporated into the body of the classroom. Christian hospitality, seen…

  6. Hospitality Healthscapes: The New Standard for Making Hospitals More Hospitable

    Directory of Open Access Journals (Sweden)

    Courtney Suess Raeisinafchi

    2017-06-01

    Full Text Available What comes to mind when you think of a hospital room? Stark. Sterile. Bare. Clinical. What might it mean for patients if the association with the environment shifted to something like: Comforting. Bright. Elegant. Personal?

  7. A comprehensive nuclear test ban

    International Nuclear Information System (INIS)

    1985-01-01

    The conclusion of a comprehensive nuclear test ban is of critical importance for the future of arms limitation and disarmament. As the 1980 report of the Secretary-General concluded, a comprehensive nuclear test ban is regarded as the first and most urgent step towards the cessation of the nuclear arms race and, in particular, of its qualitative aspects. It could serve as an important measure for the non-proliferation of nuclear weapons, both vertical and horizontal. It would have a major arms limitation impact in that it would make it difficult, if not impossible, to develop new designs of nuclear weapons and would also place constraints on the modification of existing weapon designs. The permanent cessation of all nuclear-weapon tests has long been sought by the world community and its achievement would be an event of great international significance

  8. Comprehensive numerical modelling of tokamaks

    International Nuclear Information System (INIS)

    Cohen, R.H.; Cohen, B.I.; Dubois, P.F.

    1991-01-01

    We outline a plan for the development of a comprehensive numerical model of tokamaks. The model would consist of a suite of independent, communicating packages describing the various aspects of tokamak performance (core and edge transport coefficients and profiles, heating, fueling, magnetic configuration, etc.) as well as extensive diagnostics. These codes, which may run on different computers, would be flexibly linked by a user-friendly shell which would allow run-time specification of packages and generation of pre- and post-processing functions, including workstation-based visualization of output. One package in particular, the calculation of core transport coefficients via gyrokinetic particle simulation, will become practical on the scale required for comprehensive modelling only with the advent of teraFLOP computers. Incremental effort at LLNL would be focused on gyrokinetic simulation and development of the shell

  9. Emergency preparedness: a comprehensive plan

    International Nuclear Information System (INIS)

    Wilson, R.H.

    1975-01-01

    The Atlantic Richfield Hanford Company (ARHCO) has developed comprehensive plans for coping with emergencies ranging from criticality to civil disturbance. A unique notification system provides for immediate contact with key personnel by using a central communications center, crash alarm warning networks, and a continuing telephone cascade notification system. There is also the capability of immediately contacting other contractor key personnel. Certain jobs have been predetermined as necessary for coping with an emergency. An emergency staff consisting of responsible management, with alternates, has been preselected to automatically fill these jobs when notified. Control centers for headquarters and ''field'' are established with telephone and radio communication capabilities and are also supplied with some source materials to assist initiating plans for containing an emergency for recovery. A comprehensive emergency procedures manual has been developed, which contains information of company-wide application and procedures for specific facilities covering almost all accident situations

  10. Helping Students Develop Listening Comprehension

    Directory of Open Access Journals (Sweden)

    Cárdenas Beltrán Melba Libia

    2000-08-01

    Full Text Available Listening practice is often neglected or handled inappropriately in the teachinglearning process. This poses problem because listening is an integral part of conversations. Oral skills without equally welldeveloped listening abilities are of little practical value. In this article, I will take a look at issues related to the area of listening that may be considered when guiding students toward developing listening comprehension.

  11. Optimising Comprehensibility in Interlingual Translation

    DEFF Research Database (Denmark)

    Nisbeth Jensen, Matilde

    2015-01-01

    The increasing demand for citizen engagement in areas traditionally belonging exclusively to experts, such as health, law and technology has given rise to the necessity of making expert knowledge available to the general public through genres such as instruction manuals for consumer goods, patien...... the functional text type of Patient Information Leaflet. Finally, the usefulness of applying the principles of Plain Language and intralingual translation for optimising comprehensibility in interlingual translation is discussed....

  12. Cardiac rehabilitation: a comprehensive review

    OpenAIRE

    Lear, Scott A; Ignaszewski, Andrew

    2001-01-01

    Abstract Cardiac rehabilitation (CR) is a commonly used treatment for men and women with cardiovascular disease. To date, no single study has conclusively demonstrated a comprehensive benefit of CR. Numerous individual studies, however, have demonstrated beneficial effects such as improved risk-factor profile, slower disease progression, decreased morbidity, and decreased mortality. This paper will review the evidence for the use of CR and discuss the implications and limitations of these stu...

  13. Alarm management a comprehensive guide

    CERN Document Server

    Hollifield, Bill R

    2011-01-01

    In this second edition, Alarm Management: A Comprehensive Guide, various problems of alarm systems are covered with precise guidance on how they come about and how to effectively correct them. It is written by individuals with vast experience in the different plants, processes, and environments requiring effective alarm management. The second edition is filled with good examples and explanations of procedures, with practical lists and tips on how one should proceed. It is based on hundreds of successful projects.

  14. Comprehensive asymmetric dark matter model

    OpenAIRE

    Lonsdale, Stephen J.; Volkas, Raymond R.

    2018-01-01

    Asymmetric dark matter (ADM) is motivated by the similar cosmological mass densities measured for ordinary and dark matter. We present a comprehensive theory for ADM that addresses the mass density similarity, going beyond the usual ADM explanations of similar number densities. It features an explicit matter-antimatter asymmetry generation mechanism, has one fully worked out thermal history and suggestions for other possibilities, and meets all phenomenological, cosmological and astrophysical...

  15. A comprehensive radiology information system

    International Nuclear Information System (INIS)

    Jost, R.G.

    1985-01-01

    DECrad version II was recently tested by members of the Radiology Information System Consortium (RISC) and was found to meet the specifications prepared by the consortium. It is a comprehensive tailorable system that can be interfaced to practically any HIS. This paper provides an overall view of the major functions of the system which include registration, scheduling, tracking, film library management, reporting, statistics, and teaching modules. The evolution of the specification and user experiences is reported

  16. Hospital development plans: a new tool to break ground for strategic thinking in Tanzanian hospitals.

    Science.gov (United States)

    Flessa, Steffen

    2005-12-01

    Tanzanian hospitals suffer from underfunding and poor management. In particular, planning and strategic thinking need improvement. Cultural values such as subordination, risk aversion, and high time preference, together with a long history of socialist government, result in lack of responsibility, accountability, and planning. This has been addressed by the health sector reform with its focus on decentralization, strengthened by the introduction of basket funding facilitated by the Comprehensive Council Health Plans. As a consequence of this the next logical step is to improve the authority of regional and district hospitals in the use of their resources by introducing hospital development plans. These strategic plans were introduced as tools of strategic planning in 2001 by the Kreditanstalt für Wiederaufbau in close collaboration with the Tanzanian Ministry of Health, binding the release of rehabilitation funds to presentation of a strategic hospital plan. This study examines the rationale and content of hospital development plans. Initial experiences are discussed. The quality of presented plans has steadily improved, but there is a tendency for hospitals with a close connection to development partners to present well prepared reports while other hospitals have severe problems fulfilling the requirements. For many hospitals it is in fact the first time that they have had to define their functions and future role, thus breaking ground for strategic thinking.

  17. Comprehensive update on cancer scenario of Bangladesh

    Directory of Open Access Journals (Sweden)

    Syed Md Akram Hussain

    2013-01-01

    Full Text Available Bangladesh, at 142 million people, is the ninth most populous country in the world. There are 13 to 15 lakh cancer patients in Bangladesh, with about two lakh patients newly diagnosed with cancer each year. As an overview, lung cancer and mouth-oropharynx cancer rank as the top two prevalent cancers in males. Other types of cancers are esophagus cancer and stomach cancer. In women, cancer cervix uteri and breast cancer are most prevalent. Other cancer types, which affect women, are mouth and oropharynx cancer, lung cancer, and esophagus cancer. There are around 150 qualified clinical oncologists and 16 pediatric oncologists working in the different parts of the country. Regular cancer treatment is available in 19 hospitals and 465 hospital beds are attached as indoor or day care facilities for chemotherapy in the oncology/radiotherapy departments. There are about 15 linear accelerators, 12 Co-60 teletherapy and 12 brachytherapy units currently available. Approximately, 56 cancer chemotherapeutic agents are obtainable in Bangladesh. Research facilities are available at tertiary care centers and a few multi country collaborative research activities are ongoing. Bangladesh has a unique National Cancer Control Strategy and Plan of Action 2009-2015 formulated with the assistance of WHO with an objective to develop and implement continuum of cancer care through a comprehensive cancer control programe. Preventive measures taken to reduce the incidence of cancer include reduced tobacco smoking, change of dietary habit and reduced food adulteration, ensuring reproductive hygiene, increased physical activity, and reduced occupational hazard. Awareness buildup and media campaign are going on by organizing the general people, opinion leaders of the society, and boy and girl scout. Training of general physicians on cancer warning signs and setup of early cancer detection centers at each medical college and district levels are ongoing. Beside these, some

  18. 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.

  19. Neuronal basis of speech comprehension.

    Science.gov (United States)

    Specht, Karsten

    2014-01-01

    Verbal communication does not rely only on the simple perception of auditory signals. It is rather a parallel and integrative processing of linguistic and non-linguistic information, involving temporal and frontal areas in particular. This review describes the inherent complexity of auditory speech comprehension from a functional-neuroanatomical perspective. The review is divided into two parts. In the first part, structural and functional asymmetry of language relevant structures will be discus. The second part of the review will discuss recent neuroimaging studies, which coherently demonstrate that speech comprehension processes rely on a hierarchical network involving the temporal, parietal, and frontal lobes. Further, the results support the dual-stream model for speech comprehension, with a dorsal stream for auditory-motor integration, and a ventral stream for extracting meaning but also the processing of sentences and narratives. Specific patterns of functional asymmetry between the left and right hemisphere can also be demonstrated. The review article concludes with a discussion on interactions between the dorsal and ventral streams, particularly the involvement of motor related areas in speech perception processes, and outlines some remaining unresolved issues. This article is part of a Special Issue entitled Human Auditory Neuroimaging. Copyright © 2013 Elsevier B.V. All rights reserved.

  20. Comprehensive treatment of generalized parodontitis.

    Science.gov (United States)

    Mdinaradze, N

    2006-06-01

    The complexity of pathogenesis of periodontitis makes the use of comprehensive treatment necessary. We observed 60 patients, 20 women and 40 men among them aged from 20 to 50. In the course of parodontitis, we determined the intensity of inflammatory-destructive changes (Pi) in the course of periodontitis, the degree of fang denudation, the depth of gum and parodontal recesses, degree of the teeth becoming loose; we conducted the microbiological study of the oral cavity microflora and drew up an antibiotic graph. We included laser therapy in the comprehensive treatment course of generalized parodontitis. We divided the patients into two groups. The patients of the first group were treated in two stages. We used peridex, composed of chlorhexidine for antiseptic treatment of oral cavity. We used a combined solution of sage, eucalyptus, camomile and calendula to irrigate the oral cavity. At the second stage we used ointment applications with the composition of 3% indometacin, heparin, vitamins, sea-buckthorn oil and antibiotics. In the course of comprehensive treatment of the patients of the II group we included laser therapy. Our interest in the laser beam, as in the means of parodontitis treatment was stimulated by a number of properties of the laser beam and namely, its anti-inflammatory, desensitizing and antibacterial action promotes intensifying the reparation processes and does not entail any complications. The mentioned method has produced the best therapeutic results and has resulted in the reduced treatment period.

  1. Comprehensive care of elderly patients with hip fracture: the orthogeriatric model

    OpenAIRE

    Carlo Frondini; Maria L. Lunardelli

    2013-01-01

    Introduction: Hip fractures in the elderly are a major source of morbidity and mortality. Interdisciplinary hospital care models proposed for the treatment of these patients include consultant teams, integrated orthopedic-geriatric care, and comprehensive geriatric-led care settings. A prospective interventional cohort study was conducted in 4 public hospitals in the Emilia-Romagna Region of Italy to compare the outcomes of these different care models. This report presents the preliminary res...

  2. Community Hospital Telehealth Consortium

    National Research Council Canada - National Science Library

    Williams, Elton

    2004-01-01

    The Community Hospital Telehealth Consortium is a unique, forward-thinking, community-based healthcare service project organized around 5 not-for-profit community hospitals located throughout Louisiana and Mississippi...

  3. The interstices of hospitality

    African Journals Online (AJOL)

    jane.b

    School of Hospitality and Tourism, Anhembi Morumbi University, São Paulo, Brazil ... aspects of hospitality, and the approach of the social sciences, which study the dynamics of ..... in the virtual media, the ritual always begins with an invitation.

  4. Community Hospital Telehealth Consortium

    National Research Council Canada - National Science Library

    Williams, Elton

    2003-01-01

    The Community Hospital Telehealth Consortium is a unique, forward-thinking, community-based healthcare service project organized around 5 not-for-profit community hospitals located throughout Louisiana and Mississippi...

  5. Unplanned Hospital Visits - National

    Data.gov (United States)

    U.S. Department of Health & Human Services — Unplanned Hospital Visits – national data. This data set includes national-level data for the hospital return days (or excess days in acute care) measures, the...

  6. The Hospitable Meal Model

    DEFF Research Database (Denmark)

    Justesen, Lise; Overgaard, Svend Skafte

    2017-01-01

    This article presents an analytical model that aims to conceptualize how meal experiences are framed when taking into account a dynamic understanding of hospitality: the meal model is named The Hospitable Meal Model. The idea behind The Hospitable Meal Model is to present a conceptual model...... that can serve as a frame for developing hospitable meal competencies among professionals working within the area of institutional foodservices as well as a conceptual model for analysing meal experiences. The Hospitable Meal Model transcends and transforms existing meal models by presenting a more open......-ended approach towards meal experiences. The underlying purpose of The Hospitable Meal Model is to provide the basis for creating value for the individuals involved in institutional meal services. The Hospitable Meal Model was developed on the basis of an empirical study on hospital meal experiences explored...

  7. Structural Measures - Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of hospitals and the structural measures they report. A structural measure reflects the environment in which hospitals care for patients, for example, whether...

  8. Hospital Compare - Archived Data

    Data.gov (United States)

    U.S. Department of Health & Human Services — Hospital Compare is a consumer-oriented website that provides information on how well hospitals provide recommended care to their patients. This information can help...

  9. Research in Hospitality Management

    African Journals Online (AJOL)

    Research in Hospitality Management (RHM) is a peer-reviewed journal ... to the quintessential managerial areas of Finance, Human Resources, Operations, ... competency and career development of hospitality management students · EMAIL ...

  10. Community Hospital Telehealth Consortium

    National Research Council Canada - National Science Library

    Williams, Jr, Elton L

    2007-01-01

    The Community Hospital Telehealth Consortium is a unique, forward-thinking, community-based healthcare service project organized around 5 not-for-profit community hospitals located throughout Louisiana and Mississippi...

  11. Hospital wastes management containing in radioactive refusals

    International Nuclear Information System (INIS)

    Campi, F.

    1999-01-01

    In large hospitals, featuring a nuclear medicine department, diagnostic examinations and metabolic therapies are performed using an amount of radio drugs per day averaging around some hundreds mCi. Part of these drugs are disposed in the conventional patient related waste and collected within the hospital itself. Before directing the wastes to the disposal, it is necessary verify that they do not contain radioactive materials. This article refers a study on the possibility to perform this verification by means of an automatic radio-metric system, in order to improve the efficiency, the speed and the safety of the control. Measures devoted to determined the minimum detectable activities for the main radionuclides used in the hospitals have been executed, and it has been designed a comprehensive device able to operate automatically, and unattended by any operator, the selection of radioactive refusals [it

  12. Nurses' hospital orientation and future research challenges: an integrative review.

    Science.gov (United States)

    Peltokoski, J; Vehviläinen-Julkunen, K; Miettinen, M

    2016-03-01

    This study aimed to describe the research on registered nurses' orientation processes in specialized hospital settings in order to illustrate directions for future research. The complex healthcare environment and the impact of nursing shortage and turnover make the hospital orientation process imperative. There is a growing recognition regarding research interests to meet the needs for evidence-based, effective and economically sound hospital orientation strategies. An integrative literature review was performed on publications from the period 2000 to 2013 included in the CINAHL and PubMed databases. English-language studies were included. Themes guiding the analysis were definition of the hospital orientation process, research topics, data collection and instruments and research evidence. Narrative synthesis was used. Eleven papers met the inclusion criteria. The conceptualization of orientation process reflected the complexity of the phenomenon. Less attention has been paid to designs to establish correlations or relationships between selected variables and hospital orientation process. The outcomes of hospital orientation programmes were limited primarily to retention and job satisfaction. The research evidence therefore cannot be evaluated as strong. The lack of an evidence-based approach makes it difficult to develop a comprehensive orientation process. Further research should explore interventions that will enhance the quality of hospital orientation practices to improve nurses' retention and job satisfaction. To provide a comprehensive hospital orientation process, hospital administrators have to put in place human resource development strategies along with practice implications and research efforts. Comprehensive hospital orientation benefits and outcomes should be visible to policy makers. © 2016 International Council of Nurses.

  13. Hospital information systems: experience at the fully digitized Seoul National University Bundang Hospital.

    Science.gov (United States)

    Yoo, Sooyoung; Hwang, Hee; Jheon, Sanghoon

    2016-08-01

    The different levels of health information technology (IT) adoption and its integration into hospital workflow can affect the maximization of the benefits of using of health IT. We aimed at sharing our experiences and the journey to the successful adoption of health IT over 13 years at a tertiary university hospital in South Korea. The integrated system of comprehensive applications for direct care, support care, and smart care has been implemented with the latest IT and a rich user information platform, achieving the fully digitized hospital. The users experience design methodology, barcode and radio-frequency identification (RFID) technologies, smartphone and mobile technologies, and data analytics were integrated into hospital workflow. Applications for user-centered electronic medical record (EMR) and clinical decision support (CDS), closed loop medication administration (CLMA), mobile EMR and dashboard system for care coordination, clinical data warehouse (CDW) system, and patient engagement solutions were designed and developed to improve quality of care, work efficiency, and patient safety. We believe that comprehensive electronic health record systems and patient-centered smart hospital applications will go a long way in ensuring seamless patient care and experience.

  14. Medicare Hospital Spending Per Patient - Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — The "Medicare hospital spending per patient (Medicare Spending per Beneficiary)" measure shows whether Medicare spends more, less or about the same per Medicare...

  15. Hospitality and prosumption | Ritzer | Research in Hospitality ...

    African Journals Online (AJOL)

    Research in Hospitality Management. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 5, No 1 (2015) >. Log in or Register to get access to full text downloads.

  16. A comprehensive outlook of Sannipata

    Science.gov (United States)

    Panja, Asit K; Chattopadhyaya, Abichal; Chaudhuri, Supriyo

    2011-01-01

    Nomenclature of the disease on the basis of vitiation of the body humors is stressed in ayurveda. Sannipatika, i.e., ‘conglomeration of vitiated tridosa’ is the final stage of process of manifestation of disease. In this specific state of pathogenesis, the disease becomes more advance and mostly irreversible. A detailed scientific study of Sannipatika-avastha has been documented in classics. Comprehensive analysis of sannipata-state and its ways of presentation is the main theme of the current article. PMID:22408295

  17. NRC comprehensive records disposition schedule

    International Nuclear Information System (INIS)

    1982-07-01

    Effective January 1, 1982, NRC will institute records retention and disposal practices in accordance with the approved Comprehensive Records Disposition Schedule (CRDS). CRDS is comprised of NRC Schedules (NRCS) 1 to 4 which apply to the agency's program or substantive records and General Records Schedules (GRS) 1 to 22 which apply to housekeeping or facilitative records. The schedules are assembled functionally/organizationally to facilitate their use. Preceding the records descriptions and disposition instructions for both NRCS and GRS, there are brief statements on the organizational units which accumulate the records in each functional area, and other information regarding the schedules' applicability

  18. A Comprehensive Theory of Integration.

    Science.gov (United States)

    Singer, Sara J; Kerrissey, Michaela; Friedberg, Mark; Phillips, Russell

    2018-03-01

    Efforts to transform health care delivery to improve care have increasingly focused on care integration. However, variation in how integration is defined has complicated efforts to design, synthesize, and compare studies of integration in health care. Evaluations of integration initiatives would be enhanced by describing them according to clear definitions of integration and specifying which empirical relationships they seek to test-whether among types of integration or between integration and outcomes of care. Drawing on previous work, we present a comprehensive theoretical model of relationships between types of integration and propose how to measure them.

  19. Comprehensive management of project changes

    Directory of Open Access Journals (Sweden)

    Aljaž Stare

    2010-06-01

    Full Text Available The goal of this research was to examine how project changes can be prevented, and how to reduce their negative impact. Theoretical research examined risk management, project control and change management. Based on the study a “Comprehensive Change Management Model” was developed and verified after conducting empirical research in Slovenian enterprises. The research confirmed that risk management identifies possible changes and reduces their impact; project control ensures the timely detection of changes and an efficient response, while formal change management ensures the effective implementation of changes. The combined functioning of all three areas ensures effective project execution.

  20. On the importance of listening comprehension.

    Science.gov (United States)

    Hogan, Tiffany P; Adlof, Suzanne M; Alonzo, Crystle N

    2014-06-01

    The simple view of reading highlights the importance of two primary components which account for individual differences in reading comprehension across development: word recognition (i.e., decoding) and listening comprehension. While assessments and interventions for decoding have been the focus of pedagogy in the past several decades, the importance of listening comprehension has received less attention. This paper reviews evidence showing that listening comprehension becomes the dominating influence on reading comprehension starting even in the elementary grades. It also highlights a growing number of children who fail to develop adequate reading comprehension skills, primarily due to deficient listening comprehension skills (i.e., poor comprehenders). Finally we discuss key language influences on listening comprehension for consideration during assessment and treatment of reading disabilities.

  1. Production Practice During Language Learning Improves Comprehension.

    Science.gov (United States)

    Hopman, Elise W M; MacDonald, Maryellen C

    2018-04-01

    Language learners often spend more time comprehending than producing a new language. However, memory research suggests reasons to suspect that production practice might provide a stronger learning experience than comprehension practice. We tested the benefits of production during language learning and the degree to which this learning transfers to comprehension skill. We taught participants an artificial language containing multiple linguistic dependencies. Participants were randomly assigned to either a production- or a comprehension-learning condition, with conditions designed to balance attention demands and other known production-comprehension differences. After training, production-learning participants outperformed comprehension-learning participants on vocabulary comprehension and on comprehension tests of grammatical dependencies, even when we controlled for individual differences in vocabulary learning. This result shows that producing a language during learning can improve subsequent comprehension, which has implications for theories of memory and learning, language representations, and educational practices.

  2. How Do We Motivate Reading Comprehension?

    Science.gov (United States)

    Shanahan, Timothy

    1982-01-01

    Considers the nature of motivation and its place in the development of reading comprehension. Uses A. Maslow's hierarchy of motivation as a heuristic for examining the motivational quality of several teaching methods commonly proposed for comprehension instruction. (FL)

  3. Service Robots for Hospitals

    DEFF Research Database (Denmark)

    Özkil, Ali Gürcan

    services to maintain the quality of healthcare provided. This thesis and the Industrial PhD project aim to address logistics, which is the most resource demanding service in a hospital. The scale of the transportation tasks is huge and the material flow in a hospital is comparable to that of a factory. We......Hospitals are complex and dynamic organisms that are vital to the well-being of societies. Providing good quality healthcare is the ultimate goal of a hospital, and it is what most of us are only concerned with. A hospital, on the other hand, has to orchestrate a great deal of supplementary...... believe that these transportation tasks, to a great extent, can be and will be automated using mobile robots. This thesis consequently addresses the key technical issues of implementing service robots in hospitals. In simple terms, a robotic system for automating hospital logistics has to be reliable...

  4. Hospitality and Institutional Meals

    DEFF Research Database (Denmark)

    Justesen, Lise; Strøjer, Anna-Lise

    2017-01-01

    Abstract: There is a growing interest in articulating institutional meal serving practices as a hospitality activity involving host and guest interactions. This study aims to qualify institutional hospitality and meal activities by exploring private hospitality events. The study is based......-structured interview, students reflected on their hospitality experiences. The interviews were transcribed and analyzed using a thematic analysis method. The emerging themes on hospitality activities were identified. It was found that hospitality activities could be characterized as a process where the individual...... was transformed into a guest. Information on purpose of the event and other information given in the invitation were part of this process. Furthermore, hospitality activities could be characterized by blurred host-guest relations and by being able to embrace unexpected events as well. The activities were...

  5. Hospital turnaround strategies.

    Science.gov (United States)

    Langabeer, James

    2008-01-01

    Despite reports of higher profitability in recent years, hospitals are failing at a faster rate than ever before. Although many hospitals leave decisions regarding revenues and costs to chief financial officers and their staff, this is a recipe for disaster. From research conducted over the last 4 years on hospital bankruptcies and turnarounds, the author found that a common series of actions will help organizations evade collapse. The author explored these turnaround strategies through research and analysis of a variety of hospitals and health systems that had a high probability of immediate financial crisis or collapse. His continued observation and analysis of these hospitals in subsequent years showed that most hospitals never emerge from their bleak financial conditions. However, a few hospital administrations have successfully turned around their organizations.

  6. ELEMENTAL FORMS OF HOSPITALITY

    Directory of Open Access Journals (Sweden)

    Maximiliano Emanuel Korstanje

    2010-11-01

    Full Text Available Modern studies emphasized on the needs of researching the hospitality as relevant aspects of tourism and hospitality fields. Anyway, these approaches are inextricably intertwined to the industry of tourism and do not take seriously the anthropological and sociological roots of hospitality. In fact, the hotel seems to be a partial sphere of hospitality at all. Under this context, the present paper explores the issue of hospitality enrooted in the political and economic indo-European principle of free-transit which is associated to a much broader origin.  Starting from the premise etymologically hostel and hospital share similar origins, we follow the contributions of J Derrida to determine the elements that formed the hospitality up to date.

  7. Text comprehension strategy instruction with poor readers

    NARCIS (Netherlands)

    Van den Bos, K.P.; Aarnoudse, C.C.; Brand-Gruwel, S.

    1998-01-01

    The goal of this study was to investigate the effects of teaching text comprehension strategies to children with decoding and reading comprehension problems and with a poor or normal listening ability. Two experiments are reported. Four text comprehension strategies, viz., question generation,

  8. Classroom Talk for Rigorous Reading Comprehension Instruction

    Science.gov (United States)

    Wolf, Mikyung Kim; Crosson, Amy C.; Resnick, Lauren B.

    2004-01-01

    This study examined the quality of classroom talk and its relation to academic rigor in reading-comprehension lessons. Additionally, the study aimed to characterize effective questions to support rigorous reading comprehension lessons. The data for this study included 21 reading-comprehension lessons in several elementary and middle schools from…

  9. Idiom Comprehension in Mandarin-Speaking Children

    Science.gov (United States)

    Hsieh, Shelley Ching-Yu; Hsu, Chun-Chieh Natalie

    2010-01-01

    This study examines the effect of familiarity, context, and linguistic convention on idiom comprehension in Mandarin speaking children. Two experiments (a comprehension task followed by a comprehension task coupled with a metapragmatic task) were administered to test participants in three age groups (6 and 9-year-olds, and an adult control group).…

  10. 18 CFR 801.5 - Comprehensive plan.

    Science.gov (United States)

    2010-04-01

    ... 18 Conservation of Power and Water Resources 2 2010-04-01 2010-04-01 false Comprehensive plan. 801... POLICIES § 801.5 Comprehensive plan. (a) The Compact requires that the Commission formulate and adopt a comprehensive plan for the immediate and long-range development and use of the water resources of the basin. (1...

  11. Comprehension or comprehending? Using Critical Language ...

    African Journals Online (AJOL)

    It is argued that the genre of the school reading comprehension exercise is a prime inculcator of thoughtless and non-interactive reading practices. Doing 'a comprehension' (the word is often nominalised in this manner) and answering the comprehension questions often 'counts as' reading and substitutes for other types of ...

  12. 16 CFR 1018.43 - Comprehensive review.

    Science.gov (United States)

    2010-01-01

    ... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Comprehensive review. 1018.43 Section 1018.43 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION GENERAL ADVISORY COMMITTEE MANAGEMENT Records, Annual Reports and Audits § 1018.43 Comprehensive review. A comprehensive review of all...

  13. NRC comprehensive records disposition schedule

    International Nuclear Information System (INIS)

    1992-03-01

    Title 44 United States Code, ''Public Printing and Documents,'' regulations cited in the General Services Administration's (GSA) ''Federal Information Resources Management Regulations'' (FIRMR), Part 201-9, ''Creation, Maintenance, and Use of Records,'' and regulation issued by the National Archives and Records Administration (NARA) in 36 CFR Chapter XII, Subchapter B, ''Records Management,'' require each agency to prepare and issue a comprehensive records disposition schedule that contains the NARA approved records disposition schedules for records unique to the agency and contains the NARA's General Records Schedules for records common to several or all agencies. The approved records disposition schedules specify the appropriate duration of retention and the final disposition for records created or maintained by the NRC. NUREG-0910, Rev. 2, contains ''NRC's Comprehensive Records Disposition Schedule,'' and the original authorized approved citation numbers issued by NARA. Rev. 2 totally reorganizes the records schedules from a functional arrangement to an arrangement by the host office. A subject index and a conversion table have also been developed for the NRC schedules to allow staff to identify the new schedule numbers easily and to improve their ability to locate applicable schedules

  14. Prediction During Natural Language Comprehension.

    Science.gov (United States)

    Willems, Roel M; Frank, Stefan L; Nijhof, Annabel D; Hagoort, Peter; van den Bosch, Antal

    2016-06-01

    The notion of prediction is studied in cognitive neuroscience with increasing intensity. We investigated the neural basis of 2 distinct aspects of word prediction, derived from information theory, during story comprehension. We assessed the effect of entropy of next-word probability distributions as well as surprisal A computational model determined entropy and surprisal for each word in 3 literary stories. Twenty-four healthy participants listened to the same 3 stories while their brain activation was measured using fMRI. Reversed speech fragments were presented as a control condition. Brain areas sensitive to entropy were left ventral premotor cortex, left middle frontal gyrus, right inferior frontal gyrus, left inferior parietal lobule, and left supplementary motor area. Areas sensitive to surprisal were left inferior temporal sulcus ("visual word form area"), bilateral superior temporal gyrus, right amygdala, bilateral anterior temporal poles, and right inferior frontal sulcus. We conclude that prediction during language comprehension can occur at several levels of processing, including at the level of word form. Our study exemplifies the power of combining computational linguistics with cognitive neuroscience, and additionally underlines the feasibility of studying continuous spoken language materials with fMRI. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  15. Beyond Grand Rounds: A Comprehensive and Sequential Intervention to Improve Identification of Delirium

    Science.gov (United States)

    Ramaswamy, Ravishankar; Dix, Edward F.; Drew, Janet E.; Diamond, James J.; Inouye, Sharon K.; Roehl, Barbara J. O.

    2011-01-01

    Purpose of the Study: Delirium is a widespread concern for hospitalized seniors, yet is often unrecognized. A comprehensive and sequential intervention (CSI) aiming to effect change in clinician behavior by improving knowledge about delirium was tested. Design and Methods: A 2-day CSI program that consisted of progressive 4-part didactic series,…

  16. Comprehensive primary health care under neo-liberalism in Australia.

    Science.gov (United States)

    Baum, Fran; Freeman, Toby; Sanders, David; Labonté, Ronald; Lawless, Angela; Javanparast, Sara

    2016-11-01

    This paper applies a critical analysis of the impact of neo-liberal driven management reform to examine changes in Australian primary health care (PHC) services over five years. The implementation of comprehensive approaches to primary health care (PHC) in seven services: five state-managed and two non-government organisations (NGOs) was tracked from 2009 to 2014. Two questions are addressed: 1) How did the ability of Australian PHC services to implement comprehensive PHC change over the period 2009-2014? 2) To what extent is the ability of the PHC services to implement comprehensive PHC shaped by neo-liberal health sector reform processes? The study reports on detailed tracking and observations of the changes and in-depth interviews with 63 health service managers and practitioners, and regional and central health executives. The documented changes were: in the state-managed services (although not the NGOs) less comprehensive service coverage and more focus on clinical services and integration with hospitals and much less development activity including community development, advocacy, intersectoral collaboration and attention to the social determinants. These changes were found to be associated with practices typical of neo-liberal health sector reform: considerable uncertainty, more directive managerial control, budget reductions and competitive tendering and an emphasis on outputs rather than health outcomes. We conclude that a focus on clinical service provision, while highly compatible with neo-liberal reforms, will not on its own produce the shifts in population disease patterns that would be required to reduce demand for health services and promote health. Comprehensive PHC is much better suited to that task. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  17. Listening Comprehension in Middle-Aged Adults.

    Science.gov (United States)

    Sommers, Mitchell S

    2015-06-01

    The purpose of this summary is to examine changes in listening comprehension across the adult lifespan and to identify factors associated with individual differences in listening comprehension. In this article, the author reports on both cross-sectional and longitudinal changes in listening comprehension. Despite significant declines in both sensory and cognitive abilities, listening comprehension remains relatively unchanged in middle-aged listeners (between the ages of 40 and 60 years) compared with young listeners. These results are discussed with respect to possible compensatory factors that maintain listening comprehension despite impaired hearing and reduced cognitive capacities.

  18. Hospital diversification strategy.

    Science.gov (United States)

    Eastaugh, Steven R

    2014-01-01

    To determine the impact of health system restructuring on the levels of hospital diversification and operating ratio this article analyzed 94 teaching hospitals and 94 community hospitals during the period 2008-2013. The 47 teaching hospitals are matched with 47 other teaching hospitals experiencing the same financial market position in 2008, but with different levels of preference for risk and diversification in their strategic plan. Covariates in the analysis included levels of hospital competition and the degree of local government planning (for example, highly regulated in New York, in contrast to Texas). Moreover, 47 nonteaching community hospitals are matched with 47 other community hospitals in 2008, having varying manager preferences for service-line diversification and risk. Diversification and operating ratio are modeled in a two-stage least squares (TSLS) framework as jointly dependent. Institutional diversification is found to yield better financial position, and the better operating profits provide the firm the wherewithal to diversify. Some services are in a growth phase, like bariatric weight-loss surgery and sleep disorder clinics. Hospital managers' preferences for risk/return potential were considered. An institution life cycle hypothesis is advanced to explain hospital behavior: boom and bust, diversification, and divestiture, occasionally leading to closure or merger.

  19. Nursing supervision for care comprehensiveness.

    Science.gov (United States)

    Chaves, Lucieli Dias Pedreschi; Mininel, Vivian Aline; Silva, Jaqueline Alcântara Marcelino da; Alves, Larissa Roberta; Silva, Maria Ferreira da; Camelo, Silvia Helena Henriques

    2017-01-01

    To reflect on nursing supervision as a management tool for care comprehensiveness by nurses, considering its potential and limits in the current scenario. A reflective study based on discourse about nursing supervision, presenting theoretical and practical concepts and approaches. Limits on the exercise of supervision are related to the organization of healthcare services based on the functional and clinical model of care, in addition to possible gaps in the nurse training process and work overload. Regarding the potential, researchers emphasize that supervision is a tool for coordinating care and management actions, which may favor care comprehensiveness, and stimulate positive attitudes toward cooperation and contribution within teams, co-responsibility, and educational development at work. Nursing supervision may help enhance care comprehensiveness by implying continuous reflection on including the dynamics of the healthcare work process and user needs in care networks. refletir a supervisão de enfermagem como instrumento gerencial do enfermeiro para integralidade do cuidado, considerando suas potencialidades e limitações no cenário atual. estudo reflexivo baseado na formulação discursiva sobre a supervisão de enfermagem, apresentando conceitos e enfoques teóricos e/ou práticos. limitações no exercício da supervisão estão relacionadas à organização dos serviços de saúde embasada no modelo funcional e clínico de atenção, assim como possíveis lacunas no processo de formação do enfermeiro e sobrecarga de trabalho. Quanto às potencialidades, destaca-se a supervisão como instrumento de articulação de ações assistenciais e gerenciais, que pode favorecer integralidade da atenção, estimular atitudes de cooperação e colaboração em equipe, além da corresponsabilização e promoção da educação no trabalho. supervisão de enfermagem pode contribuir para fortalecimento da integralidade do cuidado, pressupondo reflexão cont

  20. [Hospital financing in 2016. Relevant changes for rheumatology].

    Science.gov (United States)

    Fiori, W; Bunzemeier, H; Lakomek, H-J; Buscham, K; Lehmann, H; Fuchs, A-K; Bessler, F; Roeder, N

    2016-03-01

    Hospital financing 2016 will be influenced by the prospects of the approaching considerable changes. It is assumed that the following years will lead to a considerable reallocation of financial resources between hospitals. While not directly targeted by new regulations, reallocations always also affect specialties like rheumatology. Compared to the alterations in the legislative framework the financial effects of the yearly adaptation of the German diagnosis-related groups system are subordinate. Only by comprehensive consideration of current and expected changes a forward-looking and sustainable strategy can be developed. The following article presents the relevant changes and discusses the consequences for hospitals specialized in rheumatology.

  1. Comprehensive care improves health outcomes among elderly Taiwanese patients with hip fracture.

    Science.gov (United States)

    Shyu, Yea-Ing L; Liang, Jersey; Tseng, Ming-Yueh; Li, Hsiao-Juan; Wu, Chi-Chuan; Cheng, Huey-Shinn; Yang, Ching-Tzu; Chou, Shih-Wei; Chen, Ching-Yen

    2013-02-01

    Few studies have investigated the effects of care models that combine interdisciplinary care with nutrition consultation, depression management, and fall prevention in older persons with hip fracture. The purpose of this study was to compare the effects of a comprehensive care program with those of interdisciplinary care and usual care for elderly patients with hip fracture. A randomized experimental trial was used to explore outcomes for 299 elderly patients with hip fracture receiving three treatment care models: interdisciplinary care (n = 101), comprehensive care (n = 99), and usual care (n = 99). Interdisciplinary care included geriatric consultation, continuous rehabilitation, and discharge planning with post-hospital services. Comprehensive care consisted of interdisciplinary care plus nutrition consultation, depression management, and fall prevention. Usual care included only in-hospital rehabilitation without geriatric consultation, in-home rehabilitation, and home environmental assessment. Participants in the comprehensive care group had better self-care ability (odds ratio, OR = 3.19, p malnutrition (OR = 0.48, p hip fracture benefitted more from the comprehensive care program than from interdisciplinary care and usual care. Older persons with hip fracture benefitted more from comprehensive care including interdisciplinary care and nutrition consultation, depression management, and fall prevention than simply interdisciplinary care.

  2. Hospital utilization and aging in Spain (2006).

    Science.gov (United States)

    Moreno-Millán, Emilio; Molina-Morales, Agustin; Amate-Fortes, Ignacio

    2010-07-01

    The main objective of this study is to verify the existence of a direct relation between age, ageing and hospital resources utilization. For this purpose, we use not only population variables, but also clinical parameters such as severity and complexity, as proxy of consumption and hospital costs. Through a comprehensive statistical analysis, quantitative variables of the Spanish Minimum Data Set of year 2006 (length of stay, relative weight, number of diagnoses and procedures) according to age groups and gender, types of admission (emergency or scheduled) and discharge (alive or dead), measuring the severity by weight, complications, comorbidities and mortality, and complexity by weight and length of stay. The highest severity was observed in 65-69 year-old males and the highest complexity in 75-79 year-old males and 85-89 year-old females (p<.0001). The severity and complexity are also higher among 65-69 year-old males and 70-79 year-old patients of both sexes with emergency access (p<.0001). The deceased patients are more aged with higher severity and complexity than the survivors (p<.0001). The age per se is not directly related to consumption of hospital resources. Therefore, aging does not necessarily imply higher consumption or increased hospital costs. Emergency admitted in-patients are older and more severe and complex than the scheduled ones, thus consuming more resources and implying higher hospital costs; the same is true for the deceased versus the survivors.

  3. Strategic planning processes and hospital financial performance.

    Science.gov (United States)

    Kaissi, Amer A; Begun, James W

    2008-01-01

    Many common management practices in healthcare organizations, including the practice of strategic planning, have not been subject to widespread assessment through empirical research. If management practice is to be evidence-based, evaluations of such common practices need to be undertaken. The purpose of this research is to provide evidence on the extent of strategic planning practices and the association between hospital strategic planning processes and financial performance. In 2006, we surveyed a sample of 138 chief executive officers (CEOs) of hospitals in the state of Texas about strategic planning in their organizations and collected financial information on the hospitals for 2003. Among the sample hospitals, 87 percent reported having a strategic plan, and most reported that they followed a variety of common practices recommended for strategic planning-having a comprehensive plan, involving physicians, involving the board, and implementing the plan. About one-half of the hospitals assigned responsibility for the plan to the CEO. We tested the association between these planning characteristics in 2006 and two measures of financial performance for 2003. Three dimensions of the strategic planning process--having a strategic plan, assigning the CEO responsibility for the plan, and involving the board--are positively associated with earlier financial performance. Further longitudinal studies are needed to evaluate the cause-and-effect relationship between planning and performance.

  4. Probability theory a comprehensive course

    CERN Document Server

    Klenke, Achim

    2014-01-01

    This second edition of the popular textbook contains a comprehensive course in modern probability theory. Overall, probabilistic concepts play an increasingly important role in mathematics, physics, biology, financial engineering and computer science. They help us in understanding magnetism, amorphous media, genetic diversity and the perils of random developments at financial markets, and they guide us in constructing more efficient algorithms.   To address these concepts, the title covers a wide variety of topics, many of which are not usually found in introductory textbooks, such as:   • limit theorems for sums of random variables • martingales • percolation • Markov chains and electrical networks • construction of stochastic processes • Poisson point process and infinite divisibility • large deviation principles and statistical physics • Brownian motion • stochastic integral and stochastic differential equations. The theory is developed rigorously and in a self-contained way, with the c...

  5. Understanding peace a comprehensive introduction

    CERN Document Server

    Fox, Michael Allen

    2013-01-01

    Understanding Peace: A Comprehensive Introduction fills the need for an original, contemporary examination of peace that is challenging, informative, and empowering. This well-researched, fully documented, and highly accessible textbook moves beyond fixation on war to highlight the human capacity for nonviolent cooperation in everyday life and in conflict situations. After deconstructing numerous ideas about war and explaining its heavy costs to humans, animals, and the environment, discussion turns to evidence for the existence of peaceful societies. Further topics include the role of nonviolence in history, the nature of violence and aggression, and the theory and practice of nonviolence. The book offers two new moral arguments against war, and concludes by defining peace carefully from different angles and then describing conditions for creating a culture of peace. Understanding Peace brings a fresh philosophical perspective to discussions of peace, and also addresses down-to-earth issues about effecting ...

  6. Building Information Modeling Comprehensive Overview

    Directory of Open Access Journals (Sweden)

    Sergey Kalinichuk

    2015-07-01

    Full Text Available The article is addressed to provide a comprehensive review on recently accelerated development of the Information Technology within project market such as industrial, engineering, procurement and construction. Author’s aim is to cover the last decades of the growth of the Information and Communication Technology in construction industry in particular Building Information Modeling and testifies that the problem of a choice of the effective project realization method not only has not lost its urgency, but has also transformed into one of the major condition of the intensive technology development. All of it has created a great impulse on shortening the project duration and has led to the development of various schedule compression techniques what becomes a focus of modern construction.

  7. Investigating reading comprehension through EEG

    Directory of Open Access Journals (Sweden)

    Luciane Baretta

    2012-12-01

    Full Text Available http://dx.doi.org/10.5007/2175-8026.2012n63p69   Experimental studies point that different factors can influence reading comprehension, such as the topic, text type, reading task, and others. The advances in technologies for the past decades have provided researchers with several possibilities to investigate what goes on in one’s brain since their eyes meet the page until comprehension is achieved. Since the mid-80’s, numerous studies have been conducted with the use of the electroencephalogram (EEG to investigate the process of reading, through the analysis of different components – n400, n100 or n1, P2, among others. These components reveal, for example, how the brain integrates the meaning of a specific word in the semantic context of a given sentence.  based on previous studies, which demonstrate that different types of words affect cognitive load, this paper aims at investigating how the brain processes function and content words inserted in expository and narrative texts with suitable / unsuitable conclusions. results showed that the type of text and word influence the cognitive load in different scalp areas (midline, right and left hemispheres. The  n1s were more pronounced to the content words inserted in narrative texts and to the function words inserted in the expository type of texts, corroborating former studies.

  8. Hospitality and Facility Care Services. Ohio's Competency Analysis Profile.

    Science.gov (United States)

    Ohio State Univ., Columbus. Vocational Instructional Materials Lab.

    Developed through a modified DACUM (Developing a Curriculum) process involving business, industry, labor, and community agency representatives in Ohio, this document is a comprehensive and verified employer competency profile for hospitality and facility care occupations. The list contains units (with and without subunits), competencies, and…

  9. Community-acquired Pneumonia in Hospitalized Urban Young ...

    African Journals Online (AJOL)

    As part of a comprehensive hospital-based study of acute lower respiratory infections (ALRI) in under-five urban Nigerian children, we sought to identify the possible clinical and investigative correlates of lobar versus bronchopneumonia, and the possible determinants of mortality in community-acquired pneumonia. Over a ...

  10. Study rates U.S. hospitals vs. other nations, industries.

    Science.gov (United States)

    Burda, D

    1991-10-07

    American hospitals generally are further along with their total quality management programs than their Canadian counterparts but lag behind companies in other U.S. industries, according to a comprehensive international study that examined four industries--healthcare, automotive, banking and computer--in four countries--the United States, Canada, Germany and Japan.

  11. Hospital Dermatology, Introduction.

    Science.gov (United States)

    Fox, Lindy P

    2017-03-01

    Inpatient dermatology is emerging as a distinct dermatology subspecialty where dermatologists specialize in caring for patients hospitalized with skin disease. While the main focus of inpatient dermatology is the delivery of top-quality and timely dermatologic care to patients in the hospital setting, the practice of hospital-based dermatology has many additional components that are critical to its success. ©2017 Frontline Medical Communications.

  12. 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.

  13. Hospital Management Software Development

    OpenAIRE

    sobogunGod, olawale

    2012-01-01

    The purpose of this thesis was to implement a hospital management software which is suitable for small private hospitals in Nigeria, especially for the ones that use a file based system for storing information rather than having it stored in a more efficient and safer environment like databases or excel programming software. The software developed within this thesis project was specifically designed for the Rainbow specialist hospital which is based in Lagos, the commercial neurological cente...

  14. Fraud in Hospitals

    OpenAIRE

    Musau, Steve; Vian, Taryn

    2008-01-01

    Hospitals are vulnerable to corruption. In the U.S., health care fraud has been stimated to cost $60 billion per year, or 3% of total health care expenditures - much of it in the hospital sector. Hospitals account for 50% or more of health care pending in many countries. Fraud and corruption in hospitals negatively affect access and quality, as public servants make off with resources which could have been used to reduce out-of-pocket expenditures for patients, or improve needed services. This...

  15. [Comprehensive system integration and networking in operating rooms].

    Science.gov (United States)

    Feußner, H; Ostler, D; Kohn, N; Vogel, T; Wilhelm, D; Koller, S; Kranzfelder, M

    2016-12-01

    comprehensive surveillance and control system integrating all devices and functions is a precondition for realization of the operating room of the future. Multiple proprietary integrated operation room systems are currently available with a central user interface; however, they only cover a relatively small part of all functionalities. Internationally, there are at least three different initiatives to promote a comprehensive systems integration and networking in the operating room: the Japanese smart cyber operating theater (SCOT), the American medical device plug-and-play interoperability program (MDPnP) and the German secure and dynamic networking in operating room and hospital (OR.NET) project supported by the Federal Ministry of Education and Research. Within the framework of the internationally advanced OR.NET project, prototype solution approaches were realized, which make short-term and mid-term comprehensive data retrieval systems probable. An active and even autonomous control of the medical devices by the surveillance and control system (closed loop) is expected only in the long run due to strict regulatory barriers.

  16. Late Abortion: A Comprehensive Review

    Directory of Open Access Journals (Sweden)

    Sheng Chiang

    2005-12-01

    Full Text Available Late termination of pregnancy (LTOP is defined as an abortion carried out beyond 24 gestational weeks, when the fetus has arguably attained viability. In Taiwan, the current abortion law, bearing a eugenic title, allows LTOP on certain medical grounds. However, the fetal and maternal conditions that constitute medical grounds are not clarified and remain legally untested. Professional debate on the abortion issue is also lacking in academia in Taiwan, despite societal concerns. With the advent of technology to detect fetal abnormalities, obstetricians are now confronted more frequently with acute dilemmas regarding LTOP. Quite often, they sail in an uncharted sea with no clinical guidelines from their professional societies or affiliated hospitals. Recently, LTOP at 35 gestational weeks for a fetus with Down syndrome, complicated with polyhydramnios and tetralogy of Fallot, triggered media scrutiny and aroused much public attention. Although the clinical decision making for pregnancies with fetal abnormalities entails increasingly balanced information and consideration in terms of the medical, ethical, legal, psychologic, and societal aspects, society at large is unaware of the complexity and intertwined nature of various abortion issues, especially LTOP. Obstetricians are now in a vulnerable position in Taiwanese society, where litigations relevant to the practice of early abortions are not rare. Therefore, a global and in-depth look into abortion issues from legal and ethical dimensions is indispensable for modern obstetric practice. This review considers the core issues in LTOP, including what conditions constitute a “serious” fetal abnormality to justify LTOP, the incidence of LTOP, legislation regarding LTOP in Western countries, and recent research on ambivalent fetal pain. It will also present procedures, some under the auspices of the ethical committee of a Presbyterian hospital in Taiwan, for clinical decision making, particularly

  17. [Hospital clinical engineer orientation and function in the maintenance system of hospital medical equipment].

    Science.gov (United States)

    Li, Bin; Zheng, Yunxin; He, Dehua; Jiang, Ruiyao; Chen, Ying; Jing, Wei

    2012-03-01

    The quantity of medical equipment in hospital rise quickly recent year. It provides the comprehensive support to the clinical service. The maintenance of medical equipment becomes more important than before. It is necessary to study on the orientation and function of clinical engineer in medical equipment maintenance system. Refer to three grade health care system, the community doctors which is called General practitioner, play an important role as the gatekeeper of health care system to triage and cost control. The paper suggests that hospital clinical engineer should play similar role as the gatekeeper of medical equipment maintenance system which composed by hospital clinical engineer, manufacture engineer and third party engineer. The hospital clinical engineer should be responsible of guard a pass of medical equipment maintenance quality and cost control. As the gatekeeper, hospital clinical engineer should take the responsibility of "General engineer" and pay more attention to safety and health of medical equipment. The responsibility description and future transition? development of clinical engineer as "General Engineer" is discussed. More attention should be recommended to the team building of hospital clinical engineer as "General Engineer".

  18. Comprehension and production of idioms in dysphasia.

    Science.gov (United States)

    Bush, P G; Drummond, S S

    1985-10-01

    The comprehension and production of idioms was investigated in 10 dysphasic adults. Two different tasks, one comprehension and the other production, were developed. The production task required the subject to verbally explain 15 idioms. The comprehension task necessitated the selection of the correct figurative representation of the idiom from four illustrations: a literal, a literal variation, a figurative, and an unrelated picture. Results indicated no significant correlation between overall comprehension and production performances. No significant difference was found between the comprehension or the production of idioms when type or severity of dysphasia was considered. A significant difference was found, however, in the type of incorrect response, in that subjects selected the literal depiction more often than other foil representations for the comprehension.

  19. Going to the Hospital

    Science.gov (United States)

    ... and therapists will show you how to use pieces of equipment, like crutches, if you need them. Some hospitals have child life specialists. Their job is to make sure kids in the hospital understand what's going on around them and help them feel more ...

  20. Hospitality Services Reference Book.

    Science.gov (United States)

    Texas Tech Univ., Lubbock. Home Economics Curriculum Center.

    This reference book provides information needed by employees in hospitality services occupations. It includes 29 chapters that cover the following topics: the hospitality services industry; professional ethics; organization and management structures; safety practices and emergency procedures; technology; property maintenance and repair; purchasing…

  1. GENERAL PRACTITIONERS AND HOSPITALS

    African Journals Online (AJOL)

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

  2. Hospital 360°.

    Science.gov (United States)

    Giraldo Valencia, Juan Carlos; Delgado, Liliana Claudia

    2015-01-01

    There are forces that are greater than the individual performance of each hospital institution and of the health system structural of each country. The world is changing and to face up to the future in the best possible way, we need to understand how contexts and emerging trends link up and how they affect the hospital sector. The Columbian Association of Hospitals and Clinics, ACHC, has thus come up with the Hospital 360° concept which uses hospitals capable of anticipating changing contexts by means of the transition between present and future and takes on board the experience of global, socio-economic, demographic, political, environmental and technological fields as its model. Hospital 360° is an invitation to reinvent processes and institution themselves allowing them to adapt and incorporate a high degree of functional flexibility. Hospital 360° purses goals of efficiency, effectiveness and relevance, but also of impact and sustainability, and is coherent with the internal needs of hospital institutions and society for long-term benefits.

  3. Hospitality services generate revenue.

    Science.gov (United States)

    Bizouati, S

    1993-01-01

    An increasing number of hospitals are undertaking external revenue-generating activities to supplement their shrinking budgets. Written at the request of Leadership, this article outlines an example of a successful catering service -- a money-generating business that more Canadian hospitals could profitably consider.

  4. Virtual Pediatric Hospital

    Science.gov (United States)

    ... Thoracopaedia - An Imaging Encyclopedia of Pediatric Thoracic Disease Virtual Pediatric Hospital is the Apprentice's Assistant™ Last revised ... pediatric resources: GeneralPediatrics.com | PediatricEducation.org | SearchingPediatrics.com Virtual Pediatric Hospital is curated by Donna M. D' ...

  5. Hospitality Services. Curriculum Guide.

    Science.gov (United States)

    Texas Tech Univ., Lubbock. Home Economics Curriculum Center.

    This guide, which was developed as part of Texas' home economics education program, is intended to assist teachers of a hospitality services course focusing on the food and lodging segments of the hospitality and tourism industry. The first 40% of the approximately 600-page guide consists of strategies for teaching each of 29 essential…

  6. Hospitality Occupations. Curriculum Guide.

    Science.gov (United States)

    California State Dept. of Education, Sacramento. Bureau of Homemaking Education.

    This curriculum guide on the hospitality occupations was developed to help secondary and postsecondary home economics teachers prepare individuals for entry-level jobs in the hospitality industry. The content is in seven sections. The first section presents organizational charts of a medium-size hotel, food and beverage division, housekeeping and…

  7. Comprehensive information system development and networking in ...

    African Journals Online (AJOL)

    Background/Aim: Hospital Information System(HIS) and Networking development is now the most important technology that must be embraced by all hospitals and clinics these days. Patients sometimes used to face problems in order to have quick and good services in the hospitals, often due to delay in searching for the ...

  8. Swine Flu -A Comprehensive View

    Science.gov (United States)

    Singh, Vandana; Sood, Meenakshi

    2012-07-01

    The present article is aimed on comprehensive view of Swine flu. It was first isolated from pigs in 1930 in USA. Pandemic caused by H1N1 in 2009 brought it in limelight. Itís a viral respiratory disease caused by viruses that infects pigs, resulting in nasal secretions, barking cough, decreased appetite, and listless behavior. Swine virus consist of eight RNA strands, one strand derived from human flu strains, two from avian (bird) strains, and five from swine strains. Swine flu spreads from infected person to healthy person by inhalation or ingestion of droplets contaminated with virus while sneezing or coughing. Two antiviral agents have been reported to help prevent or reduce the effects of swine flu, flu shot and nasal spray. WHO recommended for pandemic period to prevent its future outbreaks through vaccines or non-vaccines means. Antiviral drugs effective against this virus are Tamiflu and Relenza. Rapid antigen testing (RIDT), DFA testing, viral culture, and molecular testing (RT-PCR) are used for its diagnosis in laboratory

  9. NRC comprehensive records disposition schedule

    International Nuclear Information System (INIS)

    1983-05-01

    Effective January 1, 1982, NRC will institute records retention and disposal practives in accordance with the approved Comprehensive Records Disposition Schedule (CRDS). CRDS is comprised of NRC Schedules (NRCS) 1 to 4 which apply to the agency's program or substantive records and General Records Schedules (GRS) 1 to 24 which apply to housekeeping or facilitative records. NRCS-I applies to records common to all or most NRC offices; NRCS-II applies to program records as found in the various offices of the Commission, Atomic Safety and Licensing Board Panel, and the Atomic Safety and Licensing Appeal Panel; NRCS-III applies to records accumulated by the Advisory Committee on Reactor Safeguards; and NRCS-IV applies to records accumulated in the various NRC offices under the Executive Director for Operations. The schedules are assembled functionally/organizationally to facilitate their use. Preceding the records descriptions and disposition instructions for both NRCS and GRS, there are brief statements on the organizational units which accumulate the records in each functional area, and other information regarding the schedules' applicability

  10. Comprehensive approach to diabetic nephropathy

    Directory of Open Access Journals (Sweden)

    Bancha Satirapoj

    2014-09-01

    Full Text Available Diabetic nephropathy (DN is a leading cause of mortality and morbidity in patients with diabetes. This complication reflects a complex pathophysiology, whereby various genetic and environmental factors determine susceptibility and progression to end-stage renal disease. DN should be considered in patients with type 1 diabetes for at least 10 years who have microalbuminuria and diabetic retinopathy, as well as in patients with type 1 or type 2 diabetes with macroalbuminuria in whom other causes for proteinuria are absent. DN may also present as a falling estimated glomerular filtration rate with albuminuria as a minor presenting feature, especially in patients taking renin–angiotensin–aldosterone system inhibitors (RAASi. The pathological characteristic features of disease are three major lesions: diffuse mesangial expansion, diffuse thickened glomerular basement membrane, and hyalinosis of arterioles. Functionally, however, the pathophysiology is reflected in dysfunction of the mesangium, the glomerular capillary wall, the tubulointerstitium, and the vasculature. For all diabetic patients, a comprehensive approach to management including glycemic and hypertensive control with RAASi combined with lipid control, dietary salt restriction, lowering of protein intake, increased physical activity, weight reduction, and smoking cessation can reduce the rate of progression of nephropathy and minimize the risk for cardiovascular events. This review focuses on the latest published data dealing with the mechanisms, diagnosis, and current treatment of DN.

  11. Abdominopelvic washings: A comprehensive review

    Directory of Open Access Journals (Sweden)

    Erika F Rodriguez

    2013-01-01

    Full Text Available Intraperitoneal spread may occur with gynecological epithelial neoplasms, as well as with non-gynecological malignancies, which may result in serosal involvement with or without concomitant effusion. Therefore, washings in patients with abdominopelvic tumors represent important specimens for cytologic examination. They are primarily utilized for staging ovarian cancers, although their role has decreased in staging of endometrial and cervical carcinoma. Abdominopelvic washings can be positive in a variety of pathologic conditions, including benign conditions, borderline neoplastic tumors, locally invasive tumors, or distant metastases. In a subset of cases, washings can be diagnostically challenging due to the presence of co-existing benign cells (e.g., mesothelial hyperplasia, endosalpingiosis, or endometriosis, lesions in which there is only minimal atypia (e.g., serous borderline tumors or scant atypical cells, and the rarity of specific tumor types (e.g., mesothelioma. Ancillary studies including immunocytochemistry and fluorescence in situ hybridization may be required in difficult cases to resolve the diagnosis. This article provides a comprehensive and contemporary review of abdominopelvic washings in the evaluation of gynecologic and non-gynecologic tumors, including primary peritoneal and mesothelial entities.

  12. CEDR: Comprehensive Epidemiologic Data Resource

    Energy Technology Data Exchange (ETDEWEB)

    1993-08-01

    The Department of Energy (DOE) and its predecessor agencies have a long history of epidemiologic research programs. The main focus of these programs has been the Health and Mortality Study of the DOE work force. This epidemiologic study began in 1964 with a feasibility study of workers at the Hanford facility. Studies of other populations exposed to radiation have also been supported, including the classic epidemiologic study of radium dial painters and studies of atomic bomb survivors. From a scientific perspective, these epidemiologic research program have been productive, highly credible, and formed the bases for many radiological protection standards. Recently, there has been concern that, although research results were available, the data on which these results were based were not easily obtained by interested investigators outside DOE. Therefore, as part of an effort to integrate and broaden access to its epidemiologic information, the DOE has developed the Comprehensive Epidemiologic Data Resource (CEDR) Program. Included in this effort is the development of a computer information system for accessing the collection of CEDR data and its related descriptive information. The epidemiologic data currently available through the CEDAR Program consist of analytic data sets, working data sets, and their associated documentation files. In general, data sets are the result of epidemiologic studies that have been conducted on various groups of workers at different DOE facilities during the past 30 years.

  13. The Comprehensive Emergent Literacy Model

    Directory of Open Access Journals (Sweden)

    Leigh Rohde

    2015-03-01

    Full Text Available The early skills of Emergent Literacy include the knowledge and abilities related to the alphabet, phonological awareness, symbolic representation, and communication. However, existing models of emergent literacy focus on discrete skills and miss the perspective of the surrounding environment. Early literacy skills, including their relationship to one another, and the substantial impact of the setting and context, are critical in ensuring that children gain all of the preliminary skills and awareness they will need to become successful readers and writers. Research findings over the last few decades have led to a fuller understanding of all that emergent literacy includes, resulting in a need for a new, more comprehensive model. A new model, described in this article, strives to explain how emergent literacy can be viewed as an interactive process of skills and context rather than a linear series of individual components. Early literacy learning opportunities are more likely to happen when teachers have a solid knowledge base of emergent literacy and child development. Research has shown that preschool teachers with limited knowledge about literacy development are significantly less able to provide such experiences for children. Teachers will be better able to facilitate all of the components of emergent literacy if they have access to, and understanding of, a model that describes the components, their interactions, and the importance of environmental factors in supporting children.

  14. Factors driving physician-hospital alignment in orthopaedic surgery.

    Science.gov (United States)

    Page, Alexandra E; Butler, Craig A; Bozic, Kevin J

    2013-06-01

    The relationships between physicians and hospitals are viewed as central to the proposition of delivering high-quality health care at a sustainable cost. Over the last two decades, major changes in the scope, breadth, and complexities of these relationships have emerged. Despite understanding the need for physician-hospital alignment, identification and understanding the incentives and drivers of alignment prove challenging. Our review identifies the primary drivers of physician alignment with hospitals from both the physician and hospital perspectives. Further, we assess the drivers more specific to motivating orthopaedic surgeons to align with hospitals. We performed a comprehensive literature review from 1992 to March 2012 to evaluate published studies and opinions on the issues surrounding physician-hospital alignment. Literature searches were performed in both MEDLINE(®) and Health Business™ Elite. Available literature identifies economic and regulatory shifts in health care and cultural factors as primary drivers of physician-hospital alignment. Specific to orthopaedics, factors driving alignment include the profitability of orthopaedic service lines, the expense of implants, and issues surrounding ambulatory surgery centers and other ancillary services. Evolving healthcare delivery and payment reforms promote increased collaboration between physicians and hospitals. While economic incentives and increasing regulatory demands provide the strongest drivers, cultural changes including physician leadership and changing expectations of work-life balance must be considered when pursuing successful alignment models. Physicians and hospitals view each other as critical to achieving lower-cost, higher-quality health care.

  15. Comprehensive energy management eco routing & velocity profiles

    CERN Document Server

    Brandstätter, Bernhard

    2017-01-01

    The book discusses the emerging topic of comprehensive energy management in electric vehicles from the viewpoint of academia and from the industrial perspective. It provides a seamless coverage of all relevant systems and control algorithms for comprehensive energy management, their integration on a multi-core system and their reliability assurance (validation and test). Relevant European projects contributing to the evolvement of comprehensive energy management in fully electric vehicles are also included.

  16. Towards the collaborative hospital

    DEFF Research Database (Denmark)

    Prætorius, Thim; Hasle, Peter; Edwards, Kasper

    2015-01-01

    Hospitals are increasingly faced with conflicting demands as they have to respond to increasing patient demands as well as financial, clinical and quality challenges. To handle these demands the hospital need to reconfigure its organization, and we propose to build on a concept for the collaborat......Hospitals are increasingly faced with conflicting demands as they have to respond to increasing patient demands as well as financial, clinical and quality challenges. To handle these demands the hospital need to reconfigure its organization, and we propose to build on a concept...... of the collaborative hospital concern the creation of an appropriate balance between standardization and local autonomy, shared purpose centred around providing the best possible care, and use of enabling structures that sustain the new ways of collaborative work. The chapter builds on the theoretical framework...

  17. On spaces of hospitality

    DEFF Research Database (Denmark)

    Greve, Anni

    Although specialists in hospitality have worked extensively on hospitality with respect to relations between different nations or between nations and individuals of a different nationality, for instance when they seek asylum, Jacques Derrida preferred to focus instead upon the relationship between...... the guest and the host. This has provided a much-needed rethinking of how to understand hospitality as a way of relating, as an ethics and as a politics. Within this work, there have often appeared discussions of ‘spaces of hospitality’, but these spaces have remained largely abstract. This is where...... this paper comes in: It will re open discussions of spaces of hospitality with an introduction into an on-going research project that studies the performative, structural and social dynamics of cultural encounters focusing on forms of hospitality that are related to particular sites in the city, namely...

  18. Hjertestop uden for hospital

    DEFF Research Database (Denmark)

    Frandsen, F; Nielsen, J R; Gram, L

    1989-01-01

    During the period 1.10.1986-30.9.1987, all patients with cardiac arrest outside hospital brought to the casualty department in Odense Hospital were registered. Out of 160 patients, 133 (83%) could be primarily resuscitated, 19 (12%) were resuscitated but died later in hospital and eight patients (5......%) were resuscitated and could be discharged alive from hospital. Out of the eight patients who were discharged alive, only two (1%) had retained reasonable cerebral function as assessed by dementia testing. Treatment of the cardiac arrest prior to the arrival of the ambulance, duration of the cardiac...... arrest for less than six minutes and staffing of the ambulance with three first-aid men were factors of decisive importance for survival of the patients. The results of this investigation demonstrate that treatment of cardiac arrest outside hospital is unsatisfactory. Proposals for improvement...

  19. SITE COMPREHENSIVE LISTING (CERCLIS) (Superfund) - NPL Sites

    Data.gov (United States)

    U.S. Environmental Protection Agency — National Priorities List (NPL) Sites - The Comprehensive Environmental Response, Compensation and Liability Information System (CERCLIS) (Superfund) Public Access...

  20. Implementing Comprehensive Reform: Implications for Practice

    Science.gov (United States)

    Stout, Karen A.

    2016-01-01

    This chapter describes the challenges and practical barriers community colleges face when implementing comprehensive reform, exploring how reforms are leading to some improvements but not often scaled improvements.

  1. A Trial of Nursing Cost Accounting using Nursing Practice Data on a Hospital Information System.

    Science.gov (United States)

    Miyahira, Akiko; Tada, Kazuko; Ishima, Masatoshi; Nagao, Hidenori; Miyamoto, Tadashi; Nakagawa, Yoshiaki; Takemura, Tadamasa

    2015-01-01

    Hospital administration is very important and many hospitals carry out activity-based costing under comprehensive medicine. However, nursing cost is unclear, because nursing practice is expanding both quantitatively and qualitatively and it is difficult to grasp all nursing practices, and nursing cost is calculated in many cases comprehensively. On the other hand, a nursing information system (NIS) is implemented in many hospitals in Japan and we are beginning to get nursing practical data. In this paper, we propose a nursing cost accounting model and we simulate a cost by nursing contribution using NIS data.

  2. From “Comprehensive Transportation Hub” to “City New Sitting Room”---Overall the design about Jinan East district comprehensive transportation hub

    Science.gov (United States)

    Lv, Jie; Guo, Jianmin; Li, Jin

    2017-08-01

    integrated transport hub or high-speed rail station often talked about, often known as the “city portal” and the title of “city window”, so the comprehensive transportation hub or the high-speed rail station of a city is very important to a region or a provincial. At the same time, it reflects that the managers and users of a city only focus on the comprehensive transportation hub of transportation service function and ignore her cities attributes and functions. Jinan east district comprehensive transportation hub in the beginning of design is given a feature that it has to serve both the traffic and city. We are trying to build a new center for Jinan east new town, the window to welcome people, the city hall of hospitality.

  3. Comprehensive asymmetric dark matter model

    Science.gov (United States)

    Lonsdale, Stephen J.; Volkas, Raymond R.

    2018-05-01

    Asymmetric dark matter (ADM) is motivated by the similar cosmological mass densities measured for ordinary and dark matter. We present a comprehensive theory for ADM that addresses the mass density similarity, going beyond the usual ADM explanations of similar number densities. It features an explicit matter-antimatter asymmetry generation mechanism, has one fully worked out thermal history and suggestions for other possibilities, and meets all phenomenological, cosmological and astrophysical constraints. Importantly, it incorporates a deep reason for why the dark matter mass scale is related to the proton mass, a key consideration in ADM models. Our starting point is the idea of mirror matter, which offers an explanation for dark matter by duplicating the standard model with a dark sector related by a Z2 parity symmetry. However, the dark sector need not manifest as a symmetric copy of the standard model in the present day. By utilizing the mechanism of "asymmetric symmetry breaking" with two Higgs doublets in each sector, we develop a model of ADM where the mirror symmetry is spontaneously broken, leading to an electroweak scale in the dark sector that is significantly larger than that of the visible sector. The weak sensitivity of the ordinary and dark QCD confinement scales to their respective electroweak scales leads to the necessary connection between the dark matter and proton masses. The dark matter is composed of either dark neutrons or a mixture of dark neutrons and metastable dark hydrogen atoms. Lepton asymmetries are generated by the C P -violating decays of heavy Majorana neutrinos in both sectors. These are then converted by sphaleron processes to produce the observed ratio of visible to dark matter in the universe. The dynamics responsible for the kinetic decoupling of the two sectors emerges as an important issue that we only partially solve.

  4. 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...

  5. Collaboration between Hospital and Community Pharmacists to Improve Medication Management from Hospital to Home

    Directory of Open Access Journals (Sweden)

    Judith Kristeller

    2017-05-01

    Full Text Available Objective: The objective of this study is to determine if a model for patient-centered care that integrates medication management between hospital and community pharmacists is feasible and can improve medication adherence. Design: This was a randomized, non-blinded, interventional study of 69 patients discharged from a hospital to home. Process measures include the number and type of medication-related discrepancies or problems identified, patient willingness to participate, the quality and quantity of interactions with community pharmacists, hospital readmissions, and medication adherence. Setting: A 214-bed acute care hospital in Northeastern Pennsylvania and seventeen regional community pharmacies. Patients: Enrolled patients were hospitalized with a primary or secondary diagnosis of heart failure or COPD, had a planned discharge to home, and agreed to speak to one of seventeen community pharmacists within the study network (i.e., a network community pharmacist following hospital discharge. Intervention: Information about a comprehensive medication review completed by the hospital pharmacist was communicated with the network community pharmacist to assist with providing medication therapy management following hospital discharge. Results: Of 180 patients eligible for the study, 111 declined to participate. Many patients were reluctant to talk to an additional pharmacist, however if the patient’s pharmacist was already within the network of 17 pharmacies, they usually agreed to participate. The study enrolled 35 patients in the intervention group and 34 in the control group. An average of 6 medication-related problems per patient were communicated to the patient’s network community pharmacist after discharge. In the treatment group, 44% of patients had at least one conversation with the network community pharmacist following hospital discharge. There was no difference in post-discharge adherence between the groups (Proportion of Days

  6. Teaching Listening Comprehension: Bottom-Up Approach

    Science.gov (United States)

    Khuziakhmetov, Anvar N.; Porchesku, Galina V.

    2016-01-01

    Improving listening comprehension skills is one of the urgent contemporary educational problems in the field of second language acquisition. Understanding how L2 listening comprehension works can have a serious influence on language pedagogy. The aim of the paper is to discuss the practical and methodological value of the notion of the perception…

  7. University Students with Poor Reading Comprehension

    Science.gov (United States)

    Georgiou, George K.; Das, J. P.

    2015-01-01

    The present study aimed to examine the nature of the working memory and general cognitive ability deficits experienced by university students with a specific reading comprehension deficit. A total of 32 university students with poor reading comprehension but average word-reading skills and 60 age-word-matched controls with no comprehension…

  8. Comprehensive Education Portfolio with a Career Focus

    Science.gov (United States)

    Kruger, Evonne J.; Holtzman, Diane M.; Dagavarian, Debra A.

    2013-01-01

    There are many types of student portfolios used within academia: the prior learning portfolio, credentialing portfolio, developmental portfolio, capstone portfolio, individual course portfolio, and the comprehensive education portfolio. The comprehensive education portfolio (CEP), as used by the authors, is a student portfolio, developed over…

  9. Profiling classroom reading comprehension development practices ...

    African Journals Online (AJOL)

    Of specific concern is the lack of representation of the sampled South African learners at the PIRLS international benchmarks, revealing a distinct lack of their development of thinking and reasoning abilities for reading comprehension. To shed light on potential reasons for learners' reading comprehension difficulties, this ...

  10. Comprehension of Idioms in Turkish Aphasic Participants

    Science.gov (United States)

    Aydin, Burcu; Barin, Muzaffer; Yagiz, Oktay

    2017-01-01

    Brain damaged participants offer an opportunity to evaluate the cognitive and linguistic processes and make assumptions about how the brain works. Cognitive linguists have been investigating the underlying mechanisms of idiom comprehension to unravel the ongoing debate on hemispheric specialization in figurative language comprehension. The aim of…

  11. Optimizing Visually-Assisted Listening Comprehension

    Science.gov (United States)

    Kashani, Ahmad Sabouri; Sajjadi, Samad; Sohrabi, Mohammad Reza; Younespour, Shima

    2011-01-01

    The fact that visual aids such as pictures or graphs can lead to greater comprehension by language learners has been well established. Nonetheless, the order of presenting visuals to listeners is left unattended. This study examined listening comprehension from a strategy of introducing visual information, either prior to or during an audio…

  12. Comprehensive Teacher Education: A Handbook of Knowledge.

    Science.gov (United States)

    American Association of Colleges for Teacher Education, Washington, DC.

    Since 1992, AACTE and the DeWitt Wallace-Reader's Digest Fund have worked in partnership to advance the knowledge base of comprehensive teacher education. The AACTE/DeWitt Wallace-Reader's Digest Fund's Comprehensive Teacher Education National Demonstration Project is grounded in the mutual belief that preparation of classroom teachers must…

  13. Language Skills in Classical Chinese Text Comprehension

    Science.gov (United States)

    Lau, Kit-ling

    2018-01-01

    This study used both quantitative and qualitative methods to explore the role of lower- and higher-level language skills in classical Chinese (CC) text comprehension. A CC word and sentence translation test, text comprehension test, and questionnaire were administered to 393 Secondary Four students; and 12 of these were randomly selected to…

  14. 75 FR 32169 - Comprehensive Centers Program

    Science.gov (United States)

    2010-06-07

    ... of proposed waivers were supportive of the Comprehensive Centers program and the proposed waivers... Department to continue promoting this shared oversight by involving OSERS leadership in deliberations about... identification of the valuable contribution of OSERS leadership in supporting the Comprehensive Centers program...

  15. Changing Student Teachers' Views of Comprehension Instruction ...

    African Journals Online (AJOL)

    At the same time research shows that little, if any, explicit and continuous strategy instruction takes place in classrooms. Reasons seem ... This article reports on the effect of a reading comprehension instruction course on university student teachers' lesson planning, strategy use and views about comprehension instruction.

  16. Reading Comprehension Instruction Practices in Sierra Leone

    NARCIS (Netherlands)

    Hersbach, S.; Denessen, E.J.P.G.; Droop, W.

    2014-01-01

    Aim: In this study an attempt was made to give insight in the way reading comprehension is taught in Sierra Leone. Attention was paid to the didactical strategies and the materials used during reading comprehension instruction. Methodology: Primary school teachers in Sierra Leone (N=43) were

  17. Building Effective Collaboration in a Comprehensive Approach

    NARCIS (Netherlands)

    Essens, P.J.M.D.; Thompson, M.T.; Karrasch, A.; Jermalavičius, J.

    2016-01-01

    The Comprehensive Approach (CA) to crisis management operations is an essential element in NATO’s transformation in modern operations. At the Bucharest Summit in April 2008, Allied leaders endorsed an Action Plan for the development and implementation of NATO’s contribution to a Comprehensive

  18. Comprehensive Statewide Plan for Postsecondary Education

    Science.gov (United States)

    Nebraska's Coordinating Commission for Postsecondary Education, 2016

    2016-01-01

    The constitution and statutes of Nebraska assign the Coordinating Commission for Postsecondary Education the responsibility for comprehensive planning for postsecondary education in Nebraska. The purpose of the "Comprehensive Plan for Postsecondary Education" is to provide direction for the future of postsecondary education in Nebraska.…

  19. Comprehensive Self-Management Strategies.

    Science.gov (United States)

    Bourbeau, J; Lavoie, K L; Sedeno, M

    2015-08-01

    In this article, we provide a review of the literature on self-management interventions and we are giving some thought to how, when, and by whom they should be offered to patients. The present literature based on randomized clinical trials has demonstrated benefits (reduced hospital admissions and improved health status) for chronic obstructive pulmonary disease (COPD) patients undergoing self-management interventions, although there are still problems with the heterogeneity among interventions, study populations, follow-up time, and outcome measures that make generalization difficult in real life. Key to the success, self-management intervention has to target behavior change. Proper self-management support is a basic prerequisite, for example, techniques and skills used by health care providers "case manager" to instrument patients with the knowledge, confidence, and skills required to effectively self-manage their disease. To improve health behaviors and engagement in self-management, self-management interventions need to target enhancing intrinsic motivation to change. This will best be done using client-centered communication (motivational communication) that encourages patients to express what intrinsically motivates them (e.g., consistent with their values or life goals) to adopt certain health behavior, with the goal of helping them overcome their ambivalence about change. Finally, if we want to be able to design and implement self-management interventions that are integrated, coherent, and have a strong likelihood of success, we need to take a more careful look and give more attention at the case manager, the patient (patient evaluation), and the quality assurance. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  20. Informed consent comprehension in African research settings.

    Science.gov (United States)

    Afolabi, Muhammed O; Okebe, Joseph U; McGrath, Nuala; Larson, Heidi J; Bojang, Kalifa; Chandramohan, Daniel

    2014-06-01

    Previous reviews on participants' comprehension of informed consent information have focused on developed countries. Experience has shown that ethical standards developed on Western values may not be appropriate for African settings where research concepts are unfamiliar. We undertook this review to describe how informed consent comprehension is defined and measured in African research settings. We conducted a comprehensive search involving five electronic databases: Medline, Embase, Global Health, EthxWeb and Bioethics Literature Database (BELIT). We also examined African Index Medicus and Google Scholar for relevant publications on informed consent comprehension in clinical studies conducted in sub-Saharan Africa. 29 studies satisfied the inclusion criteria; meta-analysis was possible in 21 studies. We further conducted a direct comparison of participants' comprehension on domains of informed consent in all eligible studies. Comprehension of key concepts of informed consent varies considerably from country to country and depends on the nature and complexity of the study. Meta-analysis showed that 47% of a total of 1633 participants across four studies demonstrated comprehension about randomisation (95% CI 13.9-80.9%). Similarly, 48% of 3946 participants in six studies had understanding about placebo (95% CI 19.0-77.5%), while only 30% of 753 participants in five studies understood the concept of therapeutic misconception (95% CI 4.6-66.7%). Measurement tools for informed consent comprehension were developed with little or no validation. Assessment of comprehension was carried out at variable times after disclosure of study information. No uniform definition of informed consent comprehension exists to form the basis for development of an appropriate tool to measure comprehension in African participants. Comprehension of key concepts of informed consent is poor among study participants across Africa. There is a vital need to develop a uniform definition for

  1. Innovative Ground Habitats for Lunar Operational Outpost (IGLOO), Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — NextGen Aeronautics, Inc. is proposing an alternate architecture for inflatable lunar habitats that takes advantage of inflatable beam technologies currently being...

  2. Creating Methane from Plastic: Recycling at a Lunar Outpost

    Science.gov (United States)

    Santiago-Maldonado, Edgardo; Captain, Janine; Devor, Robert; Gleaton, Jeremy

    2010-01-01

    The high cost of re-supply from Earth demands resources to be utilized to the fullest extent for exploration missions. The ability to refuel on the lunar surface would reduce the vehicle mass during launch and provide excess payload capability. Recycling is a key technology that maximizes the available resources by converting waste products into useful commodities. One example of this is to convert crew member waste such as plastic packaging, food scraps, and human waste into fuel. This process thermally degrades plastic in the presence of oxygen producing CO2 and CO. The CO2 and CO are then reacted with hydrogen over catalyst (Sabatier reaction) producing methane. An end-to-end laboratory-scale system has been designed and built to produce methane from plastic, in this case polyethylene. This first generation system yields 12-16% CH4 by weight of plastic used.

  3. The Last Possible Outposts for Life on Mars.

    Science.gov (United States)

    Davila, Alfonso F; Schulze-Makuch, Dirk

    2016-02-01

    The evolution of habitable conditions on Mars is often tied to the existence of aquatic habitats and largely constrained to the first billion years of the planet. Here, we propose an alternate, lasting evolutionary trajectory that assumes the colonization of land habitats before the end of the Hesperian period (ca. 3 billion years ago) at a pace similar to life on Earth. Based on the ecological adaptations to increasing dryness observed in dryland ecosystems on Earth, we reconstruct the most likely sequence of events leading to a late extinction of land communities on Mars. We propose a trend of ecological change with increasing dryness from widespread edaphic communities to localized lithic communities and finally to communities exclusively found in hygroscopic substrates, reflecting the need for organisms to maximize access to atmospheric sources of water. If our thought process is correct, it implies the possibility of life on Mars until relatively recent times, perhaps even the present.

  4. Architecture Analysis of Wireless Power Transmission for Lunar Outposts

    Science.gov (United States)

    2015-09-01

    continuous supply of electrical power would be required. The primary research was to determine if it is feasible to provide power to a lunar polar...space exploration business wish to go beyond the Moon, to Mars and to the asteroids , the technology for these ventures is not yet adequate for the task...klystron, both 16 developed during World War II, that the use of microwaves became available for effective transmission of energy. However, the

  5. Tonopah test range - outpost of Sandia National Laboratories

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, L.

    1996-03-01

    Tonopah Test Range is a unique historic site. Established in 1957 by Sandia Corporation, Tonopah Test Range in Nevada provided an isolated place for the Atomic Energy Commission to test ballistics and non-nuclear features of atomic weapons. It served this and allied purposes well for nearly forty years, contributing immeasurably to a peaceful conclusion to the long arms race remembered as the Cold War. This report is a brief review of historical highlights at Tonopah Test Range. Sandia`s Los Lunas, Salton Sea, Kauai, and Edgewood testing ranges also receive abridged mention. Although Sandia`s test ranges are the subject, the central focus is on the people who managed and operated the range. Comments from historical figures are interspersed through the narrative to establish this perspective, and at the end a few observations concerning the range`s future are provided.

  6. Analysis of Logistics in Support of a Human Lunar Outpost

    Science.gov (United States)

    Cirillo, William; Earle, Kevin; Goodliff, Kandyce; Reeves, j. D.; Andrashko, Mark; Merrill, R. Gabe; Stromgren, Chel

    2008-01-01

    Strategic level analysis of the integrated behavior of lunar transportation system and lunar surface system architecture options is performed to inform NASA Constellation Program senior management on the benefit, viability, affordability, and robustness of system design choices. This paper presents an overview of the approach used to perform the campaign (strategic) analysis, with an emphasis on the logistics modeling and the impacts of logistics resupply on campaign behavior. An overview of deterministic and probabilistic analysis approaches is provided, with a discussion of the importance of each approach to understanding the integrated system behavior. The logistics required to support lunar surface habitation are analyzed from both 'macro-logistics' and 'micro-logistics' perspectives, where macro-logistics focuses on the delivery of goods to a destination and micro-logistics focuses on local handling of re-supply goods at a destination. An example campaign is provided to tie the theories of campaign analysis to results generation capabilities.

  7. High-Pressure Oxygen Generation for Outpost EVA Study

    Science.gov (United States)

    Jeng, Frank F.; Conger, Bruce; Ewert, Michael K.; Anderson, Molly S.

    2009-01-01

    The amount of oxygen consumption for crew extravehicular activity (EVA) in future lunar exploration missions will be significant. Eight technologies to provide high pressure EVA O2 were investigated. They are: high pressure O2 storage, liquid oxygen (LOX) storage followed by vaporization, scavenging LOX from Lander followed by vaporization, LOX delivery followed by sorption compression, water electrolysis followed by compression, stand-alone high pressure water electrolyzer, Environmental Control and Life Support System (ECLSS) and Power Elements sharing a high pressure water electrolyzer, and ECLSS and In-Situ Resource Utilization (ISRU) Elements sharing a high pressure electrolyzer. A trade analysis was conducted comparing launch mass and equivalent system mass (ESM) of the eight technologies in open and closed ECLSS architectures. Technologies considered appropriate for the two architectures were selected and suggested for development.

  8. Premier Hospital Historical Data

    Data.gov (United States)

    U.S. Department of Health & Human Services — To provide a historical overview of the participating hospitals, before the first project report, Premier Healthcare Informatics has used data already available for...

  9. [Ryazan hospital--80 years].

    Science.gov (United States)

    Klimov, A S; Gromov, M F

    2012-02-01

    In December 2011 marked 80 years of the founding of the Ryazan garrison hospital, originally housed in two buildings: "Redut housed"--a monument of architecture of the XVIII century and the former almshouses room "for the maimed in the war", was built in 1884 now Ryazan garrison hospital (from 2010--Branch No 6 FSI "in 1586 the district military hospital in the Western Military District", the Defense Ministry of Russia)--a multi-field medical preventive institution on the basis of which soldiers, military retirees, family members and military retirees from Ryazan, Moscow, Tambov regions are treated. Every year more than 7 thousand patients get treatment here. During the counterterrorism operations in Chechnya over 800 wounded were brought to the hospital from the battle area.

  10. Hospital Compare Data

    Data.gov (United States)

    U.S. Department of Health & Human Services — These are the official datasets used on the Medicare.gov Hospital Compare Website provided by the Centers for Medicare and Medicaid Services. These data allow you to...

  11. Hospital Outpatient PPS

    Data.gov (United States)

    U.S. Department of Health & Human Services — Section 4523 of the Balanced Budget Act of 1997 (BBA) provides authority for CMS to implement a prospective payment system (PPS) under Medicare for hospital...

  12. Critical Access Hospitals (CAH)

    Science.gov (United States)

    ... for Success Am I Rural? Evidence-based Toolkits Economic Impact Analysis Tool Community Health Gateway Sustainability Planning ... hospitals and improve access to healthcare by keeping essential services in rural communities. To accomplish this goal, ...

  13. Physician-Owned Hospitals

    Data.gov (United States)

    U.S. Department of Health & Human Services — Section 6001 of the Affordable Care Act of 2010 amended section 1877 of the Social Security Act to impose additional requirements for physician-owned hospitals to...

  14. Hospitals as health educators

    Science.gov (United States)

    ... offer discounts to healthy activities in the area: Biking, hiking, or walking tours Museums Fitness clubs Farms Festivals Your hospital may offer discounts for: Retail stores such as sporting goods, health food, and art stores Acupuncture Skin care Eye ...

  15. Hospital Readmission Reduction

    Data.gov (United States)

    U.S. Department of Health & Human Services — In October 2012, CMS began reducing Medicare payments for Inpatient Prospective Payment System hospitals with excess readmissions. Excess readmissions are measured...

  16. Hospital Readmissions Reduction Program

    Data.gov (United States)

    U.S. Department of Health & Human Services — In October 2012, CMS began reducing Medicare payments for Inpatient Prospective Payment System hospitals with excess readmissions. Excess readmissions are measured...

  17. Research in Hospitality Management

    African Journals Online (AJOL)

    Research in Hospitality Management. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 5, No 1 (2015) >. Log in or Register to get access to full text downloads.

  18. Allegheny County Hospitals

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — The data on health care facilities includes the name and location of all the hospitals and primary care facilities in Allegheny County. The current listing of...

  19. Practice Hospital Bed Safety

    Science.gov (United States)

    ... Home For Consumers Consumer Updates Practice Hospital Bed Safety Share Tweet Linkedin Pin it More sharing options ... It depends on the complexity of the bed." Safety Tips CDRH offers the following safety tips for ...

  20. Ionizing radiation in hospitals

    International Nuclear Information System (INIS)

    Blok, K.; Ginkel, G. van; Leun, K. van der; Muller, H.; Oude Elferink, J.; Vesseur, A.

    1985-10-01

    This booklet dels with the risks of the use of ionizing radiation for people working in a hospital. It is subdivided in three parts. Part 1 treats the properties of ionizing radiation in general. In part 2 the various applications are discussed of ionizing radiation in hospitals. Part 3 indicates how a not completely safe situation may be improved. (H.W.). 14 figs.; 4 tabs

  1. Preventing falls in hospital.

    Science.gov (United States)

    Pearce, Lynne

    2017-02-27

    Essential facts Falls are the most frequent adverse event reported in hospitals, usually affecting older patients. Every year, more than 240,000 falls are reported in acute hospitals and mental health trusts in England and Wales, equivalent to more than 600 a day, according to the Royal College of Physicians (RCP). But research shows that when nurses, doctors and therapists work together, falls can be reduced by 20-30%.

  2. Nutrition support in hospitals

    DEFF Research Database (Denmark)

    Kondrup, Jens

    2005-01-01

    Nutrition support in hospitals is becoming an area of focus because of the evidence showing improved clinical outcome with nutrition support, its status as a human rights issue and its integration into quality assurance.......Nutrition support in hospitals is becoming an area of focus because of the evidence showing improved clinical outcome with nutrition support, its status as a human rights issue and its integration into quality assurance....

  3. [Hospital organizational structure].

    Science.gov (United States)

    Bittar, O J

    1994-01-01

    The basic point for an Institution to work is the existence of a definite organizational structure that puts together similar areas allowing decisions and the operationalization of different tasks. Knowledge and analysis of structures of private and public hospitals and a bibliography review about the issue is the purpose of this paper. Suggestions are given about the elaboration of small structures and the utilization of matrix management in order to accomplish the hospitals objectives.

  4. Hospital waste management in nonteaching hospitals of Lucknow City, India

    Directory of Open Access Journals (Sweden)

    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.

  5. Comprehensive electrocardiogram-to-device time for primary percutaneous coronary intervention in ST-segment elevation myocardial infarction: A report from the American Heart Association mission: Lifeline program.

    Science.gov (United States)

    Shavadia, Jay S; French, William; Hellkamp, Anne S; Thomas, Laine; Bates, Eric R; Manoukian, Steven V; Kontos, Michael C; Suter, Robert; Henry, Timothy D; Dauerman, Harold L; Roe, Matthew T

    2018-03-01

    Assessing hospital-related network-level primary percutaneous coronary intervention (PCI) performance for ST-segment elevation myocardial infarction (STEMI) is challenging due to differential time-to-treatment metrics based on location of diagnostic electrocardiogram (ECG) for STEMI. STEMI patients undergoing primary PCI at 588 PCI-capable hospitals in AHA Mission: Lifeline (2008-2013) were categorized by initial STEMI identification location: PCI-capable hospitals (Group 1); pre-hospital setting (Group 2); and non-PCI-capable hospitals (Group 3). Patient-specific time-to-treatment categories were converted to minutes ahead of or behind their group-specific mean; average time-to-treatment difference for all patients at a given hospital was termed comprehensive ECG-to-device time. Hospitals were then stratified into tertiles based on their comprehensive ECG-to-device times with negative values below the mean representing shorter (faster) time intervals. Of 117,857 patients, the proportion in Groups 1, 2, and 3 were 42%, 33%, and 25%, respectively. Lower rates of heart failure and cardiac arrest at presentation are noted within patients presenting to high-performing hospitals. Median comprehensive ECG-to-device time was shortest at -9 minutes (25th, 75th percentiles: -13, -6) for the high-performing hospital tertile, 1 minute (-1, 3) for middle-performing, and 11 minutes (7, 16) for low-performing. Unadjusted rates of in-hospital mortality were 2.3%, 2.6%, and 2.7%, respectively, but the adjusted risk of in-hospital mortality was similar across tertiles. Comprehensive ECG-to-device time provides an integrated hospital-related network-level assessment of reperfusion timing metrics for primary PCI, regardless of the location for STEMI identification; further validation will delineate how this metric can be used to facilitate STEMI care improvements. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Comprehensive framework for preventive maintenance priority of medical equipment.

    Science.gov (United States)

    Saleh, Neven; Balestra, Gabriella

    2015-08-01

    Throughout the medical equipment life cycle, preventive maintenance is considered one of the most important stages that should be managed properly. However, the need for better management and control by giving a reasonable prioritization for preventive maintenance becomes essential. The purpose of this study is to develop a comprehensive framework for preventive maintenance priority of medical equipment using Quality Function Deployment (QFD) and Fuzzy Logic (FL). The quality function deployment is proposed in order to identify the most important criteria that could impact preventive maintenance priority decision; meanwhile the role of the fuzzy logic is to generate a priority index of the list of equipment considering those criteria. The model validation was carried out on 140 pieces of medical equipment belonging to two hospitals. In application, we propose to classify the priority index into five classes. The results indicate that the strong correlation existence between risk-based criteria and preventive maintenance priority decision.

  7. Networks in the radiology department and the hospital

    International Nuclear Information System (INIS)

    Pelikan, E.; Timmermann, U.; Kotter, E.

    2001-01-01

    Data networks are a basic technology with regard to an appropriate design of the information technology (IT) infrastructure for the hospital. Due to the distributed workflow within the hospital, an integrated Hospital Information System (HIS) is based mostly on a set of network applications facing specific items. Medical communication standards, i. e., HL 7, DICOM, and in the near future the migration towards XML, support the interoperability between the IT subsystems and pave the way to patient information systems with access to unified and complete electronic medical records (EMR). Furthermore, with standardized communication techniques, such as CORBAmed, an object-oriented design of Healthcare applications will be possible in the near future. The intent of this paper is to give an overview of which basic technologies are suitable for building comprehensive, flexible, and reliable hospital networks and which also meet the special demands of the radiology department. (orig.)

  8. Networks in the radiology department and the hospital

    Energy Technology Data Exchange (ETDEWEB)

    Pelikan, E.; Timmermann, U. [Hospital Computer Center, University Hospital Freiburg (Germany); Kotter, E. [Freiburg Univ. (Germany). Radiologische Universitaetsklinik

    2001-02-01

    Data networks are a basic technology with regard to an appropriate design of the information technology (IT) infrastructure for the hospital. Due to the distributed workflow within the hospital, an integrated Hospital Information System (HIS) is based mostly on a set of network applications facing specific items. Medical communication standards, i. e., HL 7, DICOM, and in the near future the migration towards XML, support the interoperability between the IT subsystems and pave the way to patient information systems with access to unified and complete electronic medical records (EMR). Furthermore, with standardized communication techniques, such as CORBAmed, an object-oriented design of Healthcare applications will be possible in the near future. The intent of this paper is to give an overview of which basic technologies are suitable for building comprehensive, flexible, and reliable hospital networks and which also meet the special demands of the radiology department. (orig.)

  9. From corporate governance to hospital governance. Authority, transparency and accountability of Belgian non-profit hospitals' board and management.

    Science.gov (United States)

    Eeckloo, Kristof; Van Herck, Gustaaf; Van Hulle, Cynthia; Vleugels, Arthur

    2004-04-01

    As a result of multiple developments in health care and health care policy, hospital administrators, policy makers and researchers are increasingly challenged to reflect on the meaning of good hospital governance and how they can implement it in the hospital organisations. The question arises whether and to what extent governance models that have been developed within the corporate world can be valuable for these reflections. Due to the unique societal position of hospitals--which involves a large diversity of stakeholders--the claim for autonomy of various highly professional groups and the lack of clear business objectives, principles of corporate governance cannot be translated into the hospital sector without specific adjustments. However, irrespective of these contextual differences, corporate governance can provide for a comprehensive 'frame of reference', to which the hospital sector will have to give its own interpretation. A multidisciplinary research unit of the university of Leuven has taken the initiative to develop a governance model for Belgian hospitals. As part of the preliminary research work a survey has been performed among 82 hospitals of the Flemish Community on their governance structure, the composition of the governance entities, the partition of competencies and the relationship between management and medical staff.

  10. Moving Towards the Age-friendly Hospital: A Paradigm Shift for the Hospital-based Care of the Elderly.

    Science.gov (United States)

    Huang, Allen R; Larente, Nadine; Morais, Jose A

    2011-12-01

    Care of the older adult in the acute care hospital is becoming more challenging. Patients 65 years and older account for 35% of hospital discharges and 45% of hospital days. Up to one-third of the hospitalized frail elderly loses independent functioning in one or more activities of daily living as a result of the 'hostile environment' that is present in the acute hospitals. A critical deficit of health care workers with expertise and experience in the care of the elderly also jeopardizes successful care delivery in the acute hospital setting. We propose a paradigm shift in the culture and practice of event-driven acute hospital-based care of the elderly which we call the Age-friendly Hospital concept. Guiding principles include: a favourable physical environment; zero tolerance for ageism throughout the organization; an integrated process to develop comprehensive services using the geriatric approach; assistance with appropriateness decision-making and fostering links between the hospital and the community. Our current proposed strategy is to focus on delirium management as a hospital-wide condition that both requires and highlights the Geriatric Medicine specialist as an expert of content, for program development and of evaluation. The Age-friendly Hospital concept we propose may lead the way to enable hospitals in the fast-moving health care system to deliver high-quality care without jeopardizing risk-benefit, function, and quality of life balances for the frail elderly. Recruitment and retention of skilled health care professionals would benefit from this positive 'branding' of an institution. Convincing hospital management and managing change are significant challenges, especially with competing priorities in a fiscal environment with limited funding. The implementation of a hospital-wide delirium management program is an example of an intervention that embodies many of the principles in the Age-friendly Hospital concept. It is important to change the way

  11. Why Are There So Few Ethics Consults in Children's Hospitals?

    Science.gov (United States)

    Carter, Brian; Brockman, Manuel; Garrett, Jeremy; Knackstedt, Angie; Lantos, John

    2017-10-03

    In most children's hospitals, there are very few ethics consultations, even though there are many ethically complex cases. We hypothesize that the reason for this may be that hospitals develop different mechanisms to address ethical issues and that many of these mechanisms are closer in spirit to the goals of the pioneers of clinical ethics than is the mechanism of a formal ethics consultation. To show how this is true, we first review the history of collaboration between philosophers and physicians about clinical dilemmas. Then, as a case-study, we describe the different venues that have developed at one children's hospital to address ethical issues. At our hospital, there are nine different venues in which ethical issues are regularly and explicitly addressed. They are (1) ethics committee meetings, (2) Nursing Ethics Forum, (3) ethics Brown Bag workshops, (4) PICU ethics rounds, (5) Grand Rounds, (6) NICU Comprehensive Care Rounds, (7) Palliative Care Team (PaCT) case conferences, (8) multidisciplinary consults in Fetal Health Center, and (9) ethics consultations. In our hospital, ethics consults account for only a tiny percentage of ethics discussions. We suspect that most hospitals have multiple and varied venues for ethics discussions. We hope this case study will stimulate research in other hospitals analyzing the various ways in which ethicists and ethics committees can build an ethical environment in hospitals. Such research might suggest that ethicists need to develop a different set of "core competencies" than the ones that are needed to do ethics consultations. Instead, they should focus on their skills in creating multiple "moral spaces" in which regular and ongoing discussion of ethical issues would take place. A successful ethicist would empower everyone in the hospital to speak up about the values that they believe are central to respectful, collaborative practice and patient care. Such a role is closer to what the first hospital philosophers set

  12. Re-thinking barriers to organizational change in public hospitals.

    Science.gov (United States)

    Edwards, Nigel; Saltman, Richard B

    2017-01-01

    Public hospitals are well known to be difficult to reform. This paper provides a comprehensive six-part analytic framework that can help policymakers and managers better shape their organizational and institutional behavior. The paper first describes three separate structural characteristics which, together, inhibit effective problem description and policy design for public hospitals. These three structural constraints are i) the dysfunctional characteristics found in most organizations, ii) the particular dysfunctions of professional health sector organizations, and iii) the additional dysfunctional dimensions of politically managed organizations. While the problems in each of these three dimensions of public hospital organization are well-known, and the first two dimensions clearly affect private as well as publicly run hospitals, insufficient attention has been paid to the combined impact of all three factors in making public hospitals particularly difficult to manage and steer. Further, these three structural dimensions interact in an institutional environment defined by three restrictive context limitations, again two of which also affect private hospitals but all three of which compound the management dilemmas in public hospitals. The first contextual limitation is the inherent complexity of delivering high quality, safe, and affordable modern inpatient care in a hospital setting. The second contextual limitation is a set of specific market failures in public hospitals, which limit the scope of the standard financial incentives and reform measures. The third and last contextual limitation is the unique problem of generalized and localized anxiety , which accompanies the delivery of medical services, and which suffuses decision-making on the part of patients, medical staff, hospital management, and political actors alike. This combination of six institutional characteristics - three structural dimensions and three contextual dimensions - can help explain why

  13. Comprehensive Nuclear Test-ban Treaty

    International Nuclear Information System (INIS)

    1998-01-01

    The Comprehensive Nuclear Test-Ban Treaty was adopted by the General Assembly on 10 September 1996 (Res/50/245) and was open for signature by all states on 24 September 1996. It will enter into force 180 days after the date of deposit of the instruments of ratification by all states listed in Annex 2 to the Treaty. This document reproduces the text of the Treaty and the Protocol to the Comprehensive Nuclear Test-Ban Treaty Protocol to the Comprehensive Nuclear Test-Ban Treaty

  14. Teacher's reading comprehension: Implication for teaching practices

    Directory of Open Access Journals (Sweden)

    Adriana Benevides Soares

    2010-11-01

    Full Text Available A question of interest for educational workers is the reading comprehension process, a fundamental ability for progress in more advanced years of schooling, and its effect on pedagogical practices. This is a study that explores this question. A reading comprehension instrument composed by four structural levels of text and a scale of pedagogical practice composed by four sub-scales involving: cognitive practices with linguistic focus, cognitive practices, affective and motor practices, continuous education, was used. The results of 53 children suggest a slight tendency of teacher to prioritize cognitive practices independently of their reading comprehension level.

  15. Comprehensive Nuclear Test-ban Treaty

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-07-01

    The Comprehensive Nuclear Test-Ban Treaty was adopted by the General Assembly on 10 September 1996 (Res/50/245) and was open for signature by all states on 24 September 1996. It will enter into force 180 days after the date of deposit of the instruments of ratification by all states listed in Annex 2 to the Treaty. This document reproduces the text of the Treaty and the Protocol to the Comprehensive Nuclear Test-Ban Treaty Protocol to the Comprehensive Nuclear Test-Ban Treaty. 4 tabs.

  16. 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.

  17. [Analysis on workload for hospital DOTS service].

    Science.gov (United States)

    Nagata, Yoko; Urakawa, Minako; Kobayashi, Noriko; Kato, Seiya

    2014-04-01

    A directly observed treatment short course (DOTS) trial was launched in Japan in the late 1990s and targeted patients with social depression at urban areas. Based on these findings, the Ministry of Health, Labour and Welfare established the Japanese DOTS Strategy in 2003, which is a comprehensive support service ensuring the adherence of tuberculosis patients to drug administration. DOTS services are initially provided at the hospital to patients with infectious tuberculosis who are hospitalized according to the Infectious Diseases Control Law. After being discharged from the hospital, the patients are referred to a public health center. However, a survey conducted in 2008 indicated that all the patients do not receive appropriate DOTS services at some hospitals. In the present study, we aimed to evaluate the protocols and workload of DOTS at hospitals that are actively involved in tuberculosis medical practice, including DOTS, to assess whether the hospital DOTS services were adequate. We reviewed a series of articles on hospital DOTS from a Japanese journal on nursing for tuberculosis patients and identified 25 activities regarding the hospital DOTS service. These 25 items were then classified into 3 categories: health education to patients, support for adherence, and coordination with the health center. In total, 20 hospitals that had > 20 authorized tuberculosis beds were selected--while considering the geographical balance, schedule of this survey, etc.--from 33 hospitals where an ex-trainee of the tuberculosis control expert training program in the Research Institute of Tuberculosis (RIT) was working and 20 hospitals that had collaborated with our previous survey on tuberculosis medical facilities. All the staff associated with the DOTS service were asked to record the total working time as well as the time spent for each activity. The data were collected and analyzed at the RIT. The working times for each activity of the DOTS service for nurses, pharmacists

  18. Novel approach to parental permission and child assent for research: improving comprehension.

    Science.gov (United States)

    O'Lonergan, Theresa A; Forster-Harwood, Jeri E

    2011-05-01

    The aim of this research was to test a multimedia permission/assent (P/A) process. The overall hypothesis was that children and their parents exposed to a multimedia P/A process would have better comprehension compared with those exposed to a text-based process. Traditional and multimedia P/A processes were created by using an innovative learning-objective approach. A total of 194 parent-child dyads (children aged 11-14 years) were enrolled: 24 dyads in a prestudy testing P/A components for preference and effect on comprehension and 170 dyads in a randomized trial of a multimedia or paper P/A process for a hypothetical study. Participants were predominantly white and were from a metropolitan area served by a tertiary care pediatric hospital and outpatient facility. Comprehension of 8 essential elements of the P/A process was assessed. The majority of prestudy subjects preferred the video version of the dual-energy radiograph absorptiometry description over the animated and paper versions combined (41 of 48 [85%]; P better overall comprehension compared with the paper P/A process (P = .0009), and there were highly significant differences in understanding of study procedures (P = .0002) and risks (P multimedia group had significantly better overall comprehension (P = .03). Multimedia approaches to the research P/A process may improve overall understanding of research participation for children and parents. Improved understanding of study-specific research components (rather than research rights) may improve overall comprehension.

  19. Association between Smokefree Legislation and Hospitalizations for Cardiac, Cerebrovascular and Respiratory Diseases: A Meta-Analysis

    Science.gov (United States)

    Tan, Crystal E.; Glantz, Stanton A.

    2012-01-01

    Background Secondhand smoke causes cardiovascular and respiratory disease. Smokefree legislation is associated with a lower risk of hospitalization and death from these diseases. Methods and Results Random effects meta-analysis was conducted by law comprehensiveness to determine the relationship between smokefree legislation and hospital admission or death from cardiac, cerebrovascular, and respiratory diseases. Studies were identified using a systematic search for studies published before November 30, 2011 using Science Citation Index, Google Scholar, PubMed, and Embase and references in identified papers. Change in hospital admissions (or deaths) in the presence of a smokefree law, duration of follow-up, and law comprehensiveness (workplaces only; workplaces and restaurants; or workplaces, restaurants, and bars) were recorded. Forty-five studies of 33 smokefree laws with median follow-up of 24 months (range 2–57 months) were included. Comprehensive smokefree legislation was associated with significantly lower rates of hospital admissions (or deaths) for all 4 diagnostic groups: coronary events (RR .848, 95% CI .816–.881), other heart disease (RR .610, 95% CI .440–.847), cerebrovascular accidents (RR .840, 95% CI .753–.936), and respiratory disease (RR .760, 95% CI .682–.846). The difference in risk following comprehensive smokefree laws does not change with longer follow-up. More comprehensive laws were associated with larger changes in risk. Conclusions Smokefree legislation was associated with a lower risk of smoking-related cardiac, cerebrovascular, and respiratory diseases, with more comprehensive laws associated with greater changes in risk. PMID:23109514

  20. Racial Differences by Ischemic Stroke Subtype: A Comprehensive Diagnostic Approach

    Directory of Open Access Journals (Sweden)

    Sarah Song

    2012-01-01

    Full Text Available Background. Previous studies have suggested that black populations have more small-vessel and fewer cardioembolic strokes. We sought to analyze racial differences in ischemic stroke subtype employing a comprehensive diagnostic workup with magnetic resonance-imaging-(MRI- based evaluation including diffusion-weighted imaging (DWI. Methods. 350 acute ischemic stroke patients admitted to an urban hospital with standardized comprehensive diagnostic evaluations were retrospectively analyzed. Ischemic stroke subtype was determined by three Trial of Org 10172 in Acute Stroke Treatment (TOAST classification systems. Results. We found similar proportions of cardioembolic and lacunar strokes in the black and white cohort. The only subtype category with a significant difference by race was “stroke of other etiology,” more common in whites. Black stroke patients were more likely to have an incomplete evaluation, but this did not reach significance. Conclusions. We found similar proportions by race of cardioembolic and lacunar strokes when employing a full diagnostic evaluation including DWI MRI. The relatively high rate of cardioembolism may have been underappreciated in black stroke patients when employing a CT approach to stroke subtype diagnosis. Further research is required to better understand the racial differences in frequency of “stroke of other etiology” and explore disparities in the extent of diagnostic evaluations.

  1. Trick questions: cosmopolitan hospitality

    Directory of Open Access Journals (Sweden)

    Eleanor Byrne

    2013-08-01

    Full Text Available Byrne’s paper consists of two parallel texts. The first explores the limits of cosmopolitanism in practice, taking as its subject the Life in the UK Citizenship Test, inaugurated under the Labour Government in 2005. It argues that the test exemplifies the predicament of all attempts at cosmopolitan hospitality as unconditional welcoming, through a discussion of the relation between questioning and welcoming the stranger. Establishing the relationship between cosmopolitanism and hospitality as envisaged in Derrida’s reading of Kant it asks what kind of cosmopolitan hospitality is either possible or desirable by exploring what Derrida calls the ‘perversions’ inherent in the structures of hospitality. It focuses on the concept of the ‘trick questions’ that the state asks the foreigner observed by Derrida in his reading of The Apology of Socrates; questions that seem to invite answers but foreclose the possibilities of a free response. The second text asks how this logic that Derrida identifies can be pushed or coaxed into new ways of addressing the perceived threats of ‘unconditional’ hospitality through a reading of ‘unconditional hospitality’ as queer in the work of Tove Jansson.

  2. [Communication among hospital leaders].

    Science.gov (United States)

    Haberey-Knuessi, Véronique; Heeb, Jean-Luc; De Morgan, Paula Emilie

    2013-12-01

    New management styles imposed on hospital institutions in recent years, have fundamentally changed the organization of the latter. Many texts discuss the consequences, specifically on the field of communication. The aim of this study was to understand the real impact of new management methods on communication by managers in hospital, but also on care teams in termes of satisfaction and/or stress. This two-year study was conducted among 900 executives in hospitals in Western Switzerland using a mixed methodology. A first phase of questionnaires highlighted the problematic areas, while a second phase in the form of organized group interviews in each hospital, had the objective of achieving a better understanding of the relationship between management and communication. The latter proved to be particularly significant in terms of results, and this is the one we focused on in this article.These results indeed show that a crucial role is given to communication by carers, and, at the same time a lessening of the time devoted to relationships, both among peers and with patients. Frustration then arises, which is not without consequences both for the management of patients and the institutions themselves. It is by means of these results that awareness is raised of the omnipresence of communication at all levels and the major advantages that positive dynamic supports. And, on the contrary, of the serious problems which may arise from management practice that do not give due importance to the dimension of communication, present in all sectors of the hospital.

  3. Comprehensive Environmental Response, Compensation and Liability Act

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This data represents geographic terms used within the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA). CERCLA, commonly known as...

  4. Comprehensive highway corridor planning with sustainability indicators.

    Science.gov (United States)

    2011-10-01

    "The Maryland State Highway Administration (SHA) has initiated major planning efforts to improve transportation : efficiency, safety, and sustainability on critical highway corridors through its Comprehensive Highway Corridor : (CHC) program. This pr...

  5. Comprehension and navigation of networked hypertexts

    NARCIS (Netherlands)

    Blom, Helen; Segers, Eliane; Knoors, Harry; Hermans, Daan; Verhoeven, Ludo

    2018-01-01

    This study aims to investigate secondary school students' reading comprehension and navigation of networked hypertexts with and without a graphic overview compared to linear digital texts. Additionally, it was studied whether prior knowledge, vocabulary, verbal, and visual working memory moderated

  6. Effective strategies for comprehensive corridor management

    Science.gov (United States)

    2004-10-01

    Despite the increasing importance of comprehensive corridor management at the state and local government level, questions remain regarding effective methods for developing and implementing corridor management plans. Further insight is also needed int...

  7. Profiling classroom reading comprehension development practices ...

    African Journals Online (AJOL)

    teaching practices for reading comprehension development from case study schools with achievement profiles at the PIRLS international .... who can understand the plot, character, setting, point of view ...... A teacher's handbook. Pretoria: DoE.

  8. Comprehensive Oncologic Emergencies Research Network (CONCERN)

    Science.gov (United States)

    The Comprehensive Oncologic Emergencies Research Network (CONCERN) was established in March 2015 with the goal to accelerate knowledge generation, synthesis and translation of oncologic emergency medicine research through multi-center collaborations.

  9. [Fibromyalgia syndrome after comprehensive treatment of breast cancer: a case report].

    Science.gov (United States)

    Ding, Xia; Li, Yan; Cui, Yiyi; Shen, Yingying; Gu, Jianzhong; Guo, Yong

    2016-05-25

    Fibromyalgia syndrome after comprehensive treatment of breast cancer is rare and seldom reported. Here we present a case of a 50-year-old female patient,who was admitted to the hospital because of generalized fibromyalgia for 3 months and brain metastasis after the right breast carcinoma surgery for 1 month, and the clinical diagnosis was brain metastasis from breast carcinoma combined with fibromyalgia syndrome. The fibromyalgia were relieved with proper symptomatic treatment but the patient eventually died of tumor progression.

  10. Adapting the SERVQUAL scale to hospital services: an empirical investigation.

    Science.gov (United States)

    Babakus, E; Mangold, W G

    1992-02-01

    Defining and measuring the quality of service has been a major challenge for health care marketers. A comprehensive service quality measurement scale (SERVQUAL) is empirically evaluated for its potential usefulness in a hospital service environment. Active participation by hospital management helped to address practical and user-related aspects of the assessment. The completed expectations and perceptions scales met various criteria for reliability and validity. Suggestions are provided for the managerial use of the scale, and a number of future research issues are identified.

  11. Listening comprehension across the adult lifespan.

    Science.gov (United States)

    Sommers, Mitchell S; Hale, Sandra; Myerson, Joel; Rose, Nathan; Tye-Murray, Nancy; Spehar, Brent

    2011-01-01

    Although age-related declines in perceiving spoken language are well established, the primary focus of research has been on perception of phonemes, words, and sentences. In contrast, relatively few investigations have been directed at establishing the effects of age on the comprehension of extended spoken passages. Moreover, most previous work has used extreme-group designs in which the performance of a group of young adults is contrasted with that of a group of older adults and little if any information is available regarding changes in listening comprehension across the adult lifespan. Accordingly, the goals of the current investigation were to determine whether there are age differences in listening comprehension across the adult lifespan and, if so, whether similar trajectories are observed for age-related changes in auditory sensitivity and listening comprehension. This study used a cross-sectional lifespan design in which approximately 60 individuals in each of 7 decades, from age 20 to 89 yr (a total of 433 participants), were tested on three different measures of listening comprehension. In addition, we obtained measures of auditory sensitivity from all participants. Changes in auditory sensitivity across the adult lifespan exhibited the progressive high-frequency loss typical of age-related hearing impairment. Performance on the listening comprehension measures, however, demonstrated a very different pattern, with scores on all measures remaining relatively stable until age 65 to 70 yr, after which significant declines were observed. Follow-up analyses indicated that this same general pattern was observed across three different types of passages (lectures, interviews, and narratives) and three different question types (information, integration, and inference). Multiple regression analyses indicated that low-frequency pure-tone average was the single largest contributor to age-related variance in listening comprehension for individuals older than 65 yr, but

  12. Smart Strategy to Boost Students' Reading Comprehension

    OpenAIRE

    Sfafi'i, Muhammad Lukman

    2015-01-01

    Reading as one of language skills plays significant roles in the teaching English as a foreign language. Since the teacher still uses the conventional way to teach reading, students‘ ability in reading comprehension seems still unsatisfactory yet. So, teacher should explore and develop new strategies. One of strategies in reading comprehension that can trigger our students to attain that purpose is SMART (Self Monitoring Approach for Reading and Thinking) strategy. ...

  13. A History of Rotorcraft Comprehensive Analyses

    Science.gov (United States)

    Johnson, Wayne

    2013-01-01

    A history of the development of rotorcraft comprehensive analyses is presented. Comprehensive analyses are digital computer programs that calculate the aeromechanical behavior of the rotor and aircraft, bringing together the most advanced models of the geometry, structure, dynamics, and aerodynamics available in rotary wing technology. The development of the major codes of the last five decades from industry, government, and universities is described. A number of common themes observed in this history are discussed.

  14. Proverb and idiom comprehension in Alzheimer disease.

    Science.gov (United States)

    Kempler, D; Van Lancker, D; Read, S

    1988-01-01

    Twenty-nine patients diagnosed with Probable Alzheimer Disease were administered tests of word, familiar phrases (idioms and proverbs), and novel phrase comprehension. From the early stage of the disease, patients performed worse at understanding familiar phrases than single words or novel phrases. The results uphold common observations that AD patients have difficulty interpreting abstract meanings. Cognitive variables responsible for poor idiom/proverb comprehension and the clinical implications of this new protocol are discussed.

  15. Building a comprehensive geriatric health care system: a case study.

    Science.gov (United States)

    Bleiweiss, L; Simson, S

    1976-01-01

    This case study focuses on the efforts of three urban medical care institutions--a Health Maintenance Organization, a nursing home, and a university hospital--to form an interorganizational relationship. The purpose of the relationship was to utilize the services of the three organizations in order to respond to the comprehensive health needs of an urban geriatric population. Movements in this triadic organizational relationship are described and analyzed in terms of four conceptual stages--exploration, negotiation, interaction and performance, and termination. Problems arising during these stages were not resolved and the relationship was terminated after approximately two years of existence. A sociological discussion of the case focuses on why the relationship failed. The organizational relationship was disrupted by three stresses that occurred during the four stages of the relationship. Stresses emerged for each organization in the areas of organizational integration, professional coordination, and environmental adaptation, making it difficult for the three to become integrated into an organizational system. As a result, the HMO, the nursing home, and the hospital did not benefit from relationships that could have enabled them to develop the multi-organizational system necessary to sustain an innovative, comprehansive geriatric health project. If, as Whitehead said, the greatest invention of the nineteenth century was the invention of the method of invention, the task of the succedding century has been to organize inventiveness. The difference is not in the nature of invention or of inventors, but in the manner in which the context of social institutions is organized for their support.

  16. Comprehensive care improves physical recovery of hip-fractured elderly Taiwanese patients with poor nutritional status.

    Science.gov (United States)

    Liu, Hsin-Yun; Tseng, Ming-Yueh; Li, Hsiao-Juan; Wu, Chi-Chuan; Cheng, Huey-Shinn; Yang, Ching-Tzu; Chou, Shih-Wei; Chen, Ching-Yen; Shyu, Yea-Ing L

    2014-06-01

    The effects of nutritional management among other intervention components have not been examined for hip-fractured elderly persons with poor nutritional status. Accordingly, this study explored the intervention effects of an in-home program using a comprehensive care model that included a nutrition-management component on recovery of hip-fractured older persons with poor nutritional status at hospital discharge. A secondary analysis of data from a randomized controlled trial with 24-month follow-up. A 3000-bed medical center in northern Taiwan. Subjects were included only if they had "poor nutritional status" at hospital discharge, including those at risk for malnutrition or malnourished. The subsample included 80 subjects with poor nutritional status in the comprehensive care group, 87 in the interdisciplinary care group, and 85 in the usual care group. The 3 care models were usual care, interdisciplinary care, and comprehensive care. Usual care provided no in-home care, interdisciplinary care provided 4 months of in-home rehabilitation, and comprehensive care included management of depressive symptoms, falls, and nutrition as well as 1 year of in-home rehabilitation. Data were collected on nutritional status and physical functions, including range of motion, muscle power, proprioception, balance and functional independence, and analyzed using a generalized estimating equation approach. We also compared patients' baseline characteristics: demographic characteristics, type of surgery, comorbidities, length of hospital stay, cognitive function, and depression. Patients with poor nutritional status who received comprehensive care were 1.67 times (95% confidence interval 1.06-2.61) more likely to recover their nutritional status than those who received interdisciplinary and usual care. Furthermore, the comprehensive care model improved the functional independence and balance of patients who recovered their nutritional status over the first year following discharge

  17. Rural hospital wages

    Science.gov (United States)

    Hendricks, Ann M.

    1989-01-01

    Average fiscal year 1982 wages from 2,302 rural American hospitals were used to test for a gradient descending from hospitals in counties adjacent to metropolitan areas to those not adjacent. Considerable variation in the ratios of adjacent to nonadjacent averages existed. No statistically significant difference was found, however. Of greater importance in explaining relative wages within States were occupational mix, mix of part-time and full-time workers, case mix, presence of medical residencies, and location in a high-rent county within the State. Medicare already adjusts payments for only two of these variables. PMID:10313454

  18. 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.

  19. Costs of hospital malnutrition.

    Science.gov (United States)

    Curtis, Lori Jane; Bernier, Paule; Jeejeebhoy, Khursheed; Allard, Johane; Duerksen, Donald; Gramlich, Leah; Laporte, Manon; Keller, Heather H

    2017-10-01

    Hospital malnutrition has been established as a critical, prevalent, and costly problem in many countries. Many cost studies are limited due to study population or cost data used. The aims of this study were to determine: the relationship between malnutrition and hospital costs; the influence of confounders on, and the drivers (medical or surgical patients or degree of malnutrition) of the relationship; and whether hospital reported cost data provide similar information to administrative data. To our knowledge, the last two goals have not been studied elsewhere. Univariate and multivariate analyses were performed on data from the Canadian Malnutrition Task Force prospective cohort study combined with administrative data from the Canadian Institute for Health Information. Subjective Global Assessment was used to assess the relationship between nutritional status and length of stay and hospital costs, controlling for health and demographic characteristics, for 956 patients admitted to medical and surgical wards in 18 hospitals across Canada. After controlling for patient and hospital characteristics, moderately malnourished patients' (34% of surveyed patients) hospital stays were 18% (p = 0.014) longer on average than well-nourished patients. Medical stays increased by 23% (p = 0.014), and surgical stays by 32% (p = 0.015). Costs were, on average, between 31% and 34% (p-values < 0.05) higher than for well-nourished patients with similar characteristics. Severely malnourished patients (11% of surveyed patients) stayed 34% (p = 0.000) longer and had 38% (p = 0.003) higher total costs than well-nourished patients. They stayed 53% (p = 0.001) longer in medical beds and had 55% (p = 0.003) higher medical costs, on average. Trends were similar no matter the type of costing data used. Over 40% of patients were found to be malnourished (1/3 moderately and 1/10 severely). Malnourished patients had longer hospital stays and as a result cost more than well

  20. Optimal Hospital Layout Design

    DEFF Research Database (Denmark)

    Holst, Malene Kirstine

    foundation. The basis of the present study lies in solving the architectural design problem in order to respond to functionalities and performances. The emphasis is the practical applicability for architects, engineers and hospital planners for assuring usability and a holistic approach of functionalities...... a correlation matrix. The correlation factor defines the framework for conceptual design, whereby the design considers functionalities and their requirements and preferences. It facilitates implementation of evidence-based design as it is prepared for ongoing update and it is based on actual data. Hence......, this contribution is a model for hospital design, where design derives as a response to the defined variables, requirements and preferences....

  1. Hospitality, Tourism, and Politics

    Directory of Open Access Journals (Sweden)

    Stephen W. Litvin

    2012-09-01

    Full Text Available Government policy has a significant impact on the hospitality and tourism industry, but it is unclear if political leaders fully understand this economic sector when crafting policies. This article offers new research about the direct involvement of industry practitioners in the political process, by analyzing the backgrounds of legislators in the six New England states. The data indicate that only 3% of these legislators have current or former careers related to hospitality and tourism. The author suggests that practitioners should seek election to political office, to better influence government policy.

  2. Is Word-Problem Solving a Form of Text Comprehension?

    Science.gov (United States)

    Fuchs, Lynn S.; Fuchs, Douglas; Compton, Donald L.; Hamlett, Carol L.; Wang, Amber Y.

    2015-01-01

    This study's hypotheses were that (a) word-problem (WP) solving is a form of text comprehension that involves language comprehension processes, working memory, and reasoning, but (b) WP solving differs from other forms of text comprehension by requiring WP-specific language comprehension as well as general language comprehension. At the start of…

  3. How to Improve Patient Safety Culture in Croatian Hospitals?

    Science.gov (United States)

    Šklebar, Ivan; Mustajbegović, Jadranka; Šklebar, Duška; Cesarik, Marijan; Milošević, Milan; Brborović, Hana; Šporčić, Krunoslav; Petrić, Petar; Husedžinović, Ino

    2016-09-01

    Patient safety culture (PCS) has a crucial impact on the safety practices of healthcare delivery systems. The purpose of this study was to assess the state of PSC in Croatian hospitals and compare it with hospitals in the United States. The study was conducted in three public general hospitals in Croatia using the Croatian translation of the Hospital Survey of Patient Safety Culture (HSOPSC). A comparison of the results from Croatian and American hospitals was performed using a T-square test. We found statistically significant differences in all 12 PSC dimensions. Croatian responses were more positive in the two dimensions of Handoff s and Transitions and Overall Perceptions of Patient Safety. In the remaining ten dimensions, Croatian responses were less positive than in US hospitals, with the most prominent areas being Nonpunitive Response to Error, Frequency of Events Reported, Communication Openness, Teamwork within Units, Feedback & Communication about Error, Management Support for Patient Safety, and Staffing. Our findings show that PSC is significantly lower in Croatian than in American hospitals, particularly in the areas of Nonpunitive Response to Error, Leadership, Teamwork, Communication Openness and Staffing. This suggests that a more comprehensive system for the improvement of patient safety within the framework of the Croatian healthcare system needs to be developed. Our findings also help confirm that HSOPSC is a useful and appropriate tool for the assessment of PSC. HSOPSC highlights the PSC components in need of improvement and should be considered for use in national and international benchmarking.

  4. The use of electronic health records in Spanish hospitals.

    Science.gov (United States)

    Marca, Guillem; Perez, Angel; Blanco-Garcia, Martin German; Miravalles, Elena; Soley, Pere; Ortiga, Berta

    The aims of this study were to describe the level of adoption of electronic health records in Spanish hospitals and to identify potential barriers and facilitators to this process. We used an observational cross-sectional design. The survey was conducted between September and December 2011, using an electronic questionnaire distributed through email. We obtained a 30% response rate from the 214 hospitals contacted, all belonging to the Spanish National Health Service. The level of adoption of electronic health records in Spanish hospitals was found to be high: 39.1% of hospitals surveyed had a comprehensive EHR system while a basic system was functioning in 32.8% of the cases. However, in 2011 one third of the hospitals did not have a basic electronic health record system, although some have since implemented electronic functionalities, particularly those related to clinical documentation and patient administration. Respondents cited the acquisition and implementation costs as the main barriers to implementation. Facilitators for EHR implementation were: the possibility to hire technical support, both during and post implementation; security certification warranty; and objective third-party evaluations of EHR products. In conclusion, the number of hospitals that have electronic health records is in general high, being relatively higher in medium-sized hospitals.

  5. Assessing hospitals' clinical risk management: Development of a monitoring instrument

    Directory of Open Access Journals (Sweden)

    Pfeiffer Yvonne

    2010-12-01

    Full Text Available Abstract Background Clinical risk management (CRM plays a crucial role in enabling hospitals to identify, contain, and manage risks related to patient safety. So far, no instruments are available to measure and monitor the level of implementation of CRM. Therefore, our objective was to develop an instrument for assessing CRM in hospitals. Methods The instrument was developed based on a literature review, which identified key elements of CRM. These elements were then discussed with a panel of patient safety experts. A theoretical model was used to describe the level to which CRM elements have been implemented within the organization. Interviews with CRM practitioners and a pilot evaluation were conducted to revise the instrument. The first nationwide application of the instrument (138 participating Swiss hospitals was complemented by in-depth interviews with 25 CRM practitioners in selected hospitals, for validation purposes. Results The monitoring instrument consists of 28 main questions organized in three sections: 1 Implementation and organizational integration of CRM, 2 Strategic objectives and operational implementation of CRM at hospital level, and 3 Overview of CRM in different services. The instrument is available in four languages (English, German, French, and Italian. It allows hospitals to gather comprehensive and systematic data on their CRM practice and to identify areas for further improvement. Conclusions We have developed an instrument for assessing development stages of CRM in hospitals that should be feasible for a continuous monitoring of developments in this important area of patient safety.

  6. Assessing hospitals' clinical risk management: Development of a monitoring instrument.

    Science.gov (United States)

    Briner, Matthias; Kessler, Oliver; Pfeiffer, Yvonne; Wehner, Theo; Manser, Tanja

    2010-12-13

    Clinical risk management (CRM) plays a crucial role in enabling hospitals to identify, contain, and manage risks related to patient safety. So far, no instruments are available to measure and monitor the level of implementation of CRM. Therefore, our objective was to develop an instrument for assessing CRM in hospitals. The instrument was developed based on a literature review, which identified key elements of CRM. These elements were then discussed with a panel of patient safety experts. A theoretical model was used to describe the level to which CRM elements have been implemented within the organization. Interviews with CRM practitioners and a pilot evaluation were conducted to revise the instrument. The first nationwide application of the instrument (138 participating Swiss hospitals) was complemented by in-depth interviews with 25 CRM practitioners in selected hospitals, for validation purposes. The monitoring instrument consists of 28 main questions organized in three sections: 1) Implementation and organizational integration of CRM, 2) Strategic objectives and operational implementation of CRM at hospital level, and 3) Overview of CRM in different services. The instrument is available in four languages (English, German, French, and Italian). It allows hospitals to gather comprehensive and systematic data on their CRM practice and to identify areas for further improvement. We have developed an instrument for assessing development stages of CRM in hospitals that should be feasible for a continuous monitoring of developments in this important area of patient safety.

  7. Ergonomics and nursing in hospital environments.

    Science.gov (United States)

    Rogers, Bonnie; Buckheit, Kathleen; Ostendorf, Judith

    2013-10-01

    This study describes workplace conditions, the environment, and activities that may contribute to musculoskeletal injuries among nurses, as well as identifies solutions to decrease these risks and improve work-related conditions. The study used a mixed-methods design. Participants included nurses and stakeholders from five hospitals. Several focus groups were held with nurses, walk-throughs of clinical units were conducted, and stakeholder interviews with key occupational health and safety personnel were conducted in each of the five hospitals, as well as with representatives from the American Nurses Association, Veterans Health Administration hospital, and National Institute for Occupational Safety and Health. Several key contributing factors, including the physical environment (e.g., layout and organization of work stations), work organization and culture (e.g., heavy workload, inadequate staffing, lack of education), and work activities (e.g., manual lifting of patients, lack of assistive devices), were identified. Recommendations included the need for a multifaceted and comprehensive approach to developing a sound ergonomics program. Copyright 2013, SLACK Incorporated.

  8. Hospital diversification: how to involve the pharmacy.

    Science.gov (United States)

    Smith, J E; Black, B L

    1987-05-01

    Participation by hospital pharmacy departments in planning and development of diversified services is described. Diversification requires market planning. Seven basic marketing steps are identification of mission, goals, and objectives; identification of growth strategies (market penetration, market development, product development, and diversification); market analysis of external factors (size, growth, and logistics; reimbursement and financial considerations; competition; regulatory issues; and legal issues); market analysis of internal factors (departmental organization and reporting lines, demographics of the institution, and costs and productivity associated with the new service); program development and design; implementation; and evaluation. Hospitals can diversify by expanding acute-care services through management contracts and mergers; developing new services to include long-term-care, ambulatory-care, occupational-health, and wellness programs; starting other health-care ventures, such as consulting, continuing medical education, and continuing education for nurses; and expanding into non-health-care businesses. Vertical diversification is finding new markets for existing services; horizontal diversification is development of new services for new markets. To diversify, an institution may need to change its corporate structure; it may form a family of corporations that includes a university, nonprofit hospitals, holding companies, for-profit corporations, joint ventures, and service organizations. Through diversification, institutions and pharmacy departments can create alternative sources of funding and offer more comprehensive services to patients.

  9. Quality of coroner's post-mortems in a UK hospital.

    Science.gov (United States)

    Al Mahdy, Husayn

    2014-01-01

    The aim of this paper was, principally, to look at the coroner's post-mortem report quality regarding adult medical patients admitted to an English hospital; and to compare results with Royal College of Pathologists guidelines. Hospital clinical notes of adult medical patients dying in 2011 and who were referred to the coroner's office to determine the cause of death were scrutinised. Their clinical care was also reviewed. There needs to be a comprehensive approach to coroner's post-mortems such as routinely taking histological and microbiological specimens. Acute adult medical patient care needs to improve. Steps should be taken to ensure that comprehensive coroner's post-mortems are performed throughout the UK, including with routine histological and microbiological specimens examination. Additionally, closer collaboration between clinicians and pathologists needs to occur to improve emergency adult medical patient clinical care. The study highlights inadequacies in coroner's pathology services.

  10. Impact of Scotland's comprehensive, smoke-free legislation on stroke.

    Directory of Open Access Journals (Sweden)

    Daniel F Mackay

    Full Text Available Previous studies have reported a reduction in acute coronary events following smoke-free legislation. Evidence is lacking on whether stroke is also reduced. The aim was to determine whether the incidence of stroke, overall and by sub-type, fell following introduction of smoke-free legislation across Scotland on 26 March 2006.A negative binomial regression model was used to determine whether the introduction of smoke-free legislation resulted in a step and/or slope change in stroke incidence. The model was adjusted for age-group, sex, socioeconomic deprivation quintile, urban/rural residence and month. Interaction tests were also performed. Routine hospital administrative data and death certificates were used to identify all hospital admissions and pre-hospital deaths due to stroke (ICD10 codes I61, I63 and I64 in Scotland between 2000 and 2010 inclusive. Prior to the legislation, rates of all stroke, intracerebral haemorrhage and unspecified stroke were decreasing, whilst cerebral infarction was increasing at 0.97% per annum. Following the legislation, there was a dramatic fall in cerebral infarctions that persisted for around 20 months. No visible effect was observed for other types of stroke. The model confirmed an 8.90% (95% CI 4.85, 12.77, p<0.001 stepwise reduction in cerebral infarction at the time the legislation was implemented, after adjustment for potential confounders.Following introduction of national, comprehensive smoke-free legislation there was a selective reduction in cerebral infarction that was not apparent in other types of stroke.

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

    Directory of Open Access Journals (Sweden)

    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.

  12. Preparing strategic information management plans for hospitals: a practical guideline SIM plans for hospitals: a guideline.

    Science.gov (United States)

    Brigl, B; Ammenwerth, E; Dujat, C; Gräber, S; Grosse, A; Häber, A; Jostes, C; Winter, A

    2005-01-01

    Systematic information management in hospitals demands for a strategic information management plan (SIM plan). As preparing a SIM plan is a considerable challenge we provide a practical guideline that is directly applicable when a SIM plan is going to be prepared. The guideline recommends a detailed structure of a SIM plan and gives advice about its content and the preparation process. It may be used as template, which can be adapted to the individual demands of any hospital. The guideline was used in several hospitals preparing a SIM plan. Experiences showed that the SIM plans could be prepared very efficiently and timely using the guideline, that the proposed SIM plan structure suited well, that the guideline offers enough flexibility to meet the requirements of the individual hospitals and that the specific recommendations of the guideline were very helpful. Nevertheless, we must strive for a more comprehensive theory of strategic information management planning which -- in the sense of enterprise architecture planning -- represents the intrinsic correlations of the different parts of a SIM plan to a greater extent.

  13. A Comprehensive Study of the Incentive Award Program at General Leonard Wood Army Community Hospital

    National Research Council Canada - National Science Library

    Cox, Michael

    2001-01-01

    .... Therefore, they commissioned this study to evaluate the present incentive award program based on fairness and effectiveness and to explore methods of reshaping the program into one that both rewards...

  14. A Comprehensive Structural Model of Factors Influencing Customers' Intention to Use Biometrics in the Hospitality Industry

    Science.gov (United States)

    Kim, Jungsun

    2009-01-01

    Hoteliers have installed new technology, such as self-service and wireless technology, to improve customer service or to increase revenue. However, it seems that they tend to either be unaware of or ignore potential vulnerability of their systems when they add more technologies. The underestimated risks can possibly result in massive losses for…

  15. A Comprehensive Model Of Customer Satisfaction In Hospitality And Tourism: Strategic Implications For Management

    OpenAIRE

    Robert Christie Mill

    2011-01-01

    Providing and maintaining customer satisfaction is one of the most important challenges facing business today. Although this is a relatively new concept, research into this area has grown since the early 1980s. One ongoing debate in consumer satisfaction circles is the extent to which it is a cognitive process or an emotional state. The two theories that best explain customer satisfaction are disconfirmation paradigm and expectancy-value concept. Disconfirmation theory postulates that cus...

  16. A Comprehensive Study of the Incentive Award Program at General Leonard Wood Army Community Hospital

    National Research Council Canada - National Science Library

    Cox, Michael

    2001-01-01

    ... appropriate behavior and motivates employees. The study is broken into three phases. In Phase I, a retrospective study looked at the current incentive award program to determine if awards distribution is equitable...

  17. A Comprehensive Study of the Incentive Award Program at General Leonard Wood Army Community Hospital

    Science.gov (United States)

    2001-08-08

    the 95% confidence level (Gravalos & Jack, 1995). Due to slacking sales, Mazda Motors of America, Inc., designed a study similar to the Goodyear... Mazda studies is contained in a 1993/94 study conducted by Innovative Resources. The study Incentive Awards 15 looked at the role emotion plays in the

  18. Hacking the hospital environment

    DEFF Research Database (Denmark)

    Boisen, Kirsten A; Boisen, Anne Bank; Thomsen, Stine Legarth

    2017-01-01

    BACKGROUND: There is a need for youth-friendly hospital environments as the ward environment may affect both patient satisfaction and health outcomes. OBJECTIVE: To involve young people in designing youth-friendly ward environment. METHODS: We arranged a design competition lasting 42 h (Hackathon...

  19. Vocabulary of hospitality

    NARCIS (Netherlands)

    Bedir, M.

    2014-01-01

    Attitudes about refugees begin with the words we ascribe them. In Turkey – which has historically absorbed newcomers from a variety of outside conflicts – the term ‘guest’ is commonly used. Taking this as a starting point, Merve Bedir questions the laws of hospitality in Turkey, and the inherent

  20. Innovations in Hospitality Industry

    Science.gov (United States)

    Dzhandzhugazova, Elena A.; Blinova, Ekaterina A.; Orlova, Liubov N.; Romanova, Marianna M.

    2016-01-01

    The article focuses on the study of the role and importance of innovation, its classification, the problems of its application in the hotel industry with emphasis on the application of sensory marketing tools in the development of the innovative marketing mix within the hospitality industry. The article provides an analysis of the "seven…

  1. Drawing Hospital Foodscapes

    DEFF Research Database (Denmark)

    Tvedebrink, Tenna Doktor Olsen; Fisker, Anna Marie; Kirkegaard, Poul Henning

    This poster presents a series of drawings depicting the initial considerations made with the Ph.D. project for an improved ‘Interior Design for Food’ in a Danish hospital ward. The project concerns a study on the ontological and symbolic interrelationship possibly existing between food...

  2. Nigerian Hospital Practice

    African Journals Online (AJOL)

    Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives. Journal Homepage Image. The aim of the Nigerian Hospital Practice Journal is to aid in enhancing the advancement of medicine globally by acting as a medium for disseminating information on current clinical and drug practices in ...

  3. American Hospital Association

    Science.gov (United States)

    ... Central Office-Coding Resources AHA Team Training Health Career Center Health Forum Connect More Regulatory Relief The regulatory burden faced by hospitals is substantial and unsustainable. Read the report . More AHA Opioid Toolkit Stem the Tide: Addressing the Opioid Epidemic More ...

  4. Responsible Hospitality. Prevention Updates

    Science.gov (United States)

    Colthurst, Tom

    2004-01-01

    Responsible Hospitality (RH)--also called Responsible Beverage Service (RBS)--encompasses a variety of strategies for reducing risks associated with the sale and service of alcoholic beverages. RH programs have three goals: (1) to prevent illegal alcohol service to minors; (2) to reduce the likelihood of drinkers becoming intoxicated; and (3) to…

  5. Nigerian Hospital Practice: Submissions

    African Journals Online (AJOL)

    It also publishes miscellaneous articles – hospital administration, business practice, accounting, Law for health practitioners and letters about published papers. All manuscript will be subject to blinded peer-review and the decision of the editor would be final. Articles submitted for consideration by the author should not have ...

  6. Hospitals as food arenas

    DEFF Research Database (Denmark)

    Poulsen, Signe; Jørgensen, Michael Søgaard

    2010-01-01

    also identified. Research limitations: The assessment of the dietary changes based on the canteen take-away food was only based on indirect assessments based on interviews with users and non-users and furthermore based on a questionnaire at one of the hospitals. Value/originality: Canteen take...

  7. Tygerberg Hospital, 1980

    African Journals Online (AJOL)

    haematocrit, cord bilirubin, number of liveborn babies, birth weight, neonatal death, hyaline membrane disease .... report the outcome of babies of mothers with severe. Rh disease treated at Tygerberg Hospital since 1980 by ..... Walker W. Haemolytic disease of the newborn. In: Gairdner D, Hull 0, eds. Recent Advances iD ...

  8. Hospitals : a design manual

    NARCIS (Netherlands)

    Wagenaar, C.; Mens, N.

    Hospitals as a building type have undergone a substantial evolution in the past years. Changes in healthcare, the impact of evidence-based medicine and aspects of healthcare economics (such as the clustering of diagnostic procedures in specialized clinics) pose new and different challenges for the

  9. Surgery, Hospitals, and Medications

    Science.gov (United States)

    ... involved in your hospital care that you have Sjögren’s syndrome. • Share information about your dryness symptoms and routine ... neck, jaw, or back. For more information on Sjögren’s syndrome, visit the SSF Web site at www.sjogrens. ...

  10. Drama Therapies in Hospitals

    Science.gov (United States)

    Goodman, Judith; Prosperi, Mario

    1976-01-01

    Explores the use of drama as a therapeutic tool at various hospitals and records specific therapy groups dialogues. Available from: The Drama Review, 51 West 4th Street, Room 300, New York, N.Y. 10012. Subscription Rates: $12.50 per year. (MH)

  11. Official Centre Hospitality

    International Development Research Centre (IDRC) Digital Library (Canada)

    Sylvain Dufour

    Approved by the Management Executive Committee. - 1 -. Version 3.1.0 effective 2017-06-28. Official Centre Hospitality. 1. Objective. 2. Application. 3. Definitions. 4. Roles and Responsibilities. 5. Authorization. 6. Consultants and Contractors. 7. Reimbursement. 1. Objective. To define the circumstances under which ...

  12. Enhancing hospital productivity

    NARCIS (Netherlands)

    van Hulst, B.L.

    2016-01-01

    Healthcare expenditure in Western countries is substantial and outpaces economic growth, therefore cost containment in healthcare is high on the political agenda. One option is to increase productivity in healthcare, do more with less. This thesis uses the Dutch hospitals as a case-study and

  13. Hospital emergency preparedness

    African Journals Online (AJOL)

    Tamara Shefer

    to make informed decisions about prioritising hazards in view of limited resources ... contingency plan, for instance, the Oshikoto Regional Council has identified ..... hospital relies on exercises conducted by the Namibia Airports Company (NAC) ... Small scale exercises can also be done in which certain elements of the plan ...

  14. Foundations of reading comprehension in children with intellectual disabilities

    NARCIS (Netherlands)

    Wingerden-Fontein, E.G. van; Segers, P.C.J.; Balkom, L.J.M. van; Verhoeven, L.T.W.

    2017-01-01

    Background Knowledge about predictors for reading comprehension in children with intellectual disabilities (ID) is still fragmented. Aims This study compared reading comprehension, word decoding, listening comprehension, and reading related linguistic and cognitive precursor measures in children

  15. Is Word-Problem Solving a Form of Text Comprehension?

    Science.gov (United States)

    Fuchs, Lynn S.; Fuchs, Douglas; Compton, Donald L.; Hamlett, Carol L.; Wang, Amber Y.

    2015-01-01

    This study’s hypotheses were that (a) word-problem (WP) solving is a form of text comprehension that involves language comprehension processes, working memory, and reasoning, but (b) WP solving differs from other forms of text comprehension by requiring WP-specific language comprehension as well as general language comprehension. At the start of the 2nd grade, children (n = 206; on average, 7 years, 6 months) were assessed on general language comprehension, working memory, nonlinguistic reasoning, processing speed (a control variable), and foundational skill (arithmetic for WPs; word reading for text comprehension). In spring, they were assessed on WP-specific language comprehension, WPs, and text comprehension. Path analytic mediation analysis indicated that effects of general language comprehension on text comprehension were entirely direct, whereas effects of general language comprehension on WPs were partially mediated by WP-specific language. By contrast, effects of working memory and reasoning operated in parallel ways for both outcomes. PMID:25866461

  16. 76 FR 61103 - Medicare Program; Comprehensive Primary Care Initiative

    Science.gov (United States)

    2011-10-03

    ...] Medicare Program; Comprehensive Primary Care Initiative AGENCY: Centers for Medicare & Medicaid Services... organizations to participate in the Comprehensive Primary Care initiative (CPC), a multipayer model designed to... the Comprehensive Primary Care initiative or the application process. SUPPLEMENTARY INFORMATION: I...

  17. Beyond the Story Map: Inferential Comprehension via Character Perspective

    Science.gov (United States)

    McTigue, Erin; Douglass, April; Wright, Katherine L.; Hodges, Tracey S.; Franks, Amanda D.

    2015-01-01

    Inferential comprehension requires both emotional intelligence and cognitive skills, however instructional comprehension strategies typically underemphasize the emotional contribution. This article documents an intervention used by diverse third grade students which centers on teaching story comprehension through character perspective-taking…

  18. [Leadership in the hospital].

    Science.gov (United States)

    Schrappe, Matthias

    2009-01-01

    Current concepts in leadership and governance on the level of supervisory board, management and departments are often considered as insufficient to cope with the profound structural change which actually takes place in the German health care system. While vertical and horizontal disconnecting is typical of the professional bureaucracy of hospitals, transition from functional to divisional structure further increases this risk. Accordingly, medical experts are oriented towards their professional peers and patient care on the one side; on the other side the management gets isolated and looses operative and strategic control. Several studies provide evidence for the relevance of role models to serve as agents of change, which are now developed into the concept of "Clinical Governance": evidence-based medicine, guidelines, continuous quality improvement, safety culture, resource accountability and organisational learning. The present situation makes it necessary to extend this conception, which focuses on the departmental level in an organisation with divisional features, to one of "Clinical Corporate Governance". This term, which also includes supervisory structures and the management board and is relevant for the total hospital and company, respectively, is based on the corporate governance concept. Inside the hospital, the management and the heads of the departments have to agree that (1) experts really need to be integrated into the decision process, and that (2) the outcomes of the entire hospital have to be regarded as equal or superior to the aims of a single department. The public image of the hospital should be one of a strong and reliable partner in health care and health care business on a local, regional and national level. Members of the supervisory board should clearly put corporate aspects above political and other implications and pay attention to personal independence from the leaders of the medical departments.

  19. El hospital universitario

    Directory of Open Access Journals (Sweden)

    José Félix Patiño-Restrepo

    2016-10-01

    Full Text Available Según el Diccionario de la Real Academia Española (1, el vocablo hospital viene del latín hospitālis y en su primera acepción se define como: “1. m. Establecimiento destinado al diagnóstico y tratamiento de enfermos, donde a menudo se practican la investigación y la docencia”. Sin embargo, las otras acepciones se refieren a sus orígenes medievales: “2. m. Casa que servía para recoger pobres y peregrinos por tiempo limitado. 3. adj. ant. Afable y caritativo con los huéspedes. 4. adj. ant. Perteneciente o relativo al buen hospedaje”. El hospital moderno, en realidad, es la combinación de ciencia, tecnología, hospedaje y humanitarismo. ¿Cuándo nació el hospital y cuál es su historia? En la Edad Media temprana surgieron los xenodochia, albergues para pobres y peregrinos fundados por la iglesia católica en el marco del sentido humanitario del cristianismo. En los comienzos del siglo XIII, cuando las ciudades acumularon riqueza para sostener sus propios ejércitos, se presentó un fenómeno de crecimiento en el número de albergues y estos empezaron a caracterizarse por atender enfermos; ya para esta época no eran solo fundados por la iglesia, sino también por autoridades civiles. Aunque se siguió el modelo del Hospital del Santo Spirito de Roma, construido por orden del papa Inocencio III (1161-1216, en Francia se fundaron los Hôtel-Dieu, generalmente en la vecindad de las catedrales, que aún conservaban la característica de ser más bien albergues para los más necesitados y desamparados.

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

    Directory of Open Access Journals (Sweden)

    Yallew WW

    2016-08-01

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

  1. The founding of Zemun Hospital

    Directory of Open Access Journals (Sweden)

    Milanović Jasmina

    2014-01-01

    Full Text Available This year Zemun Hospital - Clinical Hospital Center Zemun celebrates 230th anniversary of continuous work, thus becoming the oldest medical facility in Serbia. The exact date of the hospital founding has been often questioned in history. Various dates appeared in the literature, but the most frequent one was 25th of February 1784. Until now, the document which confirms this has never been published. This article represents the first official publication of the document which confirms that Zemun Hospital was indeed founded on this date. The first hospitals started emerging in Zemun when the town became a part of the Habsburg Monarchy. The first sanitary facility ever formed was the “Kontumac” - a quarantine established in 1730. Soon after, two more confessional hospitals were opened. The Serbian (Orthodox Hospital was founded before 1769, whereas the German (Catholic Hospital started working in 1758. Both hospitals were financed, amongst others, by the Town Hall - the Magistrate. In order to improve efficiency of these hospitals, a decision was made to merge them into a single City Hospital. It was founded on 25th February 1784, when the General Command ordered the Magistrate of Zemun to merge the financess of all existing hospitals and initiate the construction of a new building. Although financially united, the hospitals continued working in separate buildings over a certain period of time. The final, physical merging of these hospitals was completed in 1795. [Projekat Ministarstva nauke Republike Srbije, br. 47030

  2. Hospital pharmacy workforce in Brazil.

    Science.gov (United States)

    Santos, Thiago R; Penm, Jonathan; Baldoni, André O; Ayres, Lorena Rocha; Moles, Rebekah; Sanches, Cristina

    2018-01-04

    This study aims to describe the distribution of the hospital pharmacy workforce in Brazil. Data were acquired, during 2016, through the Brazilian National Database of Healthcare Facilities (CNES). The following variables were extracted: hospital name, registry number, telephone, e-mail, state, type of institution, subtype, management nature, ownership, presence of research/teaching activities, complexity level, number of hospital beds, presence of pharmacists, number of pharmacists, pharmacist specialization. All statistical analyses were performed by IBM SPSS v.19. The number of hospitals with a complete registry in the national database was 4790. The majority were general hospitals (77.9%), managed by municipalities (66.1%), under public administration (44.0%), had no research/teaching activities (90.5%), classified as medium complexity (71.6%), and had no pharmacist in their team (50.6%). Furthermore, almost 60.0% of hospitals did not comply with the minimum recommendations of having a pharmacist per 50 hospital beds. The Southeast region had the highest prevalence of pharmacists, with 64.4% of hospitals having a pharmaceutical professional. This may have occurred as this region had the highest population to hospital ratio. Non-profit hospitals were more likely to have pharmacists compared to those under public administration and private hospitals. This study mapped the hospital pharmacy workforce in Brazil, showing a higher prevalence of hospital pharmacists in the Southeast region, and in non-profit specialized hospitals.

  3. Hospitals Participating In ACOs Tend To Be Large And Urban, Allowing Access To Capital And Data.

    Science.gov (United States)

    Colla, Carrie H; Lewis, Valerie A; Tierney, Emily; Muhlestein, David B

    2016-03-01

    Relationships between physicians and hospitals have changed considerably over the past decade, as hospitals and physician groups have integrated and new public and private payment policies have created financial interdependence. The extent to which accountable care organizations (ACOs) involve hospitals in their operations may prove to be vitally important, because managing hospital care is a key part of improving health care quality and lowering cost growth. Using primary data on ACO composition and capabilities paired with hospital characteristics, we found that 20 percent of US hospitals were part of an ACO in 2014. Hospitals that were in urban areas, were nonprofit, or had a smaller share of Medicare patients were more likely to participate in ACOs, compared to hospitals that were in more rural areas, were for-profit or government owned, or had a larger share of Medicare patients, respectively. Qualitative data identified the following advantages of including a hospital in an ACO: the availability of start-up capital, advanced data sharing, and engagement of providers across the care continuum. Although the 63 percent of ACOs that included hospitals offered more comprehensive services compared to ACOs without hospitals, we found no differences between the two groups in their ability to manage hospital-related aspects of patient care. Project HOPE—The People-to-People Health Foundation, Inc.

  4. 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).

  5. Dichotic listening performance predicts language comprehension.

    Science.gov (United States)

    Asbjørnsen, Arve E; Helland, Turid

    2006-05-01

    Dichotic listening performance is considered a reliable and valid procedure for the assessment of language lateralisation in the brain. However, the documentation of a relationship between language functions and dichotic listening performance is sparse, although it is accepted that dichotic listening measures language perception. In particular, language comprehension should show close correspondence to perception of language stimuli. In the present study, we tested samples of reading-impaired and normally achieving children between 10 and 13 years of age with tests of reading skills, language comprehension, and dichotic listening to consonant-vowel (CV) syllables. A high correlation between the language scores and the dichotic listening performance was expected. However, since the left ear score is believed to be an error when assessing language laterality, covariation was expected for the right ear scores only. In addition, directing attention to one ear input was believed to reduce the influence of random factors, and thus show a more concise estimate of left hemisphere language capacity. Thus, a stronger correlation between language comprehension skills and the dichotic listening performance when attending to the right ear was expected. The analyses yielded a positive correlation between the right ear score in DL and language comprehension, an effect that was stronger when attending to the right ear. The present results confirm the assumption that dichotic listening with CV syllables measures an aspect of language perception and language skills that is related to general language comprehension.

  6. Strategy-based listening and pragmatic comprehension

    Directory of Open Access Journals (Sweden)

    Corsetti, Cristiane Ruzicki

    2014-01-01

    Full Text Available This article addresses the role of strategy-based listening as an alternative methodological approach to develop pragmatic comprehension in L2 contexts. Pragmatic comprehension refers to the understanding of speech acts and conversational implicatures. Listening comprehension comprises both bottom-up and top-down processes. Strategy-based listening encompasses the activation of pragmatic knowledge through pre-listening activities and the development of specific listening micro-skills. An empirical project which included a classroom project carried out with a group of eight learners preparing for the IELTS examination in 2009 corroborated the following assumptions: in order to achieve listening proficiency, learners need practice in making inferences as semantic and pragmatic inferences are embedded in verbal communication; semantic and pragmatic aspects affecting the meaning of utterances can be highlighted via comprehension activities focusing on specific listening subskills. The results of the classroom project suggested that strategy-based listening is potentially capable of directly enhancing pragmatic comprehension but were inconclusive with regards to pragmatic production

  7. Streamlining Workflow for Endovascular Mechanical Thrombectomy: Lessons Learned from a Comprehensive Stroke Center.

    Science.gov (United States)

    Wang, Hongjin; Thevathasan, Arthur; Dowling, Richard; Bush, Steven; Mitchell, Peter; Yan, Bernard

    2017-08-01

    Recently, 5 randomized controlled trials confirmed the superiority of endovascular mechanical thrombectomy (EMT) to intravenous thrombolysis in acute ischemic stroke with large-vessel occlusion. The implication is that our health systems would witness an increasing number of patients treated with EMT. However, in-hospital delays, leading to increased time to reperfusion, are associated with poor clinical outcomes. This review outlines the in-hospital workflow of the treatment of acute ischemic stroke at a comprehensive stroke center and the lessons learned in reduction of in-hospital delays. The in-hospital workflow for acute ischemic stroke was described from prehospital notification to femoral arterial puncture in preparation for EMT. Systematic review of literature was also performed with PubMed. The implementation of workflow streamlining could result in reduction of in-hospital time delays for patients who were eligible for EMT. In particular, time-critical measures, including prehospital notification, the transfer of patients from door to computed tomography (CT) room, initiation of intravenous thrombolysis in the CT room, and the mobilization of neurointervention team in parallel with thrombolysis, all contributed to reduction in time delays. We have identified issues resulting in in-hospital time delays and have reported possible solutions to improve workflow efficiencies. We believe that these measures may help stroke centers initiate an EMT service for eligible patients. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  8. The Birth of Hospital, Asclepius cult and Early Christianity.

    Science.gov (United States)

    Yeo, In-Sok

    2017-04-01

    History of hospital is one of main fields of researches in medical history. Besides writing a history of an individual hospital, considerable efforts have been made to trace the origin of hospital. Those who quest for the origin of hospital are faced with an inevitable problem of defining hospital. As the different definition can lead to a different outcome, it is important to make a clear definition. In this article, the hospital was defined as an institution in which patients are housed and given medical treatments. According to the definition, the Great Basilius is regarded to have created the first hospital in 369 CE. The creation of hospital is considered to be closely related with Christian philantrophy. However, the question is raised against this explanation. As the religious philantrophy does not exclusively belong to the Christianity alone, more comprehensive and persuasive theory should be proposed to explain why the first hospital was created in the Christian World, not in the Buddhistic or other religious world. Furthermore, in spite of sharing the same Christian background, why the first hospital appeared in Byzantine Empire, not in Western Roman Empire, also should be explained. My argument is that Asclepius cult and the favorable attitude toward medicine in Greek world are responsible to the appearance of the first hospital in Byzantine Empire. The evangelic work of Jesus was heavily depended on healing activities. The healing activities of Jesus and his disciples were rivalled by Asclepius cult which had been widely spread and practiced in the Hellenistic world. The temples of Asclepius served as a model for hospital, for the temples were the institution exclusively reserved for the patients. The exclusive housing of patients alone in the temples of Asclepius is clearly contrasted with the other early forms of hospitals in which not only patients but also the poor, foreigners and pilgrims were housed altogether. Toward the healing god Asclepius

  9. 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...

  10. Planning Study Hospital, Cape Town The Hospital Information at ...

    African Journals Online (AJOL)

    Tile HOspital Information Plan- ning Study ... Hospital, and based on. the Business Systems Plan- ... technology can be of considerable benefit in dealing with these issues. .... coherenr, flexible information systems with a minimum of data.

  11. Healthy hospital food initiatives in the United States: time to ban sugar sweetened beverages to reduce childhood obesity

    OpenAIRE

    Wojcicki, Janet M

    2013-01-01

    While childhood obesity is a global problem, the extent and severity of the problem in United States, has resulted in a number of new initiatives, including recent hospital initiatives to limit the sale of sweetened beverages and other high calorie drinks in hospital vending machines and cafeterias. These proposed policy changes are not unique to United States, but are more comprehensive in the number of proposed hospitals that they will impact. Meanwhile, however, it is advised, that these i...

  12. Object orientation affects spatial language comprehension.

    Science.gov (United States)

    Burigo, Michele; Sacchi, Simona

    2013-01-01

    Typical spatial descriptions, such as "The car is in front of the house," describe the position of a located object (LO; e.g., the car) in space relative to a reference object (RO) whose location is known (e.g., the house). The orientation of the RO affects spatial language comprehension via the reference frame selection process. However, the effects of the LO's orientation on spatial language have not received great attention. This study explores whether the pure geometric information of the LO (e.g., its orientation) affects spatial language comprehension using placing and production tasks. Our results suggest that the orientation of the LO influences spatial language comprehension even in the absence of functional relationships. Copyright © 2013 Cognitive Science Society, Inc.

  13. Palliative Care: Delivering Comprehensive Oncology Nursing Care.

    Science.gov (United States)

    Dahlin, Constance

    2015-11-01

    To describe palliative care as part of comprehensive oncology nursing care. A review of the palliative care, oncology, and nursing literature over the past 10 years. Palliative care is mandated as part of comprehensive cancer care. A cancer diagnosis often results in distress in the physical, psychosocial, spiritual, and emotional domains of care. Oncology nurses are essential in providing palliative care from diagnosis to death to patients with cancer. They address the myriad aspects of cancer. With palliative care skills and knowledge, oncology nurses can provide quality cancer care. There are many opportunities in which oncology nurses can promote palliative care. Oncology nurses must obtain knowledge and skills in primary palliative care to provide comprehensive cancer care. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Effects of Psychological Attention on Pronoun Comprehension

    Science.gov (United States)

    Arnold, Jennifer E.; Lao, Shin-Yi C.

    2015-01-01

    Pronoun comprehension is facilitated for referents that are focused in the discourse context. Discourse focus has been described as a function of attention, especially shared attention, but few studies have explicitly tested this idea. Two experiments used an exogenous capture cue paradigm to demonstrate that listeners’ visual attention at the onset of a story influences their preferences during pronoun resolution later in the story. In both experiments trial-initial attention modulated listeners’ transitory biases while considering referents for the pronoun, whether it was in response to the capture cue or not. These biases even had a small influence on listeners’ final interpretation of the pronoun. These results provide independently-motivated evidence that the listener’s attention influences the on-line processes of pronoun comprehension. Trial-initial attentional shifts were made on the basis of non-shared, private information, demonstrating that attentional effects on pronoun comprehension are not restricted to shared attention among interlocutors. PMID:26191533

  15. The impact of HMO and hospital competition on hospital costs.

    Science.gov (United States)

    Younis, Mustafa Z; Rivers, Patrick A; Fottler, Myron D

    2005-01-01

    This study examines the impact of HMO penetration and competition on health system performance, as measured by hospital cost per adjusted admissions. The study population consisted of acute-care hospitals in the United States. The findings of this study suggest that there is no relationship between HMO competition and hospital cost per adjusted admission. Governmental efforts to stimulate competition in the hospital market, if focused on promoting HMOs, are not likely to produce cost-containing results quickly.

  16. The Role of First-Language Listening Comprehension in Second-Language Reading Comprehension

    Science.gov (United States)

    Edele, Aileen; Stanat, Petra

    2016-01-01

    Although the simple view of reading and other theories suggest that listening comprehension is an important determinant of reading comprehension, previous research on linguistic transfer has mainly focused on the role of first language (L1) decoding skills in second language (L2) reading. The present study tested the assumption that listening…

  17. Individual differences in reading comprehension : A componential approach to eighth graders’ expository text comprehension

    NARCIS (Netherlands)

    Welie, C.J.M.

    2017-01-01

    Why do secondary school students differ in their text comprehension? This is an important question because many secondary school students are unable to achieve the level of text comprehension required to enable learning from their school book texts. This thesis contributes to answering this question

  18. Pediatric out-of-hospital deaths following hospital discharge: a ...

    African Journals Online (AJOL)

    Background: Out-of-hospital death among children living in resource poor settings occurs frequently. Little is known about the location and circumstances of child death following a hospital discharge. Objectives: This study aimed to understand the context surrounding out-of-hospital deaths and the barriers to accessing ...

  19. 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) ...

  20. Cellular communications a comprehensive and practical guide

    CERN Document Server

    Tripathi, Nishith

    2014-01-01

    Even as newer cellular technologies and standards emerge, many of the fundamental principles and the components of the cellular network remain the same. Presenting a simple yet comprehensive view of cellular communications technologies, Cellular Communications provides an end-to-end perspective of cellular operations, ranging from physical layer details to call set-up and from the radio network to the core network. This self-contained source forpractitioners and students represents a comprehensive survey of the fundamentals of cellular communications and the landscape of commercially deployed

  1. [Hospital emergency rooms].

    Science.gov (United States)

    Tudela, Pere; Mòdol, Josep Maria

    2003-05-17

    Overuse of hospital emergency rooms (HERs) is parallel to their controversy. To understand this problem, some concepts should be first clarified. In HERs, there are some intrinsic aspects which are directly related to the emergency itself and thus cannot be modified (intermittent patient flow, need to prioritize, difficulty to achieve a rapid diagnosis, influence of time on treatment, value of clinical follow up, patient's expectations, impact of HER on the overall hospital working dynamics). On the other hand, there are some extrinsic aspects which indeed are not related to HER itself but are rather historically associated with it (precarious structure, delay on admission, lack of privacy, inadequate triage of cases, lack of professionalization); these latter aspects may be potentially modified and should be reconsidered.

  2. HOSPITALITY TODAY AND TOMORROW

    Directory of Open Access Journals (Sweden)

    Ray F. IUNIUS

    2017-08-01

    Full Text Available As a wise man once said, “Don’t worry about what you don’t know. Be worried about what you think you know, but don’t.” Regarding different ways “hospitality” is understood, the root of the problem lies in part in the different interpretations that hospitality has in different cultures and languages. In American English, for example, when we speak about “hospitality” we first think of it as an industry and only secondarily as an attribute of an individual or community. In other cultures, the primary meaning of hospitality is more a characteristic of people, or of a country or city, etc., and encompasses such ideas as welcome, reception, amiability, generosity, etc. – not an industry! Even in American English, other words are sometimes used to describe the same economic activity: lodging, accommodation, etc.

  3. [Play therapy in hospital].

    Science.gov (United States)

    Gold, Katharina; Grothues, Dirk; Leitzmann, Michael; Gruber, Hans; Melter, Michael

    2012-01-01

    The following article presents an overview of current research studies on play therapy in the hospital. It highlights individual diagnoses for which play therapy has shown reasonable success. The aim of this review is to describe the current status of the scientific debate on play therapy for sick children in order to allow conclusions regarding the indications for which play therapy is or might be useful.

  4. Hospital nurses' work motivation.

    Science.gov (United States)

    Toode, Kristi; Routasalo, Pirkko; Helminen, Mika; Suominen, Tarja

    2015-06-01

    The knowledge surrounding nurses' work motivation is currently insufficient, and previous studies have rarely taken into account the role of many influential background factors. This study investigates the motivation of Estonian nurses in hospitals, and how individual and organisational background factors influence their motivation to work. The study is quantitative and cross-sectional. An electronically self-reported questionnaire was used for data collection. The sample comprised of 201 Registered Nurses working in various hospital settings in Estonia. Data were analysed using descriptive statistics, two-sample Wilcoxon rank-sum (Mann-Whitney) test, Kruskal-Wallis equality-of-populations rank test and Spearman's correlation. Both extrinsic and intrinsic motivations were noted among hospital nurses. Nurses were moderately externally motivated (M = 3.63, SD = 0.89) and intrinsically strongly motivated (M = 4.98, SD = 1.03). A nurses' age and the duration of service were positively correlated with one particular area of extrinsic work motivation, namely introjected regulation (p extrinsic motivation (p = 0.016) and intrinsic work motivation (p = 0.004). The findings expand current knowledge of nurses' work motivation by describing the amount and orientation of work motivation among hospital nurses and highlighting background factors which should be taken into account in order to sustain and increase their intrinsic work motivation. The instrument used in the study can be an effective tool for nurse managers to determine a nurse's reasons to work and to choose a proper motivational strategy. Further research and testing of the instrument in different countries and in different contexts of nursing is however required. © 2014 Nordic College of Caring Science.

  5. Patient life in hospital

    DEFF Research Database (Denmark)

    Ludvigsen, Mette Spliid

    Patient life in hospital.A qualitative study of informal relationships between hospitalised patients Introduction Within a patientology framework, this PhD dissertation is about an empirical study on patient life that provides insight into the nature of informal relationships between patients...... are created through stories about three roughly framed aspects of hospitalisation: A. Being together with fellow patients entails a constant dilemma, B. Relationships between patients are restricted and extended and C. Shifting perspectives in solidarity. Conclusion Patients' hospitalisation is strongly...

  6. Hospital Presbiteriano Valley

    Directory of Open Access Journals (Sweden)

    Luckman, Charles

    1964-12-01

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

  7. [Trends in hospital care].

    Science.gov (United States)

    Vecina Neto, Gonzalo; Malik, Ana Maria

    2007-01-01

    This paper analyses trends in the delivery of hospital services in Brazil, considering the setting, the current situation and its challenges, examining what still remains to be done. The variables studied for the analysis of the setting are: demography, epidemiological profile, human resources, technology, medicalization, costs, review of the role of the citizen, legislation, equity, hospital-centricity and regionalization, care fractioning and bed availability. The Brazilian setting was studied through the supplementary healthcare model, financing and the healthcare area production chain. The observations of the current situation present external evaluation models, outsourcing, public-private relationships, de-hospitalization and financing. The analysis of the challenges examines the need for long range planning, the quest for new legal models for the 'business', the use of information and information systems, cost controls and the need for enhanced efficiency and compliance with legal directives, guaranteed universal access to full healthcare facilities, the inclusion of primary prevention in healthcare procedures, integrating the public and private sectors and engaging physicians in solving problems.

  8. Facts about Hospital Worker Safety

    Science.gov (United States)

    ... statistics show that hospitals are still relatively hazardous workplaces, and they have much room to improve. OSHA has developed this factbook to help hospital safety managers and other stakeholders understand the challenges of worker ...

  9. HSIP Hospitals in New Mexico

    Data.gov (United States)

    Earth Data Analysis Center, University of New Mexico — Hospitals in New Mexico The term "hospital" ... means an institution which- (1) is primarily engaged in providing, by or under the supervision of physicians, to...

  10. Radiological incident preparedness for community hospitals: a demonstration project.

    Science.gov (United States)

    Jafari, Mary Ellen

    2010-08-01

    In November 2007, the Wisconsin Division of Public Health Hospital Disaster Preparedness Program State Expert Panel on Radiation Emergencies issued a report titled The Management of Patients in a Radiological Incident. Gundersen Lutheran Health System was selected to conduct a demonstration project to implement the recommendations in that report. A comprehensive radiological incident response plan was developed and implemented in the hospital's Trauma and Emergency Center, including the purchase and installation of radiation detection and identification equipment, staff education and training, a tabletop exercise, and three mock incident test exercises. The project demonstrated that the State Expert Panel report provides a flexible template that can be implemented at community hospitals using existing staff for an approximate cost of $25,000.

  11. Information and communication technologies in hospital nursing care

    Directory of Open Access Journals (Sweden)

    Luís Felipe Pissaia

    2017-10-01

    Full Text Available Justification and objective: This study has the objective check the use of Information and Communication Technologies (ICT in care processes of nursing through the methodology of Systematization of Nursing Assistance (SNA in a hospital in the interior of Rio Grande do Sul, Brasil. Methods: Descriptive and exploratory study with a qualitative approach carried out six nurses of a hospital service. Results: The lack of knowledge about the importance of ICT, the deficit in the provision of continuing education to professionals and cultural prejudice to new working methods were list as existing weaknesses. Contributions are relate to organizing and planning your activities, as well as an effective personnel management based on the principles of comprehensive care provided to the client. Conclusion: This study demonstrated that ICT help in the implementation of processes and implementation of SNA, promoting new models of work to nurses and encouraging compliance by the hospitals.

  12. Analysis of the healthcare waste management status in Tehran hospitals.

    Science.gov (United States)

    Malekahmadi, Fariba; Yunesian, Masud; Yaghmaeian, Kamyar; Nadafi, Kazem

    2014-01-01

    Considering the importance of healthcare waste management, following the ratification of the Waste Management law in 2005 and the subsequent approval of its executive bylaw in 2006 and finally the healthcare waste management criteria passing by the parliament in 2008, a review on the status of healthcare waste management is needed to implement the mentioned law properly. In this retrospective study during six months period all public hospitals in Iran's capital city, Tehran, were selected to conduct the survey. Data collected through an expert-standardized questionnaire was analyzed by using SPSS software. The results of the current status of healthcare waste management in Tehran hospitals showed 5.6% of hospitals were ranked excellent, 50.7% good, 26.4% medium, and the 13.9% of hospitals were ranked weak and 3.5% ranked very poor. The findings showed that appropriate technologies should be used to have better disposal stage. As the ratified criteria were not fully observed by all the selected hospitals, training courses and comprehensive program conducting by each hospital could be enjoyed as practical tools to implement the all stages of healthcare waste management properly.

  13. Removal Efficiency of Microbial Contaminants from Hospital Wastewaters

    KAUST Repository

    Timraz, Kenda

    2016-02-01

    This study aims to evaluate the removal efficiency of microbial contaminants from two hospitals on-site Wastewater Treatment Plants (WWTPs) in Saudi Arabia. Hospital wastewaters often go untreated in Saudi Arabia as in many devolving countries, where no specific regulations are imposed regarding hospital wastewater treatment. The current guidelines are placed to ensure a safe treated wastewater quality, however, they do not regulate for pathogenic bacteria and emerging contaminants. Results from this study have detected pathogenic bacterial genera and antibiotic resistant bacteria in the sampled hospitals wastewater. And although the treatment process of one of the hospitals was able to meet current quality guidelines, the other hospital treatment process failed to meet these guidelines and disgorge of its wastewater might be cause for concern. In order to estimate the risk to the public health and the impact of discharging the treated effluent to the public sewage, a comprehensive investigation is needed that will facilitate and guide suggestions for more detailed guidelines and monitoring.

  14. Electronic health record adoption in US hospitals: the emergence of a digital "advanced use" divide.

    Science.gov (United States)

    Adler-Milstein, Julia; Holmgren, A Jay; Kralovec, Peter; Worzala, Chantal; Searcy, Talisha; Patel, Vaishali

    2017-11-01

    While most hospitals have adopted electronic health records (EHRs), we know little about whether hospitals use EHRs in advanced ways that are critical to improving outcomes, and whether hospitals with fewer resources - small, rural, safety-net - are keeping up. Using 2008-2015 American Hospital Association Information Technology Supplement survey data, we measured "basic" and "comprehensive" EHR adoption among hospitals to provide the latest national numbers. We then used new supplement questions to assess advanced use of EHRs and EHR data for performance measurement and patient engagement functions. To assess a digital "advanced use" divide, we ran logistic regression models to identify hospital characteristics associated with high adoption in each advanced use domain. We found that 80.5% of hospitals adopted at least a basic EHR system, a 5.3 percentage point increase from 2014. Only 37.5% of hospitals adopted at least 8 (of 10) EHR data for performance measurement functions, and 41.7% of hospitals adopted at least 8 (of 10) patient engagement functions. Critical access hospitals were less likely to have adopted at least 8 performance measurement functions (odds ratio [OR] = 0.58; P functions (OR = 0.68; P = 0.02). While the Health Information Technology for Economic and Clinical Health Act resulted in widespread hospital EHR adoption, use of advanced EHR functions lags and a digital divide appears to be emerging, with critical-access hospitals in particular lagging behind. This is concerning, because EHR-enabled performance measurement and patient engagement are key contributors to improving hospital performance. Hospital EHR adoption is widespread and many hospitals are using EHRs to support performance measurement and patient engagement. However, this is not happening across all hospitals. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions

  15. Pseudomonas aeruginosa from hospital environment

    Directory of Open Access Journals (Sweden)

    Milind Davane

    2014-03-01

    Full Text Available Hospital acquired infection is an additional affliction to the patient admitted to the hospital for some serious illness and is caused by pathogens which are prevalent in hospital environment. In the hospital, microbes are ubiquitous; and can reach the sick patient through various sources, such as air, water, food, contaminated equipments, linen, catheters, scopes, ventilators, contaminated disinfectants and other preparations used for treatment, visitors, infected patients, etc.

  16. Parametric Optimization of Hospital Design

    DEFF Research Database (Denmark)

    Holst, Malene Kirstine; Kirkegaard, Poul Henning; Christoffersen, L.D.

    2013-01-01

    Present paper presents a parametric performancebased design model for optimizing hospital design. The design model operates with geometric input parameters defining the functional requirements of the hospital and input parameters in terms of performance objectives defining the design requirements...... and preferences of the hospital with respect to performances. The design model takes point of departure in the hospital functionalities as a set of defined parameters and rules describing the design requirements and preferences....

  17. 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...

  18. 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...

  19. Income smoothing by Dutch hospitals

    NARCIS (Netherlands)

    Boterenbrood, D.R.

    2014-01-01

    Research indicates that hospitals manage their earnings. However, these findings might be influenced by methodological issues. In this study, I exploit specific features of Dutch hospitals to study income smoothing while limiting these methodological issues. The managers of Dutch hospitals have the

  20. Hospitality Services. Student Activity Book.

    Science.gov (United States)

    Texas Tech Univ., Lubbock. Home Economics Curriculum Center.

    This student activity book contains pencil-and-paper activities for use in a hospitality services course focusing on the food and lodging segments of the hospitality and tourism industry. The activities are organized into 29 chapters on the following topics: hospitality services industry; professional ethics; organization/management structures in…

  1. Library Hospitality: Some Preliminary Considerations

    Science.gov (United States)

    Johnson, Eric D. M.; Kazmer, Michelle M.

    2011-01-01

    Library scholars and practitioners have frequently reflected on the various factors that in combination make up a hospitable library, but there has been little theoretical synthesis of the notion of the library as a place of hospitality. The hospitality industry provides a rich vein of theoretical material from which to draw definitions of…

  2. Hospitality in College Composition Courses

    Science.gov (United States)

    Haswell, Janis; Haswell, Richard; Blalock, Glenn

    2009-01-01

    There has been little discussion of hospitality as a practice in college writing courses. Possible misuses of hospitality as an educational and ethical practice are explored, and three traditional and still tenable modes of hospitality are described and historicized: Homeric, Judeo-Christian, and nomadic. Application of these modes to…

  3. Hospitality Studies: Escaping the Tyranny?

    Science.gov (United States)

    Lashley, Conrad

    2015-01-01

    Purpose: The purpose of this paper is to explore current strands in hospitality management education and research, and suggest that future programs should reflect a more social science informed content. Design/methodology/approach: The paper reviews current research in hospitality management education and in the study of hospitality and…

  4. Propuesta de tratamiento integral de los residuos hospitalarios en el hospital ii tarapoto

    OpenAIRE

    Condori, Luisa

    2010-01-01

    This research aimed to make a diagnosis on solid waste generation in the Hospital II Tarapoto, in order to make a comprehensive proposal for their treatment and their management. In order to do that monthly samples were taken in the different services offered by the Zonal Hospital II Tarapoto in 2007. The sampling consisted of collecting information about the class, volume and weight of solid waste generated in those facilities, according to the methodology proposed by PAHO. It was found that...

  5. CMS Nonpayment Policy, Quality Improvement, and Hospital-Acquired Conditions: An Integrative Review.

    Science.gov (United States)

    Bae, Sung-Heui

    This integrative review synthesized evidence on the consequences of the Centers for Medicare & Medicaid Services (CMS) nonpayment policy on quality improvement initiatives and hospital-acquired conditions. Fourteen articles were included. This review presents strong evidence that the CMS policy has spurred quality improvement initiatives; however, the relationships between the CMS policy and hospital-acquired conditions are inconclusive. In future research, a comprehensive model of implementation of the CMS nonpayment policy would help us understand the effectiveness of this policy.

  6. Does better information about hospital quality affect patients’ choice? Empirical findings from Germany

    OpenAIRE

    Wübker, Ansgar; Sauerland, Dirk; Wübker, Achim

    2008-01-01

    Background: Economic theory strongly suggests that better information about the quality of care affects patients’ choice of health service providers. However, we have little empirical evidence about the impact of information provided on provider’s choice in Germany. Problem: In Germany, we recently find publicly available information about hospital quality. For example, 50 percent of the hospitals in the Rhine-Ruhr area do now publish their quality data voluntarily in a comprehensive, underst...

  7. Information Technology Applications in Hospitality and Tourism: A Review of Publications from 2005 to 2007

    OpenAIRE

    Law, Rob; Leung, R.; Buhalis, Dimitrios

    2009-01-01

    The tourism and hospitality industries have widely adopted information\\ud technology (IT) to reduce costs, enhance operational efficiency, and most importantly to\\ud improve service quality and customer experience. This article offers a comprehensive review of\\ud articles that were published in 57 tourism and hospitality research journals from 2005 to 2007.\\ud Grouping the findings into the categories of consumers, technologies, and suppliers, the article\\ud sheds light on the evolution of IT...

  8. Production, Usage, and Comprehension in Animal Vocalizations

    Science.gov (United States)

    Seyfarth, Robert M.; Cheney, Dorothy L.

    2010-01-01

    In this review, we place equal emphasis on production, usage, and comprehension because these components of communication may exhibit different developmental trajectories and be affected by different neural mechanisms. In the animal kingdom generally, learned, flexible vocal production is rare, appearing in only a few orders of birds and few…

  9. Towards Comprehensive Food Security Measures: Comparing Key ...

    African Journals Online (AJOL)

    Food security is a multi-dimensional issue that has been difficult to measure comprehensively, given the one-dimensional focus of existing indicators. Three indicators dominate the food security measurement debate: Household Food Insecurity Access Scale (HFIAS), Dietary Diversity Score (DDS) and Coping Strategies ...

  10. Impacts of Captioned Movies on Listening Comprehension

    Science.gov (United States)

    Janfaza, Abusaied; Jelyani, Saghar Javidi; Soori, Afshin

    2014-01-01

    With the advent of technology, the implication of authentic multimedia-based teaching materials are using widely in language classrooms. Technology can be in service of teaching different skills such as listening, reading, speaking and writing. Among these skills listening comprehension is a skill in which the learners have problems to master.…

  11. Identifying Information Focuses in Listening Comprehension

    Science.gov (United States)

    Zhang, Hong-yan

    2011-01-01

    The study explains the process of learners' listening comprehension within Halliday's information theory in functional grammar, including the skills of identifying focuses while listening in college English teaching. Identifying information focuses in listening is proved to improve the students' communicative listening ability by the means of a…

  12. Swarm Level 2 Comprehensive Inversion, 2016 Production

    DEFF Research Database (Denmark)

    Tøffner-Clausen, Lars; Sabaka, Terence; Olsen, Nils

    In the framework of the ESA Earth Observation Magnetic Mapping Mission Swarm, the Expert Support Laboratories (ESL) provides high quality Level 2 Products describing a.o. the magnetic fields of the Earth. This poster provides details of the Level 2 Products from the Comprehensive Inversion chain...

  13. Measuring Reading Comprehension with the Lexile Framework.

    Science.gov (United States)

    Stenner, A. Jackson

    This paper shows how the concept of general objectivity can be used to improve behavioral science measurement, particularly as it applies to the Lexile Framework, a tool for objectively measuring reading comprehension. It begins with a dialogue between a physicist and a psychometrician that details some of the differences between physical science…

  14. Relationship between Cultural Distance and Pragmatic Comprehension

    Science.gov (United States)

    Rafieyan, Vahid; Sharafi-Nejad, Maryam; Khavari, Zahra; Damavand, Ayoob; Eng, Lin Siew

    2014-01-01

    The distance between language learners' culture and the culture of the target language community is considered to play a crucial role in determining the level of pragmatic comprehension. In this respect, a study was conducted over 30 German students, perceived as culturally close to the British, and 30 South Korean students, perceived as…

  15. Improving reading comprehension through Reciprocal Teaching Method

    Directory of Open Access Journals (Sweden)

    Endang Komariah

    2015-10-01

    Full Text Available This study is aimed at discovering the benefits of the Reciprocal Teaching Method (RTM in the reading classroom, finding out the achievements of students after four comprehension training sessions of using RTM, and exploring the perceptions of students on the use of RTM. This method uses four comprehension strategies: predicting, questioning, clarifying, and summarizing, to help learners monitor their development of reading comprehension by themselves. Students work in groups of four or five and the members are divided into five roles which are the leader, predictor, clarifier, questioner, and summarizer. The subjects were 24 students from the twelfth grade at a high school in Banda Aceh. Observations, tests, documents and interviews were collected to get the data. The results showed that the students were more active and productive in the reading classroom after RTM sessions and their reading proficiency improved. They learnt how to apply several of the strategies from RTM while reading. The results also showed that they preferred this method for teaching-learning reading compared to the conventional one. Therefore, teachers are suggested to consider using this method for teaching reading that instils the students on how to apply the four comprehension strategies used in reading.

  16. Historical Text Comprehension Reflective Tutorial Dialogue System

    Science.gov (United States)

    Grigoriadou, Maria; Tsaganou, Grammatiki; Cavoura, Theodora

    2005-01-01

    The Reflective Tutorial Dialogue System (ReTuDiS) is a system for learner modelling historical text comprehension through reflective dialogue. The system infers learners' cognitive profiles and constructs their learner models. Based on the learner model the system plans the appropriate--personalized for learners--reflective tutorial dialogue in…

  17. Comprehension: The Challenge for Children's Television.

    Science.gov (United States)

    Storm, Susan R.

    The purpose of this research was to determine young children's comprehension of selected TV program content. The subjects were 210 children in grades K-2. All subjects in groups of five, were shown segments from four TV programs: a scalloped potatoes commercial, a "Batman" and Robin episode, a news story on the MIG-25 and a segment of the…

  18. A comprehensive review of dynamic voltage restorers

    DEFF Research Database (Denmark)

    Farhadi-Kangarlu, Mohammad; Babaei, Ebrahim; Blaabjerg, Frede

    2017-01-01

    has been done in the field of DVR and the field is rather mature now. But, a survey on the published papers showed that there is not any published paper that reviews the DVR technology. This paper tends to provide a comprehensive review on the DVR topologies, control strategies and applications. We...

  19. Comprehensive Musicianship and Undergraduate Music Curricula.

    Science.gov (United States)

    Willoughby, David

    Comprehensive musicianship is a concept about teaching and learning music. It is an approach that suggests that the source of all musical study is the "literature" of music, and promotes the integration of all aspects of music study. This volume presents a synthesis of the philosophy and practice of 32 experimental programs based on the concept of…

  20. Readers' Tellings: Narrators, Settings, Flashbacks and Comprehension

    Science.gov (United States)

    Kucer, Stephen B.

    2010-01-01

    This research explores the impact of flashbacks and changes in settings and narrators on reader comprehension. Individually, 34 fourth graders (9 and 10 years of age), mostly with above average reading abilities (5.0), orally read the first chapter of a novel. Both publisher and readability formulae estimated the text to be at a fourth- grade…

  1. A Comprehensive Enzyme Kinetic Exercise for Biochemistry

    Science.gov (United States)

    Barton, Janice S.

    2011-01-01

    This article describes a comprehensive treatment of experimental enzyme kinetics strongly coupled to electronic data acquisition and use of spreadsheets to organize data and perform linear and nonlinear least-squares analyses, all in a manner that promotes development of important reasoning skills. Kinetic parameters are obtained for the stable…

  2. A Comprehensive Mapping of Urinary Schistosomiasis Using ...

    African Journals Online (AJOL)

    A Comprehensive Mapping of Urinary Schistosomiasis Using Geographic Information Systems (GIS) in Kano State, Nigeria. ... The PDF file you selected should load here if your Web browser has a PDF reader plug-in installed (for example, a recent version of Adobe Acrobat Reader). If you would like more information about ...

  3. Comprehensive College Plan for 2000-2001.

    Science.gov (United States)

    San Antonio Coll., TX.

    The document describes San Antonio College's (Texas) strategic goals and objectives for 2000-2001. San Antonio College's comprehensive planning and evaluation process monitors the achievement of college-wide goals and initiatives supporting the college's Vision and Mission Statement and the Alamo Community College District's Strategic Plan. The…

  4. Comprehensive Family Services and Customer Satisfaction Outcomes

    Science.gov (United States)

    Huebner, Ruth A.; Jones, Blake L.; Miller, Viola P.; Custer, Melba; Critchfield, Becky

    2006-01-01

    Comprehensive Family Services (CFS) is a strengths-based and partnership-oriented approach to casework implemented through multiple initiatives. This study examines the relationship between the practice of CFS and satisfaction of clients, foster parents, and community partners. CFS indicators are paired with statewide customer satisfaction survey…

  5. Comprehensive review of the maritime safety regimes.

    NARCIS (Netherlands)

    S. Knapp (Sabine); Ph.H.B.F. Franses (Philip Hans)

    2007-01-01

    textabstractThis report presents a comprehensive review of the maritime safety regimes and provides recommendations on how to improve the system. The results show a complex legal framework which generates a high amount of inspections and overlapping of inspection areas where no cross-recognition is

  6. Comprehensive Molecular Characterization of Pheochromocytoma and Paraganglioma

    NARCIS (Netherlands)

    Fishbein, Lauren; Leshchiner, Ignaty; Walter, Vonn; Danilova, Ludmila; Robertson, A. Gordon; Johnson, Amy R.; Lichtenberg, Tara M.; Murray, Bradley A.; Ghayee, Hans K.; Else, Tobias; Ling, Shiyun; Jefferys, Stuart R.; de Cubas, Aguirre A.; Wenz, Brandon; Korpershoek, Esther; Amelio, Antonio L.; Makowski, Liza; Rathmell, W. Kimryn; Gimenez-Roqueplo, Anne Paule; Giordano, Thomas J.; Asa, Sylvia L.; Tischler, Arthur S.; Akbani, Rehan; Ally, Adrian; Amar, Laurence; Amelio, Antonio L.; Arachchi, Harindra; Asa, Sylvia L.; Auchus, Richard J.; Auman, J. Todd; Baertsch, Robert; Balasundaram, Miruna; Balu, Saianand; Bartsch, Detlef K.; Baudin, Eric; Bauer, Thomas; Beaver, Allison; Benz, Christopher; Beroukhim, Rameen; Beuschlein, Felix; Bodenheimer, Tom; Boice, Lori; Bowen, Jay; Bowlby, Reanne; Brooks, Denise; Carlsen, Rebecca; Carter, Suzie; Cassol, Clarissa A.; Cherniack, Andrew D.; Chin, Lynda; Cho, Juok; Chuah, Eric; Chudamani, Sudha; Cope, Leslie; Crain, Daniel; Curley, Erin; Danilova, Ludmila; de Cubas, Aguirre A.; de Krijger, Ronald R.; Demchok, John A.; Deutschbein, Timo; Dhalla, Noreen; Dimmock, David; Dinjens, Winand N M; Else, Tobias; Eng, Charis; Eschbacher, Jennifer; Fassnacht, Martin; Felau, Ina; Feldman, Michael; Ferguson, Martin L.; Fiddes, Ian; Fishbein, Lauren; Frazer, Scott; Gabriel, Stacey B.; Gardner, Johanna; Gastier-Foster, Julie M.; Gehlenborg, Nils; Gerken, Mark; Getz, Gad; Geurts, Jennifer; Ghayee, Hans K.; Gimenez-Roqueplo, Anne Paule; Giordano, Thomas J.; Goldman, Mary; Graim, Kiley; Gupta, Manaswi; Haan, David; Hahner, Stefanie; Hantel, Constanze; Haussler, David; Hayes, D. Neil; Heiman, David I.; Hoadley, Katherine A.; Holt, Robert A.; Hoyle, Alan P.; Huang, Mei; Hunt, Bryan; Hutter, Carolyn M.; Jefferys, Stuart R.; Johnson, Amy R.; Jones, Steven J M; Jones, Corbin D.; Kasaian, Katayoon; Kebebew, Electron; Kim, Jaegil; Kimes, Patrick; Knijnenburg, Theo; Korpershoek, Esther; Lander, Eric; Lawrence, Michael S.; Lechan, Ronald; Lee, Darlene; Leraas, Kristen M.; Lerario, Antonio; Leshchiner, Ignaty; Lichtenberg, Tara M.; Lin, Pei; Ling, Shiyun; Liu, Jia; LiVolsi, Virginia A.; Lolla, Laxmi; Lotan, Yair; Lu, Yiling; Ma, Yussanne; Maison, Nicole; Makowski, Liza; Mallery, David; Mannelli, Massimo; Marquard, Jessica; Marra, Marco A.; Matthew, Thomas; Mayo, Michael; Méatchi, Tchao; Meng, Shaowu; Merino, Maria J.; Mete, Ozgur; Meyerson, Matthew; Mieczkowski, Piotr A.; Mills, Gordon B.; Moore, Richard A.; Morozova, Olena; Morris, Scott; Mose, Lisle E.; Mungall, Andrew J.; Murray, Bradley A.; Naresh, Rashi; Nathanson, Katherine L.; Newton, Yulia; Ng, Sam; Ni, Ying; Noble, Michael S.; Nwariaku, Fiemu; Pacak, Karel; Parker, Joel S.; Paul, Evan; Penny, Robert; Perou, Charles M.; Perou, Amy H.; Pihl, Todd; Powers, James; Rabaglia, Jennifer; Radenbaugh, Amie; Ramirez, Nilsa C.; Rao, Arjun; Rathmell, W. Kimryn; Riester, Anna; Roach, Jeffrey; Robertson, A. Gordon; Sadeghi, Sara; Saksena, Gordon; Salama, Sofie; Saller, Charles; Sandusky, George; Sbiera, Silviu; Schein, Jacqueline E.; Schumacher, Steven E.; Shelton, Candace; Shelton, Troy; Sheth, Margi; Shi, Yan; Shih, Juliann; Shmulevich, Ilya; Simons, Janae V.; Sipahimalani, Payal; Skelly, Tara; Sofia, Heidi J.; Sokolov, Artem; Soloway, Matthew G.; Sougnez, Carrie; Stuart, Josh; Sun, Charlie; Swatloski, Teresa; Tam, Angela; Tan, Donghui; Tarnuzzer, Roy; Tarvin, Katherine; Thiessen, Nina; Thorne, Leigh B.; Timmers, Henri J.; Tischler, Arthur S.; Tse, Kane; Uzunangelov, Vlado; van Berkel, Anouk; Veluvolu, Umadevi; Vicha, Ales; Voet, Doug; Waldmann, Jens; Walter, Vonn; Wan, Yunhu; Wang, Zhining; Wang, Tracy S.; Weaver, Joellen; Weinstein, John N.; Weismann, Dirk; Wenz, Brandon; Wilkerson, Matthew D.; Wise, Lisa; Wong, Tina; Wong, Christopher; Wu, Ye; Yang, Liming; Zelinka, Tomas; Zenklusen, Jean C.; Zhang, Jiashan (Julia); Zhang, Wei; Zhu, Jingchun; Zinzindohoué, Franck; Zmuda, Erik; Pacak, Karel; Nathanson, Katherine L.; Wilkerson, Matthew D.

    2017-01-01

    We report a comprehensive molecular characterization of pheochromocytomas and paragangliomas (PCCs/PGLs), a rare tumor type. Multi-platform integration revealed that PCCs/PGLs are driven by diverse alterations affecting multiple genes and pathways. Pathogenic germline mutations occurred in eight

  7. Cue-Dependent Interference in Comprehension

    Science.gov (United States)

    Van Dyke, Julie A.; McElree, Brian

    2011-01-01

    The role of interference as a primary determinant of forgetting in memory has long been accepted, however its role as a contributor to poor comprehension is just beginning to be understood. The current paper reports two studies, in which speed-accuracy tradeoff and eye-tracking methodologies were used with the same materials to provide converging…

  8. Self and External Monitoring of Reading Comprehension

    Science.gov (United States)

    Shiu, Ling-po; Chen, Qishan

    2013-01-01

    The present study compared the effectiveness of 2 approaches to remedy the inaccuracy of self-monitoring of reading comprehension. The first approach attempts to enhance self-monitoring by strengthening the cues utilized in monitoring. The second approach replaces self-monitoring with external regulation based on objective evaluative information.…

  9. A comprehensive classification system for lipids

    NARCIS (Netherlands)

    Fahy, E.; Subramaniam, S.; Brown, H.A.; Glass, C.K.; Merrill, A.H.; Murphy, R.C.; Raetz, C.R.H.; Russell, D.W.; Seyama, Y.; Shaw, W.; Shimizu, T.; Spener, F.; van Meer, G.|info:eu-repo/dai/nl/068570368; VanNieuwenhze, M.S.; White, S.H.|info:eu-repo/dai/nl/304843539; Witztum, J.; Dennis, E.A.

    2005-01-01

    Lipids are produced, transported, and recognized by the concerted actions of numerous enzymes, binding proteins, and receptors. A comprehensive analysis of lipid molecules, “lipidomics,” in the context of genomics and proteomics is crucial to understanding cellular physiology and pathology;

  10. Comprehensive Achievements: All Our Geese Are Swans

    Science.gov (United States)

    Imison, Tamsyn, Ed.; Heilbronn, Ruth, Ed.; Williams, Liz, Ed.

    2013-01-01

    Schools in England are radically changing their organization and governance, casting aside the founding principle of the 1944 Education Act that education is a public service and abandoning the ideal of education as nurturing a sense of community. This book presents a portrait of a successful comprehensive school, between the years 1980 and 2000.…

  11. Comprehensive entropy weight observability-controllability risk ...

    African Journals Online (AJOL)

    Decision making for water resource planning is often related to social, economic and environmental factors. There are various methods for making decisions about water resource planning alternatives and measures with various shortcomings. A comprehensive entropy weight observability-controllability risk analysis ...

  12. Electronic Books: Children's Reading and Comprehension

    Science.gov (United States)

    Grimshaw, Shirley; Dungworth, Naomi; McKnight, Cliff; Morris, Anne

    2007-01-01

    This study investigates the differences in children's comprehension and enjoyment of storybooks according to the medium of presentation. Two different storybooks were used and 132 children participated. Of these, 51 children read an extract from "The Magicians of Caprona," about half reading an electronic version with an online dictionary, and the…

  13. Comprehension: The Key to Reading Success.

    Science.gov (United States)

    Chevalier, Kim; Del Santo, Jolene; Scheiner, Deb; Skok, Elly; Tucci, Leah Rae

    This report describes a program for using explicit instruction of reading strategies through the implementation of guided reading groups to improve student comprehension. The targeted population consisted of elementary school students in growing, middle class communities, located in northern Illinois. Evidence for the existence of a deficiency of…

  14. Discourse Memory and Reading Comprehension Skill

    Science.gov (United States)

    Perfetti, Charles A.; Goldman, Susan R.

    1976-01-01

    A study is reported in which short-term memory capacity, estimated by a probe digit task, and memory for structured language, measured by a probe discourse task, were investigated in an experiment with third and fifth grade IQ-matched children representing two levels of reading comprehension skill. (Author/RM)

  15. IQ and Reading Comprehension in Translation Quality

    Directory of Open Access Journals (Sweden)

    Mohsen Askari

    2017-10-01

    Full Text Available Having a deeper understanding of determining factors in the quality of translation is in the interest of almost all scholars of translation studies. Students’ intelligence is being measured constantly in order to determine their aptitude for entering into different programs. However, in translation studies, the variable of intelligence quotient (IQ has been curiously ignored among researchers. This study aimed to explore the strength of both IQ and reading comprehension in predicting translation quality among Iranian translation students.  A sample of forty-six translation students from Alborz University of Qazvin participated in this study. Data were collected using three tests including Raven’s Advanced Progressive Matrices, Colina’s (2008 componential translation quality rating scheme and the reading comprehension test of IELTS. The results show IQ test scores and reading comprehension significantly predict translation quality assessment. Surprisingly, the most significant finding is that IQ score is by far a better predictor of translation quality than reading comprehension. Overall, it is concluded that translation quality assessment is more of a deeper cognitive function than solely language process, which could lead to more research on cognitive aspects of translation.

  16. A Comprehensive Analysis of Marketing Journal Rankings

    Science.gov (United States)

    Steward, Michelle D.; Lewis, Bruce R.

    2010-01-01

    The purpose of this study is to offer a comprehensive assessment of journal standings in Marketing from two perspectives. The discipline perspective of rankings is obtained from a collection of published journal ranking studies during the past 15 years. The studies in the published ranking stream are assessed for reliability by examining internal…

  17. The comprehension of gesture and speech

    NARCIS (Netherlands)

    Willems, R.M.; Özyürek, A.; Hagoort, P.

    2005-01-01

    Although generally studied in isolation, action observation and speech comprehension go hand in hand during everyday human communication. That is, people gesture while they speak. From previous research it is known that a tight link exists between spoken language and such hand gestures. This study

  18. Blood Test: Comprehensive Metabolic Panel (CMP)

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Blood Test: Comprehensive Metabolic Panel (CMP) KidsHealth / For Parents / Blood ... de sangre: panel metabólico ampliado What Is a Blood Test? A blood test is when a sample of ...

  19. The Impact of Texting on Comprehension

    Directory of Open Access Journals (Sweden)

    Jamal K. M. Ali

    2015-07-01

    Full Text Available This paper presents a study of the effects of texting on English language comprehension. The authors believe that English used in texting causes a lack of comprehension for English speakers, learners, and texters. Wei, Xian-hai and Jiang (2008:3 declare “In Netspeak, there are some newly-created vocabularies, which people cannot comprehend them either from their partial pronunciation or from their figures.” Crystal (2007:23 claims; “variation causes problems of comprehension and acceptability. If you speak or write differently from the way I do, we may fail to understand each other.”  In this paper, the authors conducted a questionnaire at Aligarh Muslim University to ninety respondents from five different Faculties and four different levels. To measure respondents’ comprehension of English texting, the authors gave the respondents abbreviations used by texters and asked them to write the full forms of the abbreviations. The authors found that many abbreviations were not understood, which suggested that most of the respondents did not understand and did not use these abbreviations.

  20. Using Appropriate Strategies to Improve Students' Comprehension ...

    African Journals Online (AJOL)

    Using Appropriate Strategies to Improve Students' Comprehension of Chemistry Texts: A Guide for Chemistry Teachers. ... African Research Review ... Unfortunately, contemporary research insight into science reading is lacking and science educators tend to focus on methods of teaching specific subject matter and ...

  1. Comprehensive preserving technique for Chinese chestnut storage

    International Nuclear Information System (INIS)

    Chen Yuntang; Yang Baoan; Zhang Jianwei; Li Qiufang

    2003-01-01

    Chinese chestnut can be preserved for a long time by using a comprehensive preserving technique, which consists of casing, irradiating, treating with preserving agent and controlling environment conditions. The shelftime of the treated chestnuts reaches 11 months keeping no insects, no germination and good quality for eating with the good fruit ratio of 97.5% and water losing ratio of 3.8%

  2. Advanced Selling: A Comprehensive Course Sales Project

    Science.gov (United States)

    Yarrington-Young, Susan; Castleberry, Stephen B.; Coleman, Joshua T.

    2016-01-01

    A comprehensive project for the Advanced Selling course that has been tested at three universities is introduced. After selecting an industry and a company, students engage in a complete industry analysis, a company sales analysis, a sales-specific SWOT analysis, complete a ride day with a salesperson in that firm, then present their findings in a…

  3. Comprehensive District Reform: Philadelphia's Grand Experiment.

    Science.gov (United States)

    Useem, Elizabeth; Balfanz, Robert

    2002-01-01

    This report describes "Philadelphia's Grand Experiment" in comprehensive school district reform, from its conception through its initial months of implementation. In 2001, as part of the remedy for low student performance, the governor ordered the state to take over governance of the Philadelphia School District, with a substantial…

  4. American Learners' Comprehension of Russian Textual Humor

    Science.gov (United States)

    Shardakova, Maria

    2016-01-01

    Over the past decade, second language (L2) humor has attracted scholarly attention as both a means and a goal of L2 development. Much of this research, however, has focused on oral communication, whereas virtually no studies address humor as an aspect of reading comprehension. This exploratory study combines these two areas of inquiry, examining…

  5. Comprehension Process of Second Language Indirect Requests.

    Science.gov (United States)

    Takahashi, Satomi; Roitblat, Herbert L.

    1994-01-01

    Examines the comprehension of English conventional indirect requests by native English speakers and Japanese learners of English. Subjects read stories inducing either a conventional or a literal interpretation of a priming sentence. Results suggest that both native and nonnative speakers process both meanings of an ambiguous conventional request.…

  6. Cues, quantification, and agreement in language comprehension.

    Science.gov (United States)

    Tanner, Darren; Bulkes, Nyssa Z

    2015-12-01

    We investigated factors that affect the comprehension of subject-verb agreement in English, using quantification as a window into the relationship between morphosyntactic processes in language production and comprehension. Event-related brain potentials (ERPs) were recorded while participants read sentences with grammatical and ungrammatical verbs, in which the plurality of the subject noun phrase was either doubly marked (via overt plural quantification and morphological marking on the noun) or singly marked (via only plural morphology on the noun). Both acceptability judgments and the ERP data showed heightened sensitivity to agreement violations when quantification provided an additional cue to the grammatical number of the subject noun phrase, over and above plural morphology. This is consistent with models of grammatical comprehension that emphasize feature prediction in tandem with cue-based memory retrieval. Our results additionally contrast with those of prior studies that showed no effects of plural quantification on agreement in language production. These findings therefore highlight some nontrivial divergences in the cues and mechanisms supporting morphosyntactic processing in language production and comprehension.

  7. Comprehensive Essays for World History Finals.

    Science.gov (United States)

    Feldman, Martha J.

    1997-01-01

    Describes a novel approach to comprehensive questions in world history examinations. Recommends using current events as illustrative reference points for complex subjects such as nationalism, liberalism, and international trade. Students receive information packets on the events for several weeks and must relate the subjects to these events. (MJP)

  8. BK channel modulators: a comprehensive overview

    DEFF Research Database (Denmark)

    Nardi, Antonio; Olesen, Søren-Peter

    2008-01-01

    channels as a potentially attractive target, the design and synthesis of potent and selective BK modulators continue based on novel chemical ideas. A comprehensive overview of BK channel modulators is therefore timely and important to the current medicinal chemist for review, summary, and classification...

  9. Market reactions to the ECB's Comprehensive Assessment

    NARCIS (Netherlands)

    Sahin, Cenkhan; de Haan, Jakob

    Using an event study approach, we examine financial markets' reactions to the publication of the ECB's Comprehensive Assessment of banks in the euro area. Our results suggest that banks' stock market prices and CDS spreads generally showed no reaction. (C) 2015 Elsevier B.V. All rights reserved.

  10. Description of a comprehensive mathematical model

    DEFF Research Database (Denmark)

    Li, Xiyan; Yin, Chungen

    2017-01-01

    Biomass gasification is still a promising technology after over 30 years’ research and development and has success only in a few niche markets. In this paper, a comprehensive mathematical model for biomass particle gasification is developed within a generic particle framework, assuming the feed...

  11. Evaluating Dynamic Analysis Techniques for Program Comprehension

    NARCIS (Netherlands)

    Cornelissen, S.G.M.

    2009-01-01

    Program comprehension is an essential part of software development and software maintenance, as software must be sufficiently understood before it can be properly modified. One of the common approaches in getting to understand a program is the study of its execution, also known as dynamic analysis.

  12. Phonological and conceptual activation in speech comprehension

    NARCIS (Netherlands)

    Norris, D.; Cutler, A.; McQueen, J.M.; Butterfield, S.

    2006-01-01

    We propose that speech comprehension involves the activation of token representations of the phonological forms of current lexical hypotheses, separately from the ongoing construction of a conceptual interpretation of the current utterance. In a series of cross-modal priming experiments,

  13. Early Identification of Reading Comprehension Difficulties

    Science.gov (United States)

    Catts, Hugh W.; Nielsen, Diane Corcoran; Bridges, Mindy Sittner; Liu, Yi-Syuan

    2016-01-01

    Most research on early identification of reading disabilities has focused on word reading problems and little attention has been given to reading comprehension difficulties. In this study, we investigated whether measures of language ability and/or response to language intervention in kindergarten uniquely predicted reading comprehension…

  14. Deeper Processing for Better EFL Reading Comprehension.

    Science.gov (United States)

    Oded, Brenda; Walters, Joel

    2001-01-01

    Investigates the extent to which tasks involving processing differences in English-as-a-foreign-language (EFL) reading result in differences in performance on comprehension. Processing differences were created by the assignment of two tasks--writing a text summary and listing the examples in the text. (Author/VWL)

  15. Nursing magnet hospitals have better CMS hospital compare ratings

    Directory of Open Access Journals (Sweden)

    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.

  16. [Risk management of hospital infections as a supporting tool for the improvement of hospital quality - some European examples].

    Science.gov (United States)

    Sitek, Mateusz; Witczak, Izabela; Kiedik, Dorota

    Prevention and control of nosocomial infections is one of the main pillars of security in each medical facility. This affects the quality of services and helps to minimize the economic losses incurred as a result of such infections. (Prolonged hospitalization, expensive antibiotic therapies, court costs of damages). Nosocomial infections occur in every medical facility in the hospitals in terms of risk of infection compared to other medicinal entities are at greater risk of environmental (number of hospitalizations for one bed, the amount of disinfectants, etc.). The number and diverse category of employment of medical and auxiliary, which should meet certain standards for the prevention of hospital infections, has an impact on the incidence of infection. It is impossible to eliminate hospital-acquired infections, but can be limited by appropriate measures, ranging from monitoring through the use of risk management methods, which are one of the elements supporting the improvement of the quality of medical entities. Hospital infection is a threat not only for patients but also for workers exposed to the risk of so-called occupational exposure. A comprehensive approach including elements of active surveillance and effective monitoring can help to minimize the risk of nosocomial infections.

  17. Modeling the Potential Economic Impact of the Medicare Comprehensive Care for Joint Replacement Episode-Based Payment Model.

    Science.gov (United States)

    Maniya, Omar Z; Mather, Richard C; Attarian, David E; Mistry, Bipin; Chopra, Aneesh; Strickland, Matt; Schulman, Kevin A

    2017-11-01

    The Medicare program has initiated Comprehensive Care for Joint Replacement (CJR), a bundled payment mandate for lower extremity joint replacements. We sought to determine the degree to which hospitals will invest in care redesign in response to CJR, and to project its economic impacts. We defined 4 potential hospital management strategies to address CJR: no action, light care management, heavy care management, and heavy care management with contracting. For each of 798 hospitals included in CJR, we used hospital-specific volume, cost, and quality data to determine the hospital's economically dominant strategy. We aggregated data to assess the percentage of hospitals pursuing each strategy; savings to the health care system; and costs and percentages of CJR-derived revenues gained or lost for Medicare, hospitals, and postacute care facilities. In the model, 83.1% of hospitals (range 55.0%-100.0%) were expected to take no action in response to CJR, and 16.1% of hospitals (range 0.0%-45.0%) were expected to pursue heavy care management with contracting. Overall, CJR is projected to reduce health care expenditures by 0.5% (range 0.0%-4.1%) or $14 million (range $0-$119 million). Medicare is expected to save 2.2% (range 2.2%-2.2%), hospitals are projected to lose 3.7% (range 4.7% loss to 3.8% gain), and postacute care facilities are expected to lose 6.5% (range 0.0%-12.8%). Hospital administrative costs are projected to increase by $63 million (range $0-$148 million). CJR is projected to have a negligible impact on total health care expenditures for lower extremity joint replacements. Further research will be required to assess the actual care management strategies adopted by CJR hospitals. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Justice foundations for the Comprehensive Law Movement.

    Science.gov (United States)

    Dewhurst, Dale

    2010-01-01

    Authors examining the developing dispute resolution alternatives to the adversarial system have identified nine converging "vectors" or alternatives in what has been termed the Comprehensive Law Movement. These authors have sought to understand how the developing vectors can remain separate and vibrant movements while sharing common ground. Some analyze these developments as being within law and legal practice, others see them as alternative approaches to law, and still others take a combined approach. It will be impossible to understand how these vectors have meaningful differences from law and legal practice if the search is limited to looking within law and legal practice. It will be impossible to understand how these vectors have meaningful commonalities with law and legal practice if the search is limited to looking external to law and legal practice. Instead of comparing the vectors with the adversarial system, higher order criteria are required. What is needed is a comprehensive and internally consistent super-system of norms; one that can be used to evaluate the adversarial system and the evolving vectors on an equal footing. An Aristotelian natural law virtue theory of justice can: (a) provide a functional guiding definition of justice; (b) serve as a comprehensive and internally consistent super-system of norms; and (c) provide the theoretical and evaluative foundation required to clarify the relationships among the adversarial system and the developing vectors. Finally, it will become clear why the Comprehensive Law Movement might be more appropriately conceptualized as the Comprehensive Justice Movement. Copyright © 2010 Elsevier Ltd. All rights reserved.

  19. Do comprehensive schools reduce social mobility?

    Science.gov (United States)

    Boliver, Vikki; Swift, Adam

    2011-03-01

    This paper investigates the claim that the shift from a selective to a comprehensive school system had a deleterious effect on social mobility in Great Britain. Using data from the National Child Development Study, we compare the chances, for both class and income mobility, of those who attended different kinds of school. Where media attention focuses exclusively on the chances for upward mobility of those children from lowly origins who were (or would have been) judged worthy of selection into a grammar school, we offer more rounded analyses. We match respondents in a way that helps us to distinguish those inequalities in mobility chances that are due to differences between children from those due to differences between the schools they attended; we look at the effects of the school system on the mobility chances of all children, not merely those from less advantaged origins; and we compare comprehensive- and selective-system schools, not merely comprehensive and grammar schools. After matching, we find, first, that going to a grammar school rather than a comprehensive does not make low-origin children more likely to be upwardly mobile but it helps them move further if they are; second, that grammar schools do not benefit working-class children, in terms of class mobility, more than they benefit service-class children, but, in terms of income mobility, such schools benefit low-income children somewhat more than they benefit higher-income children - that benefit relating only to rather modest and limited movements within the income distribution. Finally, however, the selective system as a whole yields no mobility advantage of any kind to children from any particular origins: any assistance to low-origin children provided by grammar schools is cancelled out by the hindrance suffered by those who attended secondary moderns. Overall, our findings suggest that comprehensive schools were as good for mobility as the selective schools they replaced. © London School of

  20. 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.