WorldWideScience

Sample records for hospital privado diez

  1. Estudo comparativo das indicações de cesariana entre um hospital público-universitário e um hospital privado Comparative study of cesarean section indications between a public university hospital and a private hospital

    Directory of Open Access Journals (Sweden)

    Renato Humberto Fabri

    2002-04-01

    Full Text Available OBJETIVOS: analisar a incidência e as indicações de cesariana realizadas no Hospital Escola da Falculdade de Medicina do Triângulo Mineiro e um hospital privado, ambos localizados em Uberaba, Minas Gerais, Brasil. MÉTODOS: trata-se de estudo transversal desenvolvido a partir da coleta nos prontuários dos hospitais, consistindo da idade, procedência, situação conjugal, escolaridade, paridade e indicações de cesariana. RESULTADOS: a incidência de cesariana foi de 24,3% no Hospital Escola contra 89,2% no hospital privado. As indicações mais freqüentes de cesariana no Hospital Escola foram a cesárea iterativa (26,7%, distócia (22,4% e o sofrimento fetal agudo (18,2%, e no hospital privado foram cesárea iterativa (36% e distócia (36%. As pacientes do hospital privado tinham maior escolaridade. CONCLUSÕES: os dados sugerem que o aumento de cesarianas no hospital privado foi decorrente de iteratividade, distócia e a escolaridade mais elevada das pacientes.OBJECTIVES: to analyse the incidence and the indications of cesarean section performed in the University Hospital of the "Triângulo Mineiro Faculty of Medicine " and a private hospital in Uberaba, Minas Gerais, Brazil. METHODS: a cross sectional study was carried out by using the data source of the medical files from both hospitals consisting of patient age, place of origin, marital status, education level, parity and cesarean sections indications. RESULTS: the cesarean sections rate was 24,3 % (325 of 1.441 births at the university hospital against 89,2% (100 of 112 births of the private hospital. The most frequent indications in the University Hospital were previous cesarean sections (26,7%, dystocia (22,4% and acute fetal distress (18,2%. In the private hospital, indications were previous cesarean section (36% and dystocia (36%. The private hospital's patients had higher education levels. CONCLUSIONS: the higher rate of cesarean sections observed in the private hospital

  2. Grau de satisfação de usuários de um hospital privado Grado de satisfacción de usuarios de un hospital privado Degree of satisfaction of users of a private hospital

    Directory of Open Access Journals (Sweden)

    Mileide Morais Pena

    2012-01-01

    Full Text Available OBJETIVOS: Conhecer o grau de satisfação dos usuários de um hospital privado e os fatores intervenientes nessa satisfação, baseado no modelo de Parasuraman, Zeithaml e Berry. MÉTODOS: Estudo exploratório descritivo de abordagem quantitativa realizado em um hospital privado com amostra constituída de 288 usuários. A coleta dos dados ocorreu de abril a julho de 2009, por meio de um questionário e a análise estatística descritiva e inferencial. RESULTADOS: Identificaram os níveis de satisfação dos usuários, bem como as dimensões com maior escore: garantia e confiabilidade e com menor escore: responsividade e empatia. As equipes de enfermagem e médica obtiveram as maiores pontuações. CONCLUSÕES: Observou-se a necessidade de intervenção nas áreas de nutrição e atendimento inicial. Assim, este estudo propiciou um diagnóstico multissetorial, subsidiando os gestores da instituição na revisão de processos assistenciais e gerenciais.OBJETIVOS: Conocer el grado de satisfacción de usuarios de un hospital privado y los factores intervenientes en esa satisfacción, basado en el modelo de Parasuraman, Zeithaml y Berry. MÉTODOS: Estudio exploratorio descriptivo de abordaje cuantitativo realizado en un hospital privado con una muestra constituida por 288 usuarios. La recolección de los datos ocurrió de abril a julio de 2009, por medio de un cuestionario y el análisis estadístico descriptivo e inferencial. RESULTADOS: se identificaron los niveles de satisfacción de los usuarios, así como las dimensiones con mayor score: garantia y confiabilidad y con menor score: receptividad y empatía. Los equipos de enfermería y médica obtuvieron las mayores puntuaciones. CONCLUSIONES: Se observó la necesidad de intervención en las áreas de nutrición y atención inicial. Así, este estudio propició un diagnóstico multisectorial, subsidiando a los gestores de la institución en la revisión de procesos asistenciales y gerenciales

  3. Perú : diferencias salariales entre trabajadores del sector público y el sector privado, 2004-2011.

    OpenAIRE

    Tenorio Manayay, David

    2014-01-01

    En el Perú, la agenda de investigación en mercados laborales se ha centrado en el empleo generado por el sector privado el cual ha sido ampliamente estudiado en sus diversos tópicos y tendencias1. De aquellos trabajos de investigación generalmente han resultado propuestas de políticas públicas. Sin embargo, el empleo público no ha recibido la atención debida y son pocos los estudios al respecto. La mano de obra absorbida por el sector público, en los últimos diez años, ha representado alreded...

  4. CLIMA DE SEGURANÇA DO PACIENTE EM UM HOSPITAL PRIVADO

    Directory of Open Access Journals (Sweden)

    Maria Helena Barbosa

    2016-01-01

    Full Text Available Evaluar el ambiente de seguridad del paciente en la perspectiva de los profesionales del equipo de salud en un hospital privado en una ciudad del Estado de Minas Gerais. Estudio descriptivo, exploratorio y correlacional, realizado con 123 profesionales de salud, aprobado por el Comité de Ética en Investigación. Los datos se recolectaron utilizando el Safety Attitudes Questionnaire . En los análisis se utilizaron los tests t de Student, análisis de la varianza y correlación de Sperman (α=0,05. La puntuación general del instrumento fue de 67,50. El dominio con mejor puntuación fue el de satisfacción en el trabajo (82,79 y los dominios con menores puntajes fueron el de percepción de la gerencia (58,90 y condiciones de trabajo (59,58. No hubo diferencias entre los sexos, nivel de estudios, presencia de otro vínculo laboral o actuación profesional. Se han observado puntuaciones de clima de seguridad con valores por debajo de lo recomendado por la literatura.

  5. Family members' needs at intensive care units: comparative analysis between a public and a private hospital Necesidades de los familiares de pacientes en unidades de terapia intensiva: análisis comparativo entre hospital público y privado Necessidades de familiares de pacientes em unidades de terapia intensiva: análise comparativa entre hospital público e privado

    Directory of Open Access Journals (Sweden)

    Kátia Santana Freitas

    2007-02-01

    Full Text Available This cross-sectional study proposed to analyze the needs of adult ICU patients' family members at a public and a private hospital, regarding their level of importance and satisfaction. Ninety-one family members were interviewed, 47 from the public hospital and 44 from the private one, using the Brazilian adaptation of the Critical Care Family Need Inventory (INEFTI. There was no significant difference between the groups in the total score of importance attributed to the needs (p=0.410. The satisfaction score was higher in the private hospital than in the public one (p=0.002. Multiple linear regression analysis allowed us to establish a hierarchy of importance and satisfaction of the family members' needs in each group. The differences observed between the groups suggest that the fulfillment of their needs requires interventions directed at the specificity of each type of hospital.Se trata de un estudio transversal, con objeto de analizar y comparar las necesidades de los familiares de pacientes adultos internados en UTIs de un hospital público y un privado, respecto al grado de importancia y satisfacción. Se les entrevistaron a 91 familiares, 47 de la institución pública y 44 de la privada, utilizándose el Inventario de Necesidades y Estresores de Familiares en Terapia Intensiva (INEFTI. No hubo diferencia significativa entre los grupos en la puntuación total de importancia atribuida a las necesidades (p=0,410. El grado de satisfacción fue mayor en el hospital privado con relación al público (p=0,002. El análisis de regresión linear múltipla permitió establecer una jerarquía de importancia y de satisfacción de las necesidades de los familiares de cada grupo. Las diferencias observadas entre los grupos sugieren que el atendimiento de sus necesidades requiere intervenciones direccionadas a la especificidad de cada tipo de institución.Trata-se de estudo transversal que teve como proposta analisar comparativamente as necessidades de

  6. Análise da satisfação dos usuários de um hospital privado Análisis de satisfacción de los usuarios de un hospital privado Assessment levels of the user's satisfaction in a private hospital

    Directory of Open Access Journals (Sweden)

    Wilma Batista Souza da Cruz

    2010-03-01

    Full Text Available Trata-se de um estudo exploratório-descritivo de abordagem quantitativa, cujo objetivo foi analisar a satisfação dos usuários referente aos serviços prestados em unidades de internação. O local da investigação foi um hospital privado do Município de São Paulo, e a amostra constituiu-se de 71 usuários. A coleta de dados ocorreu de março a agosto de 2007, por meio de um instrumento derivado da escala Service Quality do modelo avaliativo de Parasuraman et al. O nível de satisfação geral oscilou em torno de 95%, sendo garantia (96% e confiabilidade (96% as dimensões de maior relevância, seguidas da empatia (95%, responsividade (93% e tangibilidade (88%. As equipes médica e de enfermagem apresentaram maiores níveis de satisfação, e 91% dos usuários demonstraram intenção de indicar o hospital. Esta pesquisa permitiu conhecer os atributos intervenientes na satisfação dos usuários da referida instituição, contribuindo para confirmar ou reformular os processos assistenciais e gerenciais.Se trata de un estudio exploratorio descriptivo, de abordaje cuantitativo, cuyo objetivo fue analizar la satisfacción de los usuarios respecto de los servicios prestados en unidades de internación. El trabajo se localizó en un hospital privado del Municipio de São Paulo, Brasil, y la muestra consistió en 71 usuarios. La recopilación de datos se realizó entre marzo y agosto de 2007, a través de un instrumento derivado de la escala Service Quality del modelo evaluativo de Parasuraman et al. El nivel de satisfacción general osciló en torno al 95%, resultando garantía (96% y confiabilidad (96% las dimensiones de mayor relevancia, seguidas de empatía (95%, responsividad (93% y tangibilidad (88%. Los equipos médicos y de enfermería presentaron mayores niveles de satisfacción, y el 91% de los usuarios manifestaron intenciones de recomendar al hospital. Esta investigación permitió conocer los atributos que hacen a la satisfacción de

  7. Estratégias de Coping e características de trabalhadores de enfermagem de hospital privado

    Directory of Open Access Journals (Sweden)

    Eliane Raquel Rieth Benetti

    2015-01-01

    Full Text Available analizar las relaciones entre características sociodemográficas/funcionales y las estrategias de enfrentamiento utilizadas por trabajadores de enfermería de un hospital privado. Método: estudio cuantitativo, analítico y transversal, desarrollado con 209 trabajadores de enfermería. Datos fueron recogidos, mediante Formulario sociodemográfico/funcional e Inventario de Estrategias de Enfrentamiento. Resultados: reevaluación Positiva, Apoyo Social y Resolución de Problemas fueron los factores de enfrentamiento más utilizados. Hubo diferencia estadísticamente significativa entre Autocontrol y sexo; Apoyo Social y salario; Aceptación de Responsabilidad y las variables edad, número de hijos, entrenamiento y salario. Los trabajadores utilizan estrategias centradas en la emoción y en el problema para enfrentarse o minimizar los estresores en el trabajo. Conclusión: acciones educativas deben ser alentadas para instrumentalizarlos a evaluar los estresores y utilizar estrategias de enfrentamiento efectivas.

  8. Derecho internacional privado y Derecho comunitario

    OpenAIRE

    Fernández Rozas, José Carlos

    1990-01-01

    Las Comunidades Europeas en el proceso de formación del Derecho internacional privado: un nuevo modelo de codificación. Ventajas de una interpretación uniforme por parte del TJCE. Realizaciones concretas y problemas suscitados en España tras su adhesión a las Comunidades Europeas. Las técnicas de Derecho internacional privado en la aplicación del Derecho comunitario.

  9. Cultura organizacional e satisfação profissional: estudo desenvolvido num hospital privado

    Directory of Open Access Journals (Sweden)

    Santos, Joana Vieira

    2009-01-01

    Full Text Available No presente estudo, procurou-se destacar a influência da cultura e do clima organizacionais sobre a satisfação no trabalho dos colaboradores. Esta tem bastante relevância para o desempenho organizacional, visto ter repercussões na realização pessoal dos activos humanos e na produtividade da empresa. O estudo foi realizado com 100 activos humanos de um Hospital Privado. Os dados foram recolhidos através de um instrumento constituído por duas escalas: o questionário FOCUS (First Organizational Culture Unified Search (Neves, 2000 e a Escala de Satisfação Profissional descrita por Lima, Vala e Monteiro (1994. Foram também registadas variáveis demográficas e profissionais categorizadoras dos inquiridos. Os resultados sugerem que a cultura da organização estudada é percepcionada sobretudo como uma cultura de regras. Encontrou-se uma associação sistemática e positiva entre a intensidade das percepções das diferentes orientações da cultura e as várias vertentes da satisfação analisadas. Na verdade, a percepção da cultura organizacional explica perto de 32% da variabilidade da satisfação geral, significativamente mais que o contributo trazido pelas variáveis socioprofissionais (18% e pelas variáveis de caracterização sociodemográfica dos inquiridos (2%. De um modo geral, estes resultados demonstraram a existência de influência do tipo de cultura organizacional sobre a satisfação no trabalho

  10. Diez años del Instituto de Biotecnología, Universidad Nacional de Colombia

    OpenAIRE

    G. Buitrago

    1998-01-01

    Diez años pueden considerarse como un lapso muy corto en la historia de la humanidad o en la historia de nuestro país, pero en biotecnología estos diez años se constituyen en la consolidación de desarrollos científicos y tecnológicos que reafirman la convicción de que se constituirá en la próxima revolución industrial. Durante estos diez años hemos asistido a la comercialización masiva de productos biotecnológicos destinados a la salud humana, y día a día vemos como nuevos productos para prev...

  11. Diez años del Instituto de Biotecnología, Universidad Nacional de Colombia

    OpenAIRE

    G. Buitrago

    2012-01-01

    Diez años pueden considerarse como un lapso muy corto en la historia de la humanidad o en la historia de nuestro país, pero en biotecnología estos diez años se constituyen en la consolidación de desarrollos científicos y tecnológicos que reafirman la convicción de que se constituirá en la próxima revolución industrial. Durante estos diez años hemos asistido a la comercialización masiva de productos biotecnológicos destinados a la salud humana, y día a día vemos como nuevos productos para prev...

  12. Aplicación del balanced scorecard como estrategia de control en un hospital privado ubicado en la ciudad de México

    Directory of Open Access Journals (Sweden)

    Mariana Marcelino Aranda

    2016-03-01

    Full Text Available El balanced scorecard como herramienta de gestión ha sido aplicado con éxito en varias empresas alrededor del mundo. El propósito de este trabajo consistió en elaborar una propuesta que sirva como guía de implementación para pequeños y medianos empresarios. Incluye el diagnóstico del estado actual y las acciones de mejora al implementar el balanced scorecard en un hospital privado ubicado en la ciudad de México. Se pudo deducir que la implementación del balanced scorecard constituye un reto en el caso de empresas de servicios, ya que promueve la eficiencia y el aprovechamiento de los recursos y los procesos internos; es una buena forma de hacer valer la misión y de orientar la mayor cantidad de esfuerzo y dinero a la razón de su existencia.

  13. Padrões Privados e a Atuação ou Omissão do Estado: Protecionismo Público-Privado?

    Directory of Open Access Journals (Sweden)

    Manuela Amaral

    2015-12-01

    Full Text Available ResumoA crescente proliferação de padrões privados no comércio internacional tem gerado preocupação quanto à possibilidade de representarem novo tipo de protecionismo às margens das regras da OMC. As regras multilaterais de comércio são aplicáveis à conduta de seus membros e não abrangem, portanto, esse tipo de protecionismo privado - caracterizado pela conduta e exigências técnicas, sanitárias e fitossanitárias por parte de entidades privadas, como associação de varejistas, entre outros entes não governamentais. A não aplicação das regras da OMC a entidades privadas pode contribuir para a proliferação desse tipo de regulação privada, uma vez que governos podem criar estímulos à atuação de entes não governamentais como forma de se esquivar das regras multilaterais de comércio. Nesse contexto, em que medida esses esquemas de certificação privada contam com envolvimento governamental para os efeitos da aplicação das regras da OMC? Com base na análise de três estudos de caso, verificou-se que, em diversas situações, é possível identificar diferentes níveis de envolvimento governamental em esquemas regulatórios privados. Em alguns casos, é possível, dessa forma, atribuir responsabilidade ao Estado pela conduta de entes privados em seu território. Em outros, contudo, torna-se necessário o esclarecimento de alguns termos constantes no Acordo sobre Barreiras Técnicas da OMC.

  14. Preços e níveis de complexidade dos serviços praticados por hospitais privados junto à operadoras de planos de saúde = Prices and levels of complexity of the services performed by private hospitals by the health plan operators

    Directory of Open Access Journals (Sweden)

    Romildo de Oliveira Moraes

    2011-09-01

    Full Text Available Este estudo parte da premissa de que hospitais com alto nível de complexidade incorrem em maiores custos quando comparados com hospitais com médio e baixo nível de complexidade. A lógica econômica que sustenta esse raciocínio é que a resolução de diagnósticos mais complexos exige mais investimentos tanto em ativos quanto na capacitação do seu corpo clínico e administrativo. Diante disso, este estudo teve como objetivo verificar se os preços dos serviços hospitalares praticados por hospitais privados junto à operadoras de planos de saúde seriam capazes de discriminar os hospitais de acordo com seu nível de complexidade (alto, médio e baixo. Foram coletados dados relativos a oito serviços em cinqüenta e quatro hospitais privados localizados na cidade de São Paulo. A amostra não é aleatória e foi obtida mediante a análise das faturas de 648 pacientes internados nesses hospitais no período de 2006 e 2007. A Análise Discriminante foi realizada e os resultados indicam que, para a amostra objeto deste estudo, os preços praticados pelos hospitais privados pelos serviços prestados junto a operadoras de planos de saúde não discriminam os hospitais de acordo com seu nível de complexidade, ou seja, há indícios de que, para a amostra selecionada, os planos de saúde não estejam atribuindo importância para o nível de complexidade dos hospitais privados no momento de pactuar os preços dos serviços.This study assumes that hospitals with a high level of complexity resulting in higher costs when compared with hospitals with low and medium level of complexity. The economic logic that underlies this reasoning is that the resolution of more complex diagnoses requires more investment on both the active and the training of clinical staff and administrative staff. Thus, this study aimed to determine whether prices charged for hospital services by private hospitals by the health plan operators would be able to discriminate among

  15. LA EFICIENCIA DE LOS CENTROS DE SALUD: EL CASO DE LOS HOSPITALES PRIVADOS [doi: 10.5329/RECADM.20040302009

    Directory of Open Access Journals (Sweden)

    Adriana Baltazar Silva

    2004-11-01

    Full Text Available Normal 0 21 false false false PT-BR X-NONE X-NONE MicrosoftInternetExplorer4 RESUMEN El objetivo de este artículo es comunicar una revisión de la literatura sobre la evaluación de la eficiencia de las organizaciones sanitarias en países Asiáticos, Europeos y de América Latina, en un periodo de diez años, tanto como instrumento de Benchmarking como las diversas posibilidades de aplicación que tiene el mismo. El método de valoración que se propone utilizar es el Análisis Envolvente de Datos (DEA, cuyos resultados suministrados permiten identificar los factores que explican el comportamiento ineficiente-eficiente de los centros hospitalarios públicos o privados, mediante un análisis sistémico de los procesos de producción - input/output -. El objetivo de este artículo es comunicar una revisión de la literatura sobre la evaluación de la eficiencia de las organizaciones sanitarias en países Europeos y Estados Unidos en un periodo de cinco años tanto como instrumento para Benchmarking como las diversas posibilidades de aplicación que tiene.          Es que los hospitales al igual que cualquier otra empresa, tiene como objetivo último alcanzar el éxito no sólo económicos sino también en relación a la atención de sus pacientes. Esto significar lograr antigüedad, desarrollo de liderazgo, eficiencia de su producción y desde luego la rentabilidad, entre otros aspectos importantes. Para ello se analizan las aplicaciones del modelo de frontera no parametrico DEA. En donde los resultados ponen de relieve la posibilidad del uso en estudios que analicen los hospitales públicos y/o privados mexicanos para la estimación de su eficiencia lo que resulta una herramienta de evaluación en la consultoría. Palabras clave: eficiencia, centros de salud, Calidad de Servicio, hospitales     ABSTRACT The objective of this article is to communicate a literature review on the efficiency evaluation of sanitary organizations in Asian

  16. Análise das barreiras à utilização de trombolíticos em casos de acidente vascular cerebral isquêmico em um hospital privado do Rio de Janeiro, Brasil

    OpenAIRE

    Fonseca,Luiz Henrique de Oliveira; Rosa,Maria Luiza Garcia; Silva,Arthur Carvalho; Maciel,Renan Marchesi; Volschan,André; Mesquita,Evandro Tinoco

    2013-01-01

    O acidente vascular cerebral isquêmico (AVCi) é uma importante causa de sequela e morte. A correta utilização do trombolítico enfrenta várias barreiras. O objetivo foi discutir as barreiras à terapia trombolítica em pacientes que chegam, com sintomas de AVCi agudo, à emergência de um hospital privado do Rio de Janeiro, Brasil. Coorte retrospectiva de pacientes entre 2009 e 2011. Foram admitidos 257 pacientes com suspeita de AVCi. Dos pacientes com diagnóstico confirmado (156), 11,5% (18) fora...

  17. Evaluation of the identification protocol for newborns in a private hospital Evaluación del protocolo de identificación de los recién nacidos en un hospital privado Avaliação do protocolo de identificação do neonato de um hospital privado

    Directory of Open Access Journals (Sweden)

    Ellen Regina Sevilla Quadrado

    2012-08-01

    Full Text Available This exploratory-descriptive quantitative study aimed to evaluate the protocol for identifying newborns admitted to the Neonatal Intensive and Semi-intensive Therapy Unit of a private hospital. The case series was made up of 540 observation opportunities, selected by simple random probability sampling. The data was collected between May and August 2010 according to a form and analyzed by descriptive statistic. The protocol's general performance had a conformity index of 82.2%. There were three stages to the protocol: identification components, the identification wristbands' condition and the number of identification wristbands. The highest percentage of conformity (93% was attributed to the second stage and the lowest (89.3% to the third, presenting a statistically significant difference of p= 0.046. In the group of 'special' neonates, 88.5% conformity was achieved. These results will make it possible to restructure the protocol for identifying newborns and to establish care and managerial goals so as to improve the quality of care and the patients' safety.El objetivo de este estudio exploratorio-descriptivo, cuantitativo fue evaluar protocolo de identificación de recién nacidos ingresados en Unidad de Cuidados Intensivos y Semi-intensiva Neonatal de hospital privado. La muestra consistió de 540 oportunidades de observaciones, seleccionados por muestreo probabilístico aleatorio simple. Datos colectados entre mayo y agosto 2010, según formulario y analizados por estadística descriptiva y con significación 5%. Referente desempeño global del protocolo, índice de conformidad fue de 82,2%. Referente tres etapas del protocolo, porcentaje más alto de conformidad (93% se atribuyó a la manera correcta de hacer pulseras de identificación y el más bajo (89,3% referente a presencia de tres pulseras de identificación, con diferencia estadística significativa p = 0,046. En el grupo especial de recién nacidos, se obtuvo índice 88

  18. Mecanismos de microrregulação aplicados por operadoras de planos de saúde sobre hospitais privados Mecanismos de microregulación aplicados por operadoras de seguros de salud en hospitales privados Mechanisms of microregulation of private hospitals by health plan operators

    Directory of Open Access Journals (Sweden)

    Maria Alicia Domínguez Ugá

    2009-10-01

    Full Text Available OBJETIVO: Analisar os mecanismos de microrregulação aplicados pelas operadoras de planos de saúde nas práticas de gestão da clínica e de qualificação assistencial em hospitais prestadores de serviços. MÉTODOS: Estudo transversal realizado em inquérito de abrangência nacional, cujo universo foi constituído pelos hospitais prestadores de serviços às operadoras de planos de saúde em 2006. Foi construída uma amostra de 83 unidades, estratificada segundo macrorregião do Brasil e tipo de hospital. Os dados foram obtidos por meio de aplicação de questionário em entrevista aos dirigentes dos hospitais. RESULTADOS: A microrregulação que as operadoras de planos de saúde exercem sobre os hospitais em termos da qualificação da assistência foi muito baixa ou quase nula. A atuação das operadoras foi majoritariamente destinada ao intenso controle da quantidade de serviços utilizados pelos pacientes. Os hospitais que prestavam serviços a operadoras de planos de saúde não constituíam micro-sistemas de saúde paralelos ou suplementares ao Sistema Único de Saúde (SUS. Observou-se que os prestadores hospitalares privados eram majoritariamente vinculados ao SUS. Entretanto, não pertenciam à rede alguma de prestadores privados, ainda que fossem objeto de forte regulação da utilização de seus serviços, exercida pelas operadoras de planos de saúde. A intervenção das operadoras de planos de saúde enquanto gestoras de sistemas de cuidado foi incipiente ou quase ausente. Aproximadamente a metade dos hospitais declarou adotar diretrizes clínicas, enquanto apenas 25,4% afirmaram exercer a gestão da patologia e 30,5% mencionaram a gestão dos casos. CONCLUSÕES: As relações contratuais entre hospitais e operadoras de planos de saúde se constituem em contratos meramente comerciais com pouca ou nenhuma incorporação de aspectos relativos à qualidade da assistência contratada, limitando-se, em geral, a aspectos como defini

  19. Seguros de salud públicos y privados: el caso chileno

    OpenAIRE

    Luis García Núñez

    1999-01-01

    En las últimas dos décadas Chile experimentó una profunda reforma en el área de los seguros de salud, estableciéndose una nueva configuración del sector con la coexistencia de un seguro público de salud junto a seguros privados. Este ensayo analiza un hecho estilizado del caso chileno: la presencia mayoritaria de personas de bajos ingresos y alto riesgo en el seguro público, observándose todo lo contrario en los seguros privados. Se desarrolla un modelo bisectorial basado en la teorfa estánda...

  20. EXPERIENCIA DE AMIGDALECTOMÍA EN LA FUNDACIÓN HOSPITAL DE LA MISERICORDIA DURANTE LOS ÚLTIMOS DIEZ AÑOS

    Directory of Open Access Journals (Sweden)

    Gilberto Eduardo Marrugo Pardo

    2009-10-01

    Full Text Available Antecedentes. La amigdalectomía es un procedimiento frecuente en otorrinolaringología pediátrica. Actualmente se indica en hipertrofia amigdalina que obstruya la vía aérea, amigdalitis aguda bacteriana recurrente, asimetría amigdalina y absceso periamigdalino. Es un procedimiento efectivo y con poca morbimortalidad. Las complicaciones más frecuentes son dolor, sangrado, intolerancia a la vía oral e insuficiencia velofaríngea. Objetivo. Revisar la experiencia en amigdalectomía durante los últimos diez años, en la Fundación Hospital de La Misericordia. Materiales y métodos. Estudio retrospectivo, serie de casos, de pacientes llevados a amigdalectomía desde mayo de 2000 a febrero de 2009 en la Fundación Hospital de La Misericordia. Los resultados fueron analizados con el programa SPSS16.0. Resultados. Se incluyeron 149 pacientes. Las indicaciones de amigdalectomía fueron hipertrofia amigdalina con obstrucción de vía aérea en 45 por ciento, amigdalitis a repetición e hipertrofia en 27,5 por ciento, amigdalitis a repetición en 11,4 por ciento, y asimetría amigdalina 6,7 por ciento. La técnica quirúrgica utilizada en todos los pacientes fue extracapsular, de éstas el 97 por ciento con electrocauterio monopolar y 3 por ciento con técnica fría. Dentro de las complicaciones postquirúrgicas más frecuentes estuvieron: dolor en 41 por ciento, otalgia 12,7 por ciento y sangrado postoperatorio un 4 por ciento. El estudio histopatológico reportó en la mayoría hiperplasia folicular reactiva y un solo caso de linfoma de Burkitt cuya indicación fue asimetría amigdalina. Se encontró mejoría clínica en 96 por ciento de los pacientes. Conclusión. La amigdalectomía además de ser un procedimiento costo efectivo, es seguro y con escasas complicaciones. Realizada bajo las indicaciones descritas, proporciona un beneficio indiscutible en la calidad de vida y evolución clínica del paciente.

  1. Do Universo Privado ao Espaço Aberto, do Espaço Aberto ao Universo Privado - Recepção e Gênese de L´Étranger de Albert Camus

    Directory of Open Access Journals (Sweden)

    Samara Geske

    2009-10-01

    Full Text Available Este artigo pretende traçar linhas gerais sobre a recepção e a gênese de L’Étranger , passando pelo universo privado dos primeiros leitores do manuscrito até chegar ao espaço aberto de seus primeiros críticos, para do espaço aberto da obra publicada retornar o universo privado do processo de criação do romance.

  2. Bullying y cyberbulling: diferencias entre colegios públicos-privados y religiosos-laicos

    Directory of Open Access Journals (Sweden)

    Maite Garaigordobil

    2015-01-01

    Full Text Available Objetivo. Analizar diferencias en el bullying presencial y el cyberbulling entre colegios públicos-privados y religiosos-laicos. Método. Participaron 3026 adolescentes y jóvenes del País Vasco (España, de 12 a 18 años (48.5% varones y 51.5% mujeres. Se administró el Test Cyberbullying (Garaigordobil, 2013 para evaluar el bullying cara a cara y el cyberbulling. El diseño de investigación fue descriptivo y comparativo de corte transversal. Resultados. Los resultados evidenciaron: (a la cantidad de conductas de bullying que sufren, realizan y observan es similar en centros públicos y privados; en cyberbulling la cantidad de conductas que sufren y realizan es similar, aunque en los centros privados se observa mayor cantidad de conductas; (b el porcentaje de víctimas, agresores y observadores de bullying fue similar en centros públicos y privados; entre tanto, el porcentaje de cibervíctimas y ciberagresores fue similar, sin embargo el porcentaje de ciberobservadores fue mayor en los centros privados; (c la cantidad de conductas de bullying y cyberbulling que sufren las víctimas y realizan los agresores fue similar en los centros religiosos y laicos, sin embargo en los religiosos se observaron más conductas de bullying y cyberbulling; y (d se encontró un mayor porcentaje de agresores y observadores de bullying en centros religiosos, no obstante el porcentaje de víctimas de bullying, cibervíctimas, ciberagresores y ciberobservadores fue similar en los colegios religiosos y laicos. Conclusión. El debate se centra en la presencia del acoso en todos los centros educativos, con independencia del nivel socioeconómico y de la orientación religiosa de los mismos.

  3. Gasto privado com saúde por classes de renda

    Directory of Open Access Journals (Sweden)

    KILSZTAJN SAMUEL

    2002-01-01

    Full Text Available OBJETIVO: O artigo analisa a participação do gasto privado com saúde das famílias no PIB e no total da renda familiar per capita e a distribuição do gasto privado com saúde das famílias por classes de renda. MÉTODOS: A pesquisa utilizou os microdados da Pesquisa Nacional por Amostra de Domicílios de 1998, com a divisão da população em quatro classes de renda familiar per capita e a distribuição dos gastos em planos de saúde, consultas médicas, consultas com outros profissionais de saúde, exames, medicamentos, artigos ortopédicos e aparelhos médicos, óculos e lentes, odontologia, hospitais, enfermagem domiciliar e outros gastos com saúde. RESULTADOS: Apenas 7,2% da população com renda familiar per capita até 1 salário mínimo em 1998 tinha direito a algum plano de saúde, e o gasto privado com saúde das famílias desta classe, que representava 52,5% da população, era em média de R$ 5,36 por pessoa. Para as pessoas com renda familiar per capita acima de 9 salários mínimos, os planos de saúde atingiam 83,2% da população e o gasto privado com saúde das famílias R$ 133,04. CONCLUSÕES: A implantação do Sistema Único de Saúde foi acompanhada pelo crescimento expressivo dos planos de saúde nos anos 90. Mesmo se todo o gasto público com saúde fosse destinado à população sem planos de saúde, ainda assim o gasto destas pessoas em 1998 só alcançaria R$ 352,62, ou seja, 43% do gasto com saúde das pessoas com planos, R$ 819,08.

  4. Espacio y subjetividad. Orden social desde lo privado y lo público

    OpenAIRE

    Graciela Vélez Bautista

    2005-01-01

    En este artículo se plantea la relación entre subjetividad, espacio y género como uno de los enfoques que explican la identificación de los hombres con el espacio público y de las mujeres con el espacio privado, desde una perspectiva cultural e histórica, cuya huella en la subjetividad prevalece a pesar de las transformaciones modernas en la concepción de lo femenino y masculino, así como de lo privado y público.

  5. Actividad antioxidante de extractos de diez basidiomicetos comestibles en Guatemala

    OpenAIRE

    Karen Belloso; Ivonne González; Rebeca Suárez; Armando Cáceres

    2015-01-01

    Los antioxidantes son esenciales en el cuerpo humano para prevenir el daño oxidativo. Estas substancias pueden obtenerse de diversas fuentes como frutas, plantas y hongos. En Guatemala, diversas especies de hongos comestibles son comercializadas y consumidas, sin embargo su actividad antioxidante no ha sido documentada en el país. El objetivo de este estudio fue determinar la actividad antioxidante de extractos acuosos y etanólicos obtenidos de diez especies de basidiomicetos comestibles (Aga...

  6. Humanização da assistência à saúde na percepção de enfermeiros e médicos de um hospital privado

    Directory of Open Access Journals (Sweden)

    Rita de Cássia Calegari

    2015-12-01

    Full Text Available RESUMO Objetivo Verificar o significado do termo “humanização” para enfermeiros e médicos de um hospital privado do município de São Paulo e identificar os fatores que dificultam e facilitam a humanização da assistência. Método Pesquisa exploratória, descritiva e de abordagem qualitativa. Foram entrevistados 19 profissionais de saúde e os discursos foram categorizados de acordo com o método proposto por Bardin e analisados segundo o referencial teórico da humanização. Resultados A humanização está relacionada com respeito, acolhimento e empatia. Na prática profissional, as ações que visam à humanização podem ser facilitadas pela cultura organizacional, mas dificultadas pela sobrecarga de trabalho. Conclusão É necessária a adoção de políticas e ações gerenciais que propiciem aos profissionais atender às expectativas dos pacientes e seus familiares para a prestação de uma assistência humanizada.

  7. O público e o privado: políticas públicas urbanas

    OpenAIRE

    Aguiar, Maria do Amparo Albuquerque

    2009-01-01

    A falta de clareza entre o que é o Público e o Privado tem as suas raízes no pensamento Liberal, que também apresentou diferentes correntes com posturas que se contrapunham quanto à função do Estado, negando-lhe atribuições sobre o mercado ou atribuindo-lhe papéis relevantes na regulação da produção e como facilitador das actividades económicas. As mudanças sociais ocorridas pelo desenvolvimento do capitalismo não contribuíram para uma melhor definição entre as áreas do público e do privado. ...

  8. A responsabilidade civil dos hospitais privados

    OpenAIRE

    Cavalcante, Christiane

    2007-01-01

    Nos últimos anos, no âmbito da responsabilidade civil, cresceu em demasia o número de ações indenizatórias contra os hospitais privados, notadamente sob a alegação de erro médico. O médico erra porque é humano, erra porque teve uma formação deficiente, porque falta residência para todos os egressos das escolas de medicina, porque trabalha demais e não tem tempo para estudo e pesquisa. Seja qual for a causa, o fato é que sua conduta influencia diretamente as entidades hospita...

  9. ALGUMAS NOTAS SOBRE A „CONSTITUCIONALIZAÇÃO‟ DO DIREITO PRIVADO

    Directory of Open Access Journals (Sweden)

    Roberta Drehmer de Miranda

    2009-12-01

    Full Text Available O Direito Constitucional na pós-modernidade apresenta uma nova moldura diante do fenômeno do “constitucionalismo dos valores”, proveniente do fim da Seg unda Guerra Mundial, a partir da inserção de princípios básicos e direitos humanos fundamentais nos textos das Constituições Estatais até então de origem e linha liberais. Esse mes mo fenômeno trouxe, igualmente, a recepção pelo Direito Constitucional de institutos próprios do direito privado, trazendo a tona a discussão acerca de uma provável “constitucionalização” (ou seja, tornar constitucional do direito civil, elevando essa disciplina a um nível primeiro e máximo do direito. Contudo, o que efetivamente ocorre, na contemporaneidade, é a aceitação, nos textos das Constituições, de institutos os quais não tinham proteção constitucional, seja por seus fundamentos, sejam para fins de objeto de controle de constitucionalidade. Em verdade, não existe “constitucionalização” do direito privado, cuja natureza é de direito concreto, num nível próximo; existe, simplesmente, a garantia constitucional de institutos privados desprotegidos na idéia liberal de Constituição.

  10. Sistema de gestión de redes: diez años de desarrollo; Networt Management System : Ten Years of Development

    Directory of Open Access Journals (Sweden)

    Raúl Fernández Álvarez

    2011-02-01

    Full Text Available En este trabajo se resume a través de los diez módulos más significativos el desarrollo que ha tenido elSistema de Gestión de Redes en los diez años desde su aprobación. Se identifican las ventajas mássignificativas que se logran con su implementación In this work we analyze through the 10 most significant modules the development of the NetworksManagement System in 10 years from his approval, identifying the most significant advantages that ourorganization has achieved by his implementation.

  11. Elementos para la comprensión de lo público/privado desde la comunicación

    OpenAIRE

    Fabio López Díaz

    2012-01-01

    El documento se ocupa de la transformación conceptual que ha experimentado el ámbito de lo público/privado. En principio aborda las oposiciones teóricas construidas entre estos conceptos, para luego estudiar la pertinencia de dichas oposiciones. Se busca finalmente proporcionar un punto de vista que supere esta polarización tradicional y avance hacia el papel de la comunicación en la caracterización del vasto ámbito de lo público/privado.

  12. Avances a los diez años de vigencia de la Ley del Procedimiento Administrativo General

    Directory of Open Access Journals (Sweden)

    Milagros Maraví Sumar

    2011-12-01

    Full Text Available En el artículo, la autora analiza lo ocurrido en estos diez años con respecto a temas como los principios del procedimiento administrativo, la simplificación administrativa, los procedimientos sancionadores, el contro ldifuso en sede administrativa y el silencio administrativo.

  13. El juego de los diez pases como aprendizaje de habilidades motrices

    OpenAIRE

    Llanos Sinovas, Javier

    2017-01-01

    Este trabajo tiene como principal tema las habilidades motrices básicas, y más concretamente las habilidades de lanzamiento, recepción y desplazamiento. De este modo, se puso en práctica una unidad didáctica en 2º de Educación Primaria, sobre este contenido y en la que el juego se utilizó como principal recurso didáctico. A través de la intervención educativa se pretendía comprobar si el juego de los diez pases y el juego del reloj facilitan la adquisición de las habilidades motrices básicas ...

  14. Tendencias de los fenotipos de resistencia bacteriana en hospitales públicos y privados de alta complejidad de Colombia Trends of bacterial resistance phenotypes in high-complexity public and private hospitals in Colombia

    Directory of Open Access Journals (Sweden)

    Andrea Patricia Villalobos Rodríguez

    2011-12-01

    Full Text Available OBJETIVO: Describir y comparar las frecuencias de los fenotipos de resistencia bacteriana de microorganismos obtenidos de pacientes en unidades de cuidados intensivos (UCI y otros servicios de hospitalización (no UCI públicos y privados de alta complejidad de Colombia. MÉTODOS: Estudio observacional, analítico, retrospectivo y multicéntrico, en el cual se consolidaronlos registros de los aislamientos bacterianos y los fenotipos de resistencia bacteriana de los microorganismos obtenidos de pacientes atendidos en UCI y no UCI de 79 hospitales públicos y privados de alta complejidad en el período de enero de 2007 a diciembre de 2009. La información se analizó con el programa WHONET® versión 5.5 (OMS de acuerdo con las recomendaciones del Instituto de Estándares Clínicos y de Laboratorio 2009 y se resumió en un formato de extracción de datos en Excel®. Se realizó un análisis descriptivo en el cual se calcularon proporciones. El análisis de tendencias se realizó mediante la prueba de correlación de rangos de Spearman. RESULTADOS: Las tendencias de los fenotipos de resistencia bacteriana de 2007 a 2009 muestran un comportamiento incremental en la proporción de Enterococcus faecium resistente a vancomicina, Klebsiella pneumoniae resistente a imipenem y a ciprofloxacina, Escherichia coli resistente a ceftazidima, y Enterobacter cloacae resistente a cefotaxima (ρ = 1, P OBJECTIVE: Describe and compare the frequency of bacterial resistance phenotypes of microorganisms obtained from patients in intensive care units (ICU and other (non-ICU high-complexity public and private hospital services in Colombia. METHODS: A retrospective observational, analytical, multicenter study was conducted. The records from January 2007 to December 2009 on bacterial isolates and bacterial resistance phenotypes of microorganisms obtained from ICU and non-ICU patients in 79 high-complexity public and private hospitals were consolidated. The information was

  15. Trauma, diez años de experiencia, Hospital Vicente Corral Moscoso

    OpenAIRE

    Astudillo Molina, Rubén Arturo; Salamea Molina, Juan Carlos; Crespo Riquetti, Paola Marcela; Salamea Molina, Pablo Javier

    2010-01-01

    Objetivo Realizar una descripción demográfica, forma y estado de llegada, etiología, tipo de trauma y hallazgos, en pacientes intervenidos quirúrgicamente y dados de alta del servicio de Cirugía General del Hospital Vicente Corral Moscoso, Cuenca – Ecuador. Pacientes y métodos. Es un estudio descriptivo, realizado en un periodo de 10 años, 1995 al 2005; se revisó el libro de altas hospitalarias, identificando 1415 historias clínicas. Registrando: año, sexo, edad, procedencia, signos ...

  16. Análise das barreiras à utilização de trombolíticos em casos de acidente vascular cerebral isquêmico em um hospital privado do Rio de Janeiro, Brasil

    Directory of Open Access Journals (Sweden)

    Luiz Henrique de Oliveira Fonseca

    2013-12-01

    Full Text Available O acidente vascular cerebral isquêmico (AVCi é uma importante causa de sequela e morte. A correta utilização do trombolítico enfrenta várias barreiras. O objetivo foi discutir as barreiras à terapia trombolítica em pacientes que chegam, com sintomas de AVCi agudo, à emergência de um hospital privado do Rio de Janeiro, Brasil. Coorte retrospectiva de pacientes entre 2009 e 2011. Foram admitidos 257 pacientes com suspeita de AVCi. Dos pacientes com diagnóstico confirmado (156, 11,5% (18 foram trombolisados. Dos 30 pacientes com diagnóstico de AVCi, dentro da janela terapêutica e com NIHSS na faixa para trombólise, 20 não foram trombolisados, 9 por barreiras administrativas (45%. Neste trabalho o percentual de trombólise foi superior ao observado nos Estados Unidos, mas barreiras impediram o tratamento de 45% dos pacientes com indicação à trombólise. Imagina-se que na rede pública brasileira a situação seja ainda mais desfavorável.

  17. Ciberprens@. El medio de los ‘diez mil nombres’

    Directory of Open Access Journals (Sweden)

    Dr. José Álvarez Marcos

    2000-01-01

    Full Text Available Los chinos han traducido el significado de World Wide Web como "la red de diez mil dimensiones en el cielo y la tierra". La telaraña cibernética no sólo se ha convertido en un gigantesco hipermercado de la información, donde confluyen medios tradicionales e innovadoras propuestas comunicativas, sino que aparece como el fenómeno de mayor impacto social de los últimos años. En un mundo donde la evolución tecnológica acorta cada vez más los ciclos de la innovación, como bien señala Díaz Nosty, Internet tiene visos de consolidarse como el embrión de la primera gran solución sostenible desde que apareció la televisión, al menos en una interpretación hecha desde el campo de análisis de los medios

  18. Eficacia de la reeducación vocal en diez

    Directory of Open Access Journals (Sweden)

    Alba Gutiérrez

    2012-06-01

    Full Text Available El programa de rehabilitación vocal debe basarse en un diagnóstico funcional siendo indispensable lainformación que la estroboscopia proporciona para diseñar un programa de terapia específico. Losequipos de Foniatría y Logopedia colaboran en este diseño e intervención, lo que reduce la duración deltratamiento con un mejor rendimiento y menor coste para el sistema sanitario. Para verificar la eficacia dela rehabilitación con 10 sesiones de tratamiento, se realiza un estudio con pacientes tratados por unequipo formado por un Foniatra y dos Logopedas. Se realiza una evaluación pre y post-tratamiento conherramientas subjetivas y objetivas: cuestionario de confort vocal, examen perceptual de la voz y análisisacústico. Los resultados avalan la eficacia del tratamiento realizado en tan solo diez sesiones.

  19. Making sense of others: The use of biographical statements in Rosaura a las Diez

    Directory of Open Access Journals (Sweden)

    Teófilo Espada-Brignoni

    2018-02-01

    Full Text Available Marco Denevi’s Rosaura a las Diez is a novel that explores the complex relationships between law, science, and everyday life. These fields of human experience play a fundamental role in the construction of the social categories and biographical statements individuals use to understand their world. This article draws from the works of Michel Foucault and Erving Goffman to analyse the way in which Denevi explores individuals making sense of themselves and others.

  20. Gestión de la calidad educativa en educación superior del sector privado

    Directory of Open Access Journals (Sweden)

    Martha Armida Fabela Cárdenas

    2014-06-01

    Full Text Available Este artículo presenta la teoría emergente sobre los factores determinantes para ofrecer educación de calidad en instituciones de educación superior (IES del sector privado. En particular, se presenta un modelo de factores y subfactores que influyen en la calidad de la educación y generan éxito y que emerge como resultado de entrevistas a profundidad realizadas con líderes de dichas instituciones educativas. El estudio se llevó a cabo con una muestra de veintidós líderes de instituciones de educación superior del sector privado, con una metodología Delphi o consulta a expertos y revela una actualización del modelo de Arcaro de 1995.

  1. Gestión de la calidad educativa en educación superior del sector privado

    Directory of Open Access Journals (Sweden)

    Martha Armida Fabela-Cárdenas

    2014-01-01

    Full Text Available Este artículo presenta la teoría emergente sobre los factores determinantes para ofrecer educación de calidad en insti- tuciones de educación superior (IES del sector privado. En particular, se presenta un modelo de factores y subfactores que influyen en la calidad de la educación y generan éxito y que emerge como resultado de entrevistas a profundidad realizadas con líderes de dichas instituciones educativas. El estudio se llevó a cabo con una muestra de veintidós líderes de instituciones de educación superior del sector privado, con una metodología Delphi o consulta a expertos y revela una actualización del modelo de Arcaro de 1995.

  2. Do público e do privado: uma perspectiva de género sobre uma dicotomia moderna

    Directory of Open Access Journals (Sweden)

    Sofia Aboim

    2012-05-01

    Full Text Available http://dx.doi.org/10.1590/S0104-026X2012000100006 Neste texto propomos uma interpretação crítica da dicotomia histórica entre público e privado como dinâmica fundamental da modernidade. A partir de uma perspectiva de género, discutimos as fronteiras construídas entre espaço coletivo de cidadania e de sociabilidade e espaço individual de intimidade e desigualdade. Argumentamos a favor de uma relação de cumplicidade, ainda que tensa, entre as duas esferas, observando que a vida privada foi, em grande medida, moldada pelas mudanças operadas na vida pública. Recorrendo a diferentes definições de “público”, notamos que, à medida que as sociabilidades tradicionais, essencialmente masculinas, estudadas entre outros por Ariès ou Sennett, sofriam uma erosão, crescia o sentimento de intimidade, aumentando igualmente a inclusão do privado no público através do alargamento da cidadania, em consequência das lutas travadas na esfera pública por vários movimentos de emancipação, como o operário ou o feminista. À medida que a pessoa era retirada da comunidade, do clã, do grupo de parentesco, em que eram “naturais” as desigualdades, no sentido aristotélico do termo, ia-se reencontrando progressivamente como indivíduo portador de cidadania. Se o espaço privado se tornou central na definição de uma identidade, ele é também crescentemente atravessado por mecanismos públicos de regulação. Nesse sentido, o movimento de ascensão do privado, que nas últimas décadas tem ocupado espaço de debate, deve ser cuidadosamente reinterpretado.

  3. Factores de riesgo de violencia escolar (bullying) severa en colegios privados de tres zonas de la sierra del Perú

    OpenAIRE

    Isabel Amemiya; Miguel Oliveros; Armando Barrientos

    2009-01-01

    Objetivo: Identificar los factores de riesgo de violencia escolar (bullying) severa en alumnos de colegios privados de tres zonas de la sierra del Perú. Diseño: Estudio tipo encuesta. Institución: Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Perú. Participantes: Alumnos entre quinto de primaria y quinto de secundaria de colegios privados. Intervenciones: Una encuesta validada en estudios previos, para identificar violencia escolar (bullying), fue aplicada a 736 alumno...

  4. LO PÚBLICO O LO PRIVADO: UN PRESUPUESTO DE VIRTUD EN ARISTÓTELES

    Directory of Open Access Journals (Sweden)

    Iván Cadavid

    2010-01-01

    Full Text Available Uno de los temas coyunturales de toda la teoría política del estagirita es el de lo público versus lo privado, desde el cual puede catalogarse la virtud o el vicio de un gobierno. Pero, entiéndase bien, para Aristóteles no puede existir una política buena o mala, que no devenga de una ética que la determine.De este modo, el tema de la virtud ética del gobernante, que es quienestá llamado a elegir entre lo público y lo privado, determina no solo su virtud sino también el futuro de una comunidad política. Pero aquí surge el problema, pues puede pensarse que si se privilegia al individuo se descuida a la sociedad, y a contrario sensu, si se privilegia la sociedad, se descuida al individuo. ¿Cómo sortear este problema? Ésta y otras cuestiones parecidas son las que se pretenden resolver en este artículo.

  5. Investimento privado: uma análise empírica para o Brasil Private investment: an empirical analysis for Brazil

    Directory of Open Access Journals (Sweden)

    Viviane Luporini

    2010-12-01

    Full Text Available O presente estudo identifica os determinantes do investimento privado no Brasil para o período compreendido entre 1970 e 2005. O artigo apresenta as principais teorias de investimento, os desenvolvimentos recentes e as principais aplicações para os dados brasileiros. Os resultados indicam que aumentos na renda e na atividade econômica influenciam positivamente o investimento do setor privado no Brasil. A redução no volume de crédito e a existência de instabilidades políticas e econômicas mostraram-se prejudiciais ao investimento privado no período analisado. A implementação de políticas públicas que possam garantir a estabilidade econômica e a credibilidade dos agentes, assim como aumentos na oferta de crédito, podem elevar o nível de investimento privado no Brasil.This study identifies the determinants of private investment in Brazil over the period of 1970 to 2005. The paper presents the main investment theories, and recent developments of these theories, as well as how they can be applied to Brazilian data. The results indicate that increases in income and economic activity have positively influenced private sector investment in Brazil. The reduction in credit volume and the existence of political and economic instabilities are shown as being harmful to private investment in the analyzed period. The implementation of public policies that can guarantee economic stability and improve the government's credibility, along with increases in credit offer, may boost private investment in Brazil.

  6. Ciberbullying en colegios privados y estatales de primaria en dos distritos de Lima Metropolitana

    Directory of Open Access Journals (Sweden)

    Isabel Amemiya

    2013-04-01

    Full Text Available Objetivos: Determinar las características del ciberbullying en escolares de 5° y 6° de primaria de colegios estatales y particulares, de Jesús María y Pueblo Libre. Diseño: Descriptivo transversal. Institución: Colegios estatales y particulares, de Jesús María y Pueblo Libre. Participantes: Alumnos de 5° y 6° de primaria. Intervenciones: En 826 alumnos de 5° y 6° de primaria, se aplicó una encuesta anónima de Rosario Ortega. Principales medidas de resultado: Análisis descriptivo y pruebas estadísticas de asociación. Resultados: Se comunicó ciberbullying en 24,7% de los alumnos; fue mayor en 6° grado y en colegios privados. La agresión por celular e internet ocurrió en 1,9% y hubo víctimas por celular en 6,3% y por internet 12%. La situación de victimas por internet se asoció a computadora en cuarto (p=0,019 y al uso de internet fuera de casa (p=0,000; fue mayor en colegios privados (p=0,002 y con el empleo de internet fuera de casa aumentó a 23,1% (p=0,032. Los varones agredieron más que las mujeres (p=0,000. Conclusiones: El ciberbullying fue más frecuente en alumnos de 6° de primaria de colegios privados. Las víctimas por internet fueron más frecuentes que por celular, y se asociaron a tener computadora en su cuarto o usarla fuera de casa. Predominó la agresión en los varones.

  7. Sistema privado de seguro-saúde: lições do caso americano

    Directory of Open Access Journals (Sweden)

    Mônica Viegas Andrade

    2000-01-01

    Full Text Available O mercado de serviços de atenção à saúde apresenta particularidades não observadas em outros mercados de bens, traduzidas nas relações contratuais estabelecidas entre os agentes deste mercado: relação paciente-provedor e relação seguradora-provedor. Na relação seguradora-provedor existe um problema de risco moral que cria incentivos à sobreutilização de serviços médicos. O objetivo deste trabalho é sistematizar as principais características institucionais do sistema de saúde americano, enfatizando as reformas ocorridas na década de 1970 e os problemas identificados em regulamentar o setor privado de serviços médicos e hospitalares. Estes problemas estão relacionados, em sua grande maioria, à regulamentação dos contratos permitidos entre as seguradoras, os provedores de serviços médicos e hospitalares e os segurados. A principal conclusão deste trabalho é mostrar que a flexibilização dos contratos entre provedores e seguradora tem efeito significativo na redução dos custos do seguro-saúde, resultando sobretudo em maior eficiência dos serviços ofertados. Os novos desenhos de contratos estabelecidos permitem a divisão do risco entre os provedores e seguradora, além de centralizar a decisão de encaminhamentos médicos a serem realizados configurando utilização mais racional destes serviços. A flexibilização dos contratos não significou, no entanto, eliminação da regulação por parte do Estado do setor de seguro-saúde privado, sendo fundamental para garantir a sustentabilidade financeira dos seguros.The aim of this paper is to organize the main institutional characteristics of the American Health System, emphasizing the reforms that occurred during the age of seventy and the difficulties to regulate the private sector of medical and hospital services. The most part of these problems are related to the contract regulation between the providers of medical and hospital service and the patients. The

  8. O setor privado de ensino superior na América Latina The private sector in Latin America: a comparative analysis

    Directory of Open Access Journals (Sweden)

    Eunice Ribeiro Durham

    2000-07-01

    Full Text Available O artigo trata da relação entre o setor público e o privado em cinco sistemas nacionais de ensino superior: Argentina, Brasil, Chile, Colômbia e México. Em cada país constatam-se dinâmicas muito específicas da relação público/privado em seus respectivos sistemas de ensino superior. Em contraste com o Brasil, onde a expansão do setor privado iniciou-se em meados dos anos 60 e retraiu-se ao longo da década de 80, nos demais países, o crescimento absoluto e relativo das matrículas no setor privado, além de mais recente, ainda não apresentou sinais de esgotamento. Diferenças detiming na expansão do setor privado nos cinco países suscitam questões relevantes sobre a oportunidade da abertura do ensino superior para o mercado e sobre a relação do Estado com os respectivos sistemas nacionais, temas, sem dúvida, centrais no debate contemporâneo sobre ensino superior na América Latina.The article treats the relationship between the public and private sectors in five national systems of higher education: Argentina, Brazil, Chile, Colombia and Mexico. In each country there are very specific dynamics in the public/private relationship and their respective higher education systems. In contrast with Brazil where the expansion of the private sector began the mid 60s and contracted during the 80s, in the other countries the absolute and relative growth of enrollments in the private sector, in addition to being more recent, still shows no signs of exhaustion. Differences in timing in the expansion of the private sector in the five countries invite relevant questions about the opportunity for opening up higher education to the market and about the relationship with the State with the respective national systems. These issues doubtlessly are central in the contemporary debate on higher education in Latin America.

  9. Diez pasos para el aprendizaje complejo: Un acercamiento sistemático al diseňo instruccional de los cuatro componentes

    NARCIS (Netherlands)

    Van Merriënboer, Jeroen; Kirschner, Paul A.

    2011-01-01

    Van Merriënboer, J. J. G., & Kirschner, P. A. (2010). Diez pasos para el aprendizaje complejo: Un acercamiento sistemático al diseňo instruccional de los cuatro componentes (translation from English). Cuajimalpa, México: Aseguramiento de la Calidad en la Educacion y en el Trabajo.

  10. A política cultural: regulação estatal e mecenato privado

    Directory of Open Access Journals (Sweden)

    Maria Arminda do Nascimento Arruda

    2003-11-01

    Full Text Available O artigo traça as diretrizes da política cultural implementada durante o segundo governo FHC: leis de incentivo fiscal, financiamento privado e regulação estatal. A ação cultural do governo atribuiu ao Estado o papel de intermediário no processo de financiamento, avalizando relações entre produtores culturais e agentes econômicos. Em lugar de um típico mecenato privado, instituiu-se uma nova modalidade de promoção cultural. A expansão das iniciativas nos diversos ramos da criação cultural não significou, necessariamente, a renovação das linguagens.This paper traces the guidelines of the cultural policies prevailing during Fernando Henrique Cardoso's second term of government: fiscal incentive legislation, private funding and state regulation. The government's cultural action designed the state as regulator, acting as "go-between" towards the cultural producers and the new economic agents. Instead of a typical private patronage model, the state instituted a new kind of cultural promotion. The expansion of initiatives in every domain of cultural creation did not mean, necessarily, the renewal of languages.

  11. Diferencias entre público y privado en la asistencia hospitalaria en España: ¿realidad asistencial o falacia numérica? Differences between public and private hospital care in Spain: the realities of health care or a numerical fallacy?

    Directory of Open Access Journals (Sweden)

    Rosa Gispert

    2006-03-01

    Full Text Available Objetivo: Mostrar un ejemplo de la interpretación engañosa del concepto «público» y «privado» con datos sencillos sobre la dotación y la actividad hospitalaria en España. Material y métodos: Se utilizan datos de la Encuesta de Establecimientos Sanitarios con Régimen de Internado (EESCRI del año 2002 para Cataluña y se comparan los resultados de dotación (hospitales y camas y de actividad (altas, estancias, estancia media, índice de ocupación e índice de rotación como resultado de recategorizar las variables (dependencia funcional y financiación, en función del concepto público y privado. Resultados: La dotación, actividad y los índices hospitalarios básicos dan una imagen muy diferente sobre la asistencia pública o privada según cuál sea la variable de clasificación utilizada. Conclusiones: Es necesario precisar mejor los conceptos y las variables utilizadas en el estudio del sistema sanitario y mejorar las fuentes de información para adaptarlas a las nuevas realidades de gestión de los servicios existentes.Objective: To give an example of the misleading interpretations of the concepts «public and private» when dealing with simple data from hospital resources and activities in Spain. Material and methods: Data comes from the survey of hospitals (EESCRI for the year 2002 in Catalonia. Using the figures corresponding to resources (number of centers and beds and activities (discharges, stays, mean stay, occupancy, and rotation comparisons are made among different variables (managing authority and funding source reclassified, according to the concepts of public and private. Results: The figures on resources and activities offer a very different portrait about the public or private nature of the care provided, according to the variables being used for classification. Conclusions: It is necessary to specify the concepts and variables to be used when analyzing the performance of health services and to improve the

  12. RESISTENCIA AL IMPACTO DE LA MADERA DE DIEZ ENCINOS (Quercus MEXICANOS

    Directory of Open Access Journals (Sweden)

    R. Dávalos-Sotelo

    2010-01-01

    Full Text Available Se presentan los valores de resistencia al impacto o tenacidad de la madera de diez especies de encinos mexicanos de los estados de Jalisco, México, Puebla y Veracruz ensayados en condición verde con una máquina tipo FPL. No se detectaron diferencias significativas en los valores entre los individuos de la misma especie que crecen en diferentes estados, por lo que puede establecerse un valor común. Existe un efecto directamente proporcional de la densidad básica sobre la tenacidad, el cual se acentúa al incluir los valores del espesor de la pared celular como una variable independiente adicional en los análisis de regresión múltiple. Finalmente, en este trabajo se incluyen los valores de las características anatómicas, físicas y mecánicas de la madera de Quercus crassipes.

  13. El carácter privado del proceso de inaplicabilidad por inconstitucionalidad

    OpenAIRE

    Bronfman, Alan

    2011-01-01

    El proceso de inaplicabilidad debe su estructura al modelo tradicional de litigación privada. En su seno acoge el trámite de un recurso que también nace de un litigio construido siguiendo el modelo de proceso privado. En este artículo se examinan algunas de las dificultades que surgen del uso de este modelo en un proceso de control concreto de constitucionalidad que contienes intereses y objetivos que se distancian de la litigación privada. The structure of the non-applicability process is...

  14. Calidad de vida relacionada con salud, resiliencia y felicidad en hombres privados de la libertad

    Directory of Open Access Journals (Sweden)

    Japcy Margarita Quiceno

    2012-01-01

    Full Text Available Objetivo. El propósito de este estudio fue evaluar las diferencias de la calidad de vida relacionada con la salud, la resiliencia y felicidad en hombres privados (n=21 y no privados (n=21 de la libertad. Método. Bajo un diseño descriptivo - comparativo, se utilizó el cuestionario de salud MOS SF-36, la escala de resiliencia (RS y la escala de felicidad subjetiva (SHT. Resultados. Los datos recogidos evidenciaron diferencias entre ambos grupos evaluados, en las categorías de ocupación, estrato socioeconómico y estado civil, más no en sus niveles de calidad de vida, resiliencia y felicidad, a excepción de la dimensión función social de la calidad de vida. Conclusión. Este estudio, aunque preliminar y exploratorio brinda información sobre el valor que tienen variables positivas, como la resiliencia, la felicidad y la calidad de vida relacionada con la salud en personas privadas de la libertad.

  15. Sociedades fantasma y Derecho Internacional Privado

    Directory of Open Access Journals (Sweden)

    Javier Carrascosa González

    2014-06-01

    Full Text Available Las conocidas como "sociedades fantasma" son una realidad en el escenario de la economía mundial del siglo XXI. Se trata de entes jurídicos constituidos en ciertos Estados, en los que poseen su sede social, pero en los que no realizan actividad económica o societaria alguna. El presente estudio analiza el régimen jurídico de estas sociedades fantasma en Derecho internacional privado europeo y español. Se aborda la cuestión de la determinación de la Ley reguladora de las sociedades fantasma, la reacción legal contra las pseudo-foreign corporations, la libertad de establecimiento de sociedades fantasma en la UE y la responsabilidad patrimonial de estas sociedades y de sus administradores, en especial, cuando se emplean testaferros. Por último, se presta una especial atención a régimen jurídico de la insolvencia internacional de la sociedad fantasma, lo que comporta el análisis del "centro de intereses principales" de la sociedad fantasma como deudor insolvente, así como del traslado internacional de la sede social de la sociedad fantasma

  16. A formação dos salários nos setores público e privado

    OpenAIRE

    Marconi, Nelson

    2010-01-01

    Este trabalho visa comprovar a existência de segmentação entre os mercados de trabalho público e privado, evidenciada através dos diferenciais salariais e das distintas regras de formação de salários em ambos, buscando discutir de modo mais detalhado quais seriam estas regras no setor público.

  17. Arrendamento privado em Portugal: uma leitura a partir da regulação das rendas

    DEFF Research Database (Denmark)

    Alves, Sonia; Azevedo, Alda; Moura Ferreira, Pedro

    2017-01-01

    Este artigo contribui para o debate do papel do Estado na regulação do sector de arrendamento privado em Portugal num momento em que é implementado um Novo Regime de Arrendamento Urbano. A informação estatística disponível, nomeadamente sobre a duração dos contratos e os valores das rendas, alerta...

  18. Bullying y cyberbulling: diferencias entre colegios públicos-privados y religiosos-laicos

    OpenAIRE

    Maite Garaigordobil; Vanesa Martínez-Valderrey; Darío Páez; Griselda Cardozo

    2015-01-01

    Objetivo. Analizar diferencias en el bullying presencial y el cyberbulling entre colegios públicos-privados y religiosos-laicos. Método. Participaron 3026 adolescentes y jóvenes del País Vasco (España), de 12 a 18 años (48.5% varones y 51.5% mujeres). Se administró el Test Cyberbullying (Garaigordobil, 2013) para evaluar el bullying cara a cara y el cyberbulling. El diseño de investigación fue descriptivo y comparativo de corte transversal. Resultados. Los resultados evidenciaron: (a) la cant...

  19. ÚLTIMOS RETOS PARA EL DERECHO PRIVADO: LAS NUEVAS TECNOLOGÍAS DE LA INFORMACIÓN

    Directory of Open Access Journals (Sweden)

    Erick Rincón-Cárdenas

    2010-03-01

    Full Text Available El artículo analiza algunas de las formas en que se ve afectado el derecho privado como resultado de la incidencia de las nuevas tecnologías de la información y la comunicación en nuestra sociedad. Para ello se tendrá en cuenta la siguiente estructura metodológica: en primer lugar se desarrollará una breve introducción sobre las nuevas tecnologías de la información y la comunicación, y su incidencia en  el derecho. Seguidamente, se exponen algunos de los temas centrales de afectación del derecho privado por las nuevas tecnologías, para lo cual se utilizará el siguiente esquema: a la contratación electrónica y la nueva forma del negocio jurídico; b la propiedad en los entornos electrónicos; e la responsabilidad y los seguros en los entornos electrónicos; d los derechos del consumidor y la privacidad en los entornos electrónicos, y e la banca electrónica  y los medios de pago. Finalmente, en la tercera parte, se desarrollarán algunas conclusiones.

  20. Evaluación de la calidad de servicio de centros deportivos privados. Influencia de la gestión en el bienestar de los usuarios

    OpenAIRE

    Molina García, Nuria

    2016-01-01

    Titulo de tesis doctoral: Evaluación de la calidad de servicio de centros deportivos privados. Influencia de la gestión en el bienestar de los usuarios Presentada por: Dña. Nuria Molina García Dirigida por: Dr. D. Ferran Calabuig Moreno y Dr. D. Josep Crespo Hervàs TEMA: En tema o idea principal de este trabajo es conocer la realidad sobre la opinión de los usuarios de tres centros deportivos privados de la provincia de Alicante sobre dos temáticas principales, la calidad perci...

  1. As parcerias entre prefeituras paulistas e o setor privado na política educacional: expressão de simbiose?

    Directory of Open Access Journals (Sweden)

    Theresa Adrião

    2012-06-01

    Full Text Available O artigo apresenta resultados finais de pesquisa interinstitucional que teve por objetivo analisar a natureza e as consequências de parcerias firmadas entre setores privados e governos municipais paulistas para atendimento da educação infantil e do ensino fundamental. O período correspondeu aos anos de 1996 a 2006, tendo em vista a percepção de que o aumento das responsabilidades dos municípios pela oferta educacional, decorrente da municipalização do ensino fundamental, poderia estimular processos de privatização da educação municipal, por meio do aumento de "parcerias" entre a gestão municipal e o setor privado lucrativo e não lucrativo. O estudo apresenta tendências relacionadas a três modalidades de parcerias: subvenção pública para oferta de vagas em instituições privadas de educação infantil, aquisição de "sistemas" privados de ensino e contratação de assessoria privada para a gestão da educação municipal. As tendências percebidas na análise indicam que as atuais relações entre as esferas públicas e privadas no campo da educação, decorrentes da descentralização havida no setor, representam um movimento em direção a sua privatização.

  2. Direito Internacional Privado: o diálogo como instrumento de efetivação dos Direitos Humanos

    Directory of Open Access Journals (Sweden)

    Gisele Cittadino

    2012-07-01

    Full Text Available The Private international law, having as the axiological axis the man, is one of the most important tools of legal science in the recognition and preservation of dignity and human rights. The intercultural dialogue, in turn, is an instrument used by private international law as a way to find a common denominator between the rights of different peoples from different cultures. The standardization and codification of Private International Law, through the composition of large spaces of debate and negotiation, as the Permanent Convention Hague, allow respect for cultural and social differences. Consequently, during the construction of the best law to be applied or even the substantive law adopted by the Convention, it’s built a solid and legitimate set of rules that provides promotion to the individual.Resumo: O Direito Internacional Privado, tendo como eixo axiológico o homem, é um dos mais importantes instrumentos da ciência jurídica no reconhecimento e preservação da dignidade e dos direitos humanos. O dialogo intercultural, por sua vez, é instrumento utilizado pelo Direito Internacional Privado como forma de encontrar um denominador comum entre os direitos dos mais diversos povos das mais diversas culturas. A uniformização e a codificação do Direito Internacional Privado, por meio da composição de grandes ambientes de debates e negociação, como a Convenção Permanente da Haia, possibilitam o respeito às diferenças culturais e sociais. Consequentemente, no momento da construção da melhor lei a ser aplicada ou até mesmo da lei material adotada pela Convenção, constrói-se um conjunto normativo sólido e legítimo que fornece ao indivíduo sua promoção.

  3. Estrategias gerenciales administrativas para Centros Médicos Privados

    Directory of Open Access Journals (Sweden)

    Thaide Torres Guerra

    2013-01-01

    Full Text Available El problema abordado en este artículo plantea la necesidad de nuevas estrategias gerenciales administrativas para los Centros Médicos Privados de la Parroquia Raúl Leoni del Municipio Maracaibo, con el fin de identificar las fallas, para la mejora del desempeño gerencial. La metodología corresponde a un estudio descriptivo, pues contextualiza el desempeño gerencial administrativo actual en cuanto a las funciones en los centros seleccionados, identificando métodos y test que sirvan para su medición en aspectos relevantes de la planificación, organización, dirección y control. Finalmente se concluye que la estructura organizacional y la caracterización del enfoque confirma con los resultados que el liderazgo, la motivación, comunicación y toma de decisiones, son medianamente efectivas, siendo una debilidad para alcanzar la integración y unificación de los equipos de trabajo y de todos sus miembros que hacen vida en la institución.

  4. Baños privados y termas públicas en el Lugo romano

    Directory of Open Access Journals (Sweden)

    C. Carreño

    1992-01-01

    Full Text Available Durante los cinco últimos años de excavaciones arqueológicas en la ciudad de Lugo, han aparecido varios establecimientos termales de uso privado, que vienen a sumarse a las ya archiconocidas termas públicas romanas de la ciudad. En el presente artículo se da cuenta somera de todos estos hallazgos.During the last five years of archaeological diggings in the clty of Lugo, some thermal sites of prívate use have been discovered, In additlon to the very well known Roman ones of publlc use in the city. The article herebolow deals, In a general way, wlth all these discoveries.

  5. Use of the nursing process at public and private centers in a health area Uso del proceso de enfermería en los centros públicos y privados de un área de salud Uso do processo de enfermagem nos serviços públicos e privados de um distrito de saúde

    Directory of Open Access Journals (Sweden)

    Joseba Xabier Huitzi-Egilegor

    2012-10-01

    Full Text Available AIM: to analyze whether the nursing process method is used at public and private centers in the health area Gipuzkoa (Basque Country and, if yes, to analyze in the framework of which model and how it is used. METHOD: cross-sectional study, based on the analysis of the nursing records used at the 158 centers studied. RESULTS: the nursing process is applied at 98% of the centers. It is applied at all public and 18 out of 21 private centers. Virginia Henderson's model is the most used to apply it, and most centers use nursing diagnoses, the NIC-NOC terminology and standardized care plans. CONCLUSION: the use of the nursing process is widespread in Gipuzkoa, with greater use at public than at private centers.OBJETIVO: analizar si la metodología del proceso de enfermería se utiliza en los centros públicos y privados del área de salud de Gipuzkoa (País Vasco y, en caso de utilizarse, analizar bajo qué modelo enfermero y de qué manera se utiliza. MÉTODO: estudio transversal, basado en el análisis de los registros de enfermería que utilizan los 158 centros estudiados. RESULTADOS: el proceso de enfermería se aplica en el 98% de los centros estudiados. Se aplica en todos los centros públicos y en 18 de los 21 centros privados. El modelo de Virginia Henderson es el más utilizado para aplicarlo, y el uso de los diagnósticos enfermeros, de la terminología NOC-NIC y de los planes de cuidados estandarizados es mayoritario. CONCLUSIÓN: se concluye que el uso del proceso de enfermería está extendido en Gipuzkoa, y su uso es mayor en los centros públicos que en los privados.OBJETIVO: analisar se a metodologia do processo de enfermagem é utilizada nos serviços públicos e privados do distrito de saúde de Gipuzkoa (País Basco e, caso seja, analisar sob qual modelo de enfermagem e de que maneira é utilizada. MÉTODO: estudo transversal, baseado na análise dos registros de enfermagem usados pelos 158 serviços estudados. RESULTADOS: o

  6. SOBRE UNA PROPUESTA DE LECTURAS DE DIEZ CUENTOS DE HANS CHRISTIAN ANDERSEN

    Directory of Open Access Journals (Sweden)

    Ronald Campos López

    2009-01-01

    Full Text Available Se presenta una propuesta metodológica de lecturas de diez cuentos de Hans Christian Andersen, aplicable a una situación de aula de estudiantes de quinto grado de la Escuela de San Rafael de Coronado. Dicho enfoque se orienta desde una perspectiva del valor pragmático de la literatura, en donde el niño y la niña se constituyan a sí mismos como lectores-estudiantesindividuos sociales simultáneamente, a medida que ejecutan su capacidad crítico-analítica, abstracta, simbólica, comparativa, lingüística y representativa sobre la discursividad hegemónica de la identidad y en contra de la dogmática función social del abordaje metodológico cotidiano de los textos literarios aún en las aulas costarricenses. Es por ello que resultan imperativos lecturas y análisis (deconstructivos de textos, literarios propiamente en este caso, los cuales problematicen la institucionalidad del lenguaje en los procesos de enseñanza y aprendizaje.

  7. CONTRIBUCIÓN DEL SISTEMA DE PENSIONES PRIVADO DE CAPITALIZACIÓN INDIVIDUAL AL DESARROLLO DEL MERCADO DE CAPITALES EN BOLIVIA, 1997– 2009

    Directory of Open Access Journals (Sweden)

    Pamela Córdova Olivera

    2011-01-01

    Full Text Available El establecimiento del Sistema de Pensiones de Capitalización Individual en Bolivia aprobado en el año 1996, constituye el reemplazo de un sistema tradicional de reparto colectivo, de contribuciones comunes y administradas por el Estado, por un sistema de capitalización individual, de contribuciones definidas y administradas por el sector privado. A más de una década de su establecimiento, es posible realizar una estimación más completa y precisa de sus resultados e impactos. Este estudio presenta una evaluación cualitativa y cuantitativa del impacto de los Fondos de Pensiones de Capitalización Individual sobre el desarrollo del Mercado de Capitales en Bolivia en lo que respecta a su regulación, composición, tamaño y profundidad financiera considerando alternativamente la participación del sector privado y público. Como base de demostración empírica, se plantea un modelo econométrico basado en el análisis de series de tiempo cointegradas que hacen hincapié en los factores financieros concentrados en una variable de profundidad financiera, cuyo resultado confirma el importante aporte del Sistema de Pensiones Privado a la mejora en la calidad de regulación, tamaño, trasparencia y crecimiento del mercado financiero en Bolivia.

  8. Uma abordagem da antinomia 'público x privado': descortinando relações para a saúde coletiva

    Directory of Open Access Journals (Sweden)

    Giovanni Gurgel Aciole da Silva

    2006-06-01

    Full Text Available Propõe-se descortinar a diferença entre o que reconhecemos como público e o que entendemos como privado, além dos maniqueísmos ou simplificações do senso comum. Tarefa particularmente importante para todos os que se debruçam na viabilização das políticas de saúde, e haja vista a convivência de dois sistemas de atenção à saúde em nosso país: o SUS e a Saúde Suplementar. Para compreender os significados emprestados aos termos 'público e privado', abordam-se as interfaces existentes entre ambos, a partir da recuperação histórico-crítica de elementos, articulados em duas macrodimensões da modernidade: a econômica e a política. Ao resgatar a construção da babel de significados e sentidos com que são adjetivados os dois termos, conclui-se haver mais uma relação de interpenetração entre ambos do que a tendência dicotômica e de oposição em que comumente os colocamos.

  9. CARACTERIZACIÓN DE DIEZ CULTIVARES FORRAJEROS DE Leucaena leucocephala BASADA EN LA COMPOSICIÓN QUÍMICA Y LA DEGRADABILIDAD RUMINAL

    OpenAIRE

    García M, Danny; Hilda, Wencomo G; Gonzáles C, Miriam; Medina R, María; Cova O, Luis

    2008-01-01

    Objetivo. Estudiar las variaciones en la composición química y la degradabilidad ruminal de diez cultivares de Leucaena leucocephala Lam. de Wit. mediante el análisis de componentes principales (ACP). Materiales y métodos. Se tomaron muestras durante tres años para evaluar la composición química, los niveles de metabolitos secundarios y la degradabilidad ruminal en ovinos. Los datos fueron analizados con el paquete estadístico SPSS y mediante el diagrama tridimensional se obtuvieron las agrup...

  10. Discriminación de género en el acceso a bienes y servicios en el tráfico mercantil entre privados

    Directory of Open Access Journals (Sweden)

    María Angustias Díaz Gómez

    2015-06-01

    Full Text Available La Directiva 2004/113/CE, y la Ley Orgánica 3/2007 que la traspone representan un avance en el Derecho antidiscriminatorio por razón de género y en concreto al suministro de bienes y servicios. En este trabajo nos centramos en el acceso a los ofertados desde el sector privado de la economía. Apuntamos a la deficiente incorporación en España de algunas disposiciones de la Directiva; a la necesidad de superar el recurso a la nulidad como principal solución de controversias; así como a la conveniencia de que la regulación antidiscriminatoria de derecho privado reciba un tratamiento legislativo transversal, para así hacer eficaz el derecho a la igualdad y el propio derecho del mercado en áreas tan relevantes como la competencia desleal.

  11. Mercado sanitario privado y territorio en Galicia. Neoliberalismo y nuevas pautas de comportamiento social

    Directory of Open Access Journals (Sweden)

    Jesús M. González Pérez

    2002-01-01

    Full Text Available La crisis del Estado del Bienestar, los procesos de reforma del sistema sanitario público y la introducción de la práctica privada en el Servicio Nacional de Salud (SNS se inscriben en el contexto del neoliberalismo posmoderno. La devaluación del sistema público y la progresiva aceptación social hacia la regulación sanitaria a través de las leyes del mercado explican, por un lado, el reforzamiento de la práctica sanitaria privada y, por otro, la extensión de un modelo de gestión y planificación dominado por las compañías de seguros médicos privados. El aumento en el número de primas y de su facturación en los últimos años son expresión de la confianza que el sector privado significa para las clases sociales más acomodadas del país. La distribución de las distintas tipologías hospitalarias (por finalidad asistencial y tamaño en Galicia se superponen a la jerarquía (poblacional, económica y funcional de la red urbana. El papel regulador del mercado impone una estrategia de distribución territorial marcada por la búsqueda de clientes de un determinado poder adquisitivo. No obstante, la potencialidad económica y la proyección del sector todavía se encuentran demasiado supeditadas a las políticas públicas, al establecimiento de conciertos con el Servicio Galego de Saúde

  12. Justicia acerca de la relación entre público y privado

    Directory of Open Access Journals (Sweden)

    Hanna Fenichel Pitkin

    2005-01-01

    Full Text Available Ya casi nadie avala la posibilidad de que la participación política pueda ser una recompensa en sí misma, la realización de nuestra naturaleza y no una carga. Este artículo intenta avalar dicha afirmación mediante una reevaluación crítica del significado de lo público y lo privado en el pensamiento de Hannah Arendt, la teórica política que más persuasivamente escribió sobre dicho tema en nuestra época, y quien más vigorosamente se esforzó por renovar nuestro acceso a la política como una gratificación positiva, una “felicidad pública”.

  13. Derecho internacional privado español y pensión compensatoria entre cónyuges

    OpenAIRE

    Ortega Giménez, Alfonso

    2016-01-01

    La pensión compensatoria entre cónyuges en el ámbito del Derecho internacional privado español es fiel reflejo del proceso de codificación internacional en la materia desarrollado en los tres ámbitos tradicionales: competencia judicial internacional, ley aplicable y reconocimiento y ejecución de las relaciones en esta materia. La compleja situación que ha existido hasta el momento en esta materia se ha resuelto gracias al Reglamento 4/2009 (y al Protocolo de La Haya 2007). En u...

  14. Ideación suicida en privados de libertad: Una propuesta para su atención

    OpenAIRE

    -Chacón, Maureen Baltodano; -Cueva, Miguel Márquez

    2014-01-01

    ResumenLa conducta suicida es considerada la tercera causa de muerte en prisiones. Nuestra investigación se planteó como objetivos detectar la presencia de ideación suicida en privados de libertad (elemento fundamental de la conducta suicida) en el Centro del Programa de Atención Institucional (CPI) de Liberia, Costa Rica, y diseñar una propuesta psicoeducativa de prevención ante la presencia de ideas intrusivas y repetitivas de auto-daño, desde el enfoque cognitivo conductual.De julio a dici...

  15. Estudios Urbanos -Regionales desde el Caribe: El crecimiento “moderno” espacial-urbano en Barranquilla: ¿Planeación pública-oficial o manejo del sector privado?

    Directory of Open Access Journals (Sweden)

    Günter Mertins

    2007-01-01

    Full Text Available El artículo presenta un análisis del proceso de crecimiento urbano de Barranquilla mostrando cómo desde los inicios del siglo XX, el sector privado siempre ha estado presente en la planeación y en la toma de decisiones de la planeación del crecimiento de la ciudad. En su primera parte presenta los aspectos generales del crecimiento urbano y poblacional de Barranquilla y contextualiza a la ciudad dentro de la llamada Área Metropolitana de Barranquilla. En la segunda parte analiza el tema de la segregación socio-espacial en Barranquilla. En la tercera parte describe y analiza el llamado comienzo del crecimiento espacial-urbano “moderno” en Barranquilla, caracterizado precisamente por la presencia permanente del sector privado y por último presenta los parámetros de dicho crecimiento caracterizando las etapas de crecimiento, las formas y tipos de la urbanización, los mecanismos de dirección de la urbanización en el nor-occidente de Barranquilla, el potencial de demanda de los nuevos asentamientos urbanos y los Servicios privados de alto rango en el “corredor“ Barranquilla – Puerto Colombia

  16. Usos do conceito de eventos privados à luz de proposições pragmatistas Uses of the concept of private events from the standpoint of pragmatist assumptions

    Directory of Open Access Journals (Sweden)

    Aécio Borba

    2009-08-01

    Full Text Available O conceito de eventos privados tem sido apontado na literatura da Análise do Comportamento como central para a abordagem de fenômenos relativos à subjetividade, no contexto de uma adesão à instrumentalidade como critério de verdade. Este trabalho discute os usos do conceito de eventos privados a partir de questões levantadas pelo pragmatismo, filosofia com a qual aquele critério de verdade tem sido consistentemente identificado. É examinado em particular o enfoque relacional verbal na análise de conceitos relativos à privacidade, e como esse enfoque se reflete em uma rejeição do mentalismo e do organicismo. O trabalho segue discutindo a importância da comunidade verbal na produção do "mundo privado" individual. Por fim, ressalta-se que alguns autores afastam-se de uma referência funcional/instrumental ao elaborarem o problema da imprecisão de auto-descrições de eventos privados.The concept of private events has been used in behavior-analytic literature as a major topic to the treatment phenomena related to subjectivity, in the context of adopting instrumentality as a criterion of truth. This paper aims to discuss uses of the concept of private events from the standpoint of Pragmatism, a philosophy in which that criterion of truth has been consistently identified. It is particularly examined the focus on verbal relations in the analysis of contents related to privacy, and also how that focus reflects a rejection on mentalism and organicism. The paper continues to discuss the importance of the verbal community in the production of an individual "inside world". In the end, the paper points out that some authors depart from functionalist/instrumentalist reference when working on the problem of imprecision of private events.

  17. Conhecimento da disponibilidade e sobre o uso da ventilação não invasiva em unidades de terapia intensiva de hospitais públicos, privados e de ensino da região metropolitana de São Paulo Availability and use of noninvasive ventilation in the intensive care units of public, private and teaching hospitals in the greater metropolitan area of São Paulo, Brazil

    Directory of Open Access Journals (Sweden)

    Lara Maris Nápolis

    2006-02-01

    Full Text Available OBJETIVO: Avaliar o conhecimento da disponibilidade de equipamentos para ventilação não invasiva e o grau de conhecimento, atualização e familiaridade sobre ventilação não invasiva entre médicos, enfermeiros e fisioterapeutas em unidades de terapia intensiva de hospitais públicos, privados e de ensino da região metropolitana de São Paulo. MÉTODOS: Preenchimento de questionário no local. RESULTADOS: A disponibilidade de equipamentos para ventilação não invasiva na região metropolitana de São Paulo é elevada, sendo maior nos hospitais privados do que nos de ensino e em ambos é maior do que nos públicos. Nos hospitais públicos predomina o uso de aparelhos de ventilação invasiva adaptados para ventilação não invasiva. Nos hospitais privados predomina o gerador de fluxo e nos hospitais de ensino, os ventiladores específicos para ventilação não invasiva. Todos os fisioterapeutas sentiam-se aptos a instalar a ventilação não invasiva, contra 72,6% dos médicos e 33,3% dos enfermeiros. Médicos e fisioterapeutas tiveram grande percentagem de acertos nas indicações e contra-indicações da ventilação não invasiva, que foi menor para os enfermeiros. Em um ano, mais fisioterapeutas leram artigos científicos e participaram de aulas sobre ventilação não invasiva do que médicos, e estes mais que enfermeiros. CONCLUSÃO: A disponibilidade de equipamentos para ventilação não invasiva é elevada nos hospitais da região metropolitana de São Paulo, com diferenças no tipo de equipamento disponível. Médicos e fisioterapeutas têm elevado grau de acerto nas indicações e contra-indicações de seu uso. Fisioterapeutas sentem-se mais aptos a instalar a ventilação não invasiva e estão mais atualizados do que médicos e enfermeiros.OBJECTIVE: To determine the availability of noninvasive positive-pressure ventilation equipment, as well as the level of expertise and familiarity of physicians, nurses and

  18. La aplicación del principio del equilibrio económico a contratos estatales sometidos al régimen normativo del derecho privado

    Directory of Open Access Journals (Sweden)

    Manuela Canal-Silva

    2016-06-01

    Full Text Available En vista de la importancia del equilibrio económico del contrato dentro del marco de la contratación pública, el presente artículo pretende demostrar la procedencia de su aplicación a los contratos estatales sometidos al régimen del derecho privado. Mediante la reflexión y el estudio de la jurisprudencia sobre el tema se presentarán los principales motivos expuestos por las providencias que apoyan la tesis planteada. Se exponen así los temas del interés colectivo y los preceptos constitucionales como bases de este principio del equilibrio económico. Para luego examinar la conmutatividad del contrato y el debate frente a la consideración del equilibrio económico como un principio transversal al derecho público y privado.

  19. Factores de riesgo de violencia escolar (bullying severa en colegios privados de tres zonas de la sierra del Perú

    Directory of Open Access Journals (Sweden)

    Isabel Amemiya

    2009-12-01

    Full Text Available Objetivo: Identificar los factores de riesgo de violencia escolar (bullying severa en alumnos de colegios privados de tres zonas de la sierra del Perú. Diseño: Estudio tipo encuesta. Institución: Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Perú. Participantes: Alumnos entre quinto de primaria y quinto de secundaria de colegios privados. Intervenciones: Una encuesta validada en estudios previos, para identificar violencia escolar (bullying, fue aplicada a 736 alumnos, entre quinto de primaria y quinto de secundaria, de colegios privados de Ayacucho, Huancavelica y Cusco (Sicuani. Se consideró bullying severo cuando contestaron positivamente 5 a más de las 9 opciones posibles de la pregunta que indagaba sobre los tipos de violencia. Se comparó 37 alumnos portadores de bullying severo con 74 alumnos tomados al azar del grupo que no tuvo violencia. Con análisis bivariado y multivariado de regresión logística se identificó factores asociados significativamente a la violencia escolar severa. Principales medidas de resultados: Factores de riesgo de violencia escolar (bullying severa. Resultados: La violencia escolar severa se asoció significativamente con reacción de padres al conocer el hecho, repetición de la amenaza a pesar de comunicar las agresiones, presencia de pandilleros en el colegio, tener amigos pandilleros y poseer defecto físico. La regresión logística encontró asociación significativa con la reacción de los padres, presencia de pandilleros y poseer un defecto físico. Conclusiones: Se ha encontrado que la violencia escolar severa se asocia a múltiples factores de riesgo, que pueden y deben ser detectados precozmente, debido al daño psicológico que produce en los estudiantes.

  20. Cooperação jurídica internacional e o diálogo das fontes no Direito Internacional Privado contemporáneo

    OpenAIRE

    André de Carvalho Ramos

    2017-01-01

    El presente artículo analiza las diferentes fuentes de la cooperación jurídica internacional, que hoy representan una importante área del derecho internacional privado, centrándose en el diálogo de las fuentes para solucionar eventuales conflictos normativos.

  1. De lo privado y doméstico a lo público : transformaciones de las relaciones de género en las mujeres de los sectores populares de Lima Metropolitana

    OpenAIRE

    Luque Velarde, Martha Elena

    2012-01-01

    La investigación del espacio doméstico, espacio privado y espacio público son temáticas centrales en el desarrollo de la sociología, por sus implicancias en las relaciones de género y, de manera específica, por que posibilitan una mayor comprensión de la naturaleza de la sociedad peruana. El propósito de la tesis es analizar las transformaciones en las relaciones de género en el proceso de redefinición del espacio doméstico, la construcción del espacio privado y la conquista del espacio p...

  2. O ensino privado em Pelotas na propaganda impressa: séculos XIX, XX, XXI

    OpenAIRE

    NEVES, Helena de Araujo

    2012-01-01

    Esta tese situa-se no âmbito da História da Educação, vinculada à linha de Filosofia e História da Educação do Programa de Pós-Graduação em Educação da universidade Federal de Pelotas. Seu objetivo foi pesquisar a trajetória do ensino privado em Pelotas, município localizado ao sul do Rio Grande do Sul, no período compreendido entre o final do século XIX e o principio do século XXI. Para isso, utilizou como principal fonte documental propagandas impressas das escolas privadas de ensino primár...

  3. Funciones de la responsabilidad civil: cambio de paradigmas en el sistema de Derecho Privado argentino

    Directory of Open Access Journals (Sweden)

    Sandra Natalia Umansky

    2016-09-01

    Full Text Available El presente artículo tiene por finalidad comentar la transformación operada en el sistema del Derecho Privado patrimonial argentino; a través de la inclusión de una variedad de funciones de la responsabilidad civil; tradicionalmente pergeñada en el Código de Vélez como compensatoria. Se ha propuesto; asimismo; analizar la evolución de estas funciones desde la incorporación de algunos institutos provenientes de distintos microsistemas del Derecho Civil; como el Derecho Ambiental y el de Consumo; para estudiar el proceso de modificación de la legislación privada argentina desde el Anteproyecto de 2012 hasta su regulación actual el Código Civil y Comercial de la Nación -en adelante CCCN-; en aras de explicitar la configuración actual del sistema de responsabilidad civil vigente. Para ello se ha realizado una investigación de abordaje cualitativo; con técnicas descriptivas y bibliográficas; caracterizada como pura; si se analizan sus objetivos extrínsecos; y longitudinal en cuanto a su temporalización. Como conclusión principal podemos derivar que la responsabilidad en el Derecho privado patrimonial argentino asume una pluralidad de funciones; centralmente preventiva y resarcitoria; y periféricamente precautoria y punitiva; debiendo el intérprete realizar un adecuado diálogo de fuentes para la articulación del sistema a fin de mantener la plena vigencia de esta polifuncionalidad.

  4. Liderazgo administrativo para el cambio. Lo público y lo privado

    Directory of Open Access Journals (Sweden)

    Johnny Meoño Segura

    2010-10-01

    Full Text Available Este artículo reitera una preocupación nuestra de más de tres décadas de estudio, observación y práctica en el ámbito del fenómeno sociopolítico, jurídico e institucional integral del país. Identifica la necesidad de reconocer la importancia de la "administración política" en el mundo y en Costa Rica, las diferencias sustanciales entre los fenómenos público y privado o empresarial, y la necesidad de abordar esfuerzos nacionales de formación integral de "administradores políticos" que hoy día no se están formando en Costa Rica ni en América Latina. Tampoco en Europa o en Estados Unidos, para mencionar las regiones en las que más ciencia y tecnología se crea.

  5. SIETE DE CADA DIEZ; O EL VERDADERO FACTOR DE IMPACTO

    Directory of Open Access Journals (Sweden)

    Roberto Polanco - Carrasco

    2008-11-01

    Full Text Available Fragmento...En breve, comenzará a cobrar cada vez más importancia, contar por parte de las revistas seriadas de psicología, con un índice de factor de impacto (FI, así como la necesidad de que las mismas figuren en bases de datos a nivel mundial. El factor de impacto es el número de veces que se cita por término medio un artículo publicado en una revista determina este calculo lo realiza el Instituto de Información Científica ISI (siglas en inglés,conocido actualmente como Thomson ISI. Por medio de este indicador se mide tanto la productividad de una determinada revista como la de los autores, medida muy importante a la hora de acceder a titularidades académicas y fondos de investigación....... Para el 2009 en Chile se estima que siete de cada diez estudiantes que ingresen a la educación superior serán de primera generación, es decir ellos serán la primera generación de sus familias en acceder a este nivel de la enseñanza. Lo anterior, no debe distar mucho de la realidad de otros países de la región. Si bien no se discute que mayor acceso a la educación superior sea un gran avance desde el punto de vista del desarrollo nacional y personal, no es menos cierto que esta cifra se transforma en un poderoso factor de impacto.

  6. Elasticidad de la demanda por medicamentos en el mercado farmacéutico privado en Colombia

    OpenAIRE

    Vásquez Velásquez, Johanna; Gómez Portilla, Karoll; Castaño Vélez, Elkin; Cadavid Herrera, José Vicente; Ramírez Hassan, Andrés

    2013-01-01

    Esta investigación estimó la elasticidad de la demanda intramolecular, marca y genérico, para tres patologías trazadoras, hipertensión esencial, diabetes e hiperlipidemia, en el mercado ético y privado colombiano, a partir de una especificación dinámica del modelo AIDS basado en técnicas de cointegración -- La estimación de la elasticidad de la demanda intramolecular permite concluir que tanto medicamentos de marca como genéricos son inelásticos ante cambios en su precio, son bienes de lujo s...

  7. Elasticidad de la demanda por medicamentos en el mercado farmacéutico privado en Colombia

    OpenAIRE

    Vásquez Velásquez, Johanna; Gómez Portilla, Karoll; Castaño Vélez, Elkin; Cadavid Herrera, José Vicente; Ramírez Hassan, Andrés

    2013-01-01

    Esta investigación estimó la elasticidad de la demanda intramolecular, marca y genérico, para tres patologías trazadoras, hipertensión esencial, diabetes e hiperlipidemia, en el mercado ético y privado colombiano, a partir de una especificación dinámica del modelo AIDS basado en técnicas de cointegración. La estimación de la elasticidad de la demanda intramolecular permite concluir que tanto medicamentos de marca como genéricos son inelásticos ante cambios en su precio, son bienes de lujo seg...

  8. "Hospital Universitàri Vall d'Hebron" edificio de 50 años de antigüedad ¿puede ser sostenible?

    OpenAIRE

    Soler López, Esther

    2012-01-01

    El objeto del proyecto es valorar, definir y proponer, el compromiso y la trayectoria sobre sostenibilidad medioambiental que tiene el “Hospital Universitari Vall d’Hebron” de Barcelona. Como herramienta de valoración se ha utilizado la certificación BREEAM ES Salud, por considerarse un elemento lo suficientemente extenso y comprometido en el tema se sostenibilidad de un edificio hospitalario en uso. BREEAM ES Salud, estudia diez categorías a las que otorga una puntuación se...

  9. Cooperação jurídica internacional e o diálogo das fontes no Direito Internacional Privado contemporáneo

    Directory of Open Access Journals (Sweden)

    André de Carvalho Ramos

    2017-10-01

    Full Text Available El presente artículo analiza las diferentes fuentes de la cooperación jurídica internacional, que hoy representan una importante área del derecho internacional privado, centrándose en el diálogo de las fuentes para solucionar eventuales conflictos normativos.

  10. Triangular público, doméstico y privado, o ¿cómo negociar en pareja?

    OpenAIRE

    MARTA GUTIÉRREZ SASTRE

    2002-01-01

    Se afronta el tema de las posibilidades de negociar e iniciar cambios en la pareja, cuestionando los principios de la negociación liberal e introduciendo los matices que nos permitan establecer el tipo de intercambio que se puede producir entre dos personas situadas en posiciones distintas. Se introduce el término de lo privado, que lejos de connotaciones intimistas, se entiende como la interacción que en lo interpersonal establece la pareja en relación al medio social, económico y político. ...

  11. Optimización de la oferta vial para el transporte privado de la ciudad de Azogues

    OpenAIRE

    Cabrera Vélez, Sonia Lucía

    2017-01-01

    La optimización de la oferta vial para el transporte privado en la ciudad de Azogues, se obtiene a través de la implementación de los Sistemas Inteligentes de Transporte, que son un conjunto de soluciones diseñadas para mejorar la operación y seguridad del transporte. Enmarcados en este concepto, dentro de la Ciudad de Azogues, se estudió este tema debido al crecimiento de la flota vehicular, en gran parte, producto del aumento económico de los ingresos familiares por el fenómeno migratorio, ...

  12. Ensino superior privado: expansão das cooperativas de mão de obra docente

    OpenAIRE

    Calderón,Adolfo Ignacio; Lourenço,Henrique da Silva

    2011-01-01

    Este artigo aborda a terceirização de professores por meio de cooperativas de mão de obra no âmbito do ensino superior privado, fenômeno educacional que surgiu na metade da presente década, enquadrado como prática ilegal que fere os princípios do cooperativismo quando visa fraudar a legislação trabalhista brasileira. Tem por objetivo compreender a expansão desse fenômeno por meio da reconstrução da cronologia dos fatos, da identificação dos momentos históricos do seu entendimento legal e do m...

  13. Caracterización de diez cultivares forrajeros de Leucaena leucocephala basada en la composición química y la degradabilidad ruminal

    OpenAIRE

    García M., Danny; Wencomo G., Hilda; González C., Miriam; Medina, María; Cova O., Luis

    2008-01-01

    Objetivo. Estudiar las variaciones en la composición química y la degradabilidad ruminal de diez cultivares de Leucaena leucocephala Lam. de Wit. mediante el análisis de componentes principales (ACP). Materiales y métodos. Se tomaron muestras durante tres años para evaluar la composición química, los niveles de metabolitos secundarios y la degradabilidad ruminal en ovinos. Los datos fueron analizados con el paquete estadístico SPSS y mediante el diagrama tridimensional se obtuvieron las agrup...

  14. Lo público y lo privado: las aseguradoras y la atención médica en Mexico

    Directory of Open Access Journals (Sweden)

    Tamez Silvia

    1995-01-01

    Full Text Available Desde finales de la década de los setenta y a principios de la de los ochenta, tanto en nuestro país cuanto en la mayoría de países de América Latina, ocurrieron profundos cambios en la política sanitaria, cuya dirección apuntó fundamentalmente a un crecimiento del sector privado de la atención médica, acompañado de deterioro del sector público. Este trabajo pretende analizar, como parte del proceso privatizador de la atención médica, la evolución de los seguros médicos privados. Interesa fundamentalmente realizar un análisis de la política sectorial de salud basada en datos económicos, pero subrayando el perfil político y de modificación de las relaciones del sector con el Estado, partiendo de la hipótesis de que éste último ha asumido la función de apoyo a la expansión del mercado privado de la atención médica, enfocando el análisis a la industria de seguros médicos privados y facilitando el deterioro del sector público a través de la reducción del gasto público. Para ello se analiza el papel del Estado en las transformaciones del sector en México a partir de los principales cambios en la normatividad de la actividad aseguradora nacional. Sobre esta base se hace el análisis comparativo de la evolución de la industria aseguradora en Argentina, Brasil, Chile y México durante el período 1986-1992 profundizando el caso de México. Dentro de los principales resultados destaca que, al comparar los países mencionados, los índices Primas/PIB y Primas/per cápita en términos generales se observa crecimiento. Este crecimiento es más ascelerado en México, lo que sin duda se relaciona con lo incipiente de su proceso de privatización. Además, en México se observó que, para el período 1984-1991, las primas directas como porcentaje del PIB pasaron de 0.86% a 1.32%. En la misma línea de análisis llama la atención que el seguro de accidentes y enfermedades creció del 0.02% del PIB en 1984 a 0.11% en 1991. En

  15. Lo público y lo privado: las aseguradoras y la atención médica en Mexico

    Directory of Open Access Journals (Sweden)

    Silvia Tamez

    Full Text Available Desde finales de la década de los setenta y a principios de la de los ochenta, tanto en nuestro país cuanto en la mayoría de países de América Latina, ocurrieron profundos cambios en la política sanitaria, cuya dirección apuntó fundamentalmente a un crecimiento del sector privado de la atención médica, acompañado de deterioro del sector público. Este trabajo pretende analizar, como parte del proceso privatizador de la atención médica, la evolución de los seguros médicos privados. Interesa fundamentalmente realizar un análisis de la política sectorial de salud basada en datos económicos, pero subrayando el perfil político y de modificación de las relaciones del sector con el Estado, partiendo de la hipótesis de que éste último ha asumido la función de apoyo a la expansión del mercado privado de la atención médica, enfocando el análisis a la industria de seguros médicos privados y facilitando el deterioro del sector público a través de la reducción del gasto público. Para ello se analiza el papel del Estado en las transformaciones del sector en México a partir de los principales cambios en la normatividad de la actividad aseguradora nacional. Sobre esta base se hace el análisis comparativo de la evolución de la industria aseguradora en Argentina, Brasil, Chile y México durante el período 1986-1992 profundizando el caso de México. Dentro de los principales resultados destaca que, al comparar los países mencionados, los índices Primas/PIB y Primas/per cápita en términos generales se observa crecimiento. Este crecimiento es más ascelerado en México, lo que sin duda se relaciona con lo incipiente de su proceso de privatización. Además, en México se observó que, para el período 1984-1991, las primas directas como porcentaje del PIB pasaron de 0.86% a 1.32%. En la misma línea de análisis llama la atención que el seguro de accidentes y enfermedades creció del 0.02% del PIB en 1984 a 0.11% en 1991. En

  16. Onde estão os contratos? Análise da relação entre os prestadores privados de serviços de saúde e o SUS Where are the contracts? Analysis of the relation between private health services suppliers and the SUS

    Directory of Open Access Journals (Sweden)

    Carlos Alberto de Matos

    2003-01-01

    Full Text Available O artigo trata da situação contratual da rede assistencial privada vinculada ao Sistema Único de Saúde. Descreve essa rede e mostra o aumento do número de hospitais públicos municipais, a forte participação dos hospitais universitários. Evidencia que a rede ambulatorial é predominantemente pública. Analisa a situação contratual, com base nos dados do Cadastro Nacional de Estabelecimentos de Saúde, banco de dados recentemente implantado pelo Ministério da Saúde, visando agregar num único sistema todas as informações disponíveis sobre prestadores de serviços públicos e privados vinculados ao SUS. Aponta os problemas e indefinições no processo de contratação de prestadores privados de serviço de saúde. Conclui que os contratos podem representar uma maior responsabilização dos gestores e prestadores, além de possibilitar maior garantia dos direitos dos usuários e induzir à melhoria da qualidade dos serviços.The article deals with the contractual situation of the Private Assistance Net linked up with the Unified Brazilian Health System (SUS. It describes this net based on data from Hospital Information System and from Ambulatory Information System. It shows the growth of the number of municipal public hospitals and the strong participation of university hospitals. In relation to the Ambulatory Net, the article demonstrates that it is mainly public. It analyses the contractual situation, based on data from the National Register of Health Establishments, database recently introduced by the Health Department which aims to aggregate all available information about public and private services. It points to the problems present in the process of hiring private health service suppliers. This work concludes that contracts may represent a larger accountability of managers and health service suppliers, besides the fact they make possible a stronger guarantee of users' rights and better quality of health services.

  17. Bajo vientre: Representaciones de la sexualidad en la cultura y el arte contemporáneo. El arte impuro: Entre lo público y lo privado

    OpenAIRE

    Cuéllar, Carlos A.

    1998-01-01

    Cuéllar, CA. (1998). Bajo vientre: Representaciones de la sexualidad en la cultura y el arte contemporáneo. El arte impuro: Entre lo público y lo privado. Banda aparte. (11):89-89. http://hdl.handle.net/10251/43155. 89 89 11

  18. Composição dos gastos privados com medicamentos utilizados por aposentados e pensionistas com idade igual ou superior a 60 anos em Belo Horizonte, Minas Gerais, Brasil

    Directory of Open Access Journals (Sweden)

    Marina Guimarães Lima

    2007-06-01

    Full Text Available O objetivo do presente estudo foi analisar a composição dos gastos privados com medicamentos utilizados por indivíduos com 60 anos ou mais de idade, em Belo Horizonte, Minas Gerais, Brasil. A população estudada foi uma amostra representativa de aposentados e pensionistas do Instituto Nacional do Seguro Social (INSS nessa faixa etária e residentes no Município de Belo Horizonte, entrevistados em um inquérito domiciliar. Foram calculados os gastos mensais com medicamentos obtidos no setor privado e analisada a sua composição considerando as características dos medicamentos. Responderam ao inquérito 667 indivíduos. Foi observado um gasto mensal privado médio de R$ 122,97 (US$ 38,91 com os medicamentos utilizados pelos participantes. Os grupos terapêuticos que representaram uma maior proporção dos gastos totais foram: sistema cardiovascular (26%, sistema nervoso (24% e trato alimentar e metabolismo (15%. Em relação à categoria de registro dos medicamentos utilizados, os medicamentos de referência foram responsáveis por uma maior proporção dos gastos totais (54%. Os resultados deste estudo podem subsidiar políticas destinadas a melhorar o acesso a medicamentos e às condições sanitárias da população idosa brasileira.

  19. Fatores de risco associados à mortalidade em pacientes com sepse em unidade de terapia intensiva de hospital privado de Pernambuco Risk factors associated to mortality on septic patients in an intensive care unit of a general private hospital from Pernambuco

    Directory of Open Access Journals (Sweden)

    Joana Corrêa de A. Koury

    2007-03-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Verificar a associação entre as características clínicas, epidemiológicas e laboratoriais com a mortalidade de pacientes com sepse, internados em UTI de hospital privado do estado de Pernambuco (Nordeste do Brasil, a fim de melhorar o atendimento a essa população, através da identificação precoce dos pacientes com risco de desenvolver falência de órgãos. MÉTODO: Estudo de caso-controle aninhado a uma coorte prospectiva e observacional que incluiu os pacientes adultos admitidos na UTI com sepse ou que a desenvolveram durante a internação. Foram colhidos os dados epidemiológicos, avaliados os escores clínicos e exames laboratoriais como: D-dímero, antitrombina III, INR, contagem de plaquetas, sódio, albumina, lactato e creatinina, sendo analisada sua associação com a mortalidade. Os pacientes foram acompanhados até a alta da UTI ou óbito. RESULTADOS: Foram incluídos no estudo 199 pacientes. Após regressão logística, apenas o tempo de internação na UTI maior que 72h, a presença de doença crônica associada, o número de órgãos acometidos superior a três e o lactato maior que 4 mmol/L estiveram associados com a mortalidade. Com relação à associação com o intervalo de tempo para o óbito, apenas o escore SOFA foi significativo, pois um terço dos pacientes com pontuação superior a 12 foram a óbito em menos de 72h. CONCLUSÕES: Os pacientes admitidos com sepse na UTI provenientes da comunidade (tempo de internação hospitalar BACKGROUND AND OBJECTIVES: Verify the association between clinical, epidemiological and laboratorial characteristics with mortality of septic patient in an Intensive Care Unit (ICU from Pernambuco, northeast of Brazil, to improve the attention for patients with sepse which are in risk of developing organ dysfunction. METHODS: Case-control study, without intervention, that included adults' patients admitted in ICU with sepsis or that developed it during ICU

  20. Estimativa do impacto econômico da implantação de um protocolo hospitalar para detecção e tratamento precoce de sepse grave em hospitais púbicos e privados do sul do Brasil Estimate of the economic impact of implementing an in hospital protocol for the early detection and treatment of severe sepsis in public and private hospitals in southern Brazil

    Directory of Open Access Journals (Sweden)

    Alvaro Koenig

    2010-09-01

    Full Text Available OBJETIVO: Analisar o impacto econômico de um protocolo de detecção precoce de sepse em dois hospitais gerais. MÉTODOS: Analisamos os dados colhidos em um estudo prospectivo em pacientes sépticos antes e após a implantação do protocolo de detecção precoce de sepse grave. Realizamos uma análise de custo-efetividade comparando: taxa de mortalidade, custo do tratamento da sepse e custos indiretos atribuídos a anos de vida produtiva perdidos por óbito prematuro em ambas as fases. RESULTADOS: Foram incluídos 217 pacientes, 102 na Fase I e 115 na Fase II. Após a implantação do protocolo, em hospital privado e em hospital público, as taxas de mortalidade caíram de 50% para 32,2%, e de 68,6% para 41% (pOBJECTIVE: To analyze the economic impact of an early sepsis detection protocol in two general hospitals. METHODS: We analyzed data collected from a prospective study of septic patients before and after the implementation of a protocol for early diagnosis of severe sepsis. We conducted a cost-effectiveness analysis comparing: mortality rate, cost of sepsis treatment and indirect costs attributed to years of productive life lost to premature death in both phases. RESULTS: Two hundred seventeen patients were included, 102 in phase I and 115 in phase II. After protocol implementation, in private and public hospital, mortality rates decreased from 50% to 32.2% and from 67.6% to 41% (p < 0.05. The mean years of productive life lost due to sepsis decreased from 3.18 to 0.80 and 9.81 to 4.65 (p < 0.05, with a mean gain of 2.38 and 5.16 years of productive life, for each septic patient. Considering Brazilian gross domestic product per capita, estimated productivity loss due to sepsis decreased between 3.2 and 9.7 billion US dollars, varying based on the incidence of sepsis. Hospital costs were similar in both phases. CONCLUSION: A protocol for early detection and treatment of in-hospital septic patients is highly cost-effective from a societal

  1. Solus consensus obligat: principio general para el derecho privado de los contratos

    Directory of Open Access Journals (Sweden)

    Silvana Fortich

    2012-12-01

    Full Text Available En materia de derecho de los contratos el solus consensus obligat implica que, en principio, los contratos se forman por el solo consentimiento de las partes y los modos para su exteriorización son libres. En la actualidad la palabra “consensualismo” se encuentra casi forzosamente precedida por el sustantivo descriptivo “principio”, lo que indica que el carácter de principio del consensualismo es un asunto que se entiende natural, obvio y bastante arraigado en las bases de nuestro derecho privado de los contratos. A pesar de esta naturalidad como principio que caracteriza al consensualismo, en el presente estudio se pretende dejar de lado esta asentada convicción y regresar a las razones y fundamentos que justificaron su elevación a rango superior. Luego de algunas precisiones sobre la noción, alcance y fundamentos del principio del consensualismo se formula un ejercicio de confrontación conceptual que conduce a relevar el carácter principalista del consensualismo.

  2. 12th September 2011 - Undersecretary for Foreign Affairs F. Schmidt Ariztía in the ATLAS visitor centre with ATLAS Collaboration Former Spokesperson P. Jenni, Adviser for Chile J. Salicio Diez and Senior Physicist J. Mikenberg.

    CERN Multimedia

    Maximilien Brice

    2011-01-01

    12th September 2011 - Undersecretary for Foreign Affairs F. Schmidt Ariztía in the ATLAS visitor centre with ATLAS Collaboration Former Spokesperson P. Jenni, Adviser for Chile J. Salicio Diez and Senior Physicist J. Mikenberg.

  3. Sistemas de ensino privados em redes públicas de educação: relações com a organização do trabalho na escola

    Directory of Open Access Journals (Sweden)

    Teise de Oliveira Guaranha Garcia

    2012-01-01

    Full Text Available O presente ensaio, como parte de pesquisa em andamento, propõe-se a discutir a seguinte questão: quais seriam as decorrências da compra de sistemas de ensino privados para a organização do trabalho na escola? Para responder a essa questão, estão sendo realizados estudos de caso em unidades de ensino pertencentes a quatro redes municipais que adquiriram sistemas de ensino junto a diferentes empresas privadas. A coleta de dados foi concluída no início do segundo semestre de 2001 e no momento eles estão em fase de análise. Neste trabalho, portanto, procedemos a uma discussão teórica problematizando as relações entre a compra de sistemas de ensino privados e a organização do trabalho na escola pública.

  4. Contracepção em usuárias dos setores público e privado de saúde Contraception in users of the public and private sectors of health

    Directory of Open Access Journals (Sweden)

    Daniela Siqueira Prado

    2011-07-01

    Full Text Available OBJETIVO: Verificar os principais métodos anticoncepcionais adotados por mulheres usuárias dos setores público e privado de saúde no município de Aracaju (SE, com enfoque secundário para orientações de uso e razões para eventual interrupção destes. MÉTODOS: Estudo transversal, no qual foram incluídas 210 mulheres, 110 atendidas no serviço público e 100, no privado. Os dados foram obtidos através de aplicação de questionário às pacientes com vida sexual ativa e que concordaram em assinar o termo de consentimento livre e esclarecido. Para análise estatística utilizou-se o programa Statistical Package for Social Sciences (SPSS versão 15.0, aplicando-se os testes do , para variáveis categóricas, e t de Student, para amostras independentes. RESULTADOS: A prevalência global do uso de métodos anticoncepcionais neste estudo foi de 83,3%. Os principais métodos utilizados em ambos os setores, respectivamente público e privado, foram os hormonais (41 e 24%, p=0,008 e os definitivos (20 e 26%, p=0,1. O uso de preservativo masculino apresentou frequência de 17,3% para o setor público e 12% para o setor privado, não havendo diferença significativa (p=0,12. Receberam orientação médica quanto ao uso correto do método escolhido e/ou indicado 37,3% das usuárias do setor público e 48% do setor privado, sendo a interrupção do uso de métodos anticoncepcionais de 14,5%, no setor público e 12%, no privado, principalmente devido a efeitos colaterais e pelo desejo de engravidar. CONCLUSÕES: Os principais métodos anticoncepcionais adotados pelas usuárias dos setores públicos e privados foram anticoncepcionais hormonais e contracepção definitiva. Vale frisar a baixa frequência de uso de preservativo masculino nos dois grupos estudados.PURPOSE: To determine the main contraceptive methods adopted by users of the public and private health sectors in the city of Aracaju (SE, Brazil, with a secondary focus on orientations for

  5. Comparação da adequação de solicitação de ecocardiograma entre hospitais público e privado Comparison of echocardiography request appropriateness between public and private hospitals

    Directory of Open Access Journals (Sweden)

    Flávia Candolo Pupo Barbosa

    2011-10-01

    Full Text Available FUNDAMENTO: Buscando aprimorar a utilização dos exames de ecocardiografia, foram criados os Critérios de Adequação (CA (Appropriateness Criteria, pela Sociedade Norte-Americana de Ecocardiografia (ASE /Colégio Americano de Cardiologia (ACC. OBJETIVO: Comparar o perfil de adequação de solicitação de ecocardiograma transtorácico (ETT de acordo com os CA, entre Hospital Público Universitário (HU e Hospital Privado (HP, e verificar quais características se associam com melhor perfil de solicitação de ETT. MÉTODOS: Foram avaliados prospectivamente 779 solicitações consecutivas de ETT no HP (49,8% e no HU (50,2%. Sendo 55,6% solicitações para mulheres e 44,4%, para homens com 59,1 ± 15,7 anos. As indicações foram classificadas como: apropriadas, inapropriadas ou não classificadas, e a adequação aos CA foi correlacionada com idade, sexo dos pacientes, além do tempo de formado do solicitante. A análise estatística empregou Coeficiente Kappa e teste Qui-quadrado. RESULTADOS: Não houve diferença significativa no perfil de adequação de solicitações apropriadas de ETT nas duas instituições (71% x 75%; p = 0,3. No HP, os fatores associados a maior taxa de exames apropriados foram: sexo feminino (p = 0,001 e idade menor que 60 anos (p BACKGROUND: Aiming at improving the use of echocardiography tests, the Appropriateness Criteria (AC were created by the American Society of Echocardiography (ASE/American College of Cardiology (ACC. OBJECTIVE: To compare the appropriateness profile of transthoracic echocardiography (TTE requests in accordance with the AC, between a public University Hospital (UH and a Private Hospital (PH, and verify which characteristics are associated with a better TTE request profile. METHODS: We prospectively assessed 779 consecutive TTE requests in a PH (49.8% and a UH (50.2%, with 55.6% of requests for women and 44.4% for men, aged 59.1 ± 15.7 years. The indications were classified as appropriate

  6. Sistematização da Assistência de Enfermagem na Rede Hospitalar de Uberaba: MG Sistematización de la asistencia de enfermería en la Red Hospitalaria de Uberaba: MG Systematization of Nursing Care in the Uberaba: MG hospital network

    Directory of Open Access Journals (Sweden)

    Karoline Faria de Oliveira

    2012-12-01

    Full Text Available O planeamento da assistência de enfermagem tem como finalidade a organização do cuidado a partir de um método sistemático, sendo o enfermeiro o responsável pelo seu desenvolvimento. Objetivos: verificar o conhecimento dos enfermeiros sobre a Sistematização da Assistência de Enfermagem (SAE na rede hospitalar de Uberaba e implantar a SAE num hospital privado do município. Método: estudo descritivo, exploratório e de intervenção. Primeira etapa: enfermeiros responderam um questionário semi-estruturado sobre as suas percepções em relação à SAE. Segunda etapa: implantação da SAE em hospital privado. Resultados: a maioria dos enfermeiros tinha incentivo institucional para implantação da SAE (60,29% e referia conhecê-la desde a graduação (91,18%, revelando desconexão entre o conhecimento da SAE adquirido na graduação e a prática profissional dos enfermeiros. Obstáculos para o uso da SAE: dificuldade na realização do exame físico (47,06%, do diagnóstico de enfermagem (36,76% e o acesso aos cursos de capacitação (85,71%. A implantação da SAE ocorreu no Centro de Terapia Intensiva (CTI de um hospital privado do município. Foram identificados os diagnósticos de enfermagem mais freqüentes na UTI, originando um documento impresso que passou a compor o prontuário dos pacientes. No verso deste documento constavam as prescrições de enfermagem, que após implementadas foram verificadas.La finalidad del planeamiento de la asistencia de enfermería es el organizar el cuidado a partir de un método sistemático. Objetivos: describir la percepción de los enfermeros sobre la Sistematización de la Asistencia de Enfermería (SAE en la red hospitalaria de Uberaba y la implantación de la SAE en un hospital privado. Método: estudio descriptivo, exploratorio y de intervención. Primer paso: los enfermeros respondieron a un cuestionario semiestruturado sobre sus percepciones con respecto a la SAE. Segundo paso: implantaci

  7. Inovações na intermediação entre os setores público e privado na assistência à saúde

    Directory of Open Access Journals (Sweden)

    Rosimary Gonçalves de Souza

    2002-01-01

    Full Text Available Este artigo busca uma aproximação de algumas das mudanças em curso no sistema de saúde, focalizando especificamente o setor privado prestador de serviços de saúde, que, ao longo das últimas décadas, vem mantendo peso decisivo na condução da política de saúde. Nesse sentido, importa mapear as diferentes modalidades sob as quais se insere a iniciativa privada na prestação de serviços de saúde, mostrando as mudanças mais significativas na relação entre o setor público e o privado, tendo como contraponto o contexto das décadas de 1970 e 1980. Algumas dessas modalidades se constituem, na verdade, de uma intensificação ou consolidação de padrões e tendências presentes desde os anos 70, como o setor que integra as seguradoras de saúde e as empresas de medicina de grupo. Outras, como a atuação das cooperativas médicas junto ao setor público, mostram-se como tendências em expansão numa conjuntura de crise fiscal do estado e regressividade dos investimentos no campo social.

  8. Resistencia bacteriana de cultivos de orina en un hospital oncológico:seguimiento a diez años

    Directory of Open Access Journals (Sweden)

    Consuelo Velázquez-Acosta

    2016-07-01

    Full Text Available Objetivo. Describir los patrones de resistencia bacteriana en cultivos de orina de pacientes de un hospital oncológico en la Ciudad de México, de 2004 a 2013. Material y métodos. Se obtuvo el porcentaje de susceptibilidad para diferentes antibióticos, describiendo por separado las bacterias multidrogorresistentes (MDR. Se analizaron por separado las cepas obtenidas de pacientes hospitalizados de las de la comunidad. Resultados. Se realizaron 51 202 cultivos, de los cuales se identificaron 14 480 bacterias (28.3%. De éstas, se reportaron 11 427 Gram negativos (78.9%; 2 080 Gram positivos (14.4%; y 973 (6.6% levaduras. Escherichia coli fue el principal microorganismo aislado (56.1%; 24% de las cepas de la comunidad y 66% de las nosocomiales fueron productoras de beta-lactamasas de espectro extendido (BLEE. Klebsiella pneumoniae se identificó en 705 cultivos (4.8%, 115 de los cuales fueron BLEE (16%: 13.1% de la comunidad y 29.8% nosocomiales. Pseudomonas aeruginosa se identificó en 593 cultivos (4.1%: 9% de la comunidad y 51% nosocomiales. Conclusiones. Las cepas MDR son mucho más frecuentes en muestras de origen nosocomial. Es prioritario intensificar el uso racional de antibióticos en la comunidad y el programa de desescalamiento de antimicrobianos en el hospital.   DOI: http://dx.doi.org/10.21149/spm.v58i4.8025

  9. O novo Direito Internacional Privado e o conflito de fontes na cooperação jurídica internacional

    OpenAIRE

    Carvalho Ramos, André de

    2013-01-01

    O Direito Internacional Privado contemporâneo possui na cooperação jurídica internacional uma de suas áreas de maior dinamismo. A existência de fontes internacionais e internas da cooperação jurídica internacional exige uma análise da solução dos conflitos de fontes. The current Private International Law treats the international legal cooperation as one of its most dynamic subjects. However, the existence of both international and national law sources of legal cooperation requires a study ...

  10. Actividad antioxidante de extractos de diez basidiomicetos comestibles en Guatemala

    Directory of Open Access Journals (Sweden)

    Karen Belloso

    2015-11-01

    Full Text Available Los antioxidantes son esenciales en el cuerpo humano para prevenir el daño oxidativo. Estas substancias pueden obtenerse de diversas fuentes como frutas, plantas y hongos. En Guatemala, diversas especies de hongos comestibles son comercializadas y consumidas, sin embargo su actividad antioxidante no ha sido documentada en el país. El objetivo de este estudio fue determinar la actividad antioxidante de extractos acuosos y etanólicos obtenidos de diez especies de basidiomicetos comestibles (Agaricus aff. bisporus, Agaricus brunnescens, Armillariella polymyces, Amanita garabitoana, Boletus edulis, Cantharellus lateritius, Laccaria amethystina, Lactarius deliciosus, Neolentinus ponderosus y Pleurotus ostreatus. Se utilizó un método cualitativo por cromatografía en capa fina (CCF y tres ensayos macrométricos in vitro de cuantificación de fenoles totales, reducción del radical 1,1-difenil-2-pricrilhidrazilo (DPPH y decoloración del radical catiónico del reactivo ácido 2,2’-azinobis-(acido-3-etilbenzotiazolina-6-sulfónico (ABTS. Los extractos acuosos mostraron mayor actividad antioxidante que los extractos etanólicos en todas las técnicas cuantitativas realizadas. La especie que mostró mayor actividad antioxidante en ambos extractos fue B. edulis, cuyos resultados fueron: fenoles totales del extracto acuoso 93.46 ± 18.17 mg/g y 42.70 ± 3.48 mg/g, DPPH CI50 del extracto acuoso 0.93 mg/mL (IC95 0.65-1.28 y 2.75 mg/mL (IC95 2.46-3.07 del extracto etanólico; y en ABTS CI50 del extracto acuoso 0.96 mg/mL (IC95 0.63-1.35 y 4.13 mg/mL (IC95 2.67-5.88 del extracto etanólico. Por la actividad antioxidante de los extractos acuosos de algunas de las especies de basidiomicetos, pueden promoverse como alimentos funcionales.

  11. Vulnerabilidade e autonomia na pesquisa com adolescentes privados de liberdade Vulnerabilidad y autonomía en la investigación con adolescentes privados de libertad Vulnerability and autonomy in the search with adolescents deprived of freedom

    Directory of Open Access Journals (Sweden)

    Jana Gonçalves Zappe

    2013-01-01

    Full Text Available O planejamento de pesquisas com adolescentes privados de liberdade deve envolver escolhas éticas e bioéticas com o objetivo de atender a vulnerabilidade desses casos. O maior desafio encontra-se no fato de se buscar garantir o exercício da autonomia e da voluntariedade. Neste trabalho, apresentamos e discutimos as escolhas éticas e bioéticas efetuadas no planejamento de pesquisa que envolve adolescentes privados de liberdade, assim como as medidas especiais adotadas com vistas a garantir a autonomia e a voluntariedade dos participantes. Foram realizadas oficinas prévias que tiveram o objetivo de trabalhar os temas da autonomia e da voluntariedade com todos os adolescentes institucionalizados que tivessem a oportunidade de participar da pesquisa. Com isso, pretendeu-se que os adolescentes se tornassem mais fortalecidos e pudessem utilizar o exercício da autonomia como uma habilidade protetiva. De modo geral, avaliamos que a experiência de realização das oficinas foi bastante enriquecedora tanto para os adolescentes como para as pesquisadoras, e também que as oficinas atingiram os objetivos propostos, de forma que o planejamento resultou bem-sucedido. Os adolescentes iniciaram a participação nas oficinas com uma postura passiva e acrítica, e finalizaram-na com uma postura mais participativa, buscando discutir e esclarecer dúvidas. Sugere-se que essas questões sejam consideradas em estudos com essa população.La planificación de investigación con adolescentes privados de libertad debe involucrar elecciones éticas y bioéticas con el objetivo de atender la vulnerabilidad de esos casos. El mayor desafío se encuentra en el hecho de buscar garantizar el ejercicio de la autonomía y de la voluntariedad. En este trabajo, presentamos y discutimos las elecciones éticas y bioéticas efectuadas en la planificación de investigación que involucra adolescentes privados de libertad, así como las medidas especiales adoptadas con vistas a

  12. Lo público y lo privado en Educación

    Directory of Open Access Journals (Sweden)

    J. Félix ANGULO RASCO

    2016-01-01

    Full Text Available El presente trabajo pretende delinear qué se entiende por escuela pública o, dicho de otra manera, qué hace pública a una escuela. Para ello, se apoya en tres ejes básicos: el sentido estructural, el sentido político y el sentido pedagógico. El sentido estructural pregunta por la pertenencia de la escuela. La pertenencia privada de un centro escolar lo inhabilita para ser un centro público. Lo privado en este caso estaría por encima de lo público y lo común. Por el contrario, la pertenencia pública no ha de asimilarse a la pertenencia estatal. Lo público ha de hacer referencia a lo común. El sentido político indica que una escuela pública sirve al bien común y, especialmente, a los más necesitados. La escuela pública en ese sentido es un espacio de encuentro de la sociedad y además el único espacio educativo para aquellos sectores que no tendrían otra posibilidad. Por último, el sentido pedagógico es el que, al fin y al cabo, da sentido pleno a la escuela pública, en cuanto que supone colmar el derecho de las generaciones y la ciudadanía a la cultura y al conocimiento.

  13. Obstáculos a la adherencia y retención en los sistemas de salud público y privado según pacientes y personal de salud

    Science.gov (United States)

    Arístegui, Inés; Dorigo, Analía; Bofill, Lina; Bordatto, Alejandra; Lucas, Mar; Cabanillas, Graciela Fernández; Sued, Omar; Cahn, Pedro; Cassetti, Isabel; Weiss, Stephen; Jones., Deborah

    2016-01-01

    Resumen Introducción el Programa Nacional de Sida garantiza el acceso universal a los antirretrovirales, aun así las personas que reciben medicamentos a través del sistema público no logran obtener una carga viral indetectable en la misma proporción que los pacientes del sistema privado. Este estudio cualitativo tiene como objeto identificar los factores asociados a la adherencia y retención en la cascada de atención de VIH de los sistemas de salud público y privado de Buenos Aires, según las percepciones de pacientes y del personal de salud. Métodos se registraron datos cualitativos de 12 entrevistas semi-estructuradas a informantes clave y 4 grupos focales de pacientes y personal de salud tanto del sistema público como privado. Se codificaron y analizaron temas predeterminados sobre adherencia, utilizando el software QRS Nvivo9® de análisis de datos cualitativos. Resultados pacientes y personal de salud de ambos sistemas coinciden en la importancia del estigma asociado al VIH, la relación médicopaciente, la comunicación entre ambos y la división de responsabilidades en relación al tratamiento como aspectos fundamentales para la adherencia y retención en la cascada de atención. Se observan diferencias entre los sistemas en la forma en que algunos de estos aspectos actúan. Las barreras estructurales se presentan como principales obstáculos del sistema público. Discusión se resalta la necesidad de intervenciones focalizadas en la díada médico-paciente que considere las particularidades de cada sistema de atención para facilitar el compromiso del paciente en la adherencia. PMID:26878024

  14. La Administración de fondos privados de pensiones y las crisis financieras : caso Perú 1993 al 2013

    OpenAIRE

    Flórez García, Wilmer

    2014-01-01

    El objetivo de la investigación es el estudio de la administración de fondos privados de pensiones de Perú y la medición de su relación con las siete crisis financieras internacionales de las últimas dos décadas: Crisis mexicana, asiática, rusa, brasileña, argentina, hipotecaria subprime y europea. Adicionalmente, se busca establecer la relación de la gestión de los fondos de pensiones con el riesgo no diversificable de las inversiones, así como con el comportamiento económico financiero naci...

  15. The influence of remuneration on the behavior of hospital employees in Brazil

    Directory of Open Access Journals (Sweden)

    Alcindo Mendes

    2017-01-01

    Full Text Available El estudio tuvo como objetivo analizar la percepción de los empleados con respecto a los sistemas de compensación en dos gran hospitales de Brasil, uno público y el otro privado. La muestra de la encuesta considera 109 empleados, 54 en el hospital con la gestión privada y 55 para el hospital público. Después de la recolección de datos sobre la población muestra, la percepción de la remuneración se asoció con la ocupación, el género, la edad y la experiencia, como sugiere la Teoría de los Escalones Superiores. Los resultados muestran que la remuneración es vista como un instrumento de control, comportamiento o mecanismo para fomentar el aprendizaje, sin embargo, identificó diferencias en la percepción de los empleados en el área de la salud y el área administrativa. Estos resultados demuestran que la influencia de la retribución fija es diferente, no sólo entre los empleados de las dos áreas, sino también en relación con la gestión de los hospitales públicos y privados. Se identificó que el género no es un factor determinante de pago, y no se dio cuenta que había diferencias de comportamiento entre los empleados más jóvenes y mayores con respecto a la influencia de la remuneración en el comportamiento, que no se identificaron diferencias entre más y menos experimentados empleados Además, no hubo diferencias significativas entre las características de los hospitales. En general, los resultados ponen de manifiesto la importancia de la remuneración como un instrumento de control y gestión, tanto en el contexto de la administración pública, cuando las organizaciones privadas.

  16. VÍNCULOS COM A ORGANIZAÇÃO E OS ESTILOS DE LIDERANÇA: UMA ANÁLISE NA EQUIPE DE ENFERMAGEM DE INSTITUIÇÕES HOSPITALARES

    OpenAIRE

    Andressa Schaurich dos Santos

    2015-01-01

    Este estudo teve como objetivo analisar a relação entre os vínculos dos trabalhadores com a organização e os estilos de liderança dos gestores na equipe de Enfermagem de Hospitais Públicos e Privados no Rio Grande do Sul (RS). Para tanto, realizou-se um estudo de caso, de natureza descritiva e abordagem quantitativa. A amostra da pesquisa foi composta por 347 enfermeiros, técnicos e auxiliares de enfermagem de um Hospital público e um Hospital privado, localizados na cidade de Porto Alegre/RS...

  17. Vicios privados, beneficios públicos" o la diestra administración del legislador utilitarista

    Directory of Open Access Journals (Sweden)

    Jimena Hurtado

    2004-12-01

    Full Text Available Este artículo explora la conexión entre Bernard Mandeville y Jeremy Bentham. La complementariedad entre ellos se evidencia en dos puntos: primero, el sentido enunciativo del principio de la utilidad, axioma fundamental del utilitarismo de Bentham, reposa sobre una concepción antropológica implícita que puede ser comprendida gracias a Mandeville. Segundo, la lección de Mandeville es que “los vicios privados a través de la diestra administración de un político capaz pueden ser transformados en beneficios públicos”. El arte de la legislación de Bentham permite entender en qué consiste esta “diestra administración” y quién es el “político capaz”. Además, Mandeville explica en detalle el surgimiento del legislador, figura central tanto en su análisis como en el de Bentham pues garantiza la cohesión social.

  18. "Vicios privados, beneficios públicos" o la diestra administración del legislador utilitarista

    Directory of Open Access Journals (Sweden)

    Jimena Hurtado

    2004-01-01

    Full Text Available Este artículo explora la conexión entre Bernard Mandeville y Jeremy Bentham. La complementariedad entre ellos se evidencia en dos puntos: primero, el sentido enunciativo del principio de la utilidad, axioma fundamental del utilitarismo de Bentham, reposa sobre una concepción antropológica implícita que puede ser comprendida gracias a Mandeville. Segundo, la lección de Mandeville es que "los vicios privados a través de la diestra administración de un político capaz pueden ser transformados en beneficios públicos". El arte de la legislación de Bentham permite entender en qué consiste esta "diestra administración" y quién es el "político capaz". Además, Mandeville explica en detalle el surgimiento del legislador, figura central tanto en su análisis como en el de Bentham pues garantiza la cohesión social.

  19. "Vicios privados, beneficios públicos" o la diestra administración del legislador utilitarista

    Directory of Open Access Journals (Sweden)

    Jimena Hurtado

    2004-12-01

    Full Text Available Este artículo explora la conexión entre Bernard Mandeville y Jeremy Bentham. La complementariedad entre ellos se evidencia en dos puntos: primero, el sentido enunciativo del principio de la utilidad, axioma fundamental del utilitarismo de Bentham, reposa sobre una concepción antropológica implícita que puede ser comprendida gracias a Mandeville. Segundo, la lección de Mandeville es que “los vicios privados a través de la diestra administración de un político capaz pueden ser transformados en beneficios públicos”. El arte de la legislación de Bentham permite entender en qué consiste esta “diestra administración” y quién es el “político capaz”. Además, Mandeville explica en detalle el surgimiento del legislador, figura central tanto en su análisis como en el de Bentham pues garantiza la cohesión social.

  20. 27 February 2012 - First Lady of Mexico, M. Zavala Gómez del Campo, welcomed by Adviser J. Salicio Diez withe ALICE Management and Mexican Users at LHC Point 2 and signing the guest book with CERN Director-General R. Heuer.

    CERN Multimedia

    Maximilien Brice

    2012-01-01

    27 February 2012 - First Lady of Mexico, M. Zavala Gómez del Campo, welcomed by Adviser J. Salicio Diez withe ALICE Management and Mexican Users at LHC Point 2 and signing the guest book with CERN Director-General R. Heuer.

  1. Perfiles motivacionales de usuarios de servicios deportivos públicos y privados / Motivational Profiles of Users of Private and Public Sport Services

    Directory of Open Access Journals (Sweden)

    Román Nuviala Nuviala

    2013-06-01

    Full Text Available Las altas tasas de sedentarismo y abandono deportivo y la escasez de estudios sobre motivos de práctica en el ámbito de la actividad física no competitiva han generado la necesidad de llevar a cabo investigaciones que establezcan perfiles motivacionales de usuarios de servicios deportivos. La finalidad de esta investigación fue diferenciar los perfiles motivacionales con respecto a la práctica físico-deportiva y analizar su relación con variables sociodemográficas (edad y sexo. La muestra del estudio estuvo compuesta por un total de 2707 usuarios de servicios deportivos, públicos y privados, de Andalucía (España, que cumplimentaron la escala de Motivos de Actividad Física-Revisada (Motives for Physical Activity Measure-Revised [MPAM-R]. Se realizó un análisis por conglomerados y, seguidamente, la prueba ji-cuadrado. Los resultados obtenidos en este análisis establecieron la existencia de tres perfiles motivacionales: uno altamente motivado, especialmente hacia la salud, con sujetos principalmente varones jóvenes de organizaciones públicas; un segundo grupo con motivación por debajo de la media en todas sus dimensiones, e inducido, especialmente por razones de salud, disfrute y apariencia, con un perfil de usuario privado, mujer, de edad media o avanzada; un tercer grupo en el que primaron los motivos sociales y de disfrute, conformado mayoritariamente por usuarios de organizaciones privadas y de sexo masculino.

  2. Adaptação às mudanças climáticas no Brasil: o papel do investimento privado

    Directory of Open Access Journals (Sweden)

    Peter H May

    2012-01-01

    Full Text Available Em face da intensificação dos efeitos das mudanças climáticas, e das limitações das estratégias de mitigação em enfrentá-los, a temática da adaptação vem ganhando crescente importância. Este artigo apresenta parte dos resultados de uma ampla pesquisa que mapeou as iniciativas e os projetos em adaptação implementados pelo setor público, por organizações não governamentais e pelo setor privado, em todos os segmentos da atividade econômica e em todas as regiões do país, analisando em particular o destino dos investimentos do sistema financeiro privado. Aponta os principais vetores dos projetos de adaptação, concluindo que o binômio água-clima concentra a maior parte dos financiamentos desse segmento, e que os desafios colocados requerem uma coordenação articulada entre financiamento, governo e comunidade acadêmica.Given the intensifying effects of climate change, and limitations of mitigation strategies to address them, the issue of adaptation has become increasingly important. This article presents some results of an extensive research that mapped the initiatives and projects implemented by the public sector, by nongovernmental organizations and the private sector in all sectors of economic activity in all regions of the country, analyzing in particular the fate of the investments of private financial system. It sets out the main vectors of adaptation projects, concluding that the binomial water-climate concentrates most of the financing of this sector, and that the challenges require coordination between finance, government and academia.

  3. Estandarización en Colombia de una prueba ELISA para la evaluación de los niveles séricos de anticuerpos IgG contra diez serotipos de Streptococcus pneumoniae

    Directory of Open Access Journals (Sweden)

    Lucía Carolina Leal-Esteban

    2012-03-01

    Conclusión. Esta prueba ELISA cuantifica de forma confiable los niveles de IgG sérica contra diez serotipos de S. pneumoniae y, de acuerdo con los resultados obtenidos en individuos sanos de nuestra población, en este trabajo se validan los parámetros internacionales para considerar adecuada la respuesta a la vacuna 23-valente contra este microorganismo.   DOI: http://dx.doi.org/10.7705/biomedica.v32i1.393

  4. Crianças usuárias de lente de contato nos serviços público e privado: análise comparativa Pediatric contact lens users in public and private services: comparative analysis

    Directory of Open Access Journals (Sweden)

    Daniela Araújo Toscano

    2009-04-01

    Full Text Available OBJETIVOS: Analisar as indicações, tipo, complicações do uso de lentes de contato e acuidade visual em crianças de serviços de Oftalmologia público e privado. MÉTODOS: Os dados dos prontuários de 59 crianças usuárias de lentes de contato em serviço privado (Hospital de Olhos de Pernambuco - Grupo 1, e 43 no serviço público (Fundação Altino Ventura - Grupo 2, foram analisados. A coleta de dados incluiu características sociodemográficas, idade da primeira consulta, indicação do uso da lente, tipo de lente, complicações e acuidade visual. RESULTADOS: As mais comuns indicações do uso de lente de contato no grupo 1 foram: ametropia (55,9%, anisometropia (18,6% e esotropia (16,9%. Neste grupo o leucoma e phthisis não estavam presentes. No grupo 2, as indicações mais comuns foram: anisometropia (23,2%, ametropia e leucoma (18,6% cada, e phthisis (16,3%. A esotropia não apareceu no grupo 2. O tipo de lente de contato mais prescrita foi a gelatinosa de uso permanente (não descartável no grupo 1 (45,8% e no grupo 2 (32,6%. A complicação mais encontrada no grupo 1 foi desconforto (33,3% e no grupo 2 perda da lente (60%. CONCLUSÕES: A indicação de ametropia predominou nos pacientes privados e as anisometropias nos públicos. O tipo de lente de contato mais prescrita nos dois grupos foi a gelatinosa de uso permanente. A complicação mais frequente no grupo 1 foi desconforto e no grupo 2 perda da lente. A acuidade visual na maioria dos pacientes manteve-se.PURPOSE: To analyze the indications, type and complications of contact lens use and visual acuity in children, in ophthalmological, public and private, services. METHODS: The information from the medical records of 59 contact lens users at a private service (Hospital de Olhos de Pernambuco - Recife - PE- Brazil - group 1, and 43 at public service (Fundação Altino Ventura - Recife - PE - Brazil - group 2, was analyzed. The collected data included: demographic information

  5. Análisis del diseño institucional y regulación del sector privado en México: un acercamiento a su dinámica

    Directory of Open Access Journals (Sweden)

    M. Angélica Buendía Espinosa

    2011-01-01

    Full Text Available Producto de los cambios significativos que a partir de la década de los noventa ha experimentado el Sistema de Educación Superior (ses en México, actualmente se caracteriza por la complejidad y diversidad institucional de sus funciones académicas, de su oferta educativa, de sus funciones sustantivas, etc. En este proceso el sector privado ha cobrado relevancia dado su dinamismo que en las últimas décadas se ha reflejado en procesos de expansión significativos. No obstante, en el ámbito de la investigación sigue representado un asunto poco abordado. Con el propósito de contribuir a su conocimiento, en este trabajo se aborda el análisis del marco normativo de la educación superior privada en tres apartados. En el primero, se realiza un breve recorrido sobre la configuración del subsector privado, su participación actual en el sistema y sus principales tendencias. En el segundo, se describe el diseño institucional sobre el cual descansa la coordinación de dicho sector, para, posteriormente, analizar en el tercer apartado el marco normativo que regula las actividades del mismo. Finalmente se plantean algunas conclusiones y asuntos de investigación pendientes.

  6. Nuevas perspectivas para la Salud Laboral en un marco público y privado

    Directory of Open Access Journals (Sweden)

    Patricia Sirgo Granda

    Full Text Available Actualmente, la Vigilancia de la Salud (Salud Laboral, se mantiene aislada del resto de las especialidades médicas en curso del sistema sanitario vigente. Se desarrolla dentro un ámbito privado, dependiente de criterios de contratación de tipo empresarial, siendo un proveedor más de los servicios que precisa una empresa. Se constituye en la práctica diaria, como un servicio destinado a cumplir requisitos mínimos dispuestos en la actual normativa laboral, cuyo objetivo principal es la protección de la salud laboral del trabajador, pero en la que éste tiene un poder de decisión mínimo. Debido a su naturaleza preventiva, la Salud Laboral, a través del examen de salud y la vigilancia epidemiológica, constituye en sí misma, una herramienta muy válida de detección precoz de patología laboral y de carácter primario. El presente ensayo, tiene como objeto defender la importancia de la Salud Laboral y su impulso hacia nuevos ámbitos de aplicación, como medio de protección para el trabajador, la empresa y el sistema.

  7. Dinamización de la clase magistral en medicina: diez ejemplos de minicasos utilizados en la docencia de la farmacología

    Directory of Open Access Journals (Sweden)

    J.E. Baños

    Full Text Available Las clases magistrales constituyen un método pedagógico muy utilizado en las facultades de medicina. Sin embargo, tiene diversas limitaciones entre las que se encuentran la pasividad y la pérdida de la atención de los alumnos. A fin de estimular la atención y revigorizar su empleo, se han empleado textos cortos que plantean preguntas que pueden resolverse con la información proporcionada en la clase magistral (minicasos. El presente artículo describe una experiencia de su uso en la docencia de la farmacología y ofrece diez ejemplos para ilustrar sobre su empleo. La mayoría de ellos están ambientados en el mundo real, permiten contextualizar los conocimientos básicos de farmacología y estimulan la comprensión de los conceptos claves.

  8. O direito internacional privado acerca dos casamentos e parcerias entre pessoas do mesmo sexo no contexto do Mercosul

    Directory of Open Access Journals (Sweden)

    Bruno Rodrigues de Almeida

    2014-03-01

    Full Text Available O presente trabalho aborda certos aspectos do Direito Internacional Privado aplicáveis às projeções intersistemáticas dos casamentos e parcerias entre pessoas do mesmo sexo no contexto do Mercosul, tendo em vista que três dos cinco Estados-Partes do Tratado de Assunção (Argentina, Brasil e Uruguai já efetivamente regulamentam efeitos jurídicos às parcerias entre os indivíduos do mesmo gênero. O obejtivo deste estudo é demonstrar como a aplicação da lei material estrangeira e a cooperação jurídica internacional podem significar a proteção da dignidade humana e do direito fundamental à liberdade de orientação sexual no cenário mercosulino.

  9. Participação de religiosas na composição do serviço de enfermagem em um hospital universitário (1909-2005

    Directory of Open Access Journals (Sweden)

    Djailson José Delgado Carlos

    2014-01-01

    Full Text Available El objetivo fue analizar la participación de religiosas en la composición del servicio de Enfermería en un Hospital Universitario de Rio Grande do Norte, Brasil. Estudio cualitativo histórico-social, que consideró como período del estudio los años de 1909 a 2005, corresponde al inicio y término de la presencia de las hermanas Hijas de Sant’Ana en la institución. La investigación fue basada en el levantamiento de documentos, relatos, actas, leyes, decretos, proyectos, siendo complementada por entrevistas con diez personas, profesionales y religiosas, que actuaron en el Hospital a partir de la década de 1950. La realidad investigada coincide con el contexto brasileño en términos de falta de preparo de los ejecutantes de enfermería; actuación de religiosas en las labores hospitalarios y asistenciales. Las hermanas Hijas Sant’ Ana, fueron las pioneras y responsables durante décadas por la administración interna del Hospital y por la asistencia al paciente.

  10. Esboço de ensaio para desconstrução do discurso penal na sociedade do espetáculo, ou... surpreendendo o público em quintais privados

    Directory of Open Access Journals (Sweden)

    Aronne, Ricardo

    2008-01-01

    Full Text Available Uma das mais difusas dicotomias ainda presentes no discurso jurídico contemporâneo é a noção de Público e Privado. Essencial ao Liberalismo Clássico, essa dicotomia, revela agora sua crise. Esse artigo, em respeito às suas raízes existencialistas, posta suas lentes desconstrutoras nessas noções, para encontrar por trás delas o homem real (demasiadamente humano

  11. Biological aspects of Cirrospilus neotropicus Diez and Fidalgo (Hymenoptera: Eulophidae), parasitoid of Phyllocnistis citrella Stainton (Lepidoptera: Gracillariidae); Aspectos biologicos de Cirrospilus neotropicus Diez e Fidalgo (Hymenoptera: Eulophidae), parasitoide de Phyllocnistis citrella Stainton (Lepidoptera: Gracillariidae)

    Energy Technology Data Exchange (ETDEWEB)

    Foelkel, Ester [Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS (Brazil). Programa de Pos-Graduacao em Fitotecnia; Redaelli, Luiza R.; Jahnke, Simone M.; Losekann, Paula B. [Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS (Brazil). Dept. de Fitossanidade

    2008-05-15

    The biology of Cirrospilus neotropicus Diez and Fidalgo reared on third instar Phyllocnistis citrella Stainton larvae having Citrus limonia Osbeck as host plant, was evaluated under controlled conditions (25 {+-} 1 deg C; 12 h photophase). The survival, immature development, longevity, sex ratio, host feeding and oviposition ratio of C. neotropicus, were registered. Two groups of parasitoid females were evaluated: one, with parasitoids obtained from P. citrella pupae collected in citrus orchards and the other group came from laboratory rearing. These females, after mating, were maintained individually on gerbox containers with honey and pollen as food source. At each 48h, 12 P. citrella larvae were changed. The average biological cycle of the female progenies from orchard and laboratory generation groups were 11.8 and 11.6 days, respectively. The males progenies had biological cycles of 11.6 and 10.9 days, as well. The shortest immature survival period, for both studied groups was the larval (57.3% - orchard group and 57.4% - lab group). The mated females average longevity (21.8 days) was superior than the non mated ones (9.1 days) for the orchard group. The average daily oviposition rate for this last group was also significantly superior (2.8 eggs /day) than the lab group (1.6 eggs / day). The same trend was observed for the average daily host feeding rate (1.7 larvae /day for the orchard group and 0.9 larvae/ day for the lab group). These data suggest that C. neotropicus have potential as a biological control agent of P. citrella. (author)

  12. A PARTICIPAÇÃO DO SETOR PRIVADO NOS SERVIÇOS PÚBLICOS DE ABASTECIMENTO DE ÁGUA E ESGOTAMENTO SANITÁRIO: RESPOSTA AOS FRACASSOS DO SETOR PÚBLICO?

    Directory of Open Access Journals (Sweden)

    José Esteban Castro

    2013-03-01

    Full Text Available O artigo aborda a experiência da participação do setor privado (PSP na provisão de serviços públicos de abastecimento de água e esgotamento sanitário, desde os últimos anos da década de 1980. Em particular, examina as várias justificativas para a PSP, incluindo que esta seria mais eficiente do que as instituições/empresas públicas que prestam os serviços essenciais, contribuiria para reduzir o déficit do setor público, proporcionando novos investimentos privados, ajudaria a ampliar a cobertura de serviços para a população de menor renda e a melhorar a equidade social. O artigo considera que esses benefícios não ocorreram, conforme evidências emergentes de casos na África, Europa e América Latina, locais onde a PSP foi implementada extensivamente. Não somente as promessas de melhorias gerais em eficiência, novos investimentos privados, ajuda ao setor público e serviço estendido para os pobres não se materializaram, como há também boas razões para se associar a expansão da PSP com crescentes níveis de desigualdade social e o enfraquecimento da governança democrática e cidadania efetiva no gerenciamento da água e dos serviços públicos de abastecimento de água e esgotamento sanitário. O artigo, também, argumenta que alcançar os Objetivos de Desenvolvimento do Milênio (ODMs vai requerer uma mudança radical nas opções dos planos de ação e um comprometimento mais forte dos governos da Organização para a Cooperação e Desenvolvimento Econômico (OCDE, instituições financeiras internacionais, doadores e outros atores chave para fortalecer as empresas e instituições públicas a cargo desses serviços, em particular no nível regional e municipal.

  13. Dimensionamento de recursos humanos em serviços de alimentação e nutrição de hospitais públicos e privados

    Directory of Open Access Journals (Sweden)

    Rita de Cássia Lusia dos Santos

    2011-12-01

    Full Text Available O objetivo deste trabalho foi caracterizar e comparar o dimensionamento de recursos humanos dos Serviços de Alimentação e Nutrição Hospitalar (SANH e a qualificação do corpo técnico de nutricionistas da rede hospitalar pública e privada. Foram estudados 27 hospitais, 17 de Campinas e 10 de Ribeirão Preto, por meio de um questionário estruturado aplicado aos coordenadores do SANH, que abordou: condições de trabalho, pela relação entre número de leitos por nutricionista e por profissionais do SANH, e pelo número de refeições produzidas por leito, por nutricionistas e por funcionários do SANH; a formação acadêmica; e a experiência profissional dos nutricionistas. Foram encontradas diferenças significativas na relação número de leitos/nutricionista entre hospitais públicos (38,2 dp 11,4 e privados (94,6 dp 46,4 e de funcionários do SANH/nutricionista (11,4 dp 4,9 e 23,8 dp 13,3. A produção de refeições por leitos foi maior nos hospitais públicos (p=0,04. No setor público concentram-se nutricionistas com capacitação stricto sensu, mesmo que ainda em um número reduzido em relação ao encontrado no país; e, no privado, há mais profissionais com formação lato sensu. Uma ampla heterogeneidade no dimensionamento de recursos humanos do SANH em hospitais públicos e privados foi encontrada; contudo, o setor público apresentou condição mais favorável em alguns indicadores, mesmo estando aquém das necessidades, principalmente na área de atenção nutricional ao paciente hospitalizado. Os resultados apontam para a necessidade de se constituirem indicadores específicos de recursos humanos nos SANHs, para o desempenho de ações na área de produção de refeições e de cuidado nutricional ao paciente hospitalizado. Criar mecanismos de capacitação do nutricionista para as áreas de competência da nutrição hospitalar poderia contribuir com o aprimoramento do setor.

  14. La fidelidad de clientes en centros de fitness privados españoles: la cadena de creación y percepción de valor

    OpenAIRE

    García Fernández, Jerónimo

    2012-01-01

    El aumento del interés por la actividad física en la sociedad y la oferta de los organismos públicos y privados, ha repercutido en la proliferación de instalaciones deportivas sofisticadas y adaptadas a los diferentes tipos de practicantes. Esta situación ha supuesto que los gestores deportivos se especialicen cada vez más, trabajando por mejorar todos aquellos aspectos que puedan repercutir en una mejor percepción del usuario. Atendiendo a que una de las fuentes más importantes de ingreso...

  15. A Justiça e as Normas de Sobredireito: o Lugar das regras de Conexão em Direito Internacional Privado - 10.5102/uri.v3i2.288

    Directory of Open Access Journals (Sweden)

    Leandro de O. Moll

    2007-09-01

    Full Text Available O Direito Internacional Privado se ocupa dos problemas decorrentes de situações jurídicas privadas de dimensão internacional. Sua principal função é orientar o juiz competente no momento de decidir qual a lei aplicável a uma controvérsia que tenha contato com mais de um ordenamento jurídico, razão pela qual é classificado como espécie de “sobredireito”. Seu principal objetivo é indicar ao juiz nacional, mediante a utilização de “regras de conexão”, a lei mais adequada para reger uma relação jurídica privada de dimensão internacional (determinar o “centro de gravidade da relação jurídica”, mesmo que aquela lei seja uma lei estrangeira. Conhecido como o “direito da tolerância” não pode prescindir de considerações de justiça, seja no seu fundamento e sua obrigatoriedade, seja na sua aplicação. Com efeito, como toda norma jurídica, as regras de conexão também devem estar comprometidas com o valor final da justiça, razão pela qual é preciso rever a utilização de regras de conexão rígidas, inflexíveis e mecânicas, inclusive por fidelidade ao objetivo primeiro do Direito Internacional Privado, esclarecido pelos Pais da disciplina, a saber, o da determinação da lei mais adequada e justa para o problema dos conflitos de leis. Nesse contexto, importa proceder a uma modernização do Direito Internacional Privado brasileiro – tendo em vista as várias tendências internacionais em doutrina, jurisprudência e legislação – com o intuito de torná-lo menos mecânico e mais comprometido com a justiça substantiva.

  16. Tendências na assistência hospitalar Trends in hospital care

    Directory of Open Access Journals (Sweden)

    Gonzalo Vecina Neto

    2007-08-01

    Full Text Available Este artigo analisa as tendências observadas na assistência hospitalar brasileira, no que diz respeito ao cenário, situação atual, desafios e ao que necessita ser feito, tendo em vista os itens anteriores. As variáveis com as quais se trabalhou o cenário geral foram a demografia, o perfil epidemiológico, os recursos humanos, a tecnologia, a medicalização, os custos, a revisão do papel do cidadão, a legislação, a eqüidade, o hospitalocentrismo e a regionalização, o fracionamento do cuidado e a oferta de leitos. O cenário nacional foi estudado mediante o modelo empregado na assistência médica supletiva, o financiamento e a cadeia de produção na área de serviços de saúde. A situação atual apresenta os modelos de avaliação externa, a terceirização, o relacionamento público-privado, a desospitalização e o financiamento. Os desafios a serem enfrentados analisam a necessidade de se olhar o longo prazo, a busca por novos modelos jurídicos para o "negócio", o uso da informação e a informatização, o controle de custos e a necessidade do aumento da eficiência e do cumprimento dos ditames legais, de garantia de acesso e de integralidade na assistência, a incorporação da prevenção primária ao processo de atenção, a integração entre os setores público e privado e a incorporação do médico na solução dos problemas.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

  17. Políticas públicas para niños, niñas y adolescentes con discapacidad: Perspectiva desde el vínculo público-privado

    OpenAIRE

    Cárdenas Espinoza, María Cristina

    2010-01-01

    Director de Tesis: Andrade Guzmán, Carlos Alejandro Se busca dar respuesta a las preguntas sobre cuáles son los roles actuales que adoptan tanto el Estado como la Sociedad Civil chilena respecto a los programas y a las políticas de discapacidad; cuáles son las fortalezas y debilidades presentes en el acercamiento; y por último, busca responder cuáles son las áreas que destacan en el encuentro público - privado, en términos de su contribución a la mejora de condiciones para el desarrollo ...

  18. Autonomia financeira em estabelecimentos públicos e privados de saúde no Brasil

    Directory of Open Access Journals (Sweden)

    Maria Angelica Borges dos Santos

    2014-01-01

    Full Text Available Autonomia financeira é um diferencial positivo na gestão pública, sendo referida na Pesquisa de Assistência Médico-Sanitária (2009 por 3,9% dos 52.055 estabelecimentos públicos de saúde. Foi mais frequente em estabelecimentos públicos com internação (17,8% do total, da administração estadual (26,3% e da Região Sul (6,6% e, em geral, era parcial (apenas para algumas áreas, como despesas emergenciais, material de consumo e permanentes, serviços de terceiros e pessoal. Quanto à natureza jurídica, 83,7% dos 2.011 estabelecimentos públicos que referiram alguma autonomia são da administração direta. A atribuição de autonomia financeira a estabelecimentos públicos de saúde parece ser definição política local, que não se prende necessariamente a mudanças de natureza jurídica. Ainda assim, confirmou-se um espectro crescente de maior autonomia segundo natureza jurídica, em que estabelecimentos da administração direta da saúde são os menos autônomos e as sociedades empresariais as mais autônomas; 85,8% dos 45.394 estabelecimentos privados tinham alguma autonomia financeira.

  19. Triangular público, doméstico y privado, o ¿cómo negociar en pareja?

    Directory of Open Access Journals (Sweden)

    MARTA GUTIÉRREZ SASTRE

    2002-01-01

    Full Text Available Se afronta el tema de las posibilidades de negociar e iniciar cambios en la pareja, cuestionando los principios de la negociación liberal e introduciendo los matices que nos permitan establecer el tipo de intercambio que se puede producir entre dos personas situadas en posiciones distintas. Se introduce el término de lo privado, que lejos de connotaciones intimistas, se entiende como la interacción que en lo interpersonal establece la pareja en relación al medio social, económico y político. La triangulación de las facetas pública, doméstica y privada constituye la clave para entender las posibilidades de negociar dentro de la pareja. Se advierte la omnipresencia de la faceta pública y el declive de la doméstica en favor de la privada. Se establece, por úlitmo, una tipología de cuatro tipos de parejas en función de cómo interactúen los tres ámbitos mencionados.

  20. Revista de Derecho Electoral del Tribunal Supremo de Elecciones de Costa Rica: Diez años de aportar a la reflexión sobre democracia y elecciones

    Directory of Open Access Journals (Sweden)

    Ileana Aguilar Olivares

    2016-01-01

    Full Text Available La gestión de conocimiento es una tarea inherente en la función pública. La necesidad de propiciar espacios para la divulgación de ese conocimiento ha llevado a varias instituciones a la creación de publicaciones para su difusión. El Tribunal Supremo de Elecciones, consciente de dicha necesidad, crea en el año 2006 la Revista de Derecho Electoral en formato digital y de acceso abierto, con el objetivo de propiciar y difundir el conocimiento que día a día se genera en el área de democracia y elecciones. El artículo realiza un repaso por los principales aportes de la Revista durante sus diez años de existencia.

  1. Percepção da equipe de enfermagem acerca de um serviço de educação continuada de um hospital universitário Percepción del equipo de enfermería sobre un servicio de la educación continua de un hospital de universitario Perception of the nursing staff about service of continuing education of a university hospital

    Directory of Open Access Journals (Sweden)

    Aline Togni Braga

    2009-12-01

    Full Text Available O objetivo deste estudo foi analisar o Serviço de Educação Continuada (SEC de um hospital de ensino, sob a ótica da equipe de enfermagem, nas dimensões avaliativas de estrutura, de processo e de resultado. Trata-se de um estudo exploratório descritivo, realizado em hospital universitário privado. Para a coleta de dados utilizou-se um instrumento composto por uma escala de Likert. O tratamento dos dados foi realizado por meio da estatística descritiva e pelo emprego do teste Alpha de Cronbach. Na análise dos resultados, observou-se que nas três dimensões avaliativas (estrutura, processo e resultado a equipe de enfermagem teve percepção favorável quanto às atividades desenvolvidas por este serviço. Entretanto, na comparação, a que obteve maior escores de favorabilidade foi a de estrutura, média de 42,56 (dp±4,97 e o menor a de processo, média 40,44 (dp±5,11.Lo objetivo de este estudio fue analizar el Servicio de la Educación de Continua (SEC de un hospital universitario, de la perspectiva del equipo del oficio de enfermera en la evaluación de las dimensiones de estructura, proceso y resultados. Esto es un estudio exploratorio-descriptivo, ejecutado en un hospital de enseñanza privado. La colección de datos fue conducida a través de un cuestionario, usando una escala de Likert. El tratamiento de los datos fue llevado con las estadísticas descriptivas usando la prueba alfa de Cronbach. Analizando los datos, observamos que en el árbol evaluó las dimensiones (estructura, proceso y resultado la enfermera que el equipo tenía opinión favorable concerniente a este servicio. Sin embargo, la dimensión de la estructura recibió la cuenta más alta del favorability, promedio de 42.56 (dp±4,97, con la dimensión de proceso recibiendo la cuenta más baja de, el promedio 40.44 (dp±5,11.The objective of this study was to analyze the Service of Continuated Education (SCE of a university hospital, from the perspective of the

  2. O Desmanche do Público e do Privado na Midiatização da Crise Aérea Brasileira (2006/2007

    Directory of Open Access Journals (Sweden)

    Maria Helena Weber

    2009-03-01

    Full Text Available Este trabalho intitulado tem por objetivo analisar o processode midiatização imposto à crise aérea brasileira, denominaçãodo período em que confluíram dois graves acidentes aéreosdas companhias GOL e TAM; desordens técnicas e burocráticasnos aeroportos; eleições presidenciais e acontecimentosparalelos, que colocaram o Poder Executivo no centro dacrise. De caráter ensaístico, esse texto pretende identificarníveis de fortalecimento e diluição das fronteiras entre opúblico e o privado a partir de estratégias de informações eações relacionadas à ordem política, à mobilização social e àlógica do mercado, em meio a questões de vida e morte.

  3. A AMPLITUDE DO CONCEITO DE CORRUPÇÃO: UM CONFRONTO DE TENSÕES ENTRE INTERESSES PÚBLICO E PRIVADO.

    Directory of Open Access Journals (Sweden)

    Osvaldo Resende Neto

    2017-06-01

    Full Text Available O Brasil tem sido cenário de uma série de escândalos de corrupção, ocasionada pela confusão entre interesses públicos e privados, em que estes tendem a prevalecer excessivamente. É nesse panorama em que este trabalho suscita uma análise político-jurídica da amplitude do conceito de corrupção, não se restringindo ao modelo convencional. Para tanto, a pesquisa foi construída sobre três temas: 1 a máxima clássica da supremacia do interesse público; 2 críticas à supremacia do interesse público e o perigo do radicalismo oposto; e 3 para além da corrupção quid pro quo: uma nova proposta do papel do interesse público.

  4. [Biological aspects of Cirrospilus neotropicus Diez & Fidalgo (Hymenoptera: Eulophidae), parasitoid of Phyllocnistis citrella Stainton (Lepidoptera: Gracillariidae)].

    Science.gov (United States)

    Foelkel, Ester; Redaelli, Luiza R; Jahnke, Simone M; Losekann, Paula B

    2008-01-01

    The biology of Cirrospilus neotropicus Diez & Fidalgo reared on third instar Phyllocnistis citrella Stainton larvae having Citrus limonia Osbeck as host plant, was evaluated under controlled conditions (25 +/- 1 masculineC; 12h photophase). The survival, immatures development, longevity, sex ratio, host feeding and oviposition ratio of C. neotropicus, were registered. Two groups of parasitoid females were evaluated: one, with parasitoids obtained from P. citrella pupae collected in citrus orchards and the other group came from laboratory rearing. These females, after mating, were maintained individually on gerbox containers with honey and pollen as food source. At each 48h, 12 P. citrella larvae were changed. The average biological cycle of the female progenies from orchard and laboratory generation groups were 11.8 and 11.6 days, respectively. The males progenies had biological cycles of 11.6 and 10.9 days, as well. The shortest immature survival period, for both studied groups was the larval (57.3% - orchard group and 57.4% - lab group). The mated females average longevity (21.8 days) was superior than the non mated ones (9.1 days) for the orchard group. The average daily oviposition rate for this last group was also significantly superior (2.8 eggs /day) than the lab group (1.6 eggs / day). The same trend was observed for the average daily host feeding rate (1.7 larvae /day for the orchard group and 0.9 larvae/ day for the lab group). These data suggest that C. neotropicus have potencial as a biological control agent of P. citrella.

  5. Cuando lo Privado se Hace Público: el abogado del niño en la justicia de familia

    Directory of Open Access Journals (Sweden)

    Carla Villalta

    2016-04-01

    Full Text Available Resumo: O objetivo deste trabalho é analisar as tensões, disputas e conflitos que surgiram no processo de implementação do advogado da criança na justiça de família Argentina, especificamente na Cidade Autônoma de Buenos Aires e na cidade de La Plata. Para tanto, analisamos casos paradigmáticos - reconstruídos desde o levantamento de registros do tribunal, palestras e entrevistas com vários intervenientes ao longo do nosso trabalho de campo; os vários usos e interpretações que dele emergem a entrada deste ator social na cena judicial. Não pretendemos fazer uma abordagem legalista dos diferentes debates produzidos a partir deste processo de identificação das crianças no campo judicial, que foram identificadas como sujeitos processuais com voz própria. Pretendemos abordar este novo ator social de uma perspectiva social-antropológica e examinar duas tensões recorrentes nas discussões relativas à garantia dos direitos de crianças e adolescentes: a tensão entre público e privado, e que se desdobra em termos de autonomia versus proteção. Palavras-chave: Advogado; Antropologia Legal - pública e privada; Direitos das crianças; Justiça de Família ***  Resumen: El objetivo de este artículo es analizar las tensiones, disputas y conflictos que emergieron en el proceso de implementación del abogado del niño en la justicia de familia de la Argentina, específicamente en la Ciudad Autónoma de Buenos Aires y en la ciudad de La Plata. Para ello, a través del análisis de casos paradigmáticos –reconstruidos a partir del relevamiento de expedientes judiciales y de las charlas y entrevistas mantenidas con distintos actores en el transcurso de nuestro trabajo de campo- se indagan los diversos usos e interpretaciones que emergen a partir de la entrada de esta figura en la escena judicial. Lejos de utilizar una lente jurídica para dar cuenta de los diferentes debates producidos a partir de este proceso de individualización de

  6. Frecuencia de las mutaciones más comunes del gen CFTR en pacientes peruanos con fibrosis quística mediante la técnica ARMS-PCR

    OpenAIRE

    Aquino, Ruth; Protzel, Ana; Rivera, Juan; Abarca, Hugo; Dueñas, Milagros; Nestarez, Cecilia; Purizaga, Nestor; Diringer, Benoit

    2017-01-01

    Objetivos. Determinar la frecuencia de las diez mutaciones más comúnmente reportadas en América Latina del gen CFTR mediante Sistema de Mutación Refractario a la amplificación por PCR (ARMS-PCR) en los pacientes con fibrosis quística (FQ) de dos instituciones hospitalarias de referencia en el Perú durante el año 2014. Materiales y métodos. Se evaluó la frecuencia de las diez comúnmente reportadas más comúnmente reportadas del gen CFTR en los pacientes del Hospital Nacional Edgardo Rebagliati ...

  7. Estudio De Los Problemas Intrafamiliares Frecuentes Que Perjudica El Rendimiento Académico De Los Estudiantes De La Unidad Educativa “Diez De Agosto” Del Cantón Vinces, Provincia De Los Ríos

    OpenAIRE

    ZAVALA RODRÍGUEZ, LUISINA

    2014-01-01

    El objetivo del trabajo investigativo es determinar los efectos de los problemas intrafamiliar en el rendimiento académico de los estudiantes de la Unidad Educativa “Diez de Agosto” del Cantón Vinces, Provincia de Los Ríos. La muestra está conformada por 338 estudiantes de los Décimos Años de Educación Básica Superior. Los datos obtenidos a través de la aplicación de encuestas, se estableció su percepción de los problemas en sus hogares, fueron analizados estadísticamente utilizand...

  8. 6 November 2013 - Permanent Representative of Chile to the United Nations Office and Other international organizations in Geneva Ambassador J. Balmaceda Serigos signing the guest book with Adviser for Latin America J. Salicio Diez; visiting the ATLAS experimental cavern with Spokesperson D. Charlton (Spouse, Son and First Secretary present).

    CERN Multimedia

    Anna Pantelia

    2013-01-01

    6 November 2013 - Permanent Representative of Chile to the United Nations Office and Other international organizations in Geneva Ambassador J. Balmaceda Serigos signing the guest book with Adviser for Latin America J. Salicio Diez; visiting the ATLAS experimental cavern with Spokesperson D. Charlton (Spouse, Son and First Secretary present).

  9. Actualidad y proyecciones de la maternidad subrogada en el derecho internacional privado argentino

    Directory of Open Access Journals (Sweden)

    Brodsky, Jonathan M.

    2013-12-01

    Full Text Available La maternidad subrogada, y en general las técnicas de reproducción humana asistida, son hoy una realidad de la que el derecho interno e internacional no pueden desentenderse. El silencio en la materia de la normativa argentina es insostenible, mas el Proyecto de Código Civil y Comercial de la Nación acierta en hacerse cargo de regular la gestación por sustitución, tanto a nivel interno como en la sección dedicada especialmente al derecho internacional privado. Tras una sucinta evaluación de la (inconveniencia de admitir legislativamente la institución, el presente trabajo se centrará en los requisitos de procedencia exigidos para dicha práctica en el Código proyectado (porque son de orden público internacional, así como en los criterios de atribución de jurisdicción y ley aplicable en la especie, y el reconocimiento de la filiación habiendo nacido el hijo, a través de la maternidad por otro, en un país extranjero (y cuya ley lo permite. Finalmente, se abordará el juego del orden público internacional con el principio del interés superior del niño, y se examinará la aplicación analógica de las soluciones propuestas ante supuestos que se pudieran plantear en la actualidad, frente al actual vacío normativo.

  10. Diez sugerencias para repensar, críticamente, la Unión Europea

    Directory of Open Access Journals (Sweden)

    Carlos Taibo

    2004-01-01

    Full Text Available En este artículo, el autor ofrece diez sugerencias para repensar críticamente Europa: 1 La Europa de la tradición inventada: la Europa marcada por una larga etapa de guerras, que se presenta como centro histórico del mundo, como corazón de la civilización, como cuna del progreso, la libertad y la razón; 2 La Europa de los mercaderes y de las jerarquías. La Europa de las alianzas económicas vinculadas al neoliberalismo más ultramontano, en la que la dimensión político-democrática ha tenido un relieve secundario; y también la Europa de las jerarquías, con los Estados Unidos ocupando un papel prominente; 3 El mito de la Europa del estado del bienestar, del capitalismo bueno, frente al capitalismo feroz de los Estados Unidos; 4 La Europa de los derechos y libertades en franco reculaje, especialmente tras los atentados del 11-S; la Europa de la demonización y represión de los movimientos antiglobalización capitalista; y la Europa de las normas duras frente a los inmigrantes pobres; 5 La Europa de Blair, Chirac, Schröeder, Berlusconi o Aznar, sin compromiso con la causa de la justicia, la solidaridad y la paz; 6 La Europa carente de un proyecto estratégico y con notables divisiones internas; 7 La Europa que mantiene una relación incierta con los Estados Unidos; la Europa de las colisiones dólar/euro, que pueden terminar provocando una dinámica de irrefrenable confrontación; 8 La Europa de las diferentes velocidades, en la que los recién llegados están obligados a instalarse en una periferia poco cómoda, y quienes se quedan al margen entran en proceso de tercermundización; 9 La Europa de una constitución sin pueblo, nación o Estado, con problemas preocupantes para la izquierda que resiste: déficit democrático, fragilidad de derechos sociales, estatalización de esquemas, política exterior en la que llueve sobre mojado; y 10 El concepto de Europa como construcción mental imaginada, frente al mito de Europa como realidad

  11. La formación de masculinidades hegemónicas en la clase dominante: el caso de la sexualidad en los colegios privados de elite en Chile

    OpenAIRE

    Madrid, Sebastián

    2016-01-01

    Resumen: Sobre la base de 41 historias de vida, de hombres y mujeres (de 19 a 45 años), ex-estudiantes de tres tipos de colegios privados de elite en Santiago de Chile, este artículo analiza el proceso de construcción de masculinidades hegemónicas en la clase dominante chilena. Se examina la forma en que la producción de distintos patrones de masculinidades se relaciona con cambios en la parte alta de la estructura social y se analiza el modo en que la sexualidad conecta la formación simultán...

  12. Biological aspects of Cirrospilus neotropicus Diez and Fidalgo (Hymenoptera: Eulophidae), parasitoid of Phyllocnistis citrella Stainton (Lepidoptera: Gracillariidae)

    International Nuclear Information System (INIS)

    Foelkel, Ester; Redaelli, Luiza R.; Jahnke, Simone M.; Losekann, Paula B.

    2008-01-01

    The biology of Cirrospilus neotropicus Diez and Fidalgo reared on third instar Phyllocnistis citrella Stainton larvae having Citrus limonia Osbeck as host plant, was evaluated under controlled conditions (25 ± 1 deg C; 12 h photophase). The survival, immature development, longevity, sex ratio, host feeding and oviposition ratio of C. neotropicus, were registered. Two groups of parasitoid females were evaluated: one, with parasitoids obtained from P. citrella pupae collected in citrus orchards and the other group came from laboratory rearing. These females, after mating, were maintained individually on gerbox containers with honey and pollen as food source. At each 48h, 12 P. citrella larvae were changed. The average biological cycle of the female progenies from orchard and laboratory generation groups were 11.8 and 11.6 days, respectively. The males progenies had biological cycles of 11.6 and 10.9 days, as well. The shortest immature survival period, for both studied groups was the larval (57.3% - orchard group and 57.4% - lab group). The mated females average longevity (21.8 days) was superior than the non mated ones (9.1 days) for the orchard group. The average daily oviposition rate for this last group was also significantly superior (2.8 eggs /day) than the lab group (1.6 eggs / day). The same trend was observed for the average daily host feeding rate (1.7 larvae /day for the orchard group and 0.9 larvae/ day for the lab group). These data suggest that C. neotropicus have potential as a biological control agent of P. citrella. (author)

  13. EVALUACIÓN DE ACTIVIDADES ENDOGLUCANASA, EXOGLUCANASA, LACASA Y LIGNINA PEROXIDASA EN DIEZ HONGOS DE PUDRICIÓN BLANCA

    Directory of Open Access Journals (Sweden)

    SANDRA MONTOYA B.

    Full Text Available Este trabajo presenta una vía de rastreo de producción de enzimas lignocelulolíticas en diez especies de hongos de pudrición blanca: Lentinula edodes, Schizophyllum commune, Trametes trogii, Coriolus versicolor, Pycnoporus sanguineus, Ganoderma applanatum, Ganoderma lucidum, Grifola frondosa, Pleurotus ostreatus y Auricularia delicata. Estas especies primero fueron rastreadas sobre medios de cultivo sólido que contienen carboximetil celulosa, celulosa cristalina, ABTS (2,2´-azino-bis(3-etilbenzotiazolina-6-sulfonato y azure B, los cuales evidenciaron la producción de las enzimas endoglucanasa, exoglucanasa, lacasa y lignina peroxidasa (LiP. Las actividades celulolíticas fueron detectadas a los cinco días de incubación con el indicador rojo congo, formándose un halo claro-blanco en las zonas donde se degrada la celulosa. Para las ligninasas, este rastreo consistió en el seguimiento a la formación de halos verdes por oxidación del ABTS para lacasa y halos de decoloración sobre el azure B para la LiP durante 14 días de incubación. De este rastreo cualitativo, se seleccionaron cuatro cepas (G. lucidum, L. edodes, C. versicolor y T. Trogii, como las mejores productoras de enzimas celulolíticas y ligninolíticas. Estas cuatro especies fueron inoculadas sobre un sustrato de aserrín de roble, obteniéndose 51,8% de lignina degradada por L. edodes y 22% de celulosa degrada por C. versicolor.

  14. Do público e do privado: uma perspectiva de género sobre uma dicotomia moderna From the public and the private: a gender perspective on a modern dichotomy

    Directory of Open Access Journals (Sweden)

    Sofia Aboim

    2012-04-01

    Full Text Available Neste texto propomos uma interpretação crítica da dicotomia histórica entre público e privado como dinâmica fundamental da modernidade. A partir de uma perspectiva de género, discutimos as fronteiras construídas entre espaço coletivo de cidadania e de sociabilidade e espaço individual de intimidade e desigualdade. Argumentamos a favor de uma relação de cumplicidade, ainda que tensa, entre as duas esferas, observando que a vida privada foi, em grande medida, moldada pelas mudanças operadas na vida pública. Recorrendo a diferentes definições de "público", notamos que, à medida que as sociabilidades tradicionais, essencialmente masculinas, estudadas entre outros por Ariès ou Sennett, sofriam uma erosão, crescia o sentimento de intimidade, aumentando igualmente a inclusão do privado no público através do alargamento da cidadania, em consequência das lutas travadas na esfera pública por vários movimentos de emancipação, como o operário ou o feminista. À medida que a pessoa era retirada da comunidade, do clã, do grupo de parentesco, em que eram "naturais" as desigualdades, no sentido aristotélico do termo, ia-se reencontrando progressivamente como indivíduo portador de cidadania. Se o espaço privado se tornou central na definição de uma identidade, ele é também crescentemente atravessado por mecanismos públicos de regulação. Nesse sentido, o movimento de ascensão do privado, que nas últimas décadas tem ocupado espaço de debate, deve ser cuidadosamente reinterpretado.In this text, we put forward a critical interpretation of the historic dichotomy between 'private' and 'public' as a fundamental dynamic of modernity. From the perspective of gender we discuss the boundaries that have been constructed between the collective space of citizenship and sociability and the individual space of intimacy and inequality. We make a case for a relationship of complicity, albeit tense, between the two spheres, observing

  15. Aumento no uso de transporte motorizado privado no deslocamento das crianças para a escola na Região Metropolitana de São Paulo, Brasil, 1997-2012

    Directory of Open Access Journals (Sweden)

    Thiago Hérick de Sá

    2016-01-01

    Full Text Available Resumo: A Região Metropolitana de São Paulo, Brasil, apresentou, entre 1997 e 2007, tendência de aumento do uso transporte motorizado privado nos deslocamentos de crianças para a escola, com potenciais prejuízos à saúde. O objetivo deste estudo foi ampliar a análise de tal tendência para 2012 e discutir possíveis estratégias para aumentar a proporção de crianças que andam, pedalam e usam o transporte público. A análise dos dados da Pesquisa de Mobilidade de 2012 indica não apenas a continuidade, mas a aceleração no aumento do uso transporte motorizado privado em deslocamentos de crianças entre 6 e 11 anos para a escola. O efeito de iniciativas em andamento sobre essa tendência só será devidamente compreendido com o devido monitoramento dos deslocamentos cotidianos e a avaliação do impacto dessas ações sobre a saúde da população. Um pacote de políticas e programas voltados especificamente para a promoção e proteção da mobilidade a pé, de bicicleta ou por transporte público de crianças é imprescindível para garantir o deslocamento seguro, independente e ativo de crianças para a escola na Região Metropolitana de São Paulo.

  16. Em busca do ethos comunitário: universidades catarinenses mantidas por fundações públicas de direito privado, um olhar a partir do pluralismo jurídico

    Directory of Open Access Journals (Sweden)

    Carlos Magno Spricigo Venerio

    2011-09-01

    Full Text Available O presente estudo pretende analisar a partir do pluralismo jurídico comunitário-participativo e dentro do atual panorama da gestão universitária catarinense a situação em que se encontram as universidades catarinenses mantidas por fundações públicas de direito privado. Confrontadas na virada do século com um cenário inédito de fim do virtual monopólio do ensino superior pago em suas regiões de abrangência, decorrente da expansão do ensino superior privado e do recente incremento do investimento público estatal em educação superior, estas instituições têm buscado de forma articulada o fortalecimento de sua identidade organizacional comunitária, com ênfase na afirmação da prática da gestão democrática. A partir de dados de matrículas em graduação na última década; atendimento de requisitos para credenciamento na forma de organização universitária; e análise dos diversos sistemas de eleições para reitor, o estudo busca apontar as tendências para o ensino superior pago inserido no sistema da Associação Catarinense das Fundações Educacionais – ACAFE -em processo de migração para o sistema federal de ensino.

  17. Cambios epidemiológicos en una unidad de Gineco- Obstetricia de un hospital chileno

    Directory of Open Access Journals (Sweden)

    Pablo Pérez C.

    2010-01-01

    Full Text Available Objetivo, Describir los cambios en el número de nacimientos, tasa de parto normal (TPN, fórceps (TPF, cesárea (TPC, tasa de embarazo múltiple (TEM y embarazo ectópico (TEE. Diseño, Estudio descriptivo y retrospectivo Lugar, Hospital Naval - Chile. Participantes, 9627 fichas clínicas entre 200-2010. Intervenciones, Formato de registro. Principales medidas de resultados, Frecuencias relativas y absolutas. Resultados, El número de nacimientos se ha reducido en un36,7%. Se vio una disminución de la TPN de un 57.8% a 53.8%, un aumento de la TPC de 32.35% a 42.4%. y una disminución de la TPF de 9.85% a 3,8%, la TEM aumentó de 0.81% a 3.2%, y la TEE de 1,45% a 1,71%. Conclusiones, Se observaron importantes cambios epidemiológicos durante los últimos diez años. Es relevante la evaluación de estos parámetros para establecer causalidades y repercusiones clínicas.

  18. Fronteiras entre análise do comportamento e fisiologia: Skinner e a temática dos eventos privados Boundaries between behavior analysis and physiology: Skinner and the issue of private events

    Directory of Open Access Journals (Sweden)

    Emmanuel Zagury Tourinho

    2000-01-01

    Full Text Available O presente estudo examinou referências de B. F. Skinner à fisiologia em textos sobre eventos privados, com o objetivo de identificar elementos para uma demarcação mais precisa das relações entre análise do comportamento e fisiologia. As contribuições de Skinner naquela direção foram categorizadas em seis temas: a variáveis biológicas como constitutivas, mas não definidoras do fenômeno comportamental privado; b autonomia do recorte analítico-comportamental diante dos fatos biológicos/fisiológicos; c limites de controle do comportamento por eventos internos/fisiológicos; d comportamento privado como comportamento do organismo como um todo; e distinção entre contato privilegiado e conhecimento privilegiado; e f preservação do recorte analítico-comportamental em situação de análise aplicada do comportamento. As proposições correspondentes às categorias descritas são apontadas como originais na definição do campo de uma ciência do comportamento e capazes de orientar coerentemente a demarcação das fronteiras entre análise do comportamento e fisiologia enquanto disciplinas independentes e complementares.This study examines B. F. Skinner´s references to physiology in publications dealing with private events, in order to identify elements for a clearer definition of the relations between behavior analysis and physiology. Skinner´s contributions were analyzed with reference to six thematic categories: a biological variables as constitutive, albeit non-defining properties of private behavioral phenomena; b the autonomous nature of the behavioral-analytical approach in the face of biological/physiological facts; c limits of behavior control by internal/physiological events; d private behavior as behavior of the organism as a whole; e a distinction between privileged access and privileged knowledge; f retention of the behavioral-analytical approach in applied behavior analysis. Skinner´s propositions concerning the

  19. Consistencia macroeconómica de las políticas públicas y proyectos de ley con impacto en las finanzas públicas

    Directory of Open Access Journals (Sweden)

    Manolo Chávez

    2011-06-01

    Full Text Available El presente documento pretende inferir sobre los efectos macro-fiscalesque tiene la ejecución presupuestal de la Ley de Reparación Integral a las Víctimas de la Violencia para el año 2012 en la economía colombiana. El actual ministro de Hacienda, Juan Carlos Echeverry, anunció que se ha estimado que para el 2012, esta ley cuente con un presupuesto de 2,2 billones de pesos, sin embargo afirma que es muy comprometedor estimar una cifra para los diez años que dura la vigencia de la ley. De esta manera, el presupuesto nacional se incrementa y, por lo tanto, debe generar variaciones en los principales agregados macroeconómicos y en los balances de los sectores privado, público y externo. La metodología utilizada para estimar el mencionado efecto, consiste en cuantificar las variaciones que tienen las principales variables macroeconómicas y los balances mencionados, a través de un modelo aplicativo de demanda estático. De acuerdo con los resultados obtenidos, se puede afirmar que los2,2 billones de pesos que costaría la ley en el año 2012 incrementa el gasto del Sector Público No Financiero (SPNF y la inversión pública en solo 0,6%, generando un incremento en la demanda de 0,9%, un déficit en el (SPNF de 0,3%, el cual es financiado por el sector privado en un 0,4%.

  20. ¿Quiénes dirigen las instituciones educativas en Cali? Perfil de los directivos docentes en colegios públicos y privados de estratos 1 a 4

    Directory of Open Access Journals (Sweden)

    Norbella Miranda

    2011-12-01

    Full Text Available El objetivo de este artículo es proveer una descripción del perfil de los administradores de la educación que laboran en instituciones públicas y privadas de educación básica y media de estratos 1 a 4 en la ciudad de Santiago de Cali, a través de los rasgos demográficos, socioeconómicos, académicos y profesionales. El artículo es producto de una investigación sobre las condiciones de implementación de la política educativa colombiana Programa Nacional de Bilingüismo. Para el estudio se empleó una encuesta que fue respondida por 70 administradores escolares de 46 instituciones educativas de la ciudad. Los resultados mostraron que el perfil típico del administrador escolar corresponde a mujeres entre los 50y 60 años que tuvieron contacto con el idioma inglés durante sus estudios de básica secundaria, tienen título de Especialización como máximo nivel de formación alcanzado y cuentan con experiencia profesional superior a 11 años. Se hallaron diferencias entre los sectores público y privado: en el primero los directivos tienen un nivel más alto de formación académica y mejores salarios. Los resultados sugieren que se necesita mayor apoyo a la formación de los directivos del sector privado y un mejor reconocimiento económico a la labor desempeñada por los directivos docentes en ambos sectores.

  1. Comportamientos relacionados con la salud en estudiantes de Santa Marta: comparación entre colegios públicos y privados

    Directory of Open Access Journals (Sweden)

    Lauris Munive Gutierrez

    2013-10-01

    Full Text Available Resumen Hoy en día se sabe que los perfiles de morbilidad y mortalidad de un país se encuentran ligados a patrones de comportamientos que pueden ser modificados y que, por tanto, cualquier persona puede adoptar conductas saludables para contribuir a su propio bienestar. Por ello, los comportamientos relacionados con la salud han sido objeto de estudios en los últimos años. Esto aunado, a sus consecuencias sociales, económicas y de la salud, como son los embarazos no planeados, infecciones de transmisión sexual (ITS, en especial el VIH-SIDA, lo cual ha hecho que se reconozca como un problema de salud pública. El objetivo de la presente investigación fue el de comparar los comportamientos relacionados con la salud de adolescentes escolarizados de colegios públicos y privados de la ciudad de Santa Marta. Se utilizó un diseño de tipo transversal, con 2039 mujeres y 1536 varones, con una edad promedio de 17.5 años. Se concluye que existen diferencias en los comportamientos relacionados con la salud en estudiantes de colegios públicos y privados de la ciudad, siendo los estudiantes de colegios públicos, independiente del género, quienes presentan mayores comportamientos de riesgo para la salud. (DUAZARY 2011, 58 - 65AbstractToday it is known that morbidity and mortality profile of a country are linked to patterns of behavior that can be modified and that therefore, anyone can adopt healthy behaviors to contribute to their own welfare. Thus, behaviors related to health have been studied in recent years. This coupled, their social, economic and health, such as unplanned pregnancies, sexually transmitted infections (STIs including HIV / AIDS, which has led to recognized as a public health problem. The objective of this research was to compare health-related behaviors of adolescent students in schools public and private in the city of Santa Marta. We used a cross-sectional design with 2039 women and 1536 men with an average age of 17

  2. Em busca do ethos comunitário: universidades catarinenses mantidas por fundações públicas de direito privado, um olhar a partir do pluralismo jurídico

    Directory of Open Access Journals (Sweden)

    Carlos Magno Spricigo Venerio

    2011-06-01

    Full Text Available http://dx.doi.org/10.5007/1983-4535.2011v4n3p63   O presente estudo pretende analisar a partir do pluralismo jurídico comunitário-participativo e dentro do atual panorama da gestão universitária catarinense a situação em que se encontram as universidades catarinenses mantidas por fundações públicas de direito privado. Confrontadas na virada do século com um cenário inédito de fim do virtual monopólio do ensino superior pago em suas regiões de abrangência, decorrente da expansão do ensino superior privado e do recente incremento do investimento público estatal em educação superior, estas instituições têm buscado de forma articulada o fortalecimento de sua identidade organizacional comunitária, com ênfase na afirmação da prática da gestão democrática. A partir de dados de matrículas em graduação na última década; atendimento de requisitos para credenciamento na forma de organização universitária; e análise dos diversos sistemas de eleições para reitor, o estudo busca apontar as tendências para o ensino superior pago inserido no sistema da Associação Catarinense das Fundações Educacionais – ACAFE - em processo de migração para o sistema federal de ensino.

  3. Participação do setor privado na governança ambiental global: Evolução, contribuições e obstáculos The participation of the private sector in the global environmental governance: Evolution, contributions and obstacles

    Directory of Open Access Journals (Sweden)

    Jose Célio Silveira Andrade

    2009-08-01

    Full Text Available Este artigo tem por objetivo analisar a evolução da participação do setor privado na Governança Ambiental Global (GAG, identificando as contribuições dadas e os principais obstáculos enfrentados por esse ator. Para atingir este objetivo, privilegiou-se a estratégia de pesquisa qualitativa baseada em análise de conteúdo da literatura acadêmica,working papers, diagnósticos e relatórios institucionais. Constatou-se que a participação do mundo dos negócios na GAG se dá pelo processo de formação e implementação de regimes ambientais internacionais e pelo desenvolvimento de regimes híbridos e privados de governança ambiental. Defende-se que o setor privado pode contribuir para a efetividade da GAG. Entretanto, existem vários obstáculos a serem superados visando uma participação mais ativa e direta desse ator na ecopolítica mundial.This article intends to study the evolution of the participation of the private sector in the Global Environmental Governance (GEG, identifying the contributions and the main obstacles faced by this actor. To achieve this goal, emphasis was done on qualitative research strategy based on analysis of academic literature, working papers, diagnostics and institutional reports. It shows that the participation of business in the GEG occurs through the process of formation and implementation of international environmental regimes and the development of hybrid and private environmental governance schemes. In conclusion, this article defends that the private sector can contribute to the effectiveness of GEG, however, there are several obstacles to a stronger participation of this actor in the world ecopolitics.

  4. Distribución y venta en España de productos fabricados en el extranjero. Cuestiones de Derecho Internacional Privado

    Directory of Open Access Journals (Sweden)

    María Dolores Ortiz Vidal

    2013-12-01

    Full Text Available La distribución y comercialización en el mercado único europeo de un producto fabricado en un tercer Estado exige el ajuste del producto en cuestión a las normas de Derecho público y a las normas de Derecho privado del Derecho de la UE. Desde el punto de vista de Derecho público, el marcado CE opera como elemento necesario para poder comercializar, en óptimas condiciones de salud y de seguridad, determinados productos en el mercado único de la UE. Desde una perspectiva internacional privatista, las normas europeas aplicables a la posición jurídica del adquirente de un producto – fabricado en un Estado miembro de la UE o en un tercer Estado – que se distribuye y comercializa en el mercado único de la UE, le proporcionan un trato jurídico diferenciado en función de si dicho sujeto ostenta la cualidad de consumidor "activo" o "pasivo".

  5. Efectos de la educación en el nivel de las contribuciones a los planes privados de pensiones de las familias en España

    Directory of Open Access Journals (Sweden)

    José Sánchez-Campillo

    2016-09-01

    Full Text Available En este trabajo se abordan los efectos de la educación en el comportamiento financiero de las familias españolas, con relación a la contratación de los planes privados de pensiones. Se realizan varias estimaciones de la probabilidad de tener planes de pensiones y de realizar aportaciones a los mismos, utilizando el modelo logit y los microdatos de la Encuesta Financiera de las Familias del Banco de España del 2005. Los resultados muestran que son los hábitos financieros, más que el nivel de estudios del cabeza de familia, los que más influyen en la participación voluntaria en planes de pensiones.

  6. Prevalencia de consumo de tabaco en vehículos privados Prevalence of smoking among drivers of private vehicles

    Directory of Open Access Journals (Sweden)

    María Tolosana

    2013-02-01

    Full Text Available Objetivo: Determinar la prevalencia de conductores fumadores en vehículos privados en la ciudad de Lleida. Métodos: Se seleccionó una muestra aleatoria de 1600 vehículos privados en seis cruces regulados por semáforos. Las variables estudiadas fueron edad y sexo, conductor fumador, acompañante >18 años, tipo de cruce (urbano/interurbano, día (laborable/festivo, hora (mañana/tarde y fumadores simultáneos. Se calculó la prevalencia de conductores fumadores y las odds ratio ajustadas (ORa, con su intervalo de confianza del 95% (IC95%. Resultados: La prevalencia fue del 6,0% (IC95%: 4,9-7,3, mayor en los hombres (6,4%, en el grupo de 41 a 60 años (6,9% y sin acompañante (6,5%. La probabilidad de que el conductor fumara aumentó con acompañante fumador (ORa=10,8; IC95%: 3,6-32,5. La frecuencia de conductores fumadores fue mayor en los días laborables (ORa=1,7; IC95%: 1,0-2,8 y por la mañana (ORa=1,6; IC95%: 1,0-2,4. Conclusiones: La prevalencia de conductores fumadores se considera elevada y perjudicial. Se recomienda evitar fumar en los vehículos.Objective: To determine the prevalence of smoking among drivers of private vehicles in the city of Lleida (Spain. Methods: A random sample of 1600 cars passing through six intersections regulated by traffic lights were selected. The variables were age, sex, smoking driver, adult passengers, intersection (urban/interurban, day (working day/weekend, hour (morning/evening and simultaneous smokers. We calculated the prevalence of smoking drivers and the corresponding odds ratios (ORs, adjusted for the potential confounding variables, as well as their 95% confidence intervals (95% CI. Results: The prevalence was 6.0% (95% CI: 4.9-7.3 and was higher in men (6.4%, in the group aged 41 to 60 years (6.9%, and in unaccompanied drivers (6.5%. The probability of the driver smoking increased if there was a smoking passenger (aOR=10.8; 95% CI: 3.6-32.5. The frequency of smoking drivers was higher on

  7. Estudo da assistência hospitalar pública e privada em bases populacionais, 1986-1996 Study of public and private hospital care on a populational basis, 1986-1996

    Directory of Open Access Journals (Sweden)

    Juan Stuardo Yazlle Rocha

    1999-02-01

    financiamento do SUS, reprimindo demanda e desestimulando os prestadores privados a trabalhar com pacientes SUS levou a uma seletividade negativa para o SUS. O resultado foi que aumentou a diferença nos padrões de assistência entre os serviços públicos e privados.INTRODUCTION: The last decade saw the creation and implementation of the Brazilian National Health System (NHS ­ public, universal and equalitarian ­ with the objective of offering wide coverage to meet the population's health needs. The objective of the study was the assessment of the evolution of public and private hospital care on a populational basis during the period of the implementation of the NHS. METHODS: The 984,142 inpatients of the general hospitals of Ribeirão Preto, Brazil, during the period 1986 to 1996 were studied and those of them living in their own municipal district were selected. The inpatients are classified according to the financing system as private, pre-payment and NHS; the social situation of the patients and the profile of hospital morbidity are analysed. RESULTS: In the period studied a continuous growth in the number of hospitalizations is observed, both in absolute numbers and in coefficient per thousand inhabitants, increasing from 43,773 to 55,844 inpatients per year. Though when the categories of the hospitalizations are studied, it is seen that private inpatients present a reduction both in absolute numbers and as a coefficient from 3,181 (7.3% to 2,215 (3.9%; the NHS inpatients decrease in absolute numbers and in a percentage by a third at the end of the period - falling from 33,254 (76.0% to 29,373 (51.7%. On the other hand the pre-payment inpatient system triplicates in absolute numbers and duplicates by rate for inhabitant - from 7,338 (16.8% to 25,256 (44.4%. The NHS hospital care attends mainly unskilled and semi-skilled manual workers; the professionals, technicians, non manual and skilled manual workers being assisted by the private services. The hospital morbidity of

  8. Situação da pesquisa em enfermagem em hospitais do município de São Paulo Situación de la investigación en enfermería en hospitales de São Paulo - Brasil Nursing research situation in hospital in the city of São Paulo

    Directory of Open Access Journals (Sweden)

    Nilce Piva Adami

    1996-01-01

    Full Text Available Tendo por objetivo descrever a situação da pesquisa em enfermagem em hospitais do município de São Paulo, no período de 1989 a 1993, foi realizada uma pesquisa exploratória, descritiva, abrangendo 14 estabelecimentos sendo sete públicos e sete da rede privada. Nos públicos foram produzidas 114 pesquisas e nos privados 40, predominando as apresentadas em eventos científicos. Foram expressas as facilidades e dificuldades para a produção de pesquisa nestas instituições, bem como, a incorporação dos resultados destas na prática, principalmente quando o objetivo de estudo emerge de problemas percebidos no processo assistencial. Centros de pesquisa, parceria serviço-universidade e contratação de enfermeiras pesquisadoras foram estratégias adotadas para o desenvolvimento de pesquisas em algumas das instituições estudadas.El propósito del presente estudio es la descripción de la situación de la investigación en enfermería en los hospitales de la ciudad de São Paulo, Brasil, en el período de 1989 hasta 1993. El diseño utilizado fue exploratorio-descriptivo, abarcando 14 instituciones hospitalarias, de las cuales 7 corresponden al sector público y 7 al sector privado. En los primeros fueron realizadas 114 investigaciones y 40 en los hospitales del sector privado. Hubo predominancia de investigaciones presentadas en coloquios científicos. Las facilidades y las dificultades para la utilización de sus resultados en la atención de enfermería, en especial cuando el objeto del estudio tuvo su origen en el proceso asistencial. Para el desarrollo de la investigación en las instituciones estudiadas, fueron empleadas algunas estrategias entre ellas: centros de investigaciones, integración servicio-universidad y contratación de enfermeras investigadoras.The objective of this study is to show nursing research situation in public and private hospitals in the city of São Paulo, form 1989 to 1993. It is an exploratory and

  9. Remplacer l’Etat ? Promotion et réseaux des Partenariats Public-Privé en France Replacing the State, or promoting public-private partnerships and networks in France ¿Sustituir al Estado ? Promoción y redes de colaboraciones entre los sectores público y privado en Francia

    Directory of Open Access Journals (Sweden)

    Élise Penalva-Icher

    2013-03-01

    -term relationships (up to 30 years focusing both on projects’ construction and maintenance and on funding for public buildings. The text questions partnership contracts’ scope and technical innovation, as well as the new relationship they posit between the private and public sectors. A description of PPP-related sectors and social networks in France is used to examine the embeddedness of the business relations that are part of this new way of building connections between the public and private sectors, and the meso-level structures thereof. Above all, the PPP project seems to be particularly fruitful at an institutional level, due to the fact that the new relational structures identified through our analyses culminate in a greater role for banks.Desde su creación en 2004, el Contrato de colaboración ha sido promovido como una innovación gerencial de primera importancia en la gestión de la interfaz entre el sector público y el sector privado. Además, ha sido alentada por los poderes públicos dado que se le considera como la forma ideal y típica de las Colaboraciones sector público-sector privado (PPP por sus siglas en francés : Partenariat Public-Privé, las cuales generalmente se presentan como herramientas para mejorar la eficacia económica de los proyectos públicos. Esta nueva forma de contrato denominada “Contrato de colaboración”, que se firma entre personas públicas y el sector privado, teje relaciones a muy largo plazo (hasta 30 años entre la persona pública y diferentes tipos de actores privados con vistas a la construcción, el mantenimiento, la conservación, así como el financiamiento de edificios públicos. En este artículo nos interrogamos acerca del alcance de esos contratos de colaboración que, amén de constituir una innovación técnica, preconizan una nueva relación entre los sectores privado y público. A través de la descripción de las redes del medio de las Colaboraciones sector público-sector privado en Francia, examinamos el

  10. Estrategias de financiamiento para el desarrollo endógeno del sector confección zuliano

    Directory of Open Access Journals (Sweden)

    Mariby Boscán

    2009-09-01

    Full Text Available Los cambios en el entorno empresarial experimentados a escala mundial en las últimas décadas, demandan para las firmas de reducido tamaño adquisición de tecnología actualizada, aprendizaje tecnológico y reestructuración de procesos, lo cual es clave para impulsar y consolidar el desarrollo endógeno local. Sin embargo, esto amerita disponibilidad de recursos financieros, siendo esta una necesidad apremiante para los empresarios zulianos. El objetivo del presente artículo, consiste en analizar las estrategias de financiamiento que faciliten el desarrollo endógeno en el sector confección zuliano. Con esta finalidad se diseñó un estudio descriptivo y de campo, utilizando una entrevista semiestructurada aplicada a diez gerentes. La investigación se basó fundamentalmente en los postulados de Brealey y Myers (1998, Diez y López (2001, Vázquez (2005 y Sunkel (1991. Entre los resultados destacan: las empresas, prefieren financiamiento privado, dado que los requisitos son sencillos y el acceso a la fuente es rápido. A corto plazo, los gerentes utilizan la estrategia pre-pago y en algunas oportunidades el crédito comercial, mientras que a largo plazo, han utilizado préstamos bancarios y manejo del patrimonio. Se concluye que, para lograr el desarrollo endógeno se requiere combinar fuentes públicas y privadas, por lo que se recomienda mejorar el acceso y tiempo para el otorgamiento de crédito de los programas públicos, por cuanto el financiamiento es uno de los factores más importantes para lograr el desarrollo económico del sector.

  11. Diseño y evaluación de un sistema de tratamiento piloto para las aguas residuales provenientes de la construcción del sector inmobiliario privado en la ciudad de Manizales

    OpenAIRE

    Cruz Henao, Claudia Patricia

    2015-01-01

    Tesis (Maestria en Desarrollo Sostenible y Medio Ambiente). Universidad de Manizales. Facultad de Ciencias Contables Económicas y Administrativas, 2015 Con el fin de diseñar un sistema de tratamiento para las aguas residuales provenientes de la construcción en el sector inmobiliario privado en la ciudad de Manizales, se realizó una caracterización de la cantidad y calidad de los vertimientos generados en esta actividad. La cantidad promedio de agua residual generada fue el 71% del agua us...

  12. Evaluación de diez leguminosas con dos niveles de tecnología en un suelo ácido

    Directory of Open Access Journals (Sweden)

    Muñoz F. Jaime E.

    1990-12-01

    Full Text Available El trabajo se realizó durante dos semestres en la zona de Santander de Quilichao, con la finalidad de estudiar el comportamiento agronómico de diez leguminosas en suelos ácidos y sin riego; se empleó un diseño experimental de bloques al azar con arreglo en parcelas divididas con 10 tratamientos y 3 repeticiones. El análisis de varianza y la diferencia mínima significativa (DMS , permitieron comparar dos modalidades de tecnología: el manejo del agricultor y ligeras modificaciones en la fertilización. En los dos ensayos efectuados, no hubo diferencia entre tecnologías, el material de mejor comportamiento en rendimiento fue Caupí TV U 289-46, la menor variabilidad en los rendimientos la presentó el mungo PI 376873; existió mejor comportamiento de los materiales caupí y mungo, respecto a los Phaseolus en suelos ácidos.The present study was carried out during two halfyears at town of Santander de Quilichao (Cauca in order to study agronomic behaviour of ten leguminous in acid soils with and without watering; the experimental design used was the randomized blocks with an arrangement in split plots with 3 replications. The variance analysis and least significant difference aIlowed to compare 2 ways of technology: farmer management and slight modifications in the fertilizations. In two assays done, there were not differences between technologies, the material of best behaviour in yield was TUV 289- 46 cowpea,the smaIIest variability was observed in PI 376873 mungo; a better behaviour was observed in two Cowpea and mungo materials in relation with phaseolus in acid soils.

  13. Planos privados de assistência à saúde: cobertura populacional no Brasil Private health plans: populational coverage in Brazil

    Directory of Open Access Journals (Sweden)

    Luiz Felipe Pinto

    2004-01-01

    Full Text Available Foram utilizados o Cadastro de Beneficiários da Agência Nacional de Saúde Suplementar (ANS e a Pesquisa Nacional por Amostra de Domicílios (PNAD/IBGE para descrever o perfil da cobertura dos serviços por planos privados de saúde. Apesar da regulação pela ANS, não se deve perder de vista que o acesso, a utilização e a cobertura populacional em planos de saúde precisam ser periodicamente monitorados, principalmente na região Sudeste, que concentra 70% da população coberta por planos de saúde. Também são necessários estudos mais detalhados sobre as capitais brasileiras, que constituem grandes centros de concentração de clientela; e investigações para os subgrupos etários que mais utilizam os serviços de saúde: crianças menores de 5 anos, mulheres em idade fértil e idosos. Os resultados do estudo indicam que, no Sistema de Saúde Brasileiro, os planos privados de assistência à saúde se configuram como mais um fator de geração de desigualdades sociais no acesso e na utilização de serviços de saúde, pois cobrem apenas uma parcela específica da população brasileira: pessoas de maior renda familiar, de cor branca, com maior nível de escolaridade, inseridas em determinados ramos de atividade do mercado de trabalho, moradores das capitais/regiões metropolitanas.The Beneficiaries' Frame from ANS and the data of the PNAD/IBGE have been used to describe the profile of the private health plans' coverage. Although the regulation functions of ANS, one should not forget that private health insurance access, use and coverage should be monitored continuously, specially the private market of Southeast Region, which concentrate 70% of coverage people in Brazil. Others studies are also necessary for Brazilian capitals, which constitute great urban cities of insurance people. Besides this, more detailed investigation must be developed for age groups with higher utilization of health services: children up to 5 years, women

  14. Consolidación de los archipiélagos de seguridad en América Latina

    Directory of Open Access Journals (Sweden)

    Nelson Arteaga Botello

    2010-01-01

    Full Text Available El incremento de los delitos de diverso tipo y de la violencia criminal en los últimos diez años en América Latina ha propiciado la extensión de los mecanismos de seguridad en las sociedades de la región. De esta forma, no sorprende que a finales del siglo pasado se haya observado un aumento en la demanda de los servicios públicos y privados de seguridad. Este proceso no es solamente el resultado de la exportación hacia América Latina de cierta lógica de seguridad establecida por los Estados Unidos luego de los atentados a las Torres Gemelas. Más bien, este evento vino a acelerar y reforzar un proceso que en gran parte de los países de América Latina ya se venía consolidando; proceso determinado por la implementación de dispositivos de control sobre aquellos sectores que, se piensa, son responsables de la violencia delictiva: los excluidos y marginados de los espacios urbanos de las grandes ciudades latinoamericanas.

  15. 5 December 2011 - Chilean President of the Comision Nacional de Investigacion Cientifica y Tecnologica J. M. Aguilera in the ATLAS visitor centre with Adviser J. Salicio Diez and ATLAS Collaboration G. Mikenberg; signing the guest book with Head of International Relations F. Pauss; visiting the LHC superconducting magnet test hall with Department Head F. Bordry.

    CERN Multimedia

    VMO Team

    2011-01-01

    5 December 2011 - Chilean President of the Comision Nacional de Investigacion Cientifica y Tecnologica J. M. Aguilera in the ATLAS visitor centre with Adviser J. Salicio Diez and ATLAS Collaboration G. Mikenberg; signing the guest book with Head of International Relations F. Pauss; visiting the LHC superconducting magnet test hall with Department Head F. Bordry.

  16. Avaliação da promoção do aleitamento materno nas maternidades públicas e privadas do Município de São Paulo Assessment of the promotion of breastfeeding in public and private maternities, Brazil

    Directory of Open Access Journals (Sweden)

    Tereza Setsuko Toma

    2001-10-01

    Full Text Available OBJETIVO: A OMS (Organização Mundial da Saúde e o Unicef (Fundo das Nações Unidas para a Infância lançaram, em 1992, uma estratégia para implementar os "dez passos para o sucesso da amamentação": a Iniciativa Hospital Amigo da Criança (IHAC. No Brasil, até junho de 2001, foram credenciados 183 hospitais como Amigos da Criança. Assim, objetivou-se avaliar e comparar as práticas de proteção, promoção e apoio ao aleitamento materno em hospitais públicos e privados, tendo como referência os "dez passos". MÉTODOS: Foram pesquisados 45 hospitais do Município de São Paulo, SP. Foram colhidos dados sobre as práticas de alimentação infantil mediante entrevista com chefias de berçário de todos os hospitais públicos do município (26; dos hospitais privados, foi estabelecida uma amostra de 19, correspondentes a 1/3 do total. RESULTADOS: Mais de 1/4 dos hospitais públicos e mais de 1/3 dos privados não cumpriam qualquer passo da IHAC. Em apenas dois hospitais, ambos públicos, observou-se a adoção de pelo menos sete dos "dez passos". De modo geral, rotinas de proteção, promoção e apoio ao aleitamento foram encontradas com mais freqüência nos hospitais públicos do que nos privados. CONCLUSÕES: O estudo mostrou que práticas consideradas prejudiciais ao início e ao estabelecimento da amamentação -- separação desnecessária de mães e recém-nascidos, restrição na duração e freqüência das mamadas, uso de alimentos pré-lácteos e suplementos -- continuavam sendo observadas com alta freqüência nos hospitais públicos e privados do Município de São Paulo. Para alcançar os benefícios da amamentação para a saúde materno-infantil e o importante papel desempenhado pelas maternidades para o início precoce e para o sucesso da prática de amamentar, é necessário que os padrões estabelecidos pela IHAC sejam adotadosOBJECTIVE: The World Health Organization (WHO and the United Nations Children's Fund (UNICEF

  17. Mortalidad y repelencia en Eupalamides cyparissias (Lepidoptera: Castniidae, plaga de la palma aceitera Elaeis guineensis, por efecto de diez extractos botánicos

    Directory of Open Access Journals (Sweden)

    Diana D. PÉREZ

    2008-01-01

    Full Text Available Las plantas con actividad insecticida constituyen un importante componente del manejo integrado de plagas. Bajo esta premisa, el objetivo del presente estudio fue evaluar la mortalidad y repelencia larval de Eupalamides cyparissias Fab. (Lepidoptera: Castniidae, plaga de la palma aceitera Elaeis guineensis Jacquin; empleando diez plantas con potencial insecticida: Ucullucuysacha ( Heliotropium indicum L., Boraginaceae, Floripondio ( Brugmansia x candida Pers., Solanaceae, Oreja de Tigre ( Tradescantia zebrina Hort ex Bosse, Commelinaceae, Piñón Blanco ( Jathropa curcas L., Euphorbiaceae, Sacha yoco ( Paullinia clavigera Schltdl., Sapindaceae, Yuquilla ( Euphorbia cotinifolia L., Euphorbiaceae, Achiote ( Bixa orellana L., Bixaceae, Retama común ( Cassia fistula L., Fabaceae, Huancahuisacha ( Aristolochia pilosa Kunth, Aristolochiaceae y Curare ( Chondrodendron tomentosum Ruiz & Pavon, Menispermaceae. Los bioensayos con E. cyparissias abarcaron entre 1 h y 24 h, bajo condiciones estandardizadas de laboratorio. A 24 h de exposición, los mayores porcentajes de mortalidad de E. cyparissias se presentaron en los tratamientos con Sacha yoco (63,3 %: corteza y hojas en decocción, Achiote (63,3 %: semillas en licuado y Yuquilla (48,3 %: hojas en licuado. En el caso de la repelencia, los mayores efectos se encontraron en los tratamientos con Achiote (83,30 %, Sacha yoco (75 % y Floripondio (66,7 %: hojas en licuado.

  18. El apoyo psicosocial docente de primer ciclo de primaria costarricense para el trabajo con estudiantes cuyo padre y/o madre se encuentran privados de libertad (EPMPL), desde su trabajo en el aula regular

    OpenAIRE

    Sáenz Villalobos, Lucía

    2013-01-01

    El presente trabajo final de graduación pretendió establecer las bases objetivas, a partir de las cuales podría establecerse un programa integral de capacitación docente de educación primaria para el apoyo, desde la clase regular, de los menores cuyo padre y/o madre se encuentren privados de libertad (EPMPL), como medio de contención que aminore las repercusiones socio-emocionales que tal situación implica, considerando que dicha población se encuentra en riesgo social. Para ello, se realizó ...

  19. Diez mitos que debilitan la política de vivienda en Latinoamerica/Ten Myths Undermining Latin American Housing Policy

    Directory of Open Access Journals (Sweden)

    Alan Gilbert

    2011-12-01

    Full Text Available La política de vivienda de Latinoamérica no puede considerarse como un gran éxito. Las cifras oficiales muestran que el déficit de vivienda está incrementando en la mayoría de países. Por su puesto, resolver el problema de la vivienda es un asunto difícil, y el rápido crecimiento urbano junto con los altos niveles de pobreza hacen que sea aún más complicado. Sin embargo, hay muchas fallas en la política de vivienda actual, y este artículo identifica diez mitos que han infiltrado el léxico de la política de vivienda. Este artículo es una invitación a los gobiernos de la región para que consideren si alguno de los mitos identificados, o todos, aún persisten dentro de sus propias políticas, y si estos mitos son tan nocivos como se sugiere en este artículo. Housing policy in Latin America cannot be regarded as having been a huge success. Official figures show that the housing deficit is rising in most countries. Of course, solving the housing problem is difficult and complicated further by rapid urban growth and too much poverty. Nonetheless, there are many failings in current housing policy and the current paper identifies ten myths that have infiltrated the housing policy lexicon. This paper is an invitation to the region's governments to consider whether any or all of the identified myths persist within their own policies and whether those myths are as damaging as will be suggested here.

  20. Distribution of physical therapists working on public and private establishments in different levels of complexity of health care in Brazil Distribuição de fisioterapeutas entre estabelecimentos públicos e privados nos diferentes níveis de complexidade de atenção à saúde

    Directory of Open Access Journals (Sweden)

    Larissa R. Costa

    2012-10-01

    processo de assistência à saúde, sendo complementada pelas ações especializadas. No entanto, a centralidade na atenção especializada ainda é uma realidade no país, principalmente no setor privado. Estudos sobre a distribuição das profissões no sistema de saúde permitem a formulação de políticas adequadas que fortaleçam a APS. OBJETIVOS: Investigar a distribuição dos fisioterapeutas nos níveis de complexidade de atenção à saúde e entre os estabelecimentos públicos e privados de acordo com dados do Cadastro Nacional de Estabelecimentos de Saúde (CNES. MÉTODO: Foi realizado um estudo transversal descritivo. Os dados foram coletados no banco nacional do CNES, em março de 2010, sendo analisados por técnicas estatísticas descritivas. RESULTADOS: Foram identificados 53.181 cadastros de fisioterapeutas, com 60% vinculados ao setor privado. Apenas 13% de todos os cadastros estiveram vinculados à APS. A predominância na atenção especializada ocorreu no setor público (65% e privado (aproximadamente 100%, sendo o maior número de profissionais vinculados a estabelecimentos privados especializados da região Sudeste (16.043. Apenas o setor público da região Sul apresentou maioria na APS. Quando considerados os portes dos municípios, verifica-se concentração na atenção especializada em municípios de maior porte. CONCLUSÃO: Este estudo identificou concentração de fisioterapeutas na atenção especializada, majoritariamente em municípios de maior porte populacional e no setor privado, sendo ainda restrita a participação na APS.

  1. Tratamiento quirúrgico de la hernia discal lumbosacra en el hospital "Ernesto Guevara de la Serna"

    Directory of Open Access Journals (Sweden)

    Henry López Jimenez

    2015-11-01

    Full Text Available Fundamento: la hernia discal lumbosacra tiene una alta prevalencia en el mundo y en Cuba. El resultado del tratamiento quirúrgico tiene gran impacto individual, familiar, laboral, social y económico.Objetivo: describir los resultados del tratamiento quirúrgico de la hernia discal en pacientes operados en el Hospital General Docente “Dr. Ernesto Guevara de la Serna”, en el período de tiempo comprendido entre enero de 2005 y mayo de 2015.Métodos: se realizó una investigación observacional descriptiva, retrospectiva, en el referido hospital de la provincia de Las Tunas y durante el período de tiempo declarado antes. Se utilizaron fuentes de recolección de datos secundarias, como expedientes clínicos e informes operatorios. Se confeccionaron registros para la recolección de datos continuos. Se creó una base de datos para el procesamiento de la información que se analizó mediante la estadística descriptiva, utilizando el valor porcentual para reportar los resultados.Resultados: la hernia discal fue más frecuente en el sexo masculino y en el grupo de edad de 40 - 49 años. El nivel discal más afectado fue L4-L5, la raíz de S1 fue la más comprimida y predominó la hernia posterolateral. Primaron los resultados satisfactorios en el tratamiento quirúrgico y las complicaciones más frecuentemente encontradas fueron la discitis y fibrosis postquirúrgica.Conclusiones: se logró describir los principales resultados del tratamiento quirúrgico de la hernia discal en pacientes operados en el Hospital General Docente “Dr. Ernesto Guevara de la Serna”, durante los últimos diez años.

  2. Conferencias anatomoclínicas: caso no. diez y ocho

    Directory of Open Access Journals (Sweden)

    San Juan de Dios Hospital

    1955-02-01

    Antecedentes Personales: Enfermedades de la infancia; menarquia a los 14 años con ciclos de 30 x 8 e hipermenorreas frecuentes. Enfermedad actual: Desde muy pequeña hace cerca de 12 años notó la aparición de una tumefacción en la región antero-inferior del cuello, la cual aumentó de tamaño en los últimos tres años y antes de su ingreso al hospital, la producían disfonía, disfagia y disnea.EXAMEN CLINICO: Enferma joven, mixedematosa, anémica, con 28 respiraciones por minuto y ligero tiraje con una masa elástica, móvil, simétrica y que sigue los movimientos de la deglución, localizada en la región antero-inferior del cuello. La paciente tiene dedos en palillo de tambor y excavación en arteza de las uñas de manos y pies, sobre el eje longitudinal. Hay desarrollo muy escaso de los caracteres sexuales secundarios.

  3. Causalidad del vértigo en el Hospital Universitario San Vicente de Paúl

    Directory of Open Access Journals (Sweden)

    Javier A. Ortiz

    1988-01-01

    Full Text Available En el período 1984-1986 se estudiaron en el Servicio de Otorrinolaringología del Hospital Universitario San Vicente de Paúl de Medellín, 87 pacientes con vértigo; se halló que el origen era periférico en el 62, 1% y central en el 11,5% de los casos; no se logró definir la causa en el 20,7% de los pacientes, pese a la observación prolongada ya los exámenes paraclínicos. En el grupo de pacientes con vértigo de origen central la mitad presentaban alteraciones de tipo vascular; la enfermedad de Meniere fue la primera causa en el grupo de pacientes con vértigo de origen periférico (18,5%; siete de los diez pacientes con esta enfermedad presentaron compromiso de ambos oídos. La sífilis ótica causó el 7,4% de los vértigos periféricos, razón por la que se recomienda practicar a todo paciente con trastornos del equilibrio una serología que incluya, en caso de negatividad de la reacción de floculación, un FTA-ABS.

  4. Diferencial salarial público-privado e desigualdade de renda per capita no Brasil

    Directory of Open Access Journals (Sweden)

    Pedro H. G. F. Souza

    2013-03-01

    Full Text Available O estudo estima a contribuição específica do diferencial salarial entre trabalhadores com características semelhantes dos setores público e privado para a desigualdade na renda domiciliar per capita no Brasil. A estimação baseia-se em simulações contrafactuais e o cálculo das contribuições para a desigualdade em uma decomposição de fatores do coeficiente de Gini. Os dados são provenientes da PNAD 2009. O diferencial equivale a cerca de 17% da massa salarial dos servidores públicos, é regressivo e altamente concentrado, mas tem volume pequeno na renda total (1% e, por isso, contribui para cerca de 3% da desigualdade total. Os efeitos sobre a desigualdade da composição da força de trabalho nos setores são muito maiores que efeitos da segmentação do mercado de trabalho entre os dois setores. Essas conclusões são pouco sensíveis a modificações de definições de setor e diferentes técnicas de estimação.We estimate the contribution of the wage differential between workers with the same attributes in the public and private sectors to the household per capita income inequality in Brazil. The estimate is based on counterfactual simulations and the contribution to inequality on a factor decomposition of the Gini coefficient. Data comes from the Brazilian National Household Survey PNAD 2009. The differential corresponds approximately to 17% of the wage bill of workers in the public sector, is regressive and highly concentrated. However, because it amounts to a small share of the total income (1% its contribution to the total inequality is of 3%. The sector composition effects on inequality are times higher than the segmentation (price effects. These conclusions are robust to changes in the definition of the sectors and to different estimation techniques.

  5. Adoção de “Sistema Privado de Ensino”: análise de dois municípios paulistas

    Directory of Open Access Journals (Sweden)

    Rosilene Rodrigues da Silva Souza

    2013-04-01

    Full Text Available Este artigo tem por objetivo analisar o processo de adoção do “sistema privado de ensino” em dois municípios paulistas, tendo em vista a autonomia pedagógica frente à padronização curricular. Nos estudos de dois casos intencionalmente selecionados utiliza-se a metodologia qualitativa constituída pela pesquisa documental e entrevistas semiestruturadas. Inicialmente, discute-se o cenário político nacional que contribuiu para a ampliação das parcerias entre esferas públicas e privadas no campo educacional. Na sequência, apresenta-se, brevemente, a caracterização e a experiência dos municípios no processo de municipalização e de aquisição do material didático, e por fim, discute-se a padronização curricular versus a autonomia pedagógica. Verifica-se que, por mais que, as Secretarias da Educação dos municípios analisado tenham contado com a participação de alguns professores na elaboração do material didático, a autonomia deles no projeto constitui-se numa autonomia regulada tanto pelas gestões públicas e quanto pelas instituições privadas.

  6. Prevalencia del síndrome de desgaste profesional (burnout) en odontólogos mexicanos del sector educativo y privado Prevalence of the syndrome of professional exhaustion (burnout) in mexican dentists of the education sector and private

    OpenAIRE

    Enrique Castañeda Aguilera; Javier Eduardo García de Alba García

    2012-01-01

    Objetivo: Determinar la prevalencia del síndrome de desgaste profesional (burnout) en odontólogos del sector educativo y privado. Material y métodos: Estudio observacional, descriptivo y transversal, mediante el censo del personal odontológico de la Zona Metropolitana de Guadalajara, México de la Universidad de Guadalajara y los que ejercen la práctica privada, donde participaron 135 de ellos aplicándoseles una ficha de identificación y el Maslach Burnout Inventory-Human Services Survey en fo...

  7. Morbimortalidad de pacientes mayores de 60 años en el servicio de cuidados intensivos de un hospital general

    Directory of Open Access Journals (Sweden)

    Jaquelyn Poma

    2012-03-01

    Full Text Available Objetivo: Determinar la morbimortalidad de los pacientes mayores de 60 años que ingresan a la unidad de cuidados intensivos (UCI de un hospital general. Material y métodos: Estudio descriptivo transversal. Se incluyeron pacientes que ingresaron a la UCI del Hospital Nacional Cayetano Heredia entre julio 2006 a diciembre 2009. Se recopilaron datos del archivo existente conformado por las hojas de epicrisis y las hojas de monitoreo ventilatorio y hemodinámico de la unidad. Resultados: La ocupación de camas por mayores de 60 años en UCI fue 38% comparado con 62% en menores de 60 (p=0,0001. La principal causa de ingreso a la unidad fue la insuficiencia respiratoria en 30,5%, las diez principales causas de ingreso y la intensidad del manejo fueron similares en ambos grupos. Existió más comorbilidad en adultos mayores [78,6%] que en jóvenes [54,5%] (p=0,071. La mortalidad en > 60 años fue 29%, en 80 años 31,4% (p=0,04. Conclusiones: El 38% de pacientes en UCI son mayores de 60 años y éste porcentaje disminuye a medida que aumenta la edad. Las principales causas de ingreso son similares a los del grupo menor de 60 años, pero existe mayor mortalidad en los pacientes mayores especialmente en el grupo que ingresó con enfermedad más severa

  8. Programas de prevenção de doenças e promoção de saúde em serviços de saúde privados: uma análise bibliométrica sobre o tema

    Directory of Open Access Journals (Sweden)

    Tatieli Dagostim Paim

    2018-03-01

    Full Text Available A complexidade inerente ao contexto de saúde entre a dicotomia da saúde púbica versus a privada promoveu através do órgão fiscalizador da saúde suplementar privada brasileira, a orientação para implantação de estratégias de programas para o controle e prevenção de riscos e patologias e para promoção da saúde. Assim passou-se a exigir pesquisas interdisciplinares para melhor compreensão e efetividade de seus programas de prevenção para minimizar custos as operadoras de planos de saúde privados, a redução da morbi-mortalidade e o engaje a qualidade de vida de seus beneficiários. Para responder à questão de como se processa a evolução dos estudos teóricos e empíricos interdisciplinares relacionados ao tema foi realizada uma pesquisa com o objetivo de compreender a evolução, a interdisciplinaridade e as variáveis teórico- empíricas relacionadas aos programas de prevenção de doenças e promoção de saúde em serviços de saúde privados, identificando as escolas invisíveis, as possíveis lacunas e oportunidades de futuras pesquisas. Este artigo apresenta os resultados de uma pesquisa exploratória realizada com procedimentos de busca sistemática da literatura com a base de dado eletrônica – Scopus, seguida de análise bibliométrica. Foram identificados cinco artigos que contemplavam o objetivo geral do estudo e distribuídos em duas grandes áreas do conhecimento, saúde e tecnologia. A limitação dos artigos encontrados pode ser justificada ao contexto temporal do assunto analisado, pois a sugestão da implantação destes programas para realidade brasileira aconteceu no final do ano de 2011, pela Agência Nacional de Saúde Suplementar (ANS, e muitos planos de saúde privados ainda não contemplarem esta realidade. Ao final, o artigo analisou as implicações para a pesquisa interdisciplinar na área da Saúde Suplementar Privada e as novas Tecnologias de Informação e Comunicação como mídias para a

  9. O mercado privado de vacinas no Brasil: a mercantilização no espaço da prevenção The private vaccines market in Brazil: privatization of public health

    Directory of Open Access Journals (Sweden)

    José Gomes Temporão

    2003-10-01

    Full Text Available Este artigo tem como objetivo principal a análise do mercado de vacinas no Brasil, que está caracterizado como composto de dois segmentos com práticas e lógicas distintas: o segmento público voltado para a oferta ao interior do Sistema Único de Saúde (SUS e o privado que se organiza em torno de clínicas, consultórios e outros espaços privados. O segmento privado, aqui estudado pela primeira vez, é caracterizado em relação à estrutura da oferta e da demanda. Os aspectos históricos de sua estruturação são analisados tomando-se como referência a criação de uma das primeiras clínicas de imunização do país. Busca-se caracterizar este segmento em relação à sua dimensão em termos econômicos (importações e vendas, principais fabricantes e produtos comercializados. Sua dimensão econômica que revelou-se muito superior ao inicialmente aventado. Os números obtidos permitem considerá-lo como um dos principais segmentos de mercado da indústria farmacêutica no país, em termos de volume de vendas. Detecta-se a penetração de lógicas privatizantes em um espaço que sempre foi marcadamente público, com isso introduzindo no SUS um novo espaço de quebra dos princípios da eqüidade e universalidade.The main objective of this article is to analyze the vaccines market in Brazil, which is characterized as consisting of two segments with distinct practices and logics: the public segment, focused on supply within the Unified National Health System (SUS and the private segment, organized around private clinics, physicians' offices, and similar private health facilities. The private vaccines market segment, studied here for the first time, is characterized in relation to the supply and demand structure. Historical aspects of its structure are analyzed, based on the creation of one of the first immunization clinics in the country. The attempt was to analyze this segment in relation to its economic dimensions (imports and sales

  10. Relações contratuais de crédito agrícola e o papel dos agentes financeiros privados: teoria e evidências dos EUA

    Directory of Open Access Journals (Sweden)

    Fabio R Chaddad

    2003-01-01

    Full Text Available Este trabalho analisa a questão do financiamento da produção agrícola sob uma ótica sistêmica, considerando o papel dos agentes privados no fornecimento de crédito rural. Desenvolve-se a idéia de que o volume e o custo de recursos financeiros disponibilizados para a produção agrícola são afetados por "fricções" em diversas transações sequenciais interligando emprestadores e tomadores de crédito. O objetivo do trabalho é analisar as vantagens comparativas dos diversos agentes que atuam no mercado de crédito, enfocando o potencial de cada agente em reduzir as tais fricções. Esta análise comparativa baseia-se na leitura do funcionamento do mercado de crédito agrícola dos Estados Unidos e pode ser aplicada nara o desenvolvimento de novos arranjos contratuais no mercado brasileiro.

  11. Factores Socioeconómicos de la Familia y su influencia en el rendimiento académico de los estudiantes de Enfermería Técnica en los Institutos Superiores Tecnológicos privados de Juliaca - 2014

    OpenAIRE

    Huanca Apaza, Elizabeth

    2017-01-01

    La investigación pretende demostrar, cómo los factores socioeconómicos de la familia influyen en el rendimiento académico de los estudiantes de enfermería técnica de los institutos superiores tecnológicos privados de Jesús de Nazaret, Tecnotronic, y Salazar Bondy de la ciudad de Juliaca – 2014. Se evidencia que, los factores socioeconómicos de la Familia tienen enorme influencia en el rendimiento académico de los estudiantes de la carrera profesional de enfermería técnica de...

  12. Diez años de estudio del comportamiento higrotérmico de la cubierta del Museo del Prado

    Directory of Open Access Journals (Sweden)

    Sánchez-Montero, J.

    2014-09-01

    Full Text Available In the current paper we present the results of the monitoring of the hygrothermal behaviour during the last ten years of the El Prado Museum roof. Sensors were installed in the south roof of the museum after it underwent mayor repair following a leak over a very important exhibition hall (the one holding Velazquez’s Las Meninas painting. The liquid water sensors reveal that water is retained at the waterproofing layer. These sensors do not show water presence in lower layers of the roof. The humidity sensors show condensation when the ambient temperature drops. The temperature sensors show the insulating capacity of the different layers of the roof, which effectively attenuate the outside temperature changes. The strain sensors placed on the liquid waterproofing layer show a constant increase of strain with time. In summary, the repaired roof can be considered to perform as intended and no more leaks have been detected.Debido a unas filtraciones detectadas al terminar la renovación de las cubiertas del Museo del Prado se decidió instalar sensores en sus diversas capas, cuyo diseño no es tradicional. Después de más de diez años de registro, los sensores de agua líquida muestran la acumulación de humedad en la capa de impermeabilización líquida. Sin embargo, no se ha detectado la presencia de agua líquida en las capas inferiores. Los sensores de humedad relativa muestran la presencia de condensaciones locales. Los sensores de temperatura muestran la capacidad aislante de las diferentes capas de la cubierta. Y los sensores de deformación muestran un incremento de deformación continuo con el tiempo, posiblemente debido a la fluencia del conjunto. Como conclusión del estudio, se puede afirmar que el comportamiento de la cubierta ha sido correcto ya que no se ha detectado la aparición de agua líquida en las capas internas de la cubierta.

  13. Evaluación de la campaña antitabaco en Uruguay: balance de diez años y desafíos

    Directory of Open Access Journals (Sweden)

    Patricia Triunfo

    Full Text Available RESUMEN En el año 2005, poco tiempo después de ratificar el Convenio Marco para el Control del Tabaco (CMCT, Uruguay comenzó una ambiciosa campaña de control de tabaco que ubicó a este país a la vanguardia mundial de la lucha antitabaco. La gran diversidad de medidas implementadas en un lapso relativamente corto y la rigurosidad con que se aplicaron y observaron las políticas tienen escasos precedentes, incluso en los países más desarrollados. En este trabajo, se presenta una síntesis y actualización de varios trabajos de los autores en los que se evalúan algunos aspectos de la campaña a diez años de la ratificación del CMCT. En particular, estas investigaciones resaltan el impacto agregado que tuvo la campaña en la caída de la prevalencia en la población adulta, en los jóvenes y en las decisiones de abandono del consumo de tabaco en las embarazadas (1, 2, así como el impacto relativo de las políticas impositivas en relación a medidas de control de tabaco distintas de los precios. Los análisis se basan en estudios observacionales (a nivel de la población o el individuo que utilizan grupos de control externos (Argentina y Chile e internos (población no fumadora. Se plantean, también, los desafíos pendientes en el diseño de políticas antitabaco.

  14. El Derecho de la competencia: ¿Derecho privado, Derecho público, regulación o Derecho económico?

    Directory of Open Access Journals (Sweden)

    Andrés Palacios Lleras

    2013-07-01

    Full Text Available Supongamos que queremos armar una nueva facultad de Derecho. ¿Cómo clasificaríamos el Derecho de la competencia en la estructura curricular de esta facultad? Partiendo de estas preguntas, este artículo muestra las dificultades inherentes en tratar de clasificar el Derecho de la competencia como Derecho privado, público, regulación o “Derecho económico”. Lo anterior se debe no solo a que estas clasificaciones son poco precisas, sino también porque parten de nociones del ordenamiento jurídico colombiano que difícilmente se ajustan a como experimentamos este campo del Derecho. Por ello, lo que comienza como una pregunta sin mayor trascendencia muestra algunas de los problemas conceptuales que tienen las formas como apreciamos nuestro Derecho. Pero además de tener incidencias teóricas, esta discusión tiene una incidencia en la práctica, y es que permite o limita el desarrollo de diferentes argumentaciones “correctas” según la clasificación que se adopte. Finalmente, este artículo concluye que la ausencia de Derecho de la competencia en los currículos de Derecho de las facultades existentes muestra una falta de conexión entre los cambios en la normatividad colombiana y las imágenes de lo que se necesita para formar abogados.

  15. Liderança e comunicação: estratégias essenciais para o gerenciamento da assistência de enfermagem no contexto hospitalar Liderazgo y comunicación: estratégias esenciales para la gestión de la asistencia de enfermería en el contexto hospitalario Leadership and communication: essential strategies for the management of nursing care in the hospital context

    Directory of Open Access Journals (Sweden)

    Cristina Maria Galvão

    2000-10-01

    Full Text Available A liderança e a comunicação são estratégias que possibilitam ao enfermeiro promover a melhoria do gerenciamento da assistência de enfermagem no contexto hospitalar. O presente estudo teve como objetivos relatar um programa de Educação Continuada desenvolvido com enfermeiros de um hospital privado sobre liderança e comunicação e apresentar a aplicação da Liderança Situacional na prática profissional destes profissionais. A técnica dos incidentes críticos foi empregada para a coleta dos dados. Os sujeitos participantes do estudo avaliaram positivamente as contribuições oriundas do programa, constatamos também a viabilidade de aplicação da Liderança Situacional no cotidiano da enfermagem.El liderazgo y la comunicación son estrategias que posibilitan al enfermero promover el mejoramiento de la gestión de la asistencia de enfermería en el contexto hospitalario. El presente estudio tuvo como objetivos relatar un programa de educación continuada desarrollado con enfermeros de un hospital privado sobre liderazgo y comunicación y presentar la aplicación del Liderazgo Situacional en su práctica profesional. La técnica de incidentes críticos fue utilizada para la recolección de datos. Los sujetos participantes del estudio evaluaron positivamente las contribuciones del programa y los autores constataron la viabilidad de la aplicación del Liderazgo Situacional en el cotidiano de enfermería.Leadership and communication are strategies that enable nurses to improve the management of nursing care within the hospital context. The present study aimed at reporting a Continuing Education Program developed by nurses from a private hospital on leadership and communication and to present the application of situational leadership in their professional practice. The technique of critical incidents was applied in data collection. The subjects evaluated positively the contributions of the Program and authors found the viability of the

  16. Manejo de los desechos solidos domiciliarios y hospitalarios [Houesehold and hospital waste management

    NARCIS (Netherlands)

    Abarca Guerrero, L.

    2005-01-01

    Se decidió analizar cuál es la situación actual en el manejo de los desechos, con el objetivo de determinar la variación en los índices de generación de los desechos domésticos y establecer cuál es la situación con respecto a algunos hospitales privados. La información servirá de insumo para el

  17. Institutos privados de investigación “pura” versus políticas públicas de ciencia y tecnología en la Argentina (1943-1955

    Directory of Open Access Journals (Sweden)

    Hurtado, Diego

    2013-06-01

    Full Text Available In June 1943 took place a coup d’etat in Argentina that initiated a process of confrontation between an important sector of academic scientists and the de facto military government. As a result, many scientists lost their positions at universities, between them a group of biomedical scientists led by the physiologist Bernardo Houssay, who was to be awarded the Nobel Prize in Physiology in 1947. From that moment on, supported by local philanthropists and the Rockefeller Foundation, Houssay’s group began to promote the creation of a series of private research institutes. This process continued during the democratic government of Juan Perón (1946-1955. This article analyzes this “project” —its motivations and objectives— as a process of “parallel” institutionalization which was divergent from the initiatives promoted for science and technology by the public sector. This “splitting” of the institutionalization process, embodied in ideologies, institutional models and hardly compatible epistemic hierarchies, would have far-reaching consequences for the future development of research in Argentina.En junio de 1943 se produjo en la Argentina un golpe de Estado que inició un proceso de enfrentamientos entre un importante sector de científicos académicos y el gobierno militar de facto. Como resultado, muchos científicos perdieron sus cargos en las universidades, entre ellos el grupo liderado por el fisiólogo Bernardo Houssay, que iba a obtener el premio Nobel de Fisiología en 1947. A partir de ese momento, este grupo de médicos impulsaron la creación de una serie de institutos privados de investigación sostenidos por filántropos locales y por la Rockefeller Foundation. Este proceso continuó durante el gobierno democrático de Juan Perón (1946-1955. El presente artículo analiza este “proyecto” de creación de institutos privados —sus motivaciones y objetivos— como un proceso de institucionalización

  18. La formación de masculinidades hegemónicas en la clase dominante: el caso de la sexualidad en los colegios privados de elite en Chile

    Directory of Open Access Journals (Sweden)

    Sebastián Madrid

    Full Text Available Resumen: Sobre la base de 41 historias de vida, de hombres y mujeres (de 19 a 45 años, ex-estudiantes de tres tipos de colegios privados de elite en Santiago de Chile, este artículo analiza el proceso de construcción de masculinidades hegemónicas en la clase dominante chilena. Se examina la forma en que la producción de distintos patrones de masculinidades se relaciona con cambios en la parte alta de la estructura social y se analiza el modo en que la sexualidad conecta la formación simultánea de estas masculinidades y de la clase dominante. Se contrasta la forma como estos colegios abordan la sexualidad y las prácticas sexuales de ex-estudiantes varones con mujeres de distintas clases sociales, especialmente, lo que los entrevistados llaman el "chaneo". Finalmente, se discuten las implicaciones de estos hallazgos para el estudio del poder y del privilegio en una sociedad de mercado.

  19. Eficacia de los principios de contratación en el proceso de unificación del Derecho Internacional Privado: comparación entre la unificación jurídica latinoamericana y la integración europea

    Directory of Open Access Journals (Sweden)

    Cristian Augusto Suárez Sánchez

    2012-06-01

    Full Text Available Búsqueda interminable de principios universales de contratación, cuyo origen se remonta a épocas inmemoriales, cuando hordas de científicos vanguardistas decidieron dirigir sus esfuerzos a la observación profunda de diversos estilos de vida y culturas jurídicas. En el presente constituye el leitmotiv de la unificación del derecho internacional privado, creando cierto nivel de factibilidad para establecer un instrumento único de envergadura global capaz de garantizar la ejecución eficaz y armoniosa de los negocios internacionales. Búsqueda incansable de puntos de convergencia apropiados para instaurar los pilares fundamentales que habrán de soportar su ordenamiento. He aquí el axioma capital de la unificación. Pero algunos sistemas jurídicos preservaron instituciones problemáticas que generaron peligrosos puntos de colisión y ensancharon aún más la brecha que separa las diversas culturas jurídicas, aislándolas. Esta búsqueda, pretende contrarrestar tal situación. En estricto rigor, confronta enfoques paradigmáticos, que son al mismo tiempo causa y efecto de la unificación, no necesariamente excluyentes, que necesitan de otras perspectivas para suceder, para complementarse y que sólo se agotan recíprocamente, configurando así el ápice determinante para la unificación total. En suma, no falta mucho para alcanzar este elevado nivel de sofisticación jurídica. La unificación del derecho internacional privado, eventualmente, quedará consumada.

  20. Eficacia de los principios de contratación en el proceso de unificación del Derecho Internacional Privado: comparación entre la unificación jurídica latinoamericana y la integración europea

    Directory of Open Access Journals (Sweden)

    Cristian Augusto Suárez Sánchez

    2012-07-01

    Full Text Available Búsqueda interminable de principios universales de contratación, cuyo origen se remonta a épocas inmemoriales, cuando hordas de científicos vanguardistas decidieron dirigir sus esfuerzos a la observación profunda de diversos estilos de vida y culturas jurídicas. En el presente constituye el leitmotiv de la unificación del derecho internacional privado, creando cierto nivel de factibilidad para establecer un instrumento único de envergadura global capaz de garantizar la ejecución eficaz y armoniosa de los negocios internacionales. Búsqueda incansable de puntos de convergencia apropiados para instaurar los pilares fundamentales que habrán de soportar su ordenamiento. He aquí el axioma capital de la unificación. Pero algunos sistemas jurídicos preservaron instituciones problemáticas que generaron peligrosos puntos de colisión y ensancharon aún más la brecha que separa las diversas culturas jurídicas, aislándolas. Esta búsqueda, pretende contrarrestar tal situación. En estricto rigor, confronta enfoques paradigmáticos, que son al mismo tiempo causa y efecto de la unificación, no necesariamente excluyentes, que necesitan de otras perspectivas para suceder, para complementarse y que sólo se agotan recíprocamente, configurando así el ápice determinante para la unificación total. En suma, no falta mucho para alcanzar este elevado nivel de sofisticación jurídica. La unificación del derecho internacional privado, eventualmente, quedará consumada.

  1. UMA ANÁLISE DA DESTINAÇÃO DOS RECURSOS PÚBLICOS, DIRETA OU INDIRETAMENTE, AO SETOR PRIVADO DE ENSINO NO BRASIL

    Directory of Open Access Journals (Sweden)

    José Marcelino de Rezende Pinto

    2016-03-01

    Full Text Available RESUMO: Este artigo analisou os diferentes mecanismos de repasse de recursos públicos ao setor privado de ensino, bem como os valores envolvidos. Serão apresentados os dados referentes a: 1 destinação direta de recursos, caso do Sistema "S", do Programa Nacional de Acesso ao Ensino Técnico e Emprego (Pronatec e dos convênios na educação infantil e especial; 2 renúncia fiscal, como é o caso do desconto padrão de imposto de renda da pessoa física para os contribuintes que possuem filhos na rede privada, do Programa Universidade para Todos (ProUni e da isenção de tributos das entidades sem fins lucrativos; e 3 subsídios ao financiamento estudantil, como é o caso do Fundo de Financiamento Estudantil (FIES. Os resultados obtidos indicam que, em 2014, o montante total destinado ao setor atingiu 0,58% do Produto Interno Bruto (PIB, um índice que representa 56% de todo gasto federal com manutenção e desenvolvimento do ensino no período. Os dados indicam também uma preocupante ampliação da destinação de recursos para o setor, em especial por meio do FIES.

  2. Entre el público y el privado. Un análisis comparativo de la cobertura de ciencia de los telediarios brasileños Repórter Brasil y Jornal Nacional

    Directory of Open Access Journals (Sweden)

    Marina Ramalho

    2014-01-01

    Full Text Available Este estudio compara la cobertura de ciencia y tecnología de dos noticieros de televisión brasileños: Jornal Nacional, de la principal cadena privada del país, y Repórter Brasil, transmitido por una emisora pública. En el período analizado -abril 2009 a marzo 2010- el noticiero privado emitió más noticias de CyT y le dio mayor destaque. Los noticieros siguieron diferentes agendas de cobertura, aunque las cuestiones médicas y de salud han sido las más comunes. En ambos noticieros, el encuadre narrativo principal fue “nueva investigación”, las investigaciones nacionales fueron priorizadas y, entre los científicos entrevistados, las mujeres fueron minoría.

  3. Estilos y estrategias de aprendizaje: una revisión empírica y conceptual de los últimos diez años

    Directory of Open Access Journals (Sweden)

    Marly Johana Bahamón Muñetón

    2012-01-01

    Full Text Available Se presenta una revisión sobre estilos, estrategias de aprendizaje y rendimiento académico durante los últimos diez años. Para ello, se revisaron las bases de datos Dialnet, Redalyc y Scielo debido a su alcance e importancia en el contexto latinoamericano. Los descriptores utilizados para la búsqueda de información fueron las palabras clave: estilos de aprendizaje, estrategias de aprendizaje, rendimiento y logro académico. Las bases de datos consultadas arrojaron un total de 4.154 artículos, de los cuales 43 cumplían todos los criterios de inclusión (periodo de tiempo 2000-2011, idioma español, artículo de investigación y población universitaria. La revisión de este material demostró que los principales instrumentos utilizados fueron el Cuestionario de Alonso-Gallego-Honey de estilos de aprendizaje (Chaea; el Inventario de estilos de aprendizaje (LSI, construido por Kolb; el Learning Styles Preferences Questionnaire de Reid; el Learning and Study Strategies Inventory (Lassi, de Weinstein, (1987, y la Escala de estrategias de aprendizaje (ACRA, de Alonso y Gallego (1994. Se concluye que el instrumento más utilizado para la medición de estilos de aprendizaje es el Chaea, a diferencia de la medición de estrategias de aprendizaje puesto que no se evidencia unicidad de criterios. Gran parte de los artículos (11 indican que el estilo predominante en la población analizada es el reflexivo. Sobre las estrategias de aprendizaje, el estilo reflexivo y pragmático correlacionan con rendimiento académico alto y con estrategias de aprendizaje profundas. Los resultados de esta revisión sugieren la ampliación de estudios que profundicen sobre las estrategias de aprendizaje y su medición.

  4. Relações entre o público e o privado na educação: o Projeto Jovem de Futuro do Instituto Unibanco

    Directory of Open Access Journals (Sweden)

    Vera Maria Peroni

    2015-12-01

    Full Text Available Este trabalho faz parte da pesquisa “Parcerias entre sistemas públicos e instituições do terceiro setor: Brasil, Argentina, Portugal e Inglaterra implicações para a democratização da educação” realizada pelo Grupo de Pesquisa “Relações entre o Público e o Privado na Educação” do Programa de Pós-Graduação em Educação da Universidade Federal do Rio Grande do Sul. Nesta etapa da pesquisa, o grupo enfoca o conteúdo da proposta, isto é, como a lógica privada mercantil está sendo inserida no sistema público e também como se dá a influência das redes nacionais e globais na política educacional brasileira de educação básica, sob a perspectiva de Thompson (1981 de que são sujeitos e relações com objetivos de classe. Assim, neste texto, daremos prioridade para estes dois aspectos - sujeitos e conteúdo da proposta - na análise do Projeto Jovem de Futuro do Instituto Unibanco.

  5. Efecto agudo de una sesión de improvisación teatral y de fútbol sala en el estado de ánimo de adolescentes privados de libertad del centro de formación Zurquí

    Directory of Open Access Journals (Sweden)

    Vivian Rodriguez Barquero

    2007-12-01

    Full Text Available El propósito del estudio fue comparar el efecto agudo de una sesión de improvisación teatral (actividad física recreativa y el de una sesión de fútbol sala (actividad deportiva competitiva, sobre los estados de ánimos de varones adolescentes privados de libertad. Metodología: muestra de 21 sujetos privados de libertad indiciados y sentenciados con promedio de edad de 15,8 ñ 1,79 años y 16,125 ñ 0,81 años respectivamente; realizaron una sesión de improvisación y una de fútbol sala, ambas de una hora. Las mediciones del estado de ánimo se realizaron por medio del perfil de estados de ánimo (POMS pre y post de cada sesión. Resultados: se encontraron efectos agudos significativos y positivos en tensión, fatiga, depresión y cólera-ira, luego de la sesión de improvisación teatral, a diferencia de lo ocurrido con la sesión de deporte, en la cual se dieron conductas de enfrentamiento (motivadas por la competencia en sí que alteraron el estado anímico de los participantes. Conclusiones: parece que la actividad físico recreativa beneficia más que el deporte, los estados de ánimo. Esta línea de estudio es prometedora y debería profundizarse más. Es importante la investigación del teatro y la expresión corporal, pues sus efectos terapéuticos, pueden ser introducidos como tratamientos de bajo costo.

  6. CARACTERIZACIÓN DE DIEZ CULTIVARES FORRAJEROS DE Leucaena leucocephala BASADA EN LA COMPOSICIÓN QUÍMICA Y LA DEGRADABILIDAD RUMINAL

    Directory of Open Access Journals (Sweden)

    Danny García M

    2008-08-01

    Full Text Available Objetivo. Estudiar las variaciones en la composición química y la degradabilidad ruminal de diez cultivares de Leucaena leucocephala Lam. de Wit. mediante el análisis de componentes principales (ACP. Materiales y métodos. Se tomaron muestras durante tres años para evaluar la composición química, los niveles de metabolitos secundarios y la degradabilidad ruminal en ovinos. Los datos fueron analizados con el paquete estadístico SPSS y mediante el diagrama tridimensional se obtuvieron las agrupaciones de las accesiones en dependencia de sus características nutritivas. Resultados. Con los primeros tres componentes del ACP se explicó el 85.83 % de la variabilidad. La concentración de proteínas, fracción fibrosa, minerales, polifenoles, fitatos y la degradación ruminal presentaron las mayores fluctuaciones. Las agrupaciones formadas permitieron identificar seis grupos con características químicas diferentes (G1: elevada cantidad de proteínas, baja proporción de fibra y de metabolitos secundarios y elevada degradación -cv. CNIA-250 y cv. K-28-; G-2: elevado contenido de materia seca, proteínas y fenoles, poca fracción de fibra y taninos y baja degradabilidad ruminal -cv. Ipil-Ipil-; G-3: composición nutricional promedio -cv. México-; G-4: bajo contenido de materia seca, fenoles, mimosina y elevada degradación ruminal -cv. Cunningham, cv. 7 y cv. América-; G-5: elevado contenido de materia seca, fenoles y valor nutritivo medio -cv. K-8 y cv. K-67-; G-6: elevado porcentaje de materia seca y taninos, y baja degradabilidad -cv. Perú-. Conclusiones. La biomasa comestible de los cultivares Cunningham, América, 7, México, CNIA-250 y K-28 constituyen las mejores opciones para la alimentación de rumiantes.

  7. Influencia del apoyo de la enfermera en el éxito de la lactancia materna

    OpenAIRE

    Martínez Dávila, Desirée

    2013-01-01

    La autora realiza una investigación en un hospital privado de Salamanca para conocer de primera mano qué tipo de información se le da a las madres acerca de la lactancia materna. Previamente la autora realiza un estudio sobre el puerperio, la lactancia materna y el apoyo que deben recibir las madres por parte del personal de enfermería.

  8. CDC Signos Vitales-Las medidas hospitalarias afectan la lactancia materna (Hospital Actions Affect Breastfeeding)

    Centers for Disease Control (CDC) Podcasts

    2015-10-06

    Este podcast se basa en la edición de octubre del 2015 del informe Signos Vitales de los CDC. Los hospitales pueden implementar los "Diez Pasos hacia una Feliz Lactancia Natural" para obtener la designación de "Amigo del Niño" y así apoyar a más mamás en su decisión de amamantar.  Created: 10/6/2015 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 10/6/2015.

  9. Lo público y lo privado en tiempos de peste Public and private in times of the pest

    Directory of Open Access Journals (Sweden)

    Sandra Caponi

    1999-06-01

    Full Text Available Usando como instrumento de análise as oposições público-privado, íntimo-social estudadas por Hannah Arendt, propomos analisar até que ponto elas podem contribuir para problematizar uma situação concreta e limite: a situação de emergência criada nesse momento preciso em que um surto epidemiológico atinge uma cidade e muda inteiramente a vida de seus indivíduos. Acreditamos que uma observação detida daquilo que os homens individuais e concretos, imaginados ou reais, sentem e pensam em tempos de epidemia pode resultar em um auxílio eficaz e pouco explorado para o estudo das mesmas. Escolhemos A peste, de Albert Camus, para tentar analisar, a partir desses fatos ocorridos na cidade de Oran, como os sujeitos atingidos pela epidemia pensam sua existência pública ou privada, seus vínculos íntimos e sociais em tempos de peste.The paper explores how Hannah Arendt’s oppositions ‘public-private’ and ‘intimate-social’ can be used as an analytical tool to better understand a very concrete, extreme situation: the state of emergency triggered when an epidemiological outbreak hits a city, totally altering its inhabitants’ lives. Studied observation of what specific individuals (be they imagined or real feel and think during times of epidemic is an underutilized tool that may prove helpful in studying epidemics themselves. Focusing on Camus’ The pest and events in the city of Oran, the article looks at how victims of the plague felt about their public or private lives and their intimate and social ties.

  10. La privatización del acueducto de Bogotá: 1887 – 1914 consideraciones históricas sobre la gestión

    Directory of Open Access Journals (Sweden)

    Juan Camilo Rodríguez Gómez

    1996-05-01

    Full Text Available RESUMEN En este trabajo se describen los antecedentes del abastecimiento de agua para la ciudad de Bogotá a lo largo de los siglos XVI, XVII y XVIII para llegar, ya en la segunda mitad del siglo XXI, a la definición de sistemas más complejos de administración que condujeron finalmente a la privatización del servicio (1887. Se estudia  luego lo que fue la gestión privada de acuerdo a su fracaso,  después de cerca de tres décadas, que llevó de nuevo a la municipalización (1914. Posteriormente se hace una rápida evaluación de las labores durante los primeros diez años  de gestión municipal (1914 – 1924 que permite plantear algunos criterios para confrontar los dos sistemas de gestión, el privado y el público. El trabajo concluye exponiendo la crisis de la empresa, luego de 1916, que llegaría de 1926. Se cierra así un amplio ciclo analítico que permite elaborar valiosos criterios para el análisis  de la historia empresarial del país.

  11. Effects of a humor-centered activity on disruptive behavior in patients in a general hospital psychiatric ward

    Directory of Open Access Journals (Sweden)

    Antonio Higueras

    2006-01-01

    Full Text Available El objetivo de este estudio cuasi-experimental es analizar lo efectos de una actividad centrada en el humor sobre las conductas disruptivas de pacientes hospitalizados en un servicio de Psiquiatría. Se han comparado, teniendo en cuenta dos grupos homogéneos de pacientes hospitalizados en un servicio de Psiquiatría de hospital general (unidad de agudos, dos periodos temporales de 83 días cada uno, siendo el período 1 el de línea base, y el período 2, el de intervención. Para ambos periodos, se codificaron y registraron un total de diez conductas disruptivas. En los 83 días del periodo de intervención, y con una frecuencia de dos días semanales, dos actores profesionales llevaban a cabo las actividades centradas en el humor. Se calculó un Indice de Disrupción Global (IGD, teniendo en cuenta conjuntamente todas las conductas disruptivas, al igual que un Indice de Disrupción Específico (IDE para cada una de las conductas disruptivas. Usando para las comparaciones la corrección de Bonferroni, los resultados indican que el IGD descendió significativamente durante el periodo de intervención, siendo tres las conductas disruptivas que mostraron un descenso significativo (intentos de fuga, autolesiones y peleas.

  12. Lo público y lo privado: las aseguradoras y la atención médica en Mexico Public and private: insurance companies and medical care in Mexico

    Directory of Open Access Journals (Sweden)

    Silvia Tamez

    1995-12-01

    Full Text Available Desde finales de la década de los setenta y a principios de la de los ochenta, tanto en nuestro país cuanto en la mayoría de países de América Latina, ocurrieron profundos cambios en la política sanitaria, cuya dirección apuntó fundamentalmente a un crecimiento del sector privado de la atención médica, acompañado de deterioro del sector público. Este trabajo pretende analizar, como parte del proceso privatizador de la atención médica, la evolución de los seguros médicos privados. Interesa fundamentalmente realizar un análisis de la política sectorial de salud basada en datos económicos, pero subrayando el perfil político y de modificación de las relaciones del sector con el Estado, partiendo de la hipótesis de que éste último ha asumido la función de apoyo a la expansión del mercado privado de la atención médica, enfocando el análisis a la industria de seguros médicos privados y facilitando el deterioro del sector público a través de la reducción del gasto público. Para ello se analiza el papel del Estado en las transformaciones del sector en México a partir de los principales cambios en la normatividad de la actividad aseguradora nacional. Sobre esta base se hace el análisis comparativo de la evolución de la industria aseguradora en Argentina, Brasil, Chile y México durante el período 1986-1992 profundizando el caso de México. Dentro de los principales resultados destaca que, al comparar los países mencionados, los índices Primas/PIB y Primas/per cápita en términos generales se observa crecimiento. Este crecimiento es más ascelerado en México, lo que sin duda se relaciona con lo incipiente de su proceso de privatización. Además, en México se observó que, para el período 1984-1991, las primas directas como porcentaje del PIB pasaron de 0.86% a 1.32%. En la misma línea de análisis llama la atención que el seguro de accidentes y enfermedades creció del 0.02% del PIB en 1984 a 0.11% en 1991. En

  13. Organizaciones que aprenden: Nivel educativo medio superior del sector privado (Learning organizations: Private high school level

    Directory of Open Access Journals (Sweden)

    Lafuente, Roy

    2016-01-01

    Full Text Available Abstract. To convert an educational institution, such as the private high school, an organization that learns, we must know the school, their strengths, opportunities, to support change, threats, weaknesses that impede it, starting from the individual learning to organizational, because both have an impact on a learner organization, involving all elements such as leadership, work in equipment, resources, culture and values that they make and provide structure, as well as the context in which this immersed; the process of internal learning which characterized them and provide scaffolding, of the new acquisition that they help you or in the future helping you to become the type of organization that not only will be able to adapt to the demands of a modern and dynamic society, but also to transform to generate meaningful learning, allowing it to be competent permanent and relevant to developing its capacities and the survival skills. Resumen. Para convertir una institución educativa, como el bachillerato privado, en una organización que aprende, debemos de conocer la escuela, sus fortalezas, las oportunidades, que apoyarán el cambio, las amenazas, las debilidades que lo impedirán, partiendo desde el aprendizaje individual hasta el organizativo, porque ambos inciden en una organización aprendiente, involucrando todos los elementos como el liderazgo, trabajo en equipo, recursos, cultura y valores, que la conforman y le proporcionan estructura, así como el contexto en el cual está inmerso; los proceso de aprendizaje internos que los caracterizan y le brindan andamiaje, a los de nueva adquisición que le ayudan o en un futuro le auxiliaran a convertirse, en el tipo de organización que no solo será capaz de adaptarse a las exigencias de una sociedad moderna y dinámica, sino también a transformarse para generar el aprendizaje significativo, permitiéndole ser competente, permanente y pertinente desarrollando sus capacidades y habilidades para

  14. Creating options in family planning for the private sector in Latin America La creación de opciones en materia de planificación familiar para el sector privado en América Latina

    Directory of Open Access Journals (Sweden)

    Suneeta Sharma

    2005-07-01

    anticonceptivos, por lo que dependen cada vez más de los limitados recursos del sector público y del papel menguante del sector privado para la provisión de anticonceptivos al público en general. Así las cosas, dichos países tendrán que crear estrategias multisectoriales para lograr la provisión segura de anticonceptivos. Deberán, asimismo, tener en cuenta la situación del mercado de los productos y servicios de planificación familiar a fin de poder definir y promover los papeles complementarios que han de desempeñar el sector público, el sector comercial y el sector de las organizaciones no gubernamentales, así como determinar con más exactitud a qué grupos de la población debe servir cada uno de estos sectores. Si bien es cierto que el sector público no puede exigirle al sector privado su participación, sí le es posible crear las condiciones propicias para que este asuma un papel más destacado en la satisfacción de las necesidades cada vez mayores de quienes usan métodos de planificación familiar. Tomar medidas para incrementar la participación del sector privado en el mercado es una estrategia esencial si se ha de lograr una distribución más equitativa de los recursos existentes, satisfacer necesidades insatisfechas y crear un futuro sustentable para los proveedores de productos y servicios de planificación familiar. En este trabajo también se examinan en detalle las experiencias de dos países, Paraguay y Perú. El mercado de servicios de planificación familiar en Paraguay es ejemplo de la vigorosa participación del sector privado, aunque el acceso a los servicios de planificación familiar es limitado para quienes no pueden afrontar los costos de dicho sector. En Perú tuvo lugar en 1995 un cambio de políticas orientado a aumentar la cobertura de los servicios de planificación familiar que redundó en un acceso restringido para los pobres y dejó al Ministerio de Salud sin poder sufragar la necesidad creciente de productos y servicios de

  15. Anestesia en el Síndrome de Down con canal auricoloventricular común

    Directory of Open Access Journals (Sweden)

    Lincoln de la Parte Pérez

    1995-08-01

    Full Text Available Se realiza un estudio retrospectivo en 22 niños con síndrome de Down y canal auriculoventricular común, operados en el Cardiocentro del Hospital Pediátrico Docente "William Soler" durante el período 1986 a 1992. Dieciocho pacientes padecían de insuficientcia cardíaca (82 % y de éstos 16 (73 % de hipertensión pulmonar preoperatoria. Diez pacientes fallecieron en el posoperatorio para una mortalidad del 45 %.

  16. Pharmacological analgesia in neonates undergoing cardiac surgery Uso de fármacos analgésicos en postoperatorio de cirugía cardiaca neonatal Uso de fármacos analgésicos em pós-operatório de cirurgia cardíaca neonatal

    Directory of Open Access Journals (Sweden)

    Mariana Bueno

    2008-08-01

    Full Text Available The objectives of this study were to verify the frequency of pharmacological analgesia and the occurrence of postoperative pain in neonates undergoing cardiac surgery. METHODS: This is a cross-sectional study and data were collected from 30 medical charts of neonates who underwent cardiac surgery in a private hospital in the city of São Paulo. RESULTS: The majority (96.6% of neonates received analgesia: 18 (60.0% received continuous analgesics, five (16.7% received intermittent drugs, and six (20.0% received a combination of continuous and intermittent analgesics. Fentanyl citrate was continuously administered to 24 (80.0% neonates. Intermittent dipyrone and morphine was administered to ten (33.3% and one (3.3% neonates, respectively. Pain registers were observed in 17 (56.7% medical charts and the occurrence of pain among neonates who received analgesics was 53.4%. CONCLUSION: There was no efficacy in pharmacological postoperative pain control in the neonates included in this study.Los objetivos de este estudio fueron verificar la frecuencia de cobertura analgésica farmacológica y la aparición de dolor postoperatorio en neonatos sometidos a la cirugía cardiaca. MÉTODO: Se Trata de un estudio transversal con recolección de datos de Historias Clínicas de 30 neonatos sometidos a cirugía cardiaca en un hospital privado de la ciudad de San Pablo. RESULTADOS: La frecuencia de cobertura analgésica fue de 96,6%, 18(60,0% recibieron analgesia continua, cinco (16,7% intermitente y seis (20,0% intermitente y continua. El citrato de fentanil fue administrado continuamente a 24 (80,0% neonatos. Dipirona y morfina fueron administradas en dosis intermitentes a diez (33,3% y a un (3,3% neonatos, respectivamente. Fueron identificados registros de ocurrencia de dolor en 17 (56,7% Historias Clínicas. La ocurrencia de dolor postoperatorio en recién nacidos con cobertura analgésica fue 53,4 %. CONCLUSIÓN: los datos apuntan que el abordaje analg

  17. Gastos privados com saúde bucal no Brasil: análise dos dados da Pesquisa de Orçamentos Familiares, 2008-2009

    Directory of Open Access Journals (Sweden)

    Andreia Morales Cascaes

    Full Text Available Resumo: O objetivo foi analisar os gastos privados com assistência odontológica e produtos de higiene bucal dos brasileiros. Foram analisados dados de 55.970 domicílios pesquisados na Pesquisa de Orçamentos Familiares de 2008-2009. Os gastos foram descritos segundo macrorregiões, estados e capitais do Brasil e de acordo com características socioeconômicas e demográficas dos domicílios (sexo, idade, cor da pele e escolaridade do chefe, renda domiciliar per capita e presença de idoso no domicílio. Os brasileiros gastaram em média no ano R$ 42,19 com serviços de assistência odontológica e R$ 10,27 com produtos de higiene bucal. Desigualdades sociais na distribuição desses gastos segundo as características dos moradores dos domicílios e segundo as diferentes macrorregiões, estados e capitais do país foram encontradas. O presente estudo evidenciou com detalhes quanto e com o que gastam os brasileiros com assistência odontológica e com produtos de higiene bucal. O monitoramento e avaliação desses gastos são condições fundamentais para avaliação e orientação de políticas públicas em saúde bucal.

  18. A influência da iniciativa hospital amigo da criança na amamentação La influencia de la Iniciativa Hospital Amigo del Niño en el amamantamiento The influence of the 'Friend of Children Hospital' campaign on breast-feeding

    Directory of Open Access Journals (Sweden)

    Valéria Lerch Lunardi

    2004-12-01

    Full Text Available O trabalho investiga a percepção de mulheres que foram parturientes num Hospital Amigo da Criança (HAC sobre a influência dessa proposta na sua decisão de aleitar. Realizamos entrevistas semi-estruturadas enfocando o processo de aleitamento materno (AM, expectativas, vivências e importância da equipe de saúde. A análise de conteúdo dos dados realizou-se a partir dos "Dez Passos para o Sucesso do Aleitamento Materno". Constatamos que em situações reconhecidas pelas mulheres como problemáticas e não encontrando respostas que atenuassem diferentes desconfortos e o sofrimento vivenciados, frente ao seu desejo de amamentar, interromperam o AM. Consideramos que com a manutenção do apoio à mulher, pelo HAC, para o enfrentamento dessas dificuldades, sua influência pode ser decisiva para a continuidade do AM.El trabajo investiga la percepción de las mujeres que eran parturientas en un Hospital Amigo del Niño (HAN sobre la influencia de esta propuesta en su decisión de amamantar. Realizamos entrevistas semiestructuradas enfocando el proceso de amamantar (AM; las expectativas; las vivencias; la importancia del equipo de salud, entre otros. El análisis de contenido de los datos se realizó a partir de los «Diez Pasos para el Éxito de Amamantamiento Materno». Constatamos que en situaciones reconocidas por las mujeres como problemáticas y no encontrando respuestas que atenuaran diferentes incomodidades y el sufrimiento vivenciado, frente a su deseo de amamantar, interrumpieron el AM. Consideramos que con el mantenimiento del apoyo a la mujer, por el HAC para el enfrentamiento de esas dificultades, su influencia puede ser decisiva para la continuidad del AM.The paper investigates the awareness of women who gave birth in a 'Friend of Children' Hospital (FCH of the influence of this campaign on their decision to breast-feed. We conducted semi-structured interviews, focusing the maternal breast-feeding process, expectations, experiences

  19. Factors influencing the missed nursing care in patients from a private hospital.

    Science.gov (United States)

    Hernández-Cruz, Raúl; Moreno-Monsiváis, María Guadalupe; Cheverría-Rivera, Sofía; Díaz-Oviedo, Aracely

    2017-07-10

    to determine the factors that influence the missed nursing care in hospitalized patients. descriptive correlational study developed at a private hospital in Mexico. To identify the missed nursing care and related factors, the MISSCARE survey was used, which measures the care missed and associated factors. The care missed and the factors were grouped in global and dimension rates. For the analysis, descriptive statistics, Spearman's correlation and simple linear regression were used. Approval for the study was obtained from the ethics committee. the participants were 71 nurses from emergency, intensive care and inpatient services. The global missed care index corresponded to M=7.45 (SD=10.74); the highest missed care index was found in the dimension basic care interventions (M=13.02, SD=17.60). The main factor contributing to the care missed was human resources (M=56.13, SD=21.38). The factors related to the care missed were human resources (rs=0.408, precursos humanos (M=56,13, DE=21,38). Os fatores relacionados ao cuidado omitido foram os recursos humanos (rs=0,408, precursos humanos; com base nos resultados deste estudo pode-se fortalecer a continuidade do cuidado de enfermagem. determinar los factores que influyen en el cuidado de enfermería perdido en pacientes hospitalizados. estudio descriptivo correlacional, se realizó en un hospital privado de México. Para identificar el cuidado perdido y factores relacionados se utilizó el instrumento MISSCARE que mide el cuidado perdido y los factores asociados. El cuidado perdido y los factores se agruparon en índices globales y por dimensiones. Para el análisis se utilizó estadística descriptiva, correlación de Spearman y regresión lineal simple. El estudio fue aprobado por el comité de ética. participaron 71 enfermeras de los servicios de urgencias, terapia intensiva y hospitalización. El índice global de cuidado perdido mostró una M=7,45 (DE=10,74); el índice con mayor cuidado perdido correspondió a

  20. INTELIGENCIA COMPETITIVA: PROPUESTA DE MODELO SISTEMICO COMO CAMBIO ORGANIZACIONAL PARA LOS HOSPITALES DEL SUR DEL BRASIL

    Directory of Open Access Journals (Sweden)

    Nilda, Tañski

    2011-01-01

    Full Text Available El éxito de una organización depende cada vez más, de la estrategia de su negocio. Un componente estructural de la estrategia es el ajuste entre sus actividades primarias y sus actividades de soporte. Y así como en la industria, en un hospital, una nueva estrategia para ser implementada en general implica revisar procesos de negocios o introducir nuevas formas de ejecutar las operaciones de la empresa. Sin embargo, organizaciones que tengan problemas de alienación entre la estrategia de negocios con su infraestructura de Tecnología de Información tendrán dificultades de implantar un modelo sistémico del proceso de inteligencia competitiva. Se cree que el segmento hospitalario privado tiene problemas de sincronismo entre la estrategia de negocios con la infraestructura de Tecnología de la Información (TI. Por lo tanto, se puede cuestionar: ¿Un modelo sistémico de Inteligencia Competitiva para el segmento hospitalario privado, puede ser un modelo conceptual del proceso de cambio, pasible de ser implementado en este tipo de organización? El objetivo principal de este trabajo de investigación es proponer un Modelo Sistémico del proceso de Inteligencia Competitiva versión 2, en los hospitales privados de la región sur de Brasil.

  1. RELAÇÃO PÚBLICO-PRIVADO NA EDUCAÇÃO BÁSICA: a democratização da educação?

    Directory of Open Access Journals (Sweden)

    Vera Maria Vidal Peroni

    2017-01-01

    Full Text Available O artigo trata das redefinições no papel do Estado, que reorganizam as fronteiras entre o público e privado e materializam-se das mais diferentes formas na educação básica pública, e suas implicações para o processo de democratização da educação. No caso brasileiro, muito lutamos no período de abertura política pela democratização com direitos sociais materializados em políticas. Mas, ao mesmo tempo em que avançamos nos direitos conquistados, também foi naturalizado que o Estado não seria mais o principal executor. Palavras-chave: parceria público-privada em educação; política educacional; democratização da educação. The article deals with the redefinitions of the role of the state, which reorganize the boundaries between public and private that materialize in many different forms in basic public education, and their implications for the process of democratization of education. In the Brazilian case, we have struggled so hard since the so-called ‘opening period’ of political democratization with social rights materialized in public policies. However, while we have advanced in the conquered rights, at the same time the idea of the State as the main provider no longer prevails. Keywords: public-private partnership in education; educational policy; democratization of education

  2. Micosis del sistema nervioso central: Estudio clínico-patológico de diez casos

    Directory of Open Access Journals (Sweden)

    Carlos E. Peña

    1966-10-01

    Full Text Available Uno de los campos de la patología en que más se refleja la influencia de la distribución geográfica sobre un grupo de entidades, es la micología. Greenfield, en su texto de Neuropatología, discute las siguientes micosis: criptococosis, coccidioidomicosis, blastomicosis norteamericana, histoplasmosis y mucormicosis. Nuestra serie incluye, por el contrario, ejemplos de criptococosis, de blastomicosis suramericana, de aspergilosis y de mucormicosis. Nueve casos, que incluyen ejemplos de criptococosis, de blastomicosis suramericana y de aspergilosis, fueron encontrados en una revisión de 162 pacientes con micosis profundas, observados en el Hospital de San Juan de Dios y en el Instituto Nacional de Cancerología (Bogotá, en el período de 11 años comprendido entre 19 54 Y 1964. Un caso de mucormicosis, procedente del Hospital Infantil del Norte, gentilmente cedido por el doctor José A. Dotado. En todos los casos se practicó autopsia. Se hicieron cortes por inclusión en parafina, coloraciones de hematoxilina-eosina y, selectivamente, coloraciones de Gridley o de P; A. S., de muci-carrnín y de Grocott. La historia clínica fue revisada en todos los pacientes. En varios, se hicieron estudios micológicos complementarios (examen directo y cultivo

  3. Teoría y práctica del aseguramiento privado de salud en Chile: brechas, consistencia y reforma pendiente

    Directory of Open Access Journals (Sweden)

    Cesar Humberto GATTINI

    2016-05-01

    Full Text Available Este artículo revisa el rol que cumplen los seguros privados de salud en Chile, comparado con los principios y recomendaciones internacionales sobre seguridad social en salud. El objetivo fue revisar la situación actual desde la perspectiva de salud pública, los sistemas de salud, protección social, y los derechos y necesidades de la población. Creados en 1981, estos seguros han logrado un sólido desarrollo institucional, pero mantienen problemas e inconsistencias que limitan el acceso adecuado al aseguramiento y a los beneficios requeridos del sistema de salud. Sus limitaciones se relacionan con el modelo neoliberal prevalente en un mercado poco regulado; su clientela y rentabilidad está concentrada en cotizantes de mayores ingresos y menor riesgo, ante quienes realizan fijación arbitraria de planes y alzas de precios. En su quehacer, predomina el interés comercial y sustentabilidad económica por sobre las necesidades y capacidad de pago de sus beneficiarios. Sin embargo, continúan siendo la alternativa preferente de elección en el grupo de población con mayores ingresos, debido a la limitada y no competitiva opción que les puede ofrecer el seguro público. Si bien están consolidados, son vulnerables a cambios que puedan arriesgar su sustentabilidad y rentabilidad. Se les ha realizado mejorías parciales y ajustes desde 1990, lo que aún es insuficiente. Desde 2010, existen estudios y propuestas gubernamentales sobre reformas concretas, lo que se mantiene pendiente, debido a las restricciones que impone el modelo prevalente y la presión de los grupos de interés económico

  4. Perfil de adolescentes privados de liberdade em Santa Maria/RS Profile of adolescents deprived of freedom in Santa Maria/RS

    Directory of Open Access Journals (Sweden)

    Jana Gonçalves Zappe

    2010-08-01

    Full Text Available Este trabalho apresenta as primeiras análises dos resultados da pesquisa intitulada "Adolescentes privados de liberdade: quem são, de onde vêm e para onde vão?", que teve como objetivo construir o perfil dos adolescentes que cumpriram medida socioeducativa de internação no Centro de Atendimento Socioeducativo Regional de Santa Maria durante o período de 1998 a 2007. As análises foram feitas através do programa Statistical Package for Social Sciences (Versão 14.0, e as características analisadas foram as seguintes: idade de ingresso, etnia, escolaridade e motivo do ingresso. Relacionamos esses resultados com a literatura sobre a situação social e psicológica em que se encontram os adolescentes autores de atos infracionais, constituindo-se como uma contribuição à construção de conhecimentos acerca dessa temática.This study presents the first analyzes of the data about the research entitled "Adolescents deprived of freedom: who are they, where do they come from and where do they go to?", which aimed to build up the profile of adolescents who have attended Socio-Educational Regional Care Center from Santa Maria, in the period of 1998 to 2007. The analyses were done by using the Statistical Package for Social Sciences (Version 14.0 Program. The variables analyzed were admission age, race/colour, educational records and reason for admission. We related these results with the literature on social and psychological situation of the adolescents who committed the infractional acts as a contribution to construct a body of knowledge on this subject.

  5. Inovações na intermediação entre os setores público e privado na assistência à saúde Innovations in the intermediation between public and private sectors in health care

    Directory of Open Access Journals (Sweden)

    Rosimary Gonçalves de Souza

    2002-01-01

    Full Text Available Este artigo busca uma aproximação de algumas das mudanças em curso no sistema de saúde, focalizando especificamente o setor privado prestador de serviços de saúde, que, ao longo das últimas décadas, vem mantendo peso decisivo na condução da política de saúde. Nesse sentido, importa mapear as diferentes modalidades sob as quais se insere a iniciativa privada na prestação de serviços de saúde, mostrando as mudanças mais significativas na relação entre o setor público e o privado, tendo como contraponto o contexto das décadas de 1970 e 1980. Algumas dessas modalidades se constituem, na verdade, de uma intensificação ou consolidação de padrões e tendências presentes desde os anos 70, como o setor que integra as seguradoras de saúde e as empresas de medicina de grupo. Outras, como a atuação das cooperativas médicas junto ao setor público, mostram-se como tendências em expansão numa conjuntura de crise fiscal do estado e regressividade dos investimentos no campo social.This article intends an approach with some of the changes in course in the health system, specifically the private supplier of health services, that comes maintaining along the last decades decisive weight in the conduction of the health policy. In that sense, it imports to show the different modalities under which this sector interferes the private initiative in the installment of health services, showing the more important changes in the relationship between the public and the private sectors, tending as counterpoint the context of the decades of 70 and 80. Some of those modalities are constituted, actually, an consolidation of patterns and present tendencies since the seventies, as the section that integrates the insurance companies of health and the group medicine companies. Other, as the performance of the medical cooperatives close to the public section, they are shown as tendencies in expansion in a conjuncture of fiscal crisis of the state and

  6. Prevalencia de micobacteriosis y de tuberculosis en pacientes de un hospital de referencia de la provincia de Córdoba Prevalence of mycobacteriosis and tuberculosis in a reference hospital, Cordoba province

    Directory of Open Access Journals (Sweden)

    A.I. Barnes

    2004-12-01

    Full Text Available Las micobacterias ambientales (MA constituyen un importante grupo de especies bacterianas que se encuentran en el medio ambiente, pueden colonizar y ocasionalmente producir enfermedad enel hombre. En este trabajo se investigó la frecuencia de casos de micobacteriosis en relación con los de tuberculosis durante un período de diez años (1.991-2.000. Se estudiaron 16.700 muestras de 9.300 pacientes adultos de ambos sexos asistidos en el Hospital Regional de Tuberculosis de la Provincia de Córdoba, por consulta espontánea. Los aislamientos se realizaron por cultivo en los medios de Lowenstein Jensen y Stonebrink. Las colonias de bacilos ácidoalcohol resistentes (BAAR se identificaron por pruebas bioquímicas y moleculares. El total de casos diagnosticados fue de 716, de los cuales 684 (95,5% correspondieron a al complejo Mycobacterium tuberculosis y a micobacterias ambientales 32 (4,5%. Los casos de micobacteriosis se definieron por reiterados aislamientos con desarrollo representativo de una micobacteria ambiental, sospecha clínica y radiológica. De los 32 casos de micobacteriosis, el 75% del total correspondió aMycobacterium avium-intracellulare,15,6% a Mycobacterium fortuitum, 3,1% a Mycobacterium kansasii y 6,3% a Mycobacterium chelonae.Los casos de tuberculosis fueron 94,5% de localización pulmonar y 5,5% extrapulmonar.Environmental mycobacteria (EM constitute an important group of bacteria species found in the environment. They can colonize and occasionally produce disease in man. Sixteen thousand three hundred samples from 9300 adult symptomatic patients from the Hospital Regional of Tuberculosis in Cordoba were bacteriolocally investigated. The isolations were performed by culture on Lowenstein Jensen and Stonebrink culture media. The colonies of acid fast bacilli (AFB were identified by biochemical and molecular tests. Among 716 culture positive cases, 684 (95.5% were due to Mycobacterium tuberculosis complex and 32 to

  7. Carcinoma de Colón en recto en menores de 40 años

    Directory of Open Access Journals (Sweden)

    Carlos Mario Salinas Q.

    1990-03-01

    Full Text Available Entre abril de 1986 y abril de 1988 se estudiaron prospectivamente 21 pacientes menores de 40 años, con diagnóstico de cáncer de colon y recto; provinieron de la Consulta Externa del Hospital Universitario San Vicente de Paúl, del Hospital Pablo Tobón Uribe y de consultorios privados. A cada paciente se le investigaron los antecedentes
    personales y familiares; los síntomas y signos de presentación de la enfermedad; la localización segmentaria de las lesiones; el tipo de carcinoma; el estadio tumoral y la sobrevida; se hizo revisión cada
    tres meses.

  8. 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%.

  9. 9 February 2012 - Permanent Representative of the Kingdom of Spain to the United Nations Office at Geneva and other International Organisations, Ambassador A. Santos Maraver signing the guest book with CERN Director-General; in the CERN Control Centre with N. Catalan; visiting the LHC tunnel at Point 5 and CMS underground experimental area with Collaboration Spokesperson J. Incandela; throughout accompanied by Adviser J. Salicio Diez and Former Physics Deputy Department Head L. Alvarez Gaumé.

    CERN Multimedia

    Visual Media Office

    2012-01-01

    9 February 2012 - Permanent Representative of the Kingdom of Spain to the United Nations Office at Geneva and other International Organisations, Ambassador A. Santos Maraver signing the guest book with CERN Director-General; in the CERN Control Centre with N. Catalan; visiting the LHC tunnel at Point 5 and CMS underground experimental area with Collaboration Spokesperson J. Incandela; throughout accompanied by Adviser J. Salicio Diez and Former Physics Deputy Department Head L. Alvarez Gaumé.

  10. 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...

  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. Algumas considerações acerca do processo de viver humano de técnicos(as de enfermagem recém-admitidos(as em um hospital escola

    Directory of Open Access Journals (Sweden)

    Zídia Rocha Magalhães

    2006-01-01

    Full Text Available El presente estudio pretende comprender el proceso de vivir humano de técnicos(as de enfermería recién admitidos en instituciones de salud, con el objetivo de aprehender su realidad, buscando, a través de la discusión colectiva, construir espacios que propicien el vivir saludable. La metodología elegida contempló principios de la investigación acción participante e incluyó la entrevista individual y la reflexión en grupo focal, del cual participaron diez técnicos(as de enfermería recién admitidos(as en un hospital escuela. El estudio concluyó que la oportunidad de discutir aspectos concretos del cotidiano del trabajo, en la perspectiva de un vivir saludable, el encuentro con el otro, la posibilidad de dividir angustias y buscar caminos para el cambio, fueron aspectos de la participación en la investigación considerados positivos. De esa forma, los técnicos(as de enfermería salen fortalecidos del proceso, entienden que no están solos en esta caminada. Sus anhelos, sus miedos, sus sueños son compartidos en el proceso cuando encuentran compañeros de esta misma jornada.

  13. Making secondary care a primary concern: the rural hospital in Ecuador Hacer de la atención secundaria una preocupación primaria: los hospitales rurales en Ecuador

    Directory of Open Access Journals (Sweden)

    David Gaus

    2008-03-01

    Full Text Available En Ecuador, el acceso de la población rural a servicios adecuados de atención secundaria de salud se ha hecho cada vez más difícil. A pesar de que los sectores público y privado han acertado en dedicar esfuerzos a la atención primaria y a la salud pública, la mayoría de las poblaciones rurales no tienen acceso a una adecuada atención secundaria. Por lo general, los modelos tradicionales de atención médica secundaria en zonas rurales no se han adaptado a las nuevas situaciones, como la tendencia general a la descentralización, el énfasis en el desarrollo de capacidades locales, el antagonismo entre el acceso universal y la autonomía financiera, las alternativas financieras innovadoras y los recién llegados médicos de familia. En 2001, la organización no gubernamental con sede en los Estados Unidos de América Andean Health & Development (Saludesa en Ecuador inauguró un hospital rural de 17 camas, construido conjuntamente con el municipio local y el Ministerio de Salud de Ecuador. El hospital atiende a una comunidad rural de 50000 personas que antes no tenían acceso local a servicios secundarios de salud. Los esfuerzos de AHD/Saludesa para desarrollar una red autosostenible pública/privada de atención primaria/secundaria de salud y de alta calidad han generado una considerable experiencia en la administración de un hospital rural. El proyecto piloto de AHD se concentró en un hospital rural y logró su autosostenibilidad total en 2007. Esto se logró mediante una combinación de mecanismos financieros, entre ellos la venta de paquetes prepagados de atención sanitaria, un contrato con el Instituto Ecuatoriano de Seguridad Social, contribuciones municipales y el pago tradicional por los servicios.

  14. Biomédica, 2012: diez años en el Index Medicus y cinco en el Science Citation Index

    Directory of Open Access Journals (Sweden)

    Comité Editorial Biomédica

    2012-06-01

    Full Text Available La revista Biomédica del Instituto Nacional de Salud es una publicación trimestral, eminentemente científica, en la que se publican gratuitamente y con acceso abierto, los resultados de las investigaciones en salud y biomedicina del Instituto y de otras instituciones públicas y privadas a nivel nacional e internacional, luego de un exhaustivo proceso editorial que incluye, necesariamente, las rigurosas evaluaciones por pares de la comunidad científica, reconocidos expertos nacionales e internacionales en las diferentes áreas del conocimiento. El cumplir diez años de haber sido incluida en el Index Medicus y cinco en el Science Citation Index –los índices internacionales más importantes para las revistas de ciencias de la salud– es un acontecimiento significativo para la revista. Sin duda alguna, es un momento que marca la madurez de la revista y, a la vez, una oportunidad para reflexionar sobre los logros obtenidos, analizar los desafíos que debe enfrentar y planear la mejor forma de resolverlos. La primera edición de Biomédica se publicó en 1981 y, desde entonces, los miembros de los diferentes comités editoriales siempre han estado atentos a la adopción de los lineamientos internacionales para el mejoramiento de este tipo de publicaciones científicas. Como resultado de ello, la revista ha alcanzado los más altos estándares de edición, como los recomendados por el International Committee of Medical Journal Editors (1. Además de mantener los criterios de objetividad y calidad del material enviado para publicación, la revista implementó un proceso editorial propio que incluye revisiones editoriales iniciales, intermedias y finales por miembros del Comité Editorial o Científico, evaluación por pares y estricta corrección de estilo por expertos en el idioma español e inglés, además de comunicación continua y directa con los autores, diagramación pulcra y dinámica, publicación impresa oportuna y de calidad, y

  15. Indutores de alinhamento estratégico: comparações preliminares sobre valor entre empresas de capital privado e empresas estatais no Brasil

    Directory of Open Access Journals (Sweden)

    José Francisco de Carvalho Rezende

    2013-06-01

    Full Text Available O artigo trata da comparação da eficiência entre empresas privadas e estatais, discutindo diferenças dos procedimentos de alinhamento estratégico e criação de valor utilizados, e apresentando evidências sobre os "tipos" de alinhamento estratégico e os "modos" de criação de valor utilizados. O estudo utiliza informações de survey aplicado anteriormente à amostra de 95 organizações brasileiras, estratificadas segundo a origem do capital em privadas ou estatais. Foram testadas hipóteses sobre diferenças de médias nos vetores de alinhamento estratégico, percentuais distintos no tocante a padrões de originação de valor e comportamento das componentes do valor total. Os testes apresentaram, de forma recorrente, diferenças de médias em favor das empresas privadas, segundo intervalo de confiança superior a 85%, nível considerado adequado a um estudo de natureza exploratória. No tocante à originação de valor, foi constatada performance superior das empresas de capital privado em todas as dimensões/perspectivas. Considerando a relevância econômica e social das empresas estatais no país, os resultados do estudo podem contribuir para o desenvolvimento de novas perspectivas de análise do desempenho das organizações gerenciadas pelo Estado, levando a mecanismos de acompanhamento mais alinhados aos desafios de gestão dessas organizações.

  16. Estudio de accesibilidad de espacios público -privado en la ciudad de Temuco-Chile. Método de valoración de accesibilidad

    Directory of Open Access Journals (Sweden)

    María Paula Simian-Fernández

    2014-12-01

    Full Text Available Introducción: La ergonomía puede contribuir al diseño de puestos, entornos y sistemas para hacerlos compatibles con las necesidades, capacidades y limitaciones de las personas. Como respuesta a las necesidades actuales y al desafío que tienen los diseñadores y ergónomos de facilitar y mejorar la calidad de vida de las personas. Objetivos: Elaborar un diagnóstico de la accesibilidad de 34 espacios públicos privados de la ciudad de Temuco. Materiales y Métodos: Se diseñó para este fin un instrumento tipo ficha que permitió registrar las observaciones hechas en terreno teniendo incorporados los criterios de accesibilidad contemplados en la legislación y normativa vigente, y aquellos recomendados por especialistas internacionales que van más allá de la norma chilena. Resultados: Se obtuvieron datos objetivos que permitieron realizar un análisis de accesibilidad de índole cuantitativo y cualitativo representativo de la ciudad que ilustra la realidad actual de la capital regional de la novena región. El instrumento permitió anexar fotografías y recomendaciones para mejorar la accesibilidad, sistematizando de forma ordenada y gráfica la información. Conclusiones: Desde un enfoque holístico se dan pautas para lograr el ajuste y la adecuación de los recintos observados en las dimensiones de entorno, entrada, zona de atención al público, ascensor y aseos públicos a los requerimientos y capacidades de personas con discapacidad.

  17. Prevalence of hypoalbuminemia and nutritional issues in hospitalized elders.

    Science.gov (United States)

    Brock, Felipe; Bettinelli, Luiz Antonio; Dobner, Taise; Stobbe, Júlio César; Pomatti, Gabriela; Telles, Cristina Trevizan

    2016-08-08

    apresentavam hipoalbuminemia. a prevalência de hipoalbuminemia mostrou-se elevada, acometendo aproximadamente nove entre dez idosos, sendo que o estado nutricional, da mesma maneira que o tempo de internação , está relacionado à diminuição dos níveis de albumina sérica. Assim, sugere-se monitorar os níveis de albuminemia para avaliar o risco que o paciente tem de desenvolver desnutrição e demais complicações durante a internação hospitalar. estimar la prevalencia de hipoalbuminemia en ancianos hospitalizados, considerando las variables sociodemográficas, estado nutricional y tiempo de internación. estudio transversal, en 200 pacientes internados en hospital de gran porte del sur de Brasil, durante un período de tres meses. Fueron realizadas evaluaciones, análisis de exámenes de laboratorio y se realizó una entrevista usando un cuestionario. el promedio de albuminemia fue 2,9 ± 0,5g/dL. El diagnóstico de hipoalbuminemia, fue encontrado en 173 sujetos (87%), y no revelado en 27 (13%), que presentaron albuminemia normal (p=0,000). Se constató que después de seis días de internación la prevalencia de niveles bajos aumentó significativamente para 90% (p=0,002), con promedio de 2,7 ± 0,5g/dL. Utilizando la Mini Evaluación Nutricional, se observó que 41 pacientes estaban desnutridos, y que de estos, 40 presentaban hipoalbuminemia. la prevalencia de hipoalbuminemia se mostró elevada, afectando aproximadamente nueve entre diez ancianos, siendo que el estado nutricional, de la misma manera que el tiempo de internación, está relacionado a la disminución de los niveles de albúmina sérica. Así, se sugiere monitorizar los niveles de albuminemia para evaluar el riesgo que el paciente tiene de desarrollar desnutrición y demás complicaciones durante la internación hospitalaria.

  18. COTIDIANO DE MULHERES COM HISTÓRIA DE VIOLÊNCIA DOMÉSTICA E ABORTO PROVOCADO

    OpenAIRE

    Telmara Menezes Couto; Rosane Gonçalves Nitschke; Regina Lúcia Mendonça Lopes; Nadirlene Pereira Gomes; Normélia Maria Freire Diniz

    2015-01-01

    Investigación cualitativa dirigida a comprender la vida cotidiana de las mujeres con un historial de violencia doméstica que tuvo un aborto. Se realizaron entrevistas en profundidad con diez mujeres que fueron ingresados en el hospital por el aborto y reportaron haber experimentado violencia doméstica. En la mayor parte, se caracterizan por ser negras, de bajo nivel educativo y con edad entre 18 y 40 años. El proceso de organización y análisis de los datos fueron basados en las nociones de la...

  19. Lucha tras las rejas franquistas. La prisión central de mujeres de Segovia

    OpenAIRE

    Santiago VEGA SOMBRÍA; Juan Carlos GARCÍA FUNES

    2012-01-01

    Edificio de tipo panóptico inaugurado en 1924 como Reformatorio de Mujeres, posteriormente sería Hospital Asilo Penitenciario para ancianos y enfermos de tuberculosis. Con la guerra civil se vio abarrotado de presos políticos, que ya no abandonarían el edificio durante toda la dictadura. En 1946 se transformó en Prisión Central de Mujeres y, durante sus diez años de existencia, albergó al mayor contingente de luchadoras antifranquistas españolas, que convirtieron esta prisión en un centro de ...

  20. 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.

  1. Governança e a lógica das associações de interesse privado: um estudo de caso da Associação Brasileira das Indústrias de Massas Alimentícias (ABIMA Governance and strategy of Private Interest Associations: a case study of the Brazilian Pasta Association

    Directory of Open Access Journals (Sweden)

    Cláudio Antonio Pinheiro Machado Filho

    2006-12-01

    Full Text Available O presente artigo analisa as características e objetivos das associações de interesse privado (AIP, destacando o papel coordenador deste tipo de organização no sentido de buscar criar e defender margens para seus associados. São destacadas as mudanças no papel do Estado e das empresas e, como decorrência, a necessidade de repensar a estrutura e a própria missão das associações, visando sua adequação a um novo ambiente institucional. Outro aspecto central relaciona-se com os mecanismos de governança em associações de interesse privado. O artigo destaca desafios no alinhamento de interesses entre os componentes das associações. A dificuldade em avaliar a eficiência dos gestores é devida à falta de informações claras e de conhecimento específico, já que a avaliação dos resultados é em grande parte intangível e são raros os indicadores que possibilitam a comparação com outras organizações. As associações de interesse privado possuem características idiossincráticas, sendo difícil a parametrização de indicadores de eficiência, em razão das especificidades próprias de cada organização. O trabalho destaca um estudo de caso de uma associação ligada ao sistema agroindustrial brasileiro, a Associação Brasileira das Indústrias de Massas Alimentícias (ABIMA, analisando um processo de gestão estratégica implementado na organização com o objetivo de um alinhamento de interesses em torno de um conjunto específico de projetos estratégicos priorizados.Characteristics and objectives of Private Interest Associations, PIA, were analyzed to highlight their coordination in creating and defending actions of benefit to associates. Changes in public and private organization roles were identified in view of the need to examine the structure and mission of these associations for better adaptation to the new institutional environment. PIA governance was then addressed as were the challenges of aligning member

  2. José Segundo de Lema : Arquitectura del siglo XIX en Aranjuez

    Directory of Open Access Journals (Sweden)

    Magdalena Merlos Romero

    2006-01-01

    Full Text Available El arquitecto José Segundo de Lema es autor de varias obras en Aranjuez en el siglo XIX. Se valora el estilo del arquitecto, la tipología arquitectónica y su integración en el concepto urbano del real sitio. Se analizan la reforma del Hospital de San Carlos, el cementerio y varios palacios privados.The architect José Segundo de Lema is the autor of several works in Aranjuez in the XIXth Century. We value the architect’s style, the architectural typology and its integration in the urban concept of the Royal Site of Aranjuez. We analyse the reform of the San Carlos Hospital, the cemetery and several private palaces.

  3. Construção solidária do habitus escolar: resultados de uma investigação nos setores público e privado

    Directory of Open Access Journals (Sweden)

    Zaia Brandão

    2012-01-01

    Full Text Available Nuestro objetivo en el presente trabajo fue ampliar la comprensión del proceso de desarrollo y manutención del habitus escolar que favorece los ingresos de los estudiantes del enseño fundamental. Analizamos parte de las respuestas fornecidas por los padres y alumnos así como las observaciones de campo obtenidas en la aplicación de uno survey en un grupo de diez escuelas públicas munícipes y privadas del Rio de Janeiro/Brazil. El resultado de los alumnos en la Prueba Brasil y en el ENEM fueran la basis para sí incluir las escuelas en la muestra investigada. Presentamos los resultados del análisis cruzada de las rutinas y esfuerzos familiares con las prácticas institucionales que muestran el esfuerzo de disposiciones favorables para el éxito académico. Nosotros encontramos entre las familias de clase popular evidencias de un esfuerzo relativamente mayor en el acompañamiento y apoyo a los estudios, que en las familias de alumnos de nivel socio-cultural más elevado. Este resultado nos hice buscar caracterizar las experiencias estudiantiles y las diferentes formas de apoyo familiar que responden a las demandas académicas. También hemos encontrado estilos de gestión institucional que, articulados a estilos de tratar con la escolaridad de los hijos por parte de las familias, indican la presencia estratégica combinada de producción de habitus académicos, ofreciendo uno panorama excitante para el debate del efecto-escuela en estabelecimientos de prestigió.

  4. Guía de dinámicas de motivación para la enseñanza- aprendizaje del idioma inglés en los niños de 4 años de edad de los centros de desarrollo infantil privados de la ciudad de Ibarra.

    OpenAIRE

    Rivadeneira Ormaza, Amparo Del Rosario

    2012-01-01

    Definir los objetivos y las estrategias metodológicas, que los docentes del área de inglés ponen en práctica para generar aprendizaje en los niños de 4 años de edad en los Centros de Desarrollo Infantil privados de la Ciudad de Ibarra. Esta investigación, abordó el tema de motivación enfocado al desarrollo de la enseñanza aprendizaje del idioma inglés en los niños de 4 años de edad, creando alternativas muy importantes dentro de la formación cognitiva del niño. Detectando un problema como ...

  5. A gestão de recursos humanos em hospitais do Sistema Único de Saúde (SUS e sua relação ao modelo de assistência: um estudo em hospitais de Belo Horizonte, Minas Gerais La gestión de los recursos humanos en hospitales del Sistema Único de Salud y su relación con el modelo de asistencia: un estudio en hospitales de Belo Horizonte, Minas Gerais Human resource management in hospitals and its relation to model assistance: a study of hospitals in Belo Horizonte, Minas Gerais

    Directory of Open Access Journals (Sweden)

    Marina Campos Morici

    2013-02-01

    Full Text Available O artigo discute a gestão de recursos humanos em hospitais de Belo Horizonte, Minas Gerais, considerando a relevância do debate no contexto gerencial contemporâneo e suas implicações ao modelo assistencial preconizado pelos hospitais analisados. A partir de levantamento de dados (entrevistas semiestruturadas com gestores e profissionais de recursos humanos e análise de documentos pertinentes às práticas e normatizações existentes, o estudo aponta uma defasagem nas políticas e práticas de recursos humanos, com a contratação via concurso público não conseguindo suprir de forma ágil a atividade assistencial. Os resultados apontam ainda ser esse um fator determinante na fixação e motivação dos profissionais, o que diferencia em termos de autonomia aqueles hospitais onde a gestão de recursos humanos ocorre via regras do direito privado.El artículo discute la gestión de los recursos humanos en hospitales de Belo Horizonte, Minas Gerais, considerando la relevancia del debate en el contexto gerencial contemporáneo y sus implicaciones con el modelo asistencial preconizado por los hospitales analizados. A partir del inventario de datos (entrevistas semiestruturadas con los gestores y profesionales de recursos humanos y el análisis de documentos pertinentes a las prácticas y los reglamentos existentes, el estudio apunta para un desfasaje en las políticas y en las prácticas de recursos humanos, siendo que la contratación por vía de concurso público no logra suplir de forma ágil la actividad asistencial. Los resultados también señalan que éste es un factor determinante en la fijación y en la motivación de los profesionales, lo que diferencia en términos de autonomía a aquellos hospitales donde la gestión de recursos humanos ocurre por vía de reglas del derecho privado.The article discusses human resource management in hospitals in Belo Horizonte, Minas Gerais. It considers the relevance of the debate within

  6. Evaluación de competencias del profesional de enfermería que labora en hospitales públicos y privados

    Directory of Open Access Journals (Sweden)

    Juan Alberto López González

    2014-10-01

    Full Text Available Antecedentes. Un profesional competente de enfermería es aquel que brinda una atención integral respecto del cuidado de enfermería frente a actividades y problemas del contexto, con idoneidad y compromiso ético, el cual integra el saber ser, el saber hacer y el saber conocer. El objetivo fue determinar si existe diferencia en el nivel de competencia del personal de enfermería asistencial según su formación académica.Método. Es un estudio de tipo no experimental, de diseño transversal, cuyo alcance es descriptivo correlacional no causal; la muestra representativa fue de 122 enfermeras (os  que laboran en hospitales públicos y privados de Hermosillo, Sonora. Resultados. Entre los resultados está que  la edad predominante de la población es de 33-46 años de edad (= 32,66, DE=7,60, la mayoría del sexo femenino 73%, con grado universitario escolarizado 52,5%, con un tiempo de finalizado  menor a los 4 años en un 45,9% y con una antigüedad laboral entre 1 a 5 años. La calificación obtenida en la evaluación  total es de medianamente competente Fx 3, 3.4 % ,  (= 72,49 DE= 3,74, por cada competencia, el resultado fue el siguiente HPAMPE (= 77.49 DE= 4.98, CACCH (= 71,69 DE= 6,38 y CAMS (= 63,01 DE= 9,34; por tanto, se rechazan las hipótesis planteadas. Conclusión. Se concluye que entre el profesional de enfermería evaluado no hay personas competentes, tan solo tres personas recibieron una calificación de medianamente competentes, con un  nivel escolarizado de nivelación presencial;  la mayor competencia se detectó en la HPAMPE , seguida por la  CACCH, mientras que en la competencia  CAMS no se halló competencia al respecto.

  7. Entre o público e o privado: a clínica psicanalítica no ambulatório hospitalar

    Directory of Open Access Journals (Sweden)

    Nadja Nara Pinheiro

    2007-01-01

    Full Text Available Approaching the subject of the development of analytical processes in hospital environments, the present study uses as major concepts public and private spheres relating both to the contexts of hospital ambulatories versus private clinics. The word public refers, specifically, to the visibility idea that penetrates the ambulatorial clinic in the hospitals exposing as much the psychoanalyst's work as the intimacy of the patient to the multiples institutional glances. Opting to abandon the private clinic as an idealized model, a research with professionals of the health field was conducted in order to narrow down the singularity of each practice. Visibility, the transitoriness and the complexity of the transferencial field were the major aspects found on the hospital context. In order to deal with what might be seen as an unknown territory the authors propose a return to Winiccott's theory as an efficient and creative approach to deal with the specifics and singularity of such practice.

  8. Entre o público e o privado: a clínica psicanalítica no ambulatório hospitalar

    Directory of Open Access Journals (Sweden)

    Nadja Nara Pinheiro

    2014-08-01

    Full Text Available Approaching the subject of the development of analytical processes in hospital environments, the present study uses as major concepts public and private spheres relating both to the contexts of hospital ambulatories versus private clinics. The word public refers, specifically, to the visibility idea that penetrates the ambulatorial clinic in the hospitals exposing as much the psychoanalyst’s work as the intimacy of the patient to the multiples institutional glances. Opting to abandon the private clinic as an idealized model, a research with professionals of the health field was conducted in order to narrow down the singularity of each practice. Visibility, the transitoriness and the complexity of the transferencial field were the major aspects found on the hospital context. In order to deal with what might be seen as an unknown territory the authors propose a return to Winiccott´s theory as an efficient and creative approach to deal with the specifics and singularity of such practice.

  9. 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.

  10. 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.

  11. 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.

  12. As dissonâncias do sistema privado de saúde e a judicialização da saúde no Distrito Federal

    Directory of Open Access Journals (Sweden)

    Isabella Cristina Fernandes da SILVA

    2013-04-01

    Full Text Available RESUMO A saúde, bem maior constante da nossa Constituição Federal da República de 1988, é um tema que tem sido bastante discutido ultimamente. O compromisso com a qualidade de vida, juntamente com os avanços da tecnologia e a precariedade no atendimento público levaram ao surgimento de diversas operadoras de saúde. Com o aumento desse segmento, o estado viu a necessidade de regulamentar essa atividade, a fim de proteger a relação usuário-operadora de saúde. Nesse contexto, foi criado um conjunto de normas jurídicas para regulação dos planos e seguros de saúde. A Agência Nacional de Saúde Suplementar representa um papel de suma importância na fiscalização e regulação das operadoras de saúde, assegurando o equilíbrio dessa relação. No entanto, o número de insatisfação dos usuários de planos e seguros de saúde vem aumentando e muitas reclamações feitas são levadas ao judiciário, fenômeno este chamado de judicialização. O presente trabalho versa sobre a identificação e análise das demandas judiciais do TJDFT atinentes às reclamações dos usuários do sistema privado de saúde no ano de 2010. ABSTRACT Health, which is considered to be the greater good of the 1988 federal constitution, has been a widely disscussed topic lately. The obligation to maintain the quality of life, along with the technological advances and the precariousness of public services, have set the grounds for the emergence of various health insurers. The state was forced to regulate these kind of activities in order to protect the user - health insurer relationship. In this context, a number of judicial norms were created. The National supplementary health agency has a very important role in the inspection and regulation of health insurers, ensuring a balanced relationship. However, the number of unsatisfied health plan users has been increasing and many of the complaints have been taken to the judiciary, which is called judicialization

  13. Ocorrência e preditores clínicos de pseudocrise hipertensiva no atendimento de emergência Occurrence rate and clinical predictors of hypertensive pseudocrisis in emergency room care

    Directory of Open Access Journals (Sweden)

    Silvestre Sobrinho

    2007-05-01

    Full Text Available OBJETIVOS: Descrever a prevalência de pseudocrise hipertensiva em pacientes atendidos em unidade de emergência com níveis de pressão arterial substancialmente elevados, comparando-a entre serviços privado e público; descrever a freqüência de tratamento indevido para essa condição; identificar, no momento da triagem, preditores independentes de pseudocrise; e avaliar o prognóstico dos pacientes com pseudocrise. MÉTODOS: Durante seis meses, foram incluídos pacientes com idade > 18 anos, atendidos nas Emergências de dois hospitais (privado e público, com pressão arterial diastólica > 120 mmHg. Pseudocrise hipertensiva foi definida na ausência de critérios para crise hipertensiva, segundo as Diretrizes da Sociedade Brasileira de Cardiologia. RESULTADOS: Em 110 pacientes estudados, a prevalência de pseudocrise hipertensiva foi de 48% (intervalo de confiança de 95% [IC 95%] = 39%-58%, predominando no serviço privado (59% vs 37%; p = 0,02. A freqüência de tratamento indevido foi semelhante nos dois serviços (94% vs 95%; p = 0,87. Após análise multivariada, a presença de cefaléia na admissão (odds ratio = 5,4; IC 95% = 5,1-13; p OBJECTIVES: To describe the prevalence of hypertensive pseudocrisis in patients treated in emergency rooms with substantially elevated blood pressure levels. To compare this prevalence in private and public hospitals. To describe the frequency of wrong treatment for this condition. To identify, during triage, independent predictors of pseudocrisis. To evaluate the prognosis of patients with pseudocrisis. METHODS: Patients above the age of 18, admitted to the Emergency Rooms of two hospitals (private and public during a 6 month timeframe, with diastolic blood pressure > 120 mmHg were included in the study. Hypertensive pseudocrisis was determined when none of the criteria for hypertensive crisis were present (Guidelines of the Brazilian Society of Cardiology¹. RESULTS: In the 110 patients studied

  14. Steering patients to safer hospitals? The effect of a tiered hospital network on hospital admissions.

    Science.gov (United States)

    Scanlon, Dennis P; Lindrooth, Richard C; Christianson, Jon B

    2008-10-01

    To determine if a tiered hospital benefit and safety incentive shifted the distribution of admissions toward safer hospitals. A large manufacturing company instituted the hospital safety incentive (HSI) for union employees. The HSI gave union patients a financial incentive to choose hospitals that met the Leapfrog Group's three patient safety "leaps." The analysis merges data from four sources: claims and enrollment data from the company, the American Hospital Association, the AHRQ HCUP-SID, and a state Office of the Insurance Commissioner. Changes in hospital admissions' patterns for union and nonunion employees using a difference-in-difference design. We estimate the probability of choosing a specific hospital from a set of available alternatives using conditional logistic regression. Patients affiliated with the engineers' union and admitted for a medical diagnosis were 2.92 times more likely to select a hospital designated as safer in the postperiod than in the preperiod, while salaried nonunion (SNU) patients (not subject to the financial incentive) were 0.64 times as likely to choose a compliant hospital in the post- versus preperiod. The difference-in-difference estimate, which is based on the predictions of the conditional logit model, is 0.20. However, the machinists' union was also exposed to the incentive and they were no more likely to choose a safer hospital than the SNU patients. The incentive did not have an effect on patients admitted for a surgical diagnosis, regardless of union status. All patients were averse to travel time, but those union patients selecting an incentive hospital were less averse to travel time. Patient price incentives and quality/safety information may influence hospital selection decisions, particularly for medical admissions, though the optimal incentive level for financial return to the plan sponsor is not clear.

  15. Fatores prognósticos de sobrevida pós-reanimação cardiorrespiratória cerebral em hospital geral In-hospital post-cardiopulmonary-cerebral resuscitation survival prognostic factors

    Directory of Open Access Journals (Sweden)

    André Mansur de Carvalho Guanaes Gomes

    2005-10-01

    Full Text Available OBJETIVO: Analisar as características clínicas e demográficas dos pacientes que receberam reanimação cardiorrespiratória e detectar fatores prognósticos de sobrevivência a curto e longo prazo. MÉTODOS: Analisamos, prospectivamente, 452 pacientes que receberam reanimação em hospitais gerais de Salvador. Utilizou-se análise uni, bivariada e estratificada nas associações entre as variáveis e a curva de sobrevida de Kaplan-Meier e a regressão de Cox para análise de nove anos de evolução. RESULTADOS: A idade variou de 14 a 93 anos, media de 54,11 anos; predominou o sexo masculino; metade dos pacientes tinha ao menos uma doença de base, enfermidade cardiovascular foi etiologia responsável em metade dos casos. Parada cardíaca foi testemunhada em 77% dos casos e em apenas 69% dos pacientes foi iniciada imediatamente a reanimação. O ritmo cardíaco inicial não foi diagnosticado em 59% dos pacientes. Assistolia foi o ritmo mais freqüente (42%, seguida de arritmia ventricular (35%. A sobrevida imediata foi de 24% e sobrevida à alta hospitalar de 5%. Foram identificados como fatores prognósticos em curto prazo: etiologia da parada; diagnóstico do ritmo cardíaco inicial; fibrilação ou taquicardia ventricular como mecanismo de parada; tempo estimado préreanimação menor ou igual a 5 minutos e, tempo de reanimação menor ou igual a 15 minutos. Os fatores prognósticos de sobrevivência em nove anos de evolução foram: não ter recebido epinefrina; ser reanimado em hospital privado e tempo de reanimação menor ou igual a 15 minutos. CONCLUSÃO: Os dados observados podem servir de subsídios para os profissionais de saúde decidir quando iniciar ou parar uma reanimação no ambiente hospitalar.OBJECTIVE: To assess clinical and demographic characteristics of patients who had cardiopulmonary resuscitation and identify short- and long-term survival prognostic factors. METHODS: Four hundred and fifty-two (452 resuscitated

  16. 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.

  17. Prestadores de serviço no campo da saúde mental: o público, o privado e o inefável da loucura

    Directory of Open Access Journals (Sweden)

    Cristina Maria Douat Loyola

    Full Text Available Abordamos nossa própria visão, muitas vezes turva, sobre a realidade dos hospitais psiquiátricos no Brasil. Ela escora-se em um discurso que, por vezes, ofusca-se pelo ideal da desospitalização. Visando uma nova realidade, esquece que a clínica muitas vezes é pesada e resistente, e lastrela nossas pretensões com a presença maciça da impossibilidade. A análise e a discussão foram realizadas a partir de dois registros de dados: notas de diário de campo, realizadas pelos autores quando em função pública de gestão estadual de saúde mental, e dois casos de supervisão clínica em instituição psiquiátrica pública municipal no Rio de Janeiro; todos os dados colhidos em 2004. A análise das anotações nos levou a concluir que podemos contribuir para mudar o estado de coisas encontrado nos dados empíricos e que temos algo afazer para não reproduzir o mesmo passado dos hospitais psiquiátricos. No plano da equipe de profissionais é preciso que ela não se transforme neste agente de horror banalizado que constrange a esperança. Entre o público, o privado e o inefável da loucura é preciso acolher a resposta do sujeito, aquele pequeno elemento que assinala a estranheza e irredutibilidade de alguém que, no caso da loucura, encontrase em ruptura com o coletivo.

  18. O ser e o não ser da universidade pública: o público e o privado em questão na educação superior brasileira

    Directory of Open Access Journals (Sweden)

    Matheus Castro da Silva

    2015-10-01

    Full Text Available Este estudo pretende investigar de que forma a Educação Superior pública se configura atualmente, levando em consideração a relação que há entre as esferas públicas e as esferas privadas em nossa sociedade. Para tanto, utilizaremos o materialismo histórico e dialético como método, em uma perspectiva para além da compreensão, mas de ação para a superação dessa realidade. Com isso, buscamos entender de que forma o Brasil está inserido na ordem mundial capitalista, que, de acordo com Autor e Autor, é de forma dependente e periférica e a maneira que isso se materializa em nossas relações sociais, neste caso, as políticas educacionais. Nesse sentido, discutir as relações entre o público e o privado na educação pública torna-se imperioso, porquanto vemos ataques cada vez maiores por parte do capital aos serviços públicos, utilizando-se do Estado, e da educação, como trincheiras avançadas no processo da luta de classes.

  19. CONEXÕES ENTRE PESQUISA E ASSISTÊNCIA: DESAFIOS EMERGENTES PARA A CIÊNCIA, A INOVAÇÃO E A TECNOLOGIA NA ENFERMAGEM

    Directory of Open Access Journals (Sweden)

    Ítalo Rodolfo Silva

    2017-01-01

    Full Text Available Objetivo: comprender los significados que permean las conexiones entre la producción/resultados de investigación y el proceso de trabajo de la enfermería en el ámbito asistencial. Método: investigación del tipo explicativa, de abordaje cualitativo que tuvo como referenciales teórico y metodológico, respectivamente, la Teoría de la Complejidad y la Teoría Fundamentada en los Datos. Los datos fueron recolectados con 25 sujetos, distribuidos en tres grupos muestrales: diez enfermeros asistenciales, vinculados a un hospital universitario; seis enfermeros investigadores y nueve estudiantes de grado en enfermería. La entrevista semiestructurada fue utilizada como técnica de recolección de datos. La investigación fue validada por diez jueces de diferentes regiones de Brasil. La investigación fue validada por diez jueces de diferentes regiones de Brasil. Resultados: se presenta la categoría: Enfrentando desafíos emergentes de la enfermería en la era de la Ciencia, la Innovación y la Tecnología, basada en las subcategorías: Puntos de partida para una enfermería contextualizada: de la producción científica al consumo de resultados de investigación; Conexiones fragilizadas entre producción científica y práctica asistencial de la enfermería. Conclusión: los sistemas de significados que influencian las conexiones entre investigación científica y práctica asistencial de la enfermería son estructurados y fortalecidos por fenómenos plurales, entre los cuales están las inflexiones negativas del proceso de comunicación, presencia y pertenencia de los pares, entre quien produce investigación y quién puede consumirla.

  20. 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...

  1. Avaliando a difusão de tecnologias médicas no sistema de saúde privado no Brasil: o caso da tomografia por emissão de pósitrons (PET Assessing the use of medical technology in the private health system in Brazil: the case of Positron Emission Tomography (PET

    Directory of Open Access Journals (Sweden)

    Ana Luiza d´Ávila Viana

    2010-11-01

    Full Text Available OBJETIVOS: analisar os determinantes da difusão da tomografia por emissão de pósitrons (PET em um conjunto selecionado de prestadores de serviços e operadoras de planos de saúde no Brasil. MÉTODOS: estudo de caso qualitativo, com coleta de dados realizada por meio de entrevistas em profundidade (N=9 com representantes de quatro prestadores de serviços de saúde privados e três operadoras de planos de saúde. RESULTADOS: as decisões para aquisição da tecnologia estudada são tomadas por dirigentes de hospitais e clínicas que adotam uma estratégia de diferenciação baseada em liderança tecnológica. Os fatores que influenciam essa decisão são: histórico de pioneirismo da instituição na incorporação de tecnologias; pressão do corpo clínico vinculado à instituição; prestígio do médico ou da área demandante; disponibilidade de recursos financeiros; acesso facilitado à tecnologia; concorrência entre os prestadores de serviços de saúde; evidências científicas; e rentabilidade do investimento. CONCLUSÕES: os atuais instrumentos de política usados para gerenciar a difusão de tecnologias médicas no sistema de saúde brasileiro exercem pouca influência nas decisões de grandes prestadores privados, cujas atividades não estão necessariamente relacionadas com as necessidades de saúde da população ou com as prioridades da política de saúde.OBJECTIVES: to analyze the determining factors underlying the extent to which positron emission tomography (PET is used in a selected medical services provider covered by private health insurance plans in Brazil. METHODS: a qualitative case study was undertaken with data collected by means of in-depth interviews (N=9 with representatives of four private health service providers and three health insurance plan operators. RESULTS: the decisions to acquire the technology under study are taken by managers of hospitals and clinics that adopt a strategy based on excellence in

  2. Regulação do trabalho no contexto das novas relações público versus privado na saúde Work regulation in the context of new public versus private relations in health

    Directory of Open Access Journals (Sweden)

    Nelson Bezerra Barbosa

    2010-08-01

    Full Text Available Este trabalho discute a gestão das relações de trabalho no contexto das novas formas de relação público/privado no setor saúde, toma como referência a experiência de habilitação de organizações sociais (OS, responsáveis pelo gerenciamento de um conjunto de unidades hospitalares no Estado de São Paulo. A emergência desta modalidade de gestão apoiada nesta figura jurídica (OS tem implicações sobre a gestão de recursos humanos em saúde (RHS, por meio da adoção de mecanismos de flexibilização deste processo, que inclui formas de seleção, contratação e descontratação, formas de remuneração e de progressão funcional mais próximas das práticas adotadas pelo mercado. Esta modalidade de gestão remete ao novo paradigma proposto pela reforma administrativa gerencial, que sugere o esgotamento do modelo burocrático para promover adequação da administração pública às transformações decorrentes da nova etapa de internacionalização da economia e seus desdobramentos do mundo do trabalho, bem como aos novos padrões de exigência de desempenho do setor público. Aspectos relativos à gestão de RHS são abordados dentro de uma abordagem comparativa entre as duas modalidades prevalentes na Secretaria de Estado da Saúde de São Paulo (SES-SP, com hospitais da administração direta (HAD e hospitais sob a modalidade OS (HOSS.This work discusses the management of the work relations in the context of the new systems of public vs. private relation in health, having as reference the experience of the habilitation of Social Organizations (SO, responsible for the administration of a group of hospitals in the state of São Paulo. The urgency in this kind of management supported on the legal figure of the SO has implications in the management of Human Resources in Health (HRH through the adoption of flexibilization mechanisms which include ways of selection, hiring and dismissal, payment rules and functional progression

  3. 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...

  4. Japanese hospitals--culture and competition: a study of ten hospitals.

    Science.gov (United States)

    Anbäcken, O

    1994-01-01

    Japanese health care is characterized by a pluralistic system with a high degree of private producers. Central government regulates the prices and the financing system. All citizens are covered by a mandatory employment-based health insurance operating on a non-profit basis. The consumer has a free choice of physician and hospital. A comparison between Japan, Sweden and some other countries shows significant dissimilarities in the length of stay, number of treatments per hospital bed and year and the staffing of hospitals. About 80 per cent of the hospitals and 94 per cent of the clinics are privately owned. The typical private hospital owned by a physician has less than 100 beds. In this paper, data collected (1992/93) in an empirical study of Japanese hospitals and their leadership is presented. Also discussed are the hospitals' style of management, tools and strategies for competition and competences--personal and formal skills required of the leadership in the hospital. There follows a study of ten hospitals, among which hospital directors and chief physicians were interviewed. Interviews are also made with key persons in the Ministry of Health and Welfare and other organizations in the health care field. The result is also analysed from a cultural perspective--'what kind of impact does the Japanese culture have on the health care organization?' and/or 'what kind of sub-culture is developed in the Japanese hospitals'. Some comparisons are made with Sweden, USA, Canada and Germany. The different roles of the professions in the hospital are included in the study as well as the incentives for different kinds of strategies--specialization, growing in size, investments in new equipment, different kind of ownership and hospitals. Another issue discussed is the attempt to uncover whether there is an implicit distribution of specialties--silent agreements between hospitals, etc.

  5. The management of hospital waste products in hospitals of Bushehr Province

    Directory of Open Access Journals (Sweden)

    kamran Mirzaie

    2008-02-01

    Full Text Available Background: Hospital waste contains a large quantity of dangerous pathogenic agents, which are hazardous to the health of man, animal, plant and the environment. In Iran, like many other developing countries, not enough attention is paid to this matter and available information regarding the generation and disposal of medical wastes are low. The existing information about production and disposal of wastes in our hospitals is little and incomplete. In this study, a survey on hospital waste management system in Bushehr province hospitals was conducted. Methods: In this cross-sectional study, 8 hospitals in Bushehr province were investigated during a period of 6 months using a questionnaire, interviews and direct observations. The questionnaire had 93 questions (open and closed about general information on the hospitals and about various systems of managing hospital waste according to the World Health Organization suggested survey questionnaire for hospital waste management in developing countries. Results: In hospitals of bushehr province, waste generation rate was 2615 kg/day, including domestic waste (51.7%, infectious waste (20.8%, sharps (15.2% and chemical and drugs wastes (12.3%. In almost all hospitals, segregation of infectious waste from domestic waste at the place of origin and putting them in special containers had been done but this segregation wasn’t complete and sometimes some hazardous waste were disposed of in domestic waste containers. All hospitals used a color coding system for waste containers, 75 % of hospitals had incinerators. In others, waste was carried out by municipal service daily. In all hospitals, all workers were trained about hospital waste management. In none of the surveyed hospitals, there was an obvious policy and plan for purchasing equipment and necessary facilities in order to dispose hospital waste correctly and also no clear budget was allocated for hospital waste management. In none of these hospitals

  6. 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...

  7. Hospitals - HOSPITALS_HAZUS_IN: Hospitals and Clinics in Indiana, Derived from HAZUS (Federal Emergency Management Agency, Point Shapefile)

    Data.gov (United States)

    NSGIC State | GIS Inventory — HOSPITALS_HAZUS_IN is a point shapefile that shows locations of hospitals and clinics in Indiana. HOSPITALS_HAZUS_IN was derived from the shapefile named "HOSPITAL."...

  8. 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...

  9. Gênese da Enfermagem hospitalar no Estado de Goiás La genesis de la Enfermería Hospitalaria en el Estado de Goiás Genesis of Hospital Nursing in Goiás State

    Directory of Open Access Journals (Sweden)

    Celma Martins Guimarães

    2005-06-01

    Full Text Available O Hospital de Caridade São Pedro de Alcântara foi criado na Cidade de Goiás, sendo a primeira instituição hospitalar implantada no estado. O trabalho objetiva compreender o contexto histórico-social no qual o "São Pedro" foi implantado, buscando informações sobre sua estrutura e funcionamento, notadamente no que diz respeito à enfermagem. A abordagem empregada foi a dialética. Os resultados mostram a existência de dez trabalhadores de enfermagem, sendo estes separados por sexo para atendimento aos pacientes. O trabalho exercido pelos trabalhadores do sexo masculino era melhor remunerado que o executado pelas mulheres. O Hospital e seus servidores, paulatinamente, foram assumindo a responsabilidade pelo disciplinamento e higienização dos espaços físicos, trabalhadores, prisioneiros, sepultamentos, etc. O trabalho era árduo e mal remunerado.El Hospital de Caridade São Pedro de Alcântara se creó en la Ciudad de Goiás, siendo la primera institución hospitalario implantada en el estado. El trabajo tiene el propósito de entender el contexto histórico-social en que el "São Pedro" fue implantado, mientras buscando la información sobre la estructura y funcionamiento, sobre todo con respecto a la enfermeria. La abordaje usada fue la dialectica. Los resultados muestran la existencia de diez obreros de la enfermeria y que estos estaban separados por el sexo para los servicios a los pacientes. El trabajo ejercido por los obreros masculinos fue mas bien remunerado que los ejercidos por las mujeres. El Hospital y sus sirvientes, gradualmente, fueron tomando la responsabilidad por la disciplina y limpieza de los espacios físicos, obreros, prisioneros, los entierros, etc. El trabajo era arduo y mal pagado.The Hospital de Caridade São Pedro de Alcântara was created in the City of Goiás, being the first hospital institution implanted in the state. The work purposes to understand the historical-social context in which the "São Pedro

  10. Patients' perceptions of interactions with hospital staff are associated with hospital readmissions: a national survey of 4535 hospitals.

    Science.gov (United States)

    Yang, Lianping; Liu, Chaojie; Huang, Cunrui; Mukamel, Dana B

    2018-01-29

    Reducing 30-day hospital readmissions has become a focus of the current national payment policies. Medicare requires that hospitals collect and report patients' experience with their care as a condition of payment. However, the extent to which patients' experience with hospital care is related to hospital readmission is unknown. We established multivariate regression models in which 30-day risk-adjusted readmission rates were the dependent variables and patients' perceptions of the responsiveness of the hospital staff and communication (as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores) were the independent variables of interest. We selected six different clinical conditions for analyses, including acute myocardial infarction (AMI), chronic obstructive pulmonary disease (COPD), heart failure, hip/knee surgery, pneumonia, and stroke. Data included all acute care hospitals reporting in Hospital Compare in 2014. The number of hospitals with reported readmissions ranged from 2234 hospitals for AMI to 3758 hospitals for pneumonia. The average 30-day readmission rates ranged from 5.19% for knee/hip surgery to 22.7% for COPD. Patient experience of hospital-staff responsiveness as "top-box" ranged from 64% to 67% across the six clinical conditions, communication with nurses ranged from 77% to 79% and communication with doctors ranged from 80% to 81% (higher numbers are better). Our finding suggests that hospitals with better staff responsiveness were significantly more likely to have lower 30-day readmissions for all conditions. The effect size depended on the baseline readmission rates, with the largest effect on hospitals in the upper 75th quartile. A ten-percentage-point increase in staff responsiveness led to a 0.03-0.18 percentage point decrease in readmission rates. We found that neither communication with physicians nor communication with nurses was significantly associated with hospital readmissions. Our findings

  11. Performance of in-hospital mortality prediction models for acute hospitalization: Hospital Standardized Mortality Ratio in Japan

    Directory of Open Access Journals (Sweden)

    Motomura Noboru

    2008-11-01

    Full Text Available Abstract Objective In-hospital mortality is an important performance measure for quality improvement, although it requires proper risk adjustment. We set out to develop in-hospital mortality prediction models for acute hospitalization using a nation-wide electronic administrative record system in Japan. Methods Administrative records of 224,207 patients (patients discharged from 82 hospitals in Japan between July 1, 2002 and October 31, 2002 were randomly split into preliminary (179,156 records and test (45,051 records groups. Study variables included Major Diagnostic Category, age, gender, ambulance use, admission status, length of hospital stay, comorbidity, and in-hospital mortality. ICD-10 codes were converted to calculate comorbidity scores based on Quan's methodology. Multivariate logistic regression analysis was then performed using in-hospital mortality as a dependent variable. C-indexes were calculated across risk groups in order to evaluate model performances. Results In-hospital mortality rates were 2.68% and 2.76% for the preliminary and test datasets, respectively. C-index values were 0.869 for the model that excluded length of stay and 0.841 for the model that included length of stay. Conclusion Risk models developed in this study included a set of variables easily accessible from administrative data, and still successfully exhibited a high degree of prediction accuracy. These models can be used to estimate in-hospital mortality rates of various diagnoses and procedures.

  12. Developing IT Infrastructure for Rural Hospitals: A Case Study of Benefits and Challenges of Hospital-to-Hospital Partnerships.

    Science.gov (United States)

    Reddy, Madhu C; Purao, Sandeep; Kelly, Mary

    2008-01-01

    This article presents a study identifying benefits and challenges of a novel hospital-to-hospital information technology (IT) outsourcing partnership (HHP). The partnership is an innovative response to the problem that many smaller, rural hospitals face: to modernize their IT infrastructure in spite of a severe shortage of resources. The investigators studied three rural hospitals that outsourced their IT infrastructure, through an HHP, to a larger, more technologically advanced hospital in the region. The study design was based on purposive sampling and interviews of senior managers from the four hospitals. The results highlight the HHP's benefits and challenges from both the rural hospitals' and vendor hospital's perspectives. The HHP was considered a success: a key outcome was that it has improved the rural hospitals' IT infrastructure at an affordable cost. The investigators discuss key elements for creating a successful HHP and offer preliminary answers to the question of what it takes for an HHP to be successful.

  13. 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...

  14. “Reprodução Proibida”: Financiamento público e direitos de cópia privados | Reproduction forbidden: public financing and private copyrights

    Directory of Open Access Journals (Sweden)

    Jorge A. S. Machado

    2011-10-01

    Full Text Available Resumo Esse texto apresenta um sumário das pesquisas realizadas pelo Grupo de Políticas Públicas para Acesso à Informação GPOPAI desde 2006 sobre o financiamento público de conteúdos científicos. Os resultados apontam que, apesar do intenso investimento público no Brasil, o setor privado vem se apropriando e impondo barreiras ao acesso a livros técnico-científicos e artigos científicos – neste caso, em especial, as editoras estrangeiras. No que se refere ao software produzido na academia, os dados apontam para uma completa indiferença da comunidade e à ausência de políticas públicas para o seu acesso. De modo geral, os resultados indicam para a necessidade de uma reforma na lei de direitos autorais, de modo a atualizá-la face as novas tecnologias de informação e comunicação e a atender ao interesse público do acesso ao conhecimento que as tecnologias digitais proporcionam. Palavras-chave acesso ao conhecimento, direitos autorais, financiamento público, ciência Abstract This paper presents a summary of research conducted since 2006 on public funding of scientific contents by the Public Policy Group for Access to Information (GPOPAI. The results suggest that in the case of technical and scientific books and scientific articles, the private sector is creating and imposing barriers to access to knowledge, despite of intensive public investments in Brazil. In relation to software produced by universities, the community is completely indifferent and there is a lack of public policies for its access. Overall, the results indicate the need for a profound reform and update of copyright law regarding new information and communication technologies, considering the public interest in access to knowledge. Keywords access to knowledge, copyright, public investiment, science

  15. Gerenciamento da qualidade: utilização no serviço de enfermagem Gerencia de la calidad: utilización en el servicio de enfermería Quality management: utilization in nursing practice

    Directory of Open Access Journals (Sweden)

    Arthur Velloso Antunes

    2000-01-01

    Full Text Available O Gerenciamento da Qualidade vem sendo cada vez mais utilizado e se tornando uma realidade nas instituições hospitalares. Com base nisto, os autores enfatizam sua importância para a Enfermagem e analisam sua utilização no Serviço de Enfermagem de um hospital privado, com o objetivo de avaliar a forma de implantação, o envolvimento dos enfermeiros e a aplicação dos Princípios de Deming. Os dados, colhidos através de entrevista e aplicação de um formulário, mostram que a implantação tem ocasionado bons resultados, que os enfermeiros estão empenhados no processo e que os Princípios de Deming estão sendo utilizados, alguns de forma adequada outros inadequadamente.La Gerencia de la Calidad viene siendo cada vez mas utilizada y tornandose una realidad en los hospitales. Con base en esto, los autores enfatizan su importancia para la Enfermería y analizan su utilización en el Servicio de Enfermería de un hospital privado, con el objetivo de evaluar la forma de implantación, el involucramiento de los enfermeros y la aplicación de los Princípios de Deming. Los datos, recojidos a través de entrevista y aplicación de un formulario, muestran que la implantación ha ocasionado buenos resultados, los enfermeros están empeñados en el proceso y los Principios de Demig han sido utilizados, algunos de forma adecuada y otros de forma inadecuada.The Quality Management has been used and it is a reality in the hospitals. Thus the authors comment about its importance for Nursing and analyse its utilization in a Nursing Service of a private hospital, with purpose to evaluate the implementation form, nurses' involvement and the Deming' Principles application. Data show that the implementation has brought good results, nurses are engaged in the process and the Deming's Principles have been utilized, adequate or inadequately.

  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. Do HMO penetration and hospital competition impact quality of hospital care?

    Science.gov (United States)

    Rivers, P A; Fottler, M D

    2004-11-01

    This study examines the impact of HMO penetration and competition on hospital markets. A modified structure-conduct-performance paradigm was applied to the health care industry in order to investigate the impact of HMO penetration and competition on risk-adjusted hospital mortality rates (i.e. quality of hospital care). Secondary data for 1957 acute care hospitals in the USA from the 1991 American Hospital Association's Annual Survey of Hospitals were used. The outcome variables were risk-adjusted mortality rates in 1991. Predictor variables were market characteristics (i.e. managed care penetration and hospital competition). Control variables were environmental, patient, and institutional characteristics. Associations between predictor and outcome variables were investigated using statistical regression techniques. Hospital competition had a negative relationship with risk-adjusted mortality rates (a negative indicator of quality of care). HMO penetration, hospital competition, and an interaction effect of HMO penetration and competition were not found to have significant effects on risk-adjusted mortality rates. These findings suggest that when faced with intense competition, hospitals may respond in ways associated with reducing their mortality rates.

  18. 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) ...

  19. 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...

  20. 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...

  1. Hospital prices and market structure in the hospital and insurance industries.

    Science.gov (United States)

    Moriya, Asako S; Vogt, William B; Gaynor, Martin

    2010-10-01

    There has been substantial consolidation among health insurers and hospitals, recently, raising questions about the effects of this consolidation on the exercise of market power. We analyze the relationship between insurer and hospital market concentration and the prices of hospital services. We use a national US dataset containing transaction prices for health care services for over 11 million privately insured Americans. Using three years of panel data, we estimate how insurer and hospital market concentration are related to hospital prices, while controlling for unobserved market effects. We find that increases in insurance market concentration are significantly associated with decreases in hospital prices, whereas increases in hospital concentration are non-significantly associated with increases in prices. A hypothetical merger between two of five equally sized insurers is estimated to decrease hospital prices by 6.7%.

  2. CONOCIMIENTO DIDÁCTICO DEL CONTENIDO SOBRE FOTOSÍNTESIS DE DOS PROFESORES DE LOS GRADOS SEXTO Y NOVENO DE EDUCACIÓN BÁSICA SECUNDARIA DE UN COLEGIO PRIVADO EN BOGOTÁ-COLOMBIA (Pag: 50-76

    Directory of Open Access Journals (Sweden)

    Sonia Esmeralda Garnica

    2012-12-01

    Full Text Available Este artículo presenta los resultados obtenidos en un estudio que tuvo como objetivo analizar el conocimiento didáctico del contenido sobre la fotosíntesis (CDCF de dos profesoras de Biología, nivel de educación de secundaria en un colegio privado de Bogotá (Colombia. El enfoque fue interpretativo de tipo cualitativo. El método consistió en un estudio de caso y se utilizó la entrevista semi-estructurada, el cuestionario y el registro fílmico como técnicas de recolección de información. Se configuraron los elementos del CDCF de acuerdo al análisis de investigaciones relativas a la enseñanza de la fotosíntesis y al conocimiento didáctico del contenido. Se encontró que hay diferencias en el CDCF de las profesoras de cada uno de los grados analizados. Además, que unos elementos del CDCF permiten construir y desarrollar otros y es necesario conocerlos para dar cuenta del conocimiento que permite a las profesoras enseñar la fotosíntesis.

  3. Performance evaluation of nonhomogeneous hospitals: the case of Hong Kong hospitals.

    Science.gov (United States)

    Li, Yongjun; Lei, Xiyang; Morton, Alec

    2018-02-14

    Throughout the world, hospitals are under increasing pressure to become more efficient. Efficiency analysis tools can play a role in giving policymakers insight into which units are less efficient and why. Many researchers have studied efficiencies of hospitals using data envelopment analysis (DEA) as an efficiency analysis tool. However, in the existing literature on DEA-based performance evaluation, a standard assumption of the constant returns to scale (CRS) or the variable returns to scale (VRS) DEA models is that decision-making units (DMUs) use a similar mix of inputs to produce a similar set of outputs. In fact, hospitals with different primary goals supply different services and provide different outputs. That is, hospitals are nonhomogeneous and the standard assumption of the DEA model is not applicable to the performance evaluation of nonhomogeneous hospitals. This paper considers the nonhomogeneity among hospitals in the performance evaluation and takes hospitals in Hong Kong as a case study. An extension of Cook et al. (2013) [1] based on the VRS assumption is developed to evaluated nonhomogeneous hospitals' efficiencies since inputs of hospitals vary greatly. Following the philosophy of Cook et al. (2013) [1], hospitals are divided into homogeneous groups and the product process of each hospital is divided into subunits. The performance of hospitals is measured on the basis of subunits. The proposed approach can be applied to measure the performance of other nonhomogeneous entities that exhibit variable return to scale.

  4. 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 ...

  5. 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.

  6. Hospital Web site 'tops' in Louisiana. Hospital PR, marketing group cites East Jefferson General Hospital.

    Science.gov (United States)

    Rees, Tom

    2002-01-01

    East Jefferson General Hospital in Metairie, La., launched a new Web site in October 2001. Its user-friendly home page offers links to hospital services, medical staff, and employer information. Its jobline is a powerful tool for recruitment. The site was awarded the 2002 Pelican Award for Best Consumer Web site by the Louisiana Society for Hospital Public Relations & Marketing.

  7. 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.

  8. Hospital networks and the dispersal of hospital-acquired pathogens by patient transfer.

    Directory of Open Access Journals (Sweden)

    Tjibbe Donker

    Full Text Available Hospital-acquired infections (HAI are often seen as preventable incidents that result from unsafe practices or poor hospital hygiene. This however ignores the fact that transmissibility is not only a property of the causative organisms but also of the hosts who can translocate bacteria when moving between hospitals. In an epidemiological sense, hospitals become connected through the patients they share. We here postulate that the degree of hospital connectedness crucially influences the rates of infections caused by hospital-acquired bacteria. To test this hypothesis, we mapped the movement of patients based on the UK-NHS Hospital Episode Statistics and observed that the proportion of patients admitted to a hospital after a recent episode in another hospital correlates with the hospital-specific incidence rate of MRSA bacteraemia as recorded by mandatory reporting. We observed a positive correlation between hospital connectedness and MRSA bacteraemia incidence rate that is significant for all financial years since 2001 except for 2008-09. All years combined, this correlation is positive and significantly different from zero (partial correlation coefficient r = 0.33 (0.28 to 0.38. When comparing the referral pattern for English hospitals with referral patterns observed in the Netherlands, we predict that English hospitals more likely see a swifter and more sustained spread of HAIs. Our results indicate that hospitals cannot be viewed as individual units but rather should be viewed as connected elements of larger modular networks. Our findings stress the importance of cooperative effects that will have a bearing on the planning of health care systems, patient management and hospital infection control.

  9. 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.

  10. Medicare's Hospital Readmissions Reduction Program in Surgery May Disproportionately Affect Minority-serving Hospitals.

    Science.gov (United States)

    Shih, Terry; Ryan, Andrew M; Gonzalez, Andrew A; Dimick, Justin B

    2015-06-01

    To project readmission penalties for hospitals performing cardiac surgery and examine how these penalties will affect minority-serving hospitals. The Hospital Readmissions Reduction Program will potentially expand penalties for higher-than-predicted readmission rates to cardiac procedures in the near future. The impact of these penalties on minority-serving hospitals is unknown. We examined national Medicare beneficiaries undergoing coronary artery bypass grafting in 2008 to 2010 (N = 255,250 patients, 1186 hospitals). Using hierarchical logistic regression, we calculated hospital observed-to-expected readmission ratios. Hospital penalties were projected according to the Hospital Readmissions Reduction Program formula using only coronary artery bypass grafting readmissions with a 3% maximum penalty of total Medicare revenue. Hospitals were classified into quintiles according to proportion of black patients treated. Minority-serving hospitals were defined as hospitals in the top quintile whereas non-minority-serving hospitals were those in the bottom quintile. Projected readmission penalties were compared across quintiles. Forty-seven percent of hospitals (559 of 1186) were projected to be assessed a penalty. Twenty-eight percent of hospitals (330 of 1186) would be penalized less than 1% of total Medicare revenue whereas 5% of hospitals (55 of 1186) would receive the maximum 3% penalty. Minority-serving hospitals were almost twice as likely to be penalized than non-minority-serving hospitals (61% vs 32%) and were projected almost triple the reductions in reimbursement ($112 million vs $41 million). Minority-serving hospitals would disproportionately bear the burden of readmission penalties if expanded to include cardiac surgery. Given these hospitals' narrow profit margins, readmission penalties may have a profound impact on these hospitals' ability to care for disadvantaged patients.

  11. 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....

  12. [Satisfaction of hospitalized patients in a hospital in Apurimac, Peru].

    Science.gov (United States)

    Sihuin-Tapia, Elsa Yudy; Gómez-Quispe, Oscar Elisban; Ibáñez-Quispe, Vladimiro

    2015-01-01

    In order to determine the satisfaction of hospitalized patients in the Sub-regional Hospital of Andahuaylas, 175 patients were surveyed using the Servqual multidimensional model. The estimate of variables associated with the satisfaction of the hospitalized patients was performed by using bivariate and multivariate logistic regression analysis. We found 25.0% satisfaction. Lower levels of satisfaction were associated with having a secondary level education (aOR: 0.05; 95% CI: 0.01 to 0.64) and with having been hospitalized in the surgery department (aOR 0.14, CI: 95%: 0.04 to 0.53). It was concluded that there was a low level of satisfaction with the quality of care received by hospitalized patients and this was associated with the level of education and type of hospital department.

  13. Patient safety in organizational culture as perceived by leaderships of hospital institutions with different types of administration.

    Science.gov (United States)

    Silva, Natasha Dejigov Monteiro da; Barbosa, Antonio Pires; Padilha, Kátia Grillo; Malik, Ana Maria

    2016-01-01

    To identify the perceptions of leaderships toward patient safety culture dimensions in the routine of hospitals with different administrative profiles: government, social and private organizations, and make correlations among participating institutions regarding dimensions of patient safety culture used. A quantitative cross-sectional study that used the Self Assessment Questionnaire 30 translated into Portuguese. The data were processed by analysis of variance (ANOVA) in addition to descriptive statistics, with statistical significance set at p-value ≤ 0.05. According to the participants' perceptions, the significant dimensions of patient safety culture were 'patient safety climate' and 'organizational learning', with 81% explanatory power. Mean scores showed that among private organizations, higher values were attributed to statements; however, the correlation between dimensions was stronger among government hospitals. Different hospital organizations present distinct values for each dimension of patient safety culture and their investigation enables professionals to identify which dimensions need to be introduced or improved to increase patient safety. Identificar percepções das lideranças sobre as dimensões da cultura de segurança do paciente no cotidiano de hospitais de diferentes perfis administrativos: públicos, organizações sociais e privados, e realizar correlação entre as instituições participantes, de acordo com as dimensões da cultura de segurança do paciente utilizadas. Estudo transversal de aspecto quantitativo obtido por meio da aplicação do instrumento Self Assessment Questionnaire 30, traduzido para a língua portuguesa. Os dados foram tratados com análise de variância (ANOVA), além das estatísticas descritivas, considerando como de significância estatística valores de p-valor ≤ 0,05. Segundo a percepção dos participantes do estudo, as dimensões significativas para a cultura de segurança do paciente foram Ambiente de

  14. LA EFICIENCIA DE LOS CENTROS DE SALUD: EL CASO DE LOS HOSPITALES PRIVADOS

    Directory of Open Access Journals (Sweden)

    Adriana Baltazar Silva

    2004-11-01

    -style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

    RESUMEN

    El objetivo de este artículo es comunicar una revisión de la literatura sobre la evaluación de la eficiencia de las organizaciones sanitarias en países Asiáticos, Europeos y de América Latina, en un periodo de diez años, tanto como instrumento de Benchmarking como las diversas posibilidades de aplicación que tiene el mismo. El método de valoración que se propone utilizar es el Análisis Envolvente de Datos (DEA, cuyos resultados suministrados permiten identificar los factores que explican el comportamiento ineficiente-eficiente de los centros hospitalarios públicos o privados, mediante un análisis sistémico de los procesos de producción - input/output -. El objetivo de este artículo es comunicar una revisión de la literatura sobre la evaluación de la eficiencia de las organizaciones sanitarias en países Europeos y Estados Unidos en un periodo de cinco años tanto como instrumento para Benchmarking como las diversas posibilidades de aplicación que tiene.          Es que los hospitales al igual que cualquier otra empresa, tiene como objetivo último alcanzar el éxito no sólo económicos sino también en relación a la atención de sus pacientes. Esto significar lograr antigüedad, desarrollo de liderazgo, eficiencia de su producción y desde luego la rentabilidad, entre otros aspectos importantes. Para ello se analizan las

  15. Sistema de salud de Brasil The health system of Brazil

    Directory of Open Access Journals (Sweden)

    Víctor Becerril Montekio

    2011-01-01

    Full Text Available En este trabajo se describe el sistema de salud de Brasil, que está compuesto por un sector público que cubre alrededor de 75% de la población y un creciente sector privado que ofrece atención a la salud al restante 25% de los brasileños. El sector público está constituido por el Sistema Único de Salud (SUS y su financiamiento proviene de impuestos generales y contribuciones sociales recaudadas por los tres niveles de gobierno (federal, estatal y municipal. El SUS presta servicios de manera descentralizada a través de sus redes de clínicas, hospitales y otro tipo de instalaciones, y a través de contratos con establecimientos privados. El SUS es además responsable de la coordinación del sector público. El sector privado está conformado por un sistema de esquemas de aseguramiento conocido como Salud Suplementaria financiado con recursos de las empresas y/o las familias: la medicina de grupo (empresas y familias, las cooperativas médicas, los llamados Planes Autoadministrados (empresas y los planes de seguros de salud individuales. También existen consultorios, hospitales, clínicas y laboratorios privados que funcionan sobre la base de pagos de bolsillo, que utilizan sobre todo la población de mayores ingresos. En este trabajo se analizan los recursos con los que cuenta el sistema, las actividades de rectoría que se desarrollan y las innovaciones más recientemente implantadas, incluyendo el Programa de Salud de la Familia y el Programa Más Salud.This paper describes the Brazilian health system, which includes a public sector covering almost 75% of the population and an expanding private sector offering health services to the rest of the population. The public sector is organized around the Sistema Único de Saúde (SUS and it is financed with general taxes and social contributions collected by the three levels of government (federal, state and municipal. SUS provides health care through a decentralized network of clinics

  16. Traços identitários da enfermeira-gerente em hospitais privados de Belo Horizonte, Brasil The nurse manager's identity features in private hospitals of Belo Horizonte, Brazil

    Directory of Open Access Journals (Sweden)

    Maria José Menezes Brito

    2008-06-01

    Full Text Available Com o propósito de compreender aspectos subjetivos do trabalho da enfermeira-gerente, buscou-se, por meio deste estudo, analisar os traços identitários da enfermeira-gerente no contexto de instituições hospitalares a partir do questionamento fundamentado na apresentação que os sujeitos fazem de si mesmos. Trata-se de um estudo de caso, com abordagem qualitativa, do qual participaram nove enfermeiras-gerente que atuam em quatro instituições hospitalares privadas de médio e grande porte, no município de Belo Horizonte. Os traços identitários foram organizados de acordo com os planos profissional, organizacional e individual, os quais abrangem: preservação e reforço de identidade social da enfermeira, a trajetória profissional como uma evolução da prática da assistência para o exercício da gerência, valorização da experiência prática e permanência em atividades ligadas à prestação da assistência direta ao paciente; identificação com a organização; e questões relativas à vida privada e auto-imagem positiva expressa pelas gerentes. O estudo permitiu a identificação de traços marcantes de um grupo profissional específico, evidenciando a influência das questões de gênero, das relações de poder e da cultura na identidade social dos sujeitos pesquisados.Aiming to understand subjective aspects of the work of nurse managers, this study analyzed their identity features in the context of hospital institutions. These were obtained through a questioning based on the introduction that the subjects make of themselves. It is a case study carried out according to the qualitative approach, in which nine nurse managers participated. They worked at four large- and medium-sized private hospitals in the city of Belo Horizonte. The identity features were organized in accordance with the professional, institutional and individual planes, which encompass: the preservation and reinforcement of the nurse's social identity

  17. 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…

  18. 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.

  19. Trends in hospital librarianship and hospital library services: 1989 to 2006.

    Science.gov (United States)

    Thibodeau, Patricia L; Funk, Carla J

    2009-10-01

    The research studied the status of hospital librarians and library services to better inform the Medical Library Association's advocacy activities. The Vital Pathways Survey Subcommittee of the Task Force on Vital Pathways for Hospital Librarians distributed a web-based survey to hospital librarians and academic health sciences library directors. The survey results were compared to data collected in a 1989 survey of hospital libraries by the American Hospital Association in order to identify any trends in hospital libraries, roles of librarians, and library services. A web-based hospital library report form based on the survey questions was also developed to more quickly identify changes in the status of hospital libraries on an ongoing basis. The greatest change in library services between 1989 and 2005/06 was in the area of access to information, with 40% more of the respondents providing access to commercial online services, 100% more providing access to Internet resources, and 28% more providing training in database searching and use of information resources. Twenty-nine percent (n = 587) of the 2005/06 respondents reported a decrease in staff over the last 5 years. Survey data support reported trends of consolidation of hospitals and hospital libraries and additions of new services. These services have likely required librarians to acquire new skills. It is hoped that future surveys will be undertaken to continue to study these trends.

  20. Conhecimentos e práticas de saúde bucal de gestantes usuárias dos serviços de saúde em São Luís, Maranhão, 2007-2008

    Directory of Open Access Journals (Sweden)

    Fernanda Ferreira Lopes

    Full Text Available Resumo OBJETIVO: descrever as características dos cuidados de saúde bucal durante o acompanhamento pré-natal e o conhecimento sobre saúde bucal entre gestantes usuárias de serviços de saúde público e privado em São Luís, Maranhão, Brasil. MÉTODOS: estudo descritivo com 300 gestantes entrevistadas em serviço público e 300 em serviço privado, no período de agosto de 2007 a julho de 2008. RESULTADOS: a frequência de escovação dentária foi similar entre as usuárias dos serviços público e privado (p=0,156, enquanto o uso de fio dental (64,0% e 47,0%; p<0,001 e de colutórios (39,7% e 27,0%; p=0,001 foi mais frequente no serviço privado, em relação ao público; a maioria das usuárias, tanto do serviço público (60,3% como do privado (65,7%, desconheciam a associação entre saúde bucal e gravidez. CONCLUSÃO: a frequência de escovação dentária foi similar entre gestantes dos serviços público e privado; os efeitos da gestação sobre a saúde bucal eram pouco conhecidos.

  1. Entropías de la movilidad urbana en el espacio metropolitano de Guadalajara: Transporte privado y calidad del aire

    Directory of Open Access Journals (Sweden)

    Fernando Quevedo García

    2017-07-01

    Full Text Available Contexto: la evidencia empírica demuestra que, en los últimos tres lustros del presente siglo, el parque vehicular se ha incrementado en más de dos millones de unidades en el área metropolitana de Guadalajara. Dentro de este incremento alarmante, muchos de los vehículos no poseen convertidores catalíticos y a pesar de ello circulan cotidianamente por las vías primarias y secundarias de la metrópoli. De ahí el objetivo del presente trabajo consistente en reflexionar sobre la movilidad motorizada que se vive actualmente en la segunda urbe más importante de México. Método: se utiliza un método analítico descriptivo basado en la revisión documental de contenidos temáticos sobre el porcentaje de contaminantes que aporta cada municipio que compone la metrópoli de Guadalajara, con respecto al incremento del parque vehicular, calidad del aire, cantidad de vehículos registrados y cantidad de vehículos verificados. Con base en el enfoque sistémico, se hacen inferencias del escenario actual de la ciudad bajo el argumento de que ésta se encuentra ante la presencia de fuerzas estabilizadoras y desestabilidazoras de su estado homeostático. Resultados: se obtiene que la política gubernamental en materia de reducción de contaminantes ha tenido poco impacto en la concientización de la población.Por lo tanto, resulta necesario realizar un repensamiento de las acciones gubernamentales y ciudadanas para reducir la probabilidad de precontingencias y contingencias ambientales y promover la cultura de la movilidad incluyente, sustentable y segura. Asimismo, los datos sugieren que existe una ausencia sistémica en la planificación de la ciudad y del territorio. Conclusiones: la ausencia sistémica en la planificación de la ciudad y el territorio ha originado condiciones hostiles manifiestas en el espacio físico. En este espacio, los vehículos privados, y en general los medios motorizados, se han convertido en estas fuerzas que alteran la

  2. 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…

  3. 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.

  4. Effects of competition on hospital quality: an examination using hospital administrative data.

    Science.gov (United States)

    Palangkaraya, Alfons; Yong, Jongsay

    2013-06-01

    This paper investigates the effects of competition on hospital quality using hospital administration data from the State of Victoria, Australia. Hospital quality is measured by 30-day mortality rates and 30-day unplanned readmission rates. Competition is measured by Herfindahl-Hirschman index and the numbers of competing public and private hospitals. The paper finds that hospitals facing higher competition have lower unplanned admission rates. However, competition is related negatively to hospital quality when measured by mortality, albeit the effects are weak and barely statistically significant. The paper also finds that the positive effect of competition on quality as measured by unplanned readmission differs greatly depending on whether the hospital is publicly or privately owned.

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

    Science.gov (United States)

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

    2017-11-01

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

  6. Practices regarding hospital waste management at public and private sector hospitals of Lahore

    International Nuclear Information System (INIS)

    Mahmood, S.; Din, N.U.; Mohsin, J.

    2011-01-01

    Health care (Biomedical) waste is a term used for all waste arising from health care establishments. In most of health care centers of Pakistan, including Lahore, hospital wastes are simply mixed with the municipal waste in collecting bins at road-sides and disposed off similarly. Proper Management of biomedical waste, especially the hazardous one, being produced in hospital settings is important in terms of their ability to cause harm to the related per-sons and the environment as well. To Observe and compare the practices regarding Hospital Waste management of the public sector hospital with private sector hospital. Descriptive, Cross sectional. Methodology: Standardized checklist was used to assess the practices of nursing and sanitary staff. Practices regarding waste segregation were same at both hospitals. While practices regarding waste collection and transportation were better at The Children's Hospital. Public sector hospital has, paradoxically, better practices regarding hospital waste management in comparison to private sector hospital. (author)

  7. Determinants of Hospital Pharmacists’ Job Satisfaction in Romanian Hospitals

    Directory of Open Access Journals (Sweden)

    Magdalena Iorga

    2017-12-01

    Full Text Available Aim: The purpose of this study is to identify the level of job satisfaction among hospital pharmacists in Romania in relation to environmental, socio-demographic, and individual factors. Material and Methods: Seventy-eight hospital pharmacists were included in the research. The Job Satisfaction Scale was used to measure the level of satisfaction with their current jobs, and the TAS-20 was used to evaluate emotional experience and awareness. Additionally, 12 items were formulated in order to identify the reasons for dissatisfaction with jobs, such as budget, number of working hours, legislation, relationships with colleagues, hospital departments, or stakeholders. Data were analyzed using IBM SPSS Statistics version 23. Results: The analyses of the data revealed a low level of satisfaction regarding the pay–promotion subscale, a high level of satisfaction with the management–interpersonal relationship dimension, and a high level of satisfaction regarding the organization–communication subscale. Seventy-four percent of subjects are dissatisfied about the annual budget, and 86.3% are not at all satisfied with present legislation. Conclusions: These results are important for hospital pharmacists and hospital management in order to focus on health policies, management, and environmental issues, with the purpose of increasing the level of satisfaction among hospital pharmacists.

  8. Determinants of Hospital Pharmacists' Job Satisfaction in Romanian Hospitals.

    Science.gov (United States)

    Iorga, Magdalena; Dondaș, Corina; Soponaru, Camelia; Antofie, Ioan

    2017-12-11

    Aim : The purpose of this study is to identify the level of job satisfaction among hospital pharmacists in Romania in relation to environmental, socio-demographic, and individual factors. Material and Methods : Seventy-eight hospital pharmacists were included in the research. The Job Satisfaction Scale was used to measure the level of satisfaction with their current jobs, and the TAS-20 was used to evaluate emotional experience and awareness. Additionally, 12 items were formulated in order to identify the reasons for dissatisfaction with jobs, such as budget, number of working hours, legislation, relationships with colleagues, hospital departments, or stakeholders. Data were analyzed using IBM SPSS Statistics version 23. Results : The analyses of the data revealed a low level of satisfaction regarding the pay-promotion subscale, a high level of satisfaction with the management-interpersonal relationship dimension, and a high level of satisfaction regarding the organization-communication subscale. Seventy-four percent of subjects are dissatisfied about the annual budget, and 86.3% are not at all satisfied with present legislation. Conclusions : These results are important for hospital pharmacists and hospital management in order to focus on health policies, management, and environmental issues, with the purpose of increasing the level of satisfaction among hospital pharmacists.

  9. [Long-term psychiatric hospitalizations].

    Science.gov (United States)

    Plancke, L; Amariei, A

    2017-02-01

    Long-term hospitalizations in psychiatry raise the question of desocialisation of the patients and the inherent costs. Individual indicators were extracted from a medical administrative database containing full-time psychiatric hospitalizations for the period 2011-2013 of people over 16 years old living in the French region of Nord-Pas-de-Calais. We calculated the proportion of people who had experienced a hospitalization with a duration of 292 days or more during the study period. A bivariate analysis was conducted, then ecological data (level of health-care offer, the deprivation index and the size of the municipalities of residence) were included into a multilevel regression model in order to identify the factors significantly related to variability of long-term hospitalization rates. Among hospitalized individuals in psychiatry, 2.6% had had at least one hospitalization of 292 days or more during the observation period; the number of days in long-term hospitalization represented 22.5% of the total of days of full-time hospitalization in psychiatry. The bivariate analysis revealed that seniority in the psychiatric system was strongly correlated with long hospitalization rates. In the multivariate analysis, the individual indicators the most related to an increased risk of long-term hospitalization were: total lack of autonomy (OR=9.0; 95% CI: 6.7-12.2; P<001); diagnoses of psychological development disorders (OR=9.7; CI95%: 4.5-20.6; P<.001); mental retardation (OR=4.5; CI95%: 2.5-8.2; P<.001): schizophrenia (OR=3.0; CI95%: 1.7-5.2; P<.001); compulsory hospitalization (OR=1.7; CI95%: 1.4-2.1; P<.001); having experienced therapeutic isolation (OR=1.8; CI95%: 1.5-2.1; P<.001). Variations of long-term hospitalization rates depending on the type of establishment were very high, but the density of hospital beds or intensity of ambulatory activity services were not significantly linked to long-term hospitalization. The inhabitants of small urban units had

  10. Candiduria in hospitalized patients in teaching hospitals of Ahvaz.

    Science.gov (United States)

    Zarei-Mahmoudabadi, A; Zarrin, M; Ghanatir, F; Vazirianzadeh, B

    2012-12-01

    Nosocomial infections are usually acquired during hospitalization. Fungal infection of the urinary tract is increasing due to predisposing factors such as; antibacterial agents, indwelling urinary catheters, diabetes mellitus, long hospitalization, immunosuppressive agents, use of IV catheters, radiation therapy, malignancy. The aim of our study was to determine the prevalence of candiduria and urinary tract infection in patients admitted in Golestan and Emam Khomeini hospitals of Ahvaz, Iran. During 14 months, a total of 744 urine samples were collected and transferred to medical mycology laboratory immediately. Ten µl of uncentrifuged sample was cultured on CHROM agar Candida plates and incubated at 37°C for 24-48h aerobically. Candida species were identified based on colony morphology on CHROM agar Candida, germ tube production and micro-morphology on corn meal agar including 1% Tween 80. In the present study, 744 hospitalized patients were sampled (49.5%, female; 50.5%, male). The prevalence of candiduria in subjects was 16.5% that included 65.1% female and 34.9% male. The most common isolates were C. albicans (53.3%), followed by C. glabrata (24.4%), C. tropicalis (3.7%), C. krusei (2.2%), and Geotrichum spp. (0.7%) Urine cultures yielded more than 10,000 yeast colonies in 34.1% of cases, and the major predisposing factor associated with candiduria was antibiotic therapy (69.1%). Candiduria is relatively common in hospitalized patients in educational hospitals of Ahvaz. In addition, there is a strong correlation between the incidence of candiduria in hospitalized patients and broad-spectrum antibiotics therapy.

  11. Algumas considerações acerca do processo de viver humano de técnicos(as) de enfermagem recém-admitidos(as) em um hospital escola

    OpenAIRE

    Magalhães,Zídia Rocha; Matos,Eliane; Gonçalves,Jadete Rodrigues; Moreira,Leocarlos Cartaxo; Gonçalves,Leonor; Espinoza,Lita Moore; Salum,Nádia Chiodelli; Cartana,Maria do Horto

    2006-01-01

    El presente estudio pretende comprender el proceso de vivir humano de técnicos(as) de enfermería recién admitidos en instituciones de salud, con el objetivo de aprehender su realidad, buscando, a través de la discusión colectiva, construir espacios que propicien el vivir saludable. La metodología elegida contempló principios de la investigación acción participante e incluyó la entrevista individual y la reflexión en grupo focal, del cual participaron diez técnicos(as) de enfermería recién adm...

  12. The Relationship between Place of Residence and Hospitalization Rate in the Biggest Referral Hospital of the Northwest according to Hospitalization Wards

    Directory of Open Access Journals (Sweden)

    Amin Talebpour

    2016-06-01

    Full Text Available ​ Background and objectives: In accordance with the global pattern, the urban population in Iran is higher than the rural population. But, are the statistics of using hospitalization services in public hospitals in these two categories similar to this pattern? This study seeks to determine the effect of place of residence on hospitalization rate by examining annual hospitalization statistics of the country’s biggest referral hospital in the northwest. Material and Methods: The method used in this study is cross-sectional and all cases of hospitalization in Imam Reza Hospital as the northwest’s biggest referral hospital were picked by available sampling method. The cases of 30260 hospitalized patients were examined through direct observation and items extracted from their files were recorded in the checklist. In order to determine the relations between the variables, K2 test was applied and the P-value was considered less than 0.05 The obtained data were analyzed by SPSS.16 software. Results: Results indicated that the frequency distribution of patients in terms of their urban or rural residence did not yield any significant difference (P>0/05. Results also showed that the highest hospitalization rate for urban patients was 16.1% (3305 individuals in surgery ward while it was 14.2% (1384 individuals for rural patients in orthopedic ward. The least significant statistical difference between urban and rural hospitalization rates was observed in renal ward with 72.9% (1162 individual urban patients and 27.1% (432 individuals rural patients of total patients hospitalized in this ward. The most significant statistical difference between urban and rural hospitalization rates was observed in ICU with 44.9% (297 individuals urban patients and 55.1% (365 individuals rural patients of the total patients hospitalized in this ward. Conclusion: A relative comparison among illnesses in urban and rural populations, aside from illnesses caused by trauma

  13. Mobile Technology in Hospital Schools: What Are Hospital Teachers' Professional Learning Needs?

    Science.gov (United States)

    McCarthy, Aidan; Maor, Dorit; McConney, Andrew

    2017-01-01

    The aim of this study was to identify hospital teachers' professional learning needs to enable effective use of mobile technology in hospital schools. Hospitalized students cannot attend their regular schools and as a result their educational progress and development can suffer. In an attempt to address this, hospital schools provide learning…

  14. Internação por ordem judicial: dilemas éticos vivenciados por enfermeiros Internación por orden judicial: dilemas éticos vividos por enfermeros Hospitalization by court order: ethical dilemmas experienced by nurses

    Directory of Open Access Journals (Sweden)

    Mara Ambrosina de Oliveira Vargas

    2013-03-01

    Full Text Available Pesquisa qualitativa, cujo objetivo foi descrever as situações vivenciadas e os dilemas éticos dos enfermeiros no percurso de encaminhamento e recebimento, por ordem judicial, de pacientes com indicação de internação em Unidade de Terapia Intensiva (UTI. Foi efetivada entrevista parcialmente estruturada com 10 enfermeiros, que atuam em UTI e 10 que atuam em emergência de hospitais públicos e privados da região metropolitana de Porto Alegre, Brasil. Os dados foram submetidos à análise temática. Os resultados indicam que os enfermeiros vivenciam dilemas éticos consequentes aos problemas de superlotação das UTI e das emergências, da precária tecnologia especializada, da orientação quanto ao benefício concedido pela lei. Concluiu-se que é fundamental a participação dos enfermeiros em debates que possibilitem mapear as diferentes instâncias que têm promovido esta situação, muitas vezes caótica.Investigación cualitativa cuyo objetivo fue describir las situaciones vividas y los dilemas éticos de los enfermeros en el transcurso del envío y recibimiento por orden judicial de pacientes con indicación de internamiento en la Unidad de Cuidados Intensivos (UCI. Se realizó una entrevista parcialmente estructurada con 10 enfermeros que actuaban en la UCI y 10 que actuaban en Emergencias de hospitales públicos y privados de la región metropolitana de Porto Alegre, Brasil. Los datos fueron analizados según el Análisis Temático. Los resultados indican que los enfermeros experimentan dilemas éticos consiguientes problemas de hacinamiento en emergencia y UCI, especialista en tecnología pobre, la orientación en cuanto a los beneficios establecidos por la ley. Se concluye que es fundamental la participación de los enfermeros en debates que posibiliten mapear las diferentes instancias que han promovido esta situación muchas veces caótica.A qualitative study aimed at describing the situations experienced and the ethical

  15. Marginal Hospital Cost of Surgery-related Hospital-acquired Pressure Ulcers.

    Science.gov (United States)

    Spector, William D; Limcangco, Rhona; Owens, Pamela L; Steiner, Claudia A

    2016-09-01

    Patients who develop hospital-acquired pressure ulcers (HAPUs) are more likely to die, have longer hospital stays, and are at greater risk of infections. Patients undergoing surgery are prone to developing pressure ulcers (PUs). To estimate the hospital marginal cost of a HAPU for adults patients who were hospitalized for major surgeries, adjusted for patient characteristics, comorbidities, procedures, and hospital characteristics. Data are from the Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases and the Medicare Patient Safety Monitoring System for 2011 and 2012. PU information was obtained using retrospective structured record review from trained MPMS data abstractors. Costs are derived using HCUP hospital-specific cost-to-charge ratios. Marginal cost estimates were made using Extended Estimating Equations. We estimated the marginal cost at the 25th, 50th, and 75th percentiles of the cost distribution using Simultaneous Quantile Regression. We find that 3.5% of major surgical patients developed HAPUs and that the HAPUs added ∼$8200 to the cost of a surgical stay after adjusting for comorbidities, patient characteristics, procedures, and hospital characteristics. This is an ∼44% addition to the cost of a major surgical stay but less than half of the unadjusted cost difference. In addition, we find that for high-cost stays (75th percentile) HAPUs added ∼$12,100, whereas for low-cost stays (25th percentile) HAPUs added ∼$3900. This paper suggests that HAPUs add ∼44% to the cost of major surgical hospital stays, but the amount varies depending on the total cost of the visit.

  16. 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...

  17. Organizational culture and its relationship with hospital performance in public hospitals in China.

    Science.gov (United States)

    Zhou, Ping; Bundorf, Kate; Le Chang, Ji; Huang, Jin Xin; Xue, Di

    2011-12-01

    To measure perceptions of organizational culture among employees of public hospitals in China and to determine whether perceptions are associated with hospital performance. Hospital, employee, and patient surveys from 87 Chinese public hospitals conducted during 2009. Developed and administered a tool to assess organizational culture in Chinese public hospitals. Used factor analysis to create measures of organizational culture. Analyzed the relationships between employee type and perceptions of culture and between perceptions of culture and hospital performance using multivariate models. Employees perceived the culture of Chinese public hospitals as stronger in internal rules and regulations, and weaker in empowerment. Hospitals in which employees perceived that the culture emphasized cost control were more profitable and had higher rates of outpatient visits and bed days per physician per day but also had lower levels of patient satisfaction. Hospitals with cultures perceived as customer-focused had longer length of stay but lower patient satisfaction. Managers in Chinese public hospitals should consider whether the culture of their organization will enable them to respond effectively to their changing environment. © Health Research and Educational Trust.

  18. The effects of health information technology adoption and hospital-physician integration on hospital efficiency.

    Science.gov (United States)

    Cho, Na-Eun; Chang, Jongwha; Atems, Bebonchu

    2014-11-01

    To determine the impact of health information technology (HIT) adoption and hospital-physician integration on hospital efficiency. Using 2010 data from the American Hospital Association's (AHA) annual survey, the AHA IT survey, supplemented by the CMS Case Mix Index, and the US Census Bureau's small area income and poverty estimates, we examined how the adoption of HIT and employment of physicians affected hospital efficiency and whether they were substitutes or complements. The sample included 2173 hospitals. We employed a 2-stage approach. In the first stage, data envelopment analysis was used to estimate technical efficiency of hospitals. In the second stage, we used instrumental variable approaches, notably 2-stage least squares and the generalized method of moments, to examine the effects of IT adoption and integration on hospital efficiency. We found that HIT adoption and hospital-physician integration, when considered separately, each have statistically significant positive impacts on hospital efficiency. Also, we found that hospitals that adopted HIT with employed physicians will achieve less efficiency compared with hospitals that adopted HIT without employed physicians. Although HIT adoption and hospital-physician integration both seem to be key parts of improving hospital efficiency when one or the other is utilized individually, they can hurt hospital efficiency when utilized together.

  19. 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...

  20. 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.

  1. 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...

  2. Adherence to hospital drug formularies and cost of drugs in hospitals in Denmark

    DEFF Research Database (Denmark)

    Plet, H. T.; Hallas, J.; Kjeldsen, L. J.

    2013-01-01

    PURPOSE: To investigate adherence rates to hospital drug formularies (HDFs) and cost of drugs in hospitals. METHODS: Data on drugs used during 2010 were analyzed for ten hospitals (two hospitals from each of the five regions), constituting 30 % of hospitals and 45 % of hospital beds in Denmark....... Drug use data from individual hospitals were retrieved from the hospital pharmacies. Adherence to the HDFs was analyzed for selected substances characterised by extensive use both in primary and secondary sectors (ATC codes A10, B03, C03, C07, C08, C09, C10, J01, N02, N05 and R03). Within each group......, we also identified the drugs constituting 90 % of the volume (= DU90%) and the adherence to the HDF in this segment (Index of Adherence). RESULTS: Substances used by hospitals varied between 598 and 1,093. The proportion of used substances that were on the HDF varied between 14 % and 44 %. University...

  3. Substantial shifts in ranking of California hospitals by hospital-associated methicillin-resistant Staphylococcus aureus infection following adjustment for hospital characteristics and case mix.

    Science.gov (United States)

    Tehrani, David M; Phelan, Michael J; Cao, Chenghua; Billimek, John; Datta, Rupak; Nguyen, Hoanglong; Kwark, Homin; Huang, Susan S

    2014-10-01

    States have established public reporting of hospital-associated (HA) infections-including those of methicillin-resistant Staphylococcus aureus (MRSA)-but do not account for hospital case mix or postdischarge events. Identify facility-level characteristics associated with HA-MRSA infection admissions and create adjusted hospital rankings. A retrospective cohort study of 2009-2010 California acute care hospitals. We defined HA-MRSA admissions as involving MRSA pneumonia or septicemia events arising during hospitalization or within 30 days after discharge. We used mandatory hospitalization and US Census data sets to generate hospital population characteristics by summarizing across admissions. Facility-level factors associated with hospitals' proportions of HA-MRSA infection admissions were identified using generalized linear models. Using state methodology, hospitals were categorized into 3 tiers of HA-MRSA infection prevention performance, using raw and adjusted values. Among 323 hospitals, a median of 16 HA-MRSA infections (range, 0-102) per 10,000 admissions was found. Hospitals serving a greater proportion of patients who had serious comorbidities, were from low-education zip codes, and were discharged to locations other than home were associated with higher HA-MRSA infection risk. Total concordance between all raw and adjusted hospital rankings was 0.45 (95% confidence interval, 0.40-0.51). Among 53 community hospitals in the poor-performance category, more than 20% moved into the average-performance category after adjustment. Similarly, among 71 hospitals in the superior-performance category, half moved into the average-performance category after adjustment. When adjusting for nonmodifiable facility characteristics and case mix, hospital rankings based on HA-MRSA infections substantially changed. Quality indicators for hospitals require adequate adjustment for patient population characteristics for valid interhospital performance comparisons.

  4. EXPERIENCIA DE AMIGDALECTOMÍA EN LA FUNDACIÓN HOSPITAL DE LA MISERICORDIA DURANTE LOS ÚLTIMOS DIEZ AÑOS

    OpenAIRE

    Gilberto Eduardo Marrugo Pardo; Diana Velosa Buitrago; María Laura Rojas Serrano

    2009-01-01

    Antecedentes. La amigdalectomía es un procedimiento frecuente en otorrinolaringología pediátrica. Actualmente se indica en hipertrofia amigdalina que obstruya la vía aérea, amigdalitis aguda bacteriana recurrente, asimetría amigdalina y absceso periamigdalino. Es un procedimiento efectivo y con poca morbimortalidad. Las complicaciones más frecuentes son dolor, sangrado, intolerancia a la vía oral e insuficiencia velofaríngea. Objetivo. Revisar la experiencia en amigdalectomía durante los ...

  5. Hospital board effectiveness: relationships between board training and hospital financial viability.

    Science.gov (United States)

    Molinari, C; Morlock, L; Alexander, J; Lyles, C A

    1992-01-01

    This study examined whether hospital governing boards that invest in board education and training are more informed and effective decision-making bodies. Measures of hospital financial viability (i.e., selected financial ratios and outcomes) are used as indicators of hospital board effectiveness. Board participation in educational programs was significantly associated with improved profitability, liquidity, and occupancy levels, suggesting that investment in the education of directors is likely to enhance hospital viability and thus increase board effectiveness.

  6. Experiencing hospitality : an exploratory study on the experiential dimensions of hospitality

    NARCIS (Netherlands)

    Pijls-Hoekstra, Ruth; Groen, Brenda H.; Galetzka, Mirjam; Pruyn, Ad T.H.

    2015-01-01

    What is hospitality? Only few academic articles tap into the meaning of the concept of hospitality. Especially academic investigation of hospitality from a guest perspective is scarce; the combination of ‘hospitality’ and ‘experience’ has received hardly any attention. The present paper describes a

  7. 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.

  8. Using the Hospital Nutrition Environment Scan to Evaluate Health Initiative in Hospital Cafeterias.

    Science.gov (United States)

    Derrick, Jennifer Willahan; Bellini, Sarah Gunnell; Spelman, Julie

    2015-11-01

    Health-promoting environments advance health and prevent chronic disease. Hospitals have been charged to promote health and wellness to patients, communities, and 5.3 million adults employed in United States health care environments. In this cross-sectional observational study, the Hospital Nutrition Environment Scan (HNES) was used to measure the nutrition environment of hospital cafeterias and evaluate the influence of the LiVe Well Plate health initiative. Twenty-one hospitals in the Intermountain West region were surveyed between October 2013 and May 2014. Six hospitals participated in the LiVe Well Plate health initiative and were compared with 15 hospitals not participating. The LiVe Well Plate health initiative identified and promoted a healthy meal defined as health initiative branding were also posted at point of purchase. Hospital cafeterias were scored on four subcategories: facilitators and barriers, grab-and-go items, menu offerings, and selection options at point of purchase. Overall, hospitals scored 35.3±13.7 (range=7 to 63) points of 86 total possible points. Cafeterias in health initiative hospitals had significantly higher mean nutrition composite scores compared with non-health initiative hospitals (49.2 vs 29.7; Penvironment of hospital cafeterias. Additional research is needed to quantify and strategize ways to improve nutrition environments within hospital cafeterias and assess the influence on healthy lifestyle behaviors. Copyright © 2015 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  9. Hospital enterprise Architecture Framework (Study of Iranian University Hospital Organization).

    Science.gov (United States)

    Haghighathoseini, Atefehsadat; Bobarshad, Hossein; Saghafi, Fatehmeh; Rezaei, Mohammad Sadegh; Bagherzadeh, Nader

    2018-06-01

    Nowadays developing smart and fast services for patients and transforming hospitals to modern hospitals is considered a necessity. Living in the world inundated with information systems, designing services based on information technology entails a suitable architecture framework. This paper aims to present a localized enterprise architecture framework for the Iranian university hospital. Using two dimensions of implementation and having appropriate characteristics, the best 17 enterprises frameworks were chosen. As part of this effort, five criteria were selected according to experts' inputs. According to these criteria, five frameworks which had the highest rank were chosen. Then 44 general characteristics were extracted from the existing 17 frameworks after careful studying. Then a questionnaire was written accordingly to distinguish the necessity of those characteristics using expert's opinions and Delphi method. The result showed eight important criteria. In the next step, using AHP method, TOGAF was chosen regarding having appropriate characteristics and the ability to be implemented among reference formats. In the next step, enterprise architecture framework was designed by TOGAF in a conceptual model and its layers. For determining architecture framework parts, a questionnaire with 145 questions was written based on literature review and expert's opinions. The results showed during localization of TOGAF for Iran, 111 of 145 parts were chosen and certified to be used in the hospital. The results showed that TOGAF could be suitable for use in the hospital. So, a localized Hospital Enterprise Architecture Modelling is developed by customizing TOGAF for an Iranian hospital at eight levels and 11 parts. This new model could be used to be performed in other Iranian hospitals. Copyright © 2018 Elsevier B.V. All rights reserved.

  10. Appropriateness of pediatric hospitalization in a general hospital in Kuwait.

    Science.gov (United States)

    Shafik, Magdy H; Seoudi, Tarek M M; Raway, Tarek S; Al Harbash, Nowair Z; Ahmad, Meshal M A; Al Mutairi, Hanan F

    2012-01-01

    To determine the rate of inappropriate pediatric admissions using the Pediatric Appropriateness Evaluation Protocol (PAEP) and to examine variables associated with inappropriateness of admissions. A prospective study was conducted in the Department of Pediatrics, Farwania General Hospital, Kuwait, to examine successive admissions for appropriateness of admission as well as several sociodemographic characteristics over a 5-month period (August 2010 to December 2010). A total of 1,022 admissions were included. Of the 1,022 admissions, 416 (40.7%) were considered inappropriate. Factors associated with a higher rate of inappropriate admission included older age of patients and self-referral. The rate of inappropriate hospitalization of children was high in Farwania Hospital, Kuwait, probably due to the relatively free health care services, parental preference for hospital care, easy access to hospital services, and insufficient education about the child's condition. Copyright © 2012 S. Karger AG, Basel.

  11. Association of Changing Hospital Readmission Rates With Mortality Rates After Hospital Discharge

    Science.gov (United States)

    Wang, Yongfei; Lin, Zhenqiu; Normand, Sharon-Lise T.; Ross, Joseph S.; Horwitz, Leora I.; Desai, Nihar R.; Suter, Lisa G.; Drye, Elizabeth E.; Bernheim, Susannah M.; Krumholz, Harlan M.

    2017-01-01

    Importance The Affordable Care Act has led to US national reductions in hospital 30-day readmission rates for heart failure (HF), acute myocardial infarction (AMI), and pneumonia. Whether readmission reductions have had the unintended consequence of increasing mortality after hospitalization is unknown. Objective To examine the correlation of paired trends in hospital 30-day readmission rates and hospital 30-day mortality rates after discharge. Design, Setting, and Participants Retrospective study of Medicare fee-for-service beneficiaries aged 65 years or older hospitalized with HF, AMI, or pneumonia from January 1, 2008, through December 31, 2014. Exposure Thirty-day risk-adjusted readmission rate (RARR). Main Outcomes and Measures Thirty-day RARRs and 30-day risk-adjusted mortality rates (RAMRs) after discharge were calculated for each condition in each month at each hospital in 2008 through 2014. Monthly trends in each hospital’s 30-day RARRs and 30-day RAMRs after discharge were examined for each condition. The weighted Pearson correlation coefficient was calculated for hospitals’ paired monthly trends in 30-day RARRs and 30-day RAMRs after discharge for each condition. Results In 2008 through 2014, 2 962 554 hospitalizations for HF, 1 229 939 for AMI, and 2 544 530 for pneumonia were identified at 5016, 4772, and 5057 hospitals, respectively. In January 2008, mean hospital 30-day RARRs and 30-day RAMRs after discharge were 24.6% and 8.4% for HF, 19.3% and 7.6% for AMI, and 18.3% and 8.5% for pneumonia. Hospital 30-day RARRs declined in the aggregate across hospitals from 2008 through 2014; monthly changes in RARRs were −0.053% (95% CI, −0.055% to −0.051%) for HF, −0.044% (95% CI, −0.047% to −0.041%) for AMI, and −0.033% (95% CI, −0.035% to −0.031%) for pneumonia. In contrast, monthly aggregate changes across hospitals in hospital 30-day RAMRs after discharge varied by condition: HF, 0.008% (95% CI, 0.007% to 0.010%); AMI, −0

  12. 42 CFR 424.13 - Requirements for inpatient services of hospitals other than psychiatric hospitals.

    Science.gov (United States)

    2010-10-01

    ... other than psychiatric hospitals. 424.13 Section 424.13 Public Health CENTERS FOR MEDICARE & MEDICAID... other than psychiatric hospitals. (a) Content of certification and recertification. Medicare Part A pays for inpatient hospital services of hospitals other than psychiatric hospitals only if a physician...

  13. A dieta hospitalar na perspectiva dos sujeitos envolvidos em sua produção e em seu planejamento Hospital diet from the perspective of those involved in its production and planning

    Directory of Open Access Journals (Sweden)

    Rosa Wanda Diez Garcia

    2006-04-01

    Full Text Available OBJETIVO: Conhecer as razões objetivas e subjetivas, materiais e simbólicas que fundamentam a atitude das instituições hospitalares frente à alimentação, considerando-as como uma construção social, produto de concepções e práticas de profissionais que, direta ou indiretamente, a determinam e a reproduzem. MÉTODOS: Trata-se de uma pesquisa qualitativa para a qual foram realizadas 32 entrevistas em profundidade, semi-estruturadas, aplicadas aos sujeitos que participam do processo de produção das dietas: cozinheiros, copeiros, nutricionistas, médicos, enfermeiros, auxiliares de enfermagem e diretores clínico e administrativo e observação de campo em dois hospitais, um público e um privado. RESULTADOS: A análise de conteúdo das entrevistas e dos dados de observação de campo foi organizada em duas categorias: aspectos nutricionais desagregados da comida, na qual se constatou a valorização do aspecto nutricional, principalmente em ações de suporte nutricional, em detrimento dos aspectos sensoriais e simbólicos da alimentação hospitalar; e dieta hospitalar, sobre a qual observou-se escassez de informações técnicas e a influência da própria hospitalização nas representações sociais sobre esta, no que diz respeito à condição de controle e disciplina, a pouca autonomia e poder de voz do doente. A importância dada à dieta hospitalar é limitada e a atenção nutricional hospitalar é ainda embrionária. CONCLUSÃO: São necessários esforços para mudanças na cultura alimentar hospitalar, a fim de constituir uma visão da assistência nutricional hospitalar na qual a dieta hospitalar e a atenção nutricional possam ser parte importante no tratamento do paciente hospitalizado e colaborem com a qualidade da experiência de internação.OBJECTIVE: To know the objective and subjective reasons, material and symbolic, which act as the foundation of the attitude of hospital institutions towards meals, considered as a

  14. 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 ...

  15. Processo de implantação da política nacional de humanização em hospital público

    Directory of Open Access Journals (Sweden)

    Alessandra Barbosa Pereira

    Full Text Available O artigo analisa a experiência de implantação da Política Nacional de Humanização em uma instituição hospitalar pública de Belo Horizonte, Minas Gerais. Focalizam-se os avanços e limites da gestão participativa proposta pela política de humanização no cenário hospitalar. Trata-se de uma abordagem qualitativa, por meio de um estudo de caso no qual se utilizam pesquisa documental, entrevistas e observação. Os dados foram tratados mediante a análise temática de conteúdo, construindo-se categorias temáticas numa perspectiva da história do processo de implantação da Política Nacional de Humanização. O esforço da fase de implantação e o apoio do Ministério da Saúde não se sustentaram a médio prazo no hospital. A Política Nacional de Humanização apresenta inovação em relação às práticas do setor privado, ao superar um modelo de humanização centrado na 'satisfação do cliente', associando as práticas de cuidado às de gestão. Contudo, o maior desafio é transpor essa lógica e instaurar uma nova forma de se relacionar e atuar na saúde. Para que isso ocorra, é necessário intervir sobre a totalidade da conjuntura institucional.

  16. Medical Student Education in State Psychiatric Hospitals: A Survey of US State Hospitals.

    Science.gov (United States)

    Nurenberg, Jeffry R; Schleifer, Steven J; Kennedy, Cheryl; Walker, Mary O; Mayerhoff, David

    2016-04-01

    State hospitals may be underutilized in medical education. US state psychiatric hospitals were surveyed on current and potential psychiatry medical student education. A 10-item questionnaire, with multiple response formats, was sent to identified hospitals in late 2012. Ninety-seven of 221 hospitals contacted responded. Fifty-three (55%) reported current medical student education programs, including 27 clinical clerkship rotations. Education and training in other disciplines was prevalent in hospitals both with and without medical students. The large majority of responders expressed enthusiasm about medical education. The most frequent reported barrier to new programs was geographic distance from the school. Limited resources were limiting factors for hospitals with and without current programs. Only a minority of US state hospitals may be involved in medical student education. While barriers such as geographic distance may be difficult to overcome, responses suggest opportunities for expanding medical education in the state psychiatric hospitals.

  17. 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...

  18. Severe Maternal Morbidity and Hospital Cost among Hospitalized Deliveries in the United States.

    Science.gov (United States)

    Chen, Han-Yang; Chauhan, Suneet P; Blackwell, Sean C

    2018-05-03

     The objective of this study was to estimate the contemporary national rate of severe maternal morbidity (SMM) and its associated hospital cost during delivery hospitalization.  We conducted a retrospective study identifying all delivery hospitalizations in the United States between 2011 and 2012. We used data from the National (Nationwide) Inpatient sample of the Healthcare Cost and Utilization Project. The delivery hospitalizations with SMM were identified by having at least one of the 25 previously established list of diagnosis and procedure codes. Aggregate and mean hospital costs were estimated. A generalized linear regression model was used to examine the association between SMM and hospital costs.  Of 7,438,946 delivery hospitalizations identified, the rate of SMM was 154 per 10,000 delivery hospitalizations. Without any SMM, the mean hospital cost was $4,300 and with any SMM, the mean hospital cost was $11,000. After adjustment, comparing to those without any SMM, the mean cost of delivery hospitalizations with any SMM was 2.1 (95% confidence interval: 2.1-2.2) times higher, and this ratio increases from 1.7-fold in those with only one SMM to 10.3-fold in those with five or more concurrent SMM.  The hospital cost with any SMM was 2.1 times higher than those without any SMM. Our findings highlight the need to identify interventions and guide research efforts to mitigate the rate of SMM and its economic burden. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  19. Diferentes Abordagens dos Fenômenos Subjetivos na Obra de B. F. Skinner

    Directory of Open Access Journals (Sweden)

    Henrique Mesquita Pompermaier

    2014-08-01

    Full Text Available Como a análise do comportamento aborda os fenômenos subjetivos? Seria a teoria de eventos privados a única maneira? Guiado por essas questões, o presente trabalho busca apresentar a abordagem dos fenômenos subjetivos na obra de B. F. Skinner, indicando não apenas a teoria de eventos privados, mas também a possibilidade de abordagens alternativas a essa temática, sem referência à privacidade, por exemplo, por meio da magnitude das ações envolvidas nos fenômenos, níveis (aberto e encoberto do comportamento e conceitos disposicionais. Indica-se ainda uma significativa diferença de ênfase na teoria de eventos privados ao longo da obra skinneriana. Por fim, conduz-se uma discussão sobre o papel da teoria de eventos privados na análise do comportamento para a abordagem dos fenômenos subjetivos.

  20. Variations in hospitalization rates among nursing home residents: the role of discretionary hospitalizations.

    Science.gov (United States)

    Carter, Mary W

    2003-08-01

    To examine variations in hospitalization rates among nursing home residents associated with discretionary hospitalization practices. Quarterly Medicaid case-mix reimbursement data from the state of Massachusetts served as the core data source for this study, which was linked with data from the Medicare Provider Analysis and Review file (MEDPAR) to specify hospitalization status, nursing facility attribute data from the state of Massachusetts to specify facility-level organizational and structural attributes, and data from the Area Resource File (ARF) to specify area market-level attributes. Data spans three years (1991-1993) to produce a longitudinal analytical file containing 72,319 person-quarter-level observations. Two-step, multivariate logistic regression models were estimated for highly discretionary hospitalizations versus those containing less discretion, and low discretionary hospitalizations versus those containing greater amounts of physician discretion. Findings indicate that facility case-mix levels and area hospital bed supply levels contribute to variations in hospitalization rates among nursing home residents. Highly discretionary hospitalizations appear to be most sensitive to patient diagnoses best described as chronic, ambulatory care sensitive conditions. Findings suggest that defining hospitalizations simply in terms of whether an event occurs versus otherwise may obscure valuable information regarding the contribution of various risk factors to highly discretionary versus low discretionary hospitalization rates.

  1. Competition among Turkish hospitals and its effect on hospital efficiency and service quality.

    Science.gov (United States)

    Torun, Nazan; Celik, Yusuf; Younis, Mustafa Z

    2013-01-01

    The level of competition among hospitals in Turkey was analyzed for the years 1990 through 2006 using the Herfindahl-Hirschman Index (HHI). Multiple and simple regression analyses were run to observe the development of competition among hospitals over this period of time, to examine likely determinants of competition, and to calculate the effects of competition on efficiency and quality in individual hospitals. This study found that the level of competition among hospitals in Turkey has increased throughout the years. Also, competition has had a positive effect on the efficiency of hospitals; however, it did not have a significant positive effect on their quality. Moreover, there are important differences in the level of competition among hospitals that vary according to the geographical region, the type of ownership, and the type of hospital. This study is one of the first to evaluate the effects of health policies on competition as well as the effects of increasing competition on hospital quality and efficiency in Turkey.

  2. Hospital benchmarking: are U.S. eye hospitals ready?

    Science.gov (United States)

    de Korne, Dirk F; van Wijngaarden, Jeroen D H; Sol, Kees J C A; Betz, Robert; Thomas, Richard C; Schein, Oliver D; Klazinga, Niek S

    2012-01-01

    Benchmarking is increasingly considered a useful management instrument to improve quality in health care, but little is known about its applicability in hospital settings. The aims of this study were to assess the applicability of a benchmarking project in U.S. eye hospitals and compare the results with an international initiative. We evaluated multiple cases by applying an evaluation frame abstracted from the literature to five U.S. eye hospitals that used a set of 10 indicators for efficiency benchmarking. Qualitative analysis entailed 46 semistructured face-to-face interviews with stakeholders, document analyses, and questionnaires. The case studies only partially met the conditions of the evaluation frame. Although learning and quality improvement were stated as overall purposes, the benchmarking initiative was at first focused on efficiency only. No ophthalmic outcomes were included, and clinicians were skeptical about their reporting relevance and disclosure. However, in contrast with earlier findings in international eye hospitals, all U.S. hospitals worked with internal indicators that were integrated in their performance management systems and supported benchmarking. Benchmarking can support performance management in individual hospitals. Having a certain number of comparable institutes provide similar services in a noncompetitive milieu seems to lay fertile ground for benchmarking. International benchmarking is useful only when these conditions are not met nationally. Although the literature focuses on static conditions for effective benchmarking, our case studies show that it is a highly iterative and learning process. The journey of benchmarking seems to be more important than the destination. Improving patient value (health outcomes per unit of cost) requires, however, an integrative perspective where clinicians and administrators closely cooperate on both quality and efficiency issues. If these worlds do not share such a relationship, the added

  3. [Crisis unit at the general hospital: Determinants of further hospitalization].

    Science.gov (United States)

    Norotte, C; Omnès, C; Crozier, C; Verlyck, C; Romanos, M

    2017-10-01

    The availability of short-stay beds for brief admission (less than 72hours) of crisis patients presenting to the emergency room is a model that has gained a growing interest because it allows time for developing alternatives to psychiatric hospitalization and favors a maintained functioning in the community. Still, the determinants influencing the disposition decision at discharge after crisis intervention remain largely unexplored. The primary objective of this study was to determine the factors predicting aftercare dispositions at crisis unit discharge: transfer for further hospitalization or return to the community. Secondary objectives included the description of clinical and socio-demographic characteristics of patients admitted to the crisis unit upon presentation to the emergency room. All patients (n=255) admitted to the short-stay unit of the emergency department of Rambouillet General Hospital during a one-year period were included in the study. Patient characteristics were collected in a retrospective manner from medical records: patterns of referral, acute stressors, presenting symptoms, initial patient demand, Diagnostic and Statistical Manual, 5th edition (DSM-5) disorders, psychiatric history, and socio-demographic characteristics were inferred. Logistic regression analysis was used to determine the factors associated with hospitalization decision upon crisis intervention at discharge. Following crisis intervention at the short-stay unit, 100 patients (39.2%) required further hospitalization and were transferred. Statistically significant factors associated with a higher probability of hospitalization (P<0.05) included the patient's initial wish to be hospitalized (OR=4.28), the presence of a comorbid disorder (OR=3.43), a referral by family or friends (OR=2.89), a history of psychiatric hospitalization (OR=2.71) and suicidal ideation on arrival in the emergency room (OR=2.26). Conversely, significant factors associated with a lower probability of

  4. 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...

  5. [Smoking prevalence in hospital workers: meta-analysis in 45 Catalan hospitals].

    Science.gov (United States)

    Martínez, Cristina; Martínez-Sánchez, Jose M; Antón, Laura; Riccobene, Anna; Fu, Marcela; Quirós, Nuria; Saltó, Esteve; Fernández, Esteve

    2016-01-01

    To estimate the prevalence of smoking in workers from hospitals within the Catalan Network for Smoke-free hospitals from 2009 to 2012 according to workers' sociodemographic characteristics and the type of hospital. A meta-analysis was performed of prevalence surveys from representative samples of workers from 45 hospitals. The combined prevalence for all hospitals was calculated using a regression model with a random effects model weighted by sample size. The overall prevalence of smoking was 28.1% (95%CI: 26.1 to 30.0%) with a maximum and minimum of 40.3% and 19.1%, respectively. The health professionals with the lowest prevalence of smoking were physicians (16.4%; 95%CI: 12.9 to 19.9) and nurses (25.4%; 95%CI 21.6 to 29.2). The prevalence of smoking in hospital health workers was lower than in the general population of working age. Physicians were the group with the lowest smoking prevalence. Smoking cessation should be promoted among other professional groups. Copyright © 2015 SESPAS. Published by Elsevier Espana. All rights reserved.

  6. [Screening for malnutrition among hospitalized patients in a Colombian University Hospital].

    Science.gov (United States)

    Cruz, Viviana; Bernal, Laura; Buitrago, Giancarlo; Ruiz, Álvaro J

    2017-04-01

    On admission, 30 to 50% of hospitalized patients have some degree of malnutrition, which is associated with longer length of stay, higher rates of complications, mortality and greater costs. To determine the frequency of screening for risk of malnutrition in medical records and assess the usefulness of the Malnutrition Screening Tool (MST). In a cross-sectional study, we searched for malnutrition screening in medical records, and we applied the MST tool to hospitalized patients at the Internal Medicine Wards of San Ignacio University Hospital. Of 295 patients included, none had been screened for malnutrition since hospital admission. Sixty one percent were at nutritional risk, with a higher prevalence among patients with HIV (85.7%), cancer (77.5%) and pneumonia. A positive MST result was associated with a 3.2 days increase in length of hospital stay (p = 0.024). The prevalence of malnutrition risk in hospitalized patients is high, but its screening is inadequate and it is underdiagnosed. The MST tool is simple, fast, low-cost, and has a good diagnostic performance.

  7. 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.

  8. Analgesia e sedacao durante a instalacao do cateter central de insercao periferica em neonatos

    OpenAIRE

    Priscila Costa; Mariana Bueno; Cintia Luiza Oliva; Talita Elci de Castro; Patricia Ponce de Camargo; Amelia Fumiko Kimura

    2013-01-01

    Objetivou-se caracterizar as estratégias de analgesia e sedação em neonatos submetidos à instalação do cateter central de inserção periférica (CCIP) e relacioná-las ao número de punções venosas, duração do procedimento e posicionamento da ponta do cateter. Estudo transversal com coleta prospectiva de dados, realizado em uma unidade de cuidados intensivos neonatais de um hospital privado na cidade de São Paulo, no período de 31 de agosto de 2010 a 01 de julho de 2011, em que foram avaliadas 25...

  9. Analgesia e sedação durante a instalação do cateter central de inserção periférica em neonatos

    OpenAIRE

    Costa,Priscila; Bueno,Mariana; Oliva,Cintia Luiza; Castro,Talita Elci de; Camargo,Patrícia Ponce de; Kimura,Amélia Fumiko

    2013-01-01

    Objetivou-se caracterizar as estratégias de analgesia e sedação em neonatos submetidos à instalação do cateter central de inserção periférica (CCIP) e relacioná-las ao número de punções venosas, duração do procedimento e posicionamento da ponta do cateter. Estudo transversal com coleta prospectiva de dados, realizado em uma unidade de cuidados intensivos neonatais de um hospital privado na cidade de São Paulo, no período de 31 de agosto de 2010 a 01 de julho de 2011, em que foram avaliadas 25...

  10. 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...

  11. Determinants of the direct cost of heart failure hospitalization in a public tertiary hospital.

    Science.gov (United States)

    Parissis, John; Athanasakis, Kostas; Farmakis, Dimitrios; Boubouchairopoulou, Nadia; Mareti, Christina; Bistola, Vasiliki; Ikonomidis, Ignatios; Kyriopoulos, John; Filippatos, Gerasimos; Lekakis, John

    2015-02-01

    Heart failure (HF) is the first reason for hospital admission in the elderly and represents a major financial burden, the greatest part of which results from hospitalization costs. We sought to analyze current HF hospitalization-related expenditure and identify predictors of cost in a public tertiary hospital in Europe. We performed a retrospective chart review of 197 consecutive patients, aged 56±16years, 80% male, with left ventricular ejection fraction (LVEF) of 30±10%, hospitalized for HF in a major university hospital in Athens, Greece. The survey involved the number of hospitalization days, laboratory investigations and medical therapies. Patients who were hospitalized in CCU/ICU or underwent interventional procedures or device implantations were excluded from analysis. Costs were estimated based on the Greek healthcare system perspective in 2013. Patients were hospitalized for a median of 7 days with a total direct cost of €3198±3260/patient. The largest part of the expenses (79%) was attributed to hospitalization (ward), while laboratory investigations and medical treatment accounted for 17% and 4%, respectively. In multivariate analysis, pre-admission New York Heart Association NYHA class (p=0.001), serum creatinine (p=0.003) and NT-proBNP (p=0.004) were significant independent predictors of hospitalization cost. Direct cost of HF hospitalization is high particularly in patients with more severe symptoms, profound neurohormonal activation and renal dysfunction. Strategies to lower hospitalization rates are warranted in the current setting of financial constraints faced by many European countries. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  12. Evaluation of Collection and Disposal of Hospital Waste in Hospitals and Healthcare Centers

    Directory of Open Access Journals (Sweden)

    Saeid Nazemi

    2012-08-01

    Full Text Available Currently, one of the environmental issues is waste of hospitals and healthcare facilities which due to hazardous, toxic, and disease-causing agents such as pharmaceutical, chemical and infectious disease, is of particular sensitivity. According to a 2002 survey by WHO, it was determined that 22 million people worldwide suffer from infectious diseases annually, because of contacting hospital wastes. Also based on a research conducted in 22 countries, 18 to 64 percent of hospitals wastes are not disposed properly [1]. The purpose f the study is to appraise collection and disposal of hospital wastes in hospitals and healthcare centers of Shahroud.In this sectional study, 3 university hospitals (580 beds and 10 healthcare facilities were investigated for six months (mehr-azar 89 at Shahroud. In order to determine the amount of waste, produced waste of an entire day was weighted in hospitals and health centers. In this research, proposed questionnaires of WHO for developing countries was used to evaluate collection and disposal system of hospitals waste. Collected data was coded and analyzed by SPSS ver.15.

  13. What happens in hospitals does not stay in hospitals: antibiotic-resistant bacteria in hospital wastewater systems.

    Science.gov (United States)

    Hocquet, D; Muller, A; Bertrand, X

    2016-08-01

    Hospitals are hotspots for antimicrobial-resistant bacteria (ARB) and play a major role in both their emergence and spread. Large numbers of these ARB will be ejected from hospitals via wastewater systems. In this review, we present quantitative and qualitative data of extended-spectrum β-lactamase (ESBL)-producing Escherichia coli, vancomycin-resistant enterococci and Pseudomonas aeruginosa in hospital wastewaters compared to community wastewaters. We also discuss the fate of these ARB in wastewater treatment plants and in the downstream environment. Published studies have shown that hospital effluents contain ARB, the burden of these bacteria being dependent on their local prevalence. The large amounts of antimicrobials rejected in wastewater exert a continuous selective pressure. Only a few countries recommend the primary treatment of hospital effluents before their discharge into the main wastewater flow for treatment in municipal wastewater treatment plants. Despite the lack of conclusive data, some studies suggest that treatment could favour the ARB, notably ESBL-producing E. coli. Moreover, treatment plants are described as hotspots for the transfer of antibiotic resistance genes between bacterial species. Consequently, large amounts of ARB are released in the environment, but it is unclear whether this release contributes to the global epidemiology of these pathogens. It is reasonable, nevertheless, to postulate that it plays a role in the worldwide progression of antibiotic resistance. Antimicrobial resistance should now be seen as an 'environmental pollutant', and new wastewater treatment processes must be assessed for their capability in eliminating ARB, especially from hospital effluents. Copyright © 2016. Published by Elsevier Ltd.

  14. Hospital network performance: a survey of hospital stakeholders' perspectives.

    Science.gov (United States)

    Bravi, F; Gibertoni, D; Marcon, A; Sicotte, C; Minvielle, E; Rucci, P; Angelastro, A; Carradori, T; Fantini, M P

    2013-02-01

    Hospital networks are an emerging organizational form designed to face the new challenges of public health systems. Although the benefits introduced by network models in terms of rationalization of resources are known, evidence about stakeholders' perspectives on hospital network performance from the literature is scanty. Using the Competing Values Framework of organizational effectiveness and its subsequent adaptation by Minvielle et al., we conducted in 2009 a survey in five hospitals of an Italian network for oncological care to examine and compare the views on hospital network performance of internal stakeholders (physicians, nurses and the administrative staff). 329 questionnaires exploring stakeholders' perspectives were completed, with a response rate of 65.8%. Using exploratory factor analysis of the 66 items of the questionnaire, we identified 4 factors, i.e. Centrality of relationships, Quality of care, Attractiveness/Reputation and Staff empowerment and Protection of workers' rights. 42 items were retained in the analysis. Factor scores proved to be high (mean score>8 on a 10-item scale), except for Attractiveness/Reputation (mean score 6.79), indicating that stakeholders attach a higher importance to relational and health care aspects. Comparison of factor scores among stakeholders did not reveal significant differences, suggesting a broadly shared view on hospital network performance. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  15. 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

  16. Radiopharmaceuticals and hospital radiopharmacy practices: course manual for accreditation/certification of hospital radiopharmacists

    International Nuclear Information System (INIS)

    Ramamoorthy, N.; Shivarudrappa, V.; Bhelose, Amita A.

    2000-02-01

    This manual on hospital radiopharmaceuticals and hospital radiopharmacy practices contains information and recommendations that could be of use to hospital radiopharmacists while the main focus of the book is to impart adequate exposure to basics of radiopharmaceuticals and purity and safety aspects of formulations to be made in hospital radiopharmacy. Papers relevant to INIS are indexed separately

  17. 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.

  18. A multicenter qualitative study on preventing hospital-acquired urinary tract infection in US hospitals.

    Science.gov (United States)

    Saint, Sanjay; Kowalski, Christine P; Forman, Jane; Damschroder, Laura; Hofer, Timothy P; Kaufman, Samuel R; Creswell, John W; Krein, Sarah L

    2008-04-01

    Although urinary tract infection (UTI) is the most common hospital-acquired infection, there is little information about why hospitals use or do not use a range of available preventive practices. We thus conducted a multicenter study to understand better how US hospitals approach the prevention of hospital-acquired UTI. This research is part of a larger study employing both quantitative and qualitative methods. The qualitative phase consisted of 38 semistructured phone interviews with key personnel at 14 purposefully sampled US hospitals and 39 in-person interviews at 5 of those 14 hospitals, to identify recurrent and unifying themes that characterize how hospitals have addressed hospital-acquired UTI. Four recurrent themes emerged from our study data. First, although preventing hospital-acquired UTI was a low priority for most hospitals, there was substantial recognition of the value of early removal of a urinary catheter for patients. Second, those hospitals that made UTI prevention a high priority also focused on noninfectious complications and had committed advocates, or "champions," who facilitated prevention activities. Third, hospital-specific pilot studies were important in deciding whether or not to use devices such as antimicrobial-impregnated catheters. Finally, external forces, such as public reporting, influenced UTI surveillance and infection prevention activities. Clinicians and policy makers can use our findings to develop initiatives that, for example, use a champion to promote the removal of unnecessary urinary catheters or exploit external forces, such public reporting, to enhance patient safety.

  19. The Medicare Hospital Readmissions Reduction Program: potential unintended consequences for hospitals serving vulnerable populations.

    Science.gov (United States)

    Gu, Qian; Koenig, Lane; Faerberg, Jennifer; Steinberg, Caroline Rossi; Vaz, Christopher; Wheatley, Mary P

    2014-06-01

    To explore the impact of the Hospital Readmissions Reduction Program (HRRP) on hospitals serving vulnerable populations. Medicare inpatient claims to calculate condition-specific readmission rates. Medicare cost reports and other sources to determine a hospital's share of duals, profit margin, and characteristics. Regression analyses and projections were used to estimate risk-adjusted readmission rates and financial penalties under the HRRP. Findings were compared across groups of hospitals, determined based on their share of duals, to assess differential impacts of the HRRP. Both patient dual-eligible status and a hospital's dual-eligible share of Medicare discharges have a positive impact on risk-adjusted hospital readmission rates. Under current Centers for Medicare and Medicaid Service methodology, which does not adjust for socioeconomic status, high-dual hospitals are more likely to have excess readmissions than low-dual hospitals. As a result, HRRP penalties will disproportionately fall on high-dual hospitals, which are more likely to have negative all-payer margins, raising concerns of unintended consequences of the program for vulnerable populations. Policies to reduce hospital readmissions must balance the need to ensure continued access to quality care for vulnerable populations. © Health Research and Educational Trust.

  20. Sistema de salud de Costa Rica The health system of Costa Rica

    Directory of Open Access Journals (Sweden)

    María del Rocío Sáenz

    2011-01-01

    Full Text Available En este trabajo se describe el sistema de salud de Costa Rica, que presta servicios de salud, agua y saneamiento. El componente de servicios de salud incluye un sector público y uno privado. El sector público está dominado por la Caja Costarricense de Seguro Social (CCSS, institución autónoma encargada del financiamiento, compra y prestación de la mayoría de los servicios personales. La CCSS se financia con contribuciones de los afiliados, los empleadores y el Estado, y administra tres regímenes: el seguro de enfermedad y maternidad, el seguro de invalidez, vejez y muerte, y el régimen no contributivo. La CCSS presta servicios en sus propias instalaciones o contrata prestadores del sector privado con los que establece contratos denominados "compromisos de gestión". El sector privado comprende una amplia red de prestadores que ofrecen servicios ambulatorios y de especialidad con fines lucrativos. Estos servicios se financian sobre todo con pagos de bolsillo, pero también con primas de seguros privados. El Ministerio de Salud es el rector del sistema y como tal cumple con funciones de dirección política, regulación sanitaria, direccionamiento de la investigación y desarrollo tecnológico. Dentro de las innovaciones relativamente recientes que se han implantado en Costa Rica destacan la implantación de los equipos básicos de atención integral de salud (EBAIS, la desconcentración de los hospitales y clínicas públicos, la introducción de los acuerdos de gestión y la creación de las Juntas de Salud.This paper describes the Costa Rican health system which provides health, water and sanitation services. The health component of the system includes a public and a private sector. The public sector is dominated by the Caja Costarricense de Seguro Social (CCSS, an autonomous institution in charge of financing, purchasing and delivering most of the personal health services in Costa Rica. CCSS is financed with contributions of the

  1. Children's Hospitals' Solutions for Patient Safety Collaborative Impact on Hospital-Acquired Harm.

    Science.gov (United States)

    Lyren, Anne; Brilli, Richard J; Zieker, Karen; Marino, Miguel; Muething, Stephen; Sharek, Paul J

    2017-09-01

    To determine if an improvement collaborative of 33 children's hospitals focused on reliable best practice implementation and culture of safety improvements can reduce hospital-acquired conditions (HACs) and serious safety events (SSEs). A 3-year prospective cohort study design with a 12-month historical control population was completed by the Children's Hospitals' Solutions for Patient Safety collaborative. Identification and dissemination of best practices related to 9 HACs and SSE reduction focused on key process and culture of safety improvements. Individual hospital improvement teams leveraged the resources of a large, structured children's hospital collaborative using electronic, virtual, and in-person interactions. Thirty-three children's hospitals from across the United States volunteered to be part of the Children's Hospitals' Solutions for Patient Safety collaborative. Thirty-two met all the data submission eligibility requirements for the HAC improvement objective of this study, and 21 participated in the high-reliability culture work aimed at reducing SSEs. Significant harm reduction occurred in 8 of 9 common HACs (range 9%-71%; P collaborative dedicated to implementing HAC-related best-practice prevention bundles and culture of safety interventions designed to increase the use of high-reliability organization practices resulted in significant HAC and SSE reductions. Structured collaboration and rapid sharing of evidence-based practices and tools are effective approaches to decreasing hospital-acquired harm. Copyright © 2017 by the American Academy of Pediatrics.

  2. Determining Disturbing Factors of Sleep Quality among Hospitalized Elderly Patients in Kashan Hospitals, Iran 2009

    Directory of Open Access Journals (Sweden)

    M Kafaei

    2013-03-01

    Full Text Available Introduction: Sleep is an effective factor in the recovery processes. Many variables affect on the sleep quality of hospitalized elderly people. This study was conducted to determine the factors disturbing sleep quality among hospitalized older adult patients in Kashan hospitals. Methods: A cross-sectional study was carried out on a sample of 390 elderly hospitalized patients in Kashan hospitals. The study data was gathered via Pittsburgh Sleep Quality Index (PSQI Questionnaire. A global total score of 5 or greater indicated a “poor" quality of sleep. The data were analyzed using Chi square, t- test and binary logistic regression at multivariate model. Results: The total quality of sleep was poor in hospitalized elderly patients (7/2±4/8. Sex, marital status, level of education, type of ward, previous hospitalization experience, use of hypnotics at home and hospital, and previous sleep disorders were statistically associated with quality of sleep; however, there was not significant relationship between quality of sleep and age, length of hospitalization, and daytime napping. In the final regression model, marital status (OR=4.6, level of education (OR=1.9, length of hospitalization (OR=1.1, Previous hospitalization experience (OR=0.4, use of hypnotics in hospital (OR=0.27 and previous sleep disorder (OR=0.01 were the most important determinants of sleep quality. Conclusion: Quality of sleep was poor in hospitalized elderly due to a wide range of sleep disturbing factors. The most important factors involved marital status, level of education, previous hospitalization experience, previous sleep disorder and use of hypnotics in hospital.

  3. Ensino superior privado: expansão das cooperativas de mão de obra docente Private higher education: the expansion of teacher's labor cooperatives

    Directory of Open Access Journals (Sweden)

    Adolfo Ignacio Calderón

    2011-08-01

    Full Text Available Este artigo aborda a terceirização de professores por meio de cooperativas de mão de obra no âmbito do ensino superior privado, fenômeno educacional que surgiu na metade da presente década, enquadrado como prática ilegal que fere os princípios do cooperativismo quando visa fraudar a legislação trabalhista brasileira. Tem por objetivo compreender a expansão desse fenômeno por meio da reconstrução da cronologia dos fatos, da identificação dos momentos históricos do seu entendimento legal e do mapeamento da sua expansão geográfica, a partir da identificação de casos concretos que envolveram a atuação da Justiça do Trabalho, do Ministério Público do Trabalho e outros órgãos do Poder Público. Apoiando-se em pesquisa qualitativa, são identificados quatro momentos claramente definidos que vão desde o surgimento dos primeiros casos até a punição das instituições de ensino superior que adotaram o sistema contratual em questão.The present article deals with the outsourcing of professors of private higher education through labor cooperatives. This educational phenomenon appeared in the middle of the decade. The matter was considered an illegal practice violating cooperative principles and defrauding labor laws. The objective of the article is to understand the expansion of this phenomenon, supported by a chronological reconstruction of the facts, the identification of historical moments aiming to provide a legal framework based on concrete cases involving the Labor Justice and the Public Ministry. Qualitative research allowed the identification of four moments: since the appearance of the first cases, until the punishments of the higher education institutions who adopted this contractual system.

  4. Impact of hyperglycemia on morbidity and mortality, length of hospitalization and rates of re-hospitalization in a general hospital setting in Brazil

    Directory of Open Access Journals (Sweden)

    Leite Silmara AO

    2010-07-01

    Full Text Available Abstract Background Hyperglycemia in hospitalized patients is known to be related to a higher incidence of clinical and surgical complications and poorer outcomes. Adequate glycemic control and earlier diagnosis of type 2 diabetes during hospitalization are cost-effective measures. Methods This prospective cohort study was designed to determine the impact of hyperglycemia on morbidity and mortality in a general hospital setting during a 3-month period by reviewing patients' records. The primary purposes of this trial were to verify that hyperglycemia was diagnosed properly and sufficiently early and that it was managed during the hospital stay; we also aimed to evaluate the relationship between in-hospital hyperglycemia control and outcomes such as complications during the hospital stay, extent of hospitalization, frequency of re-hospitalization, death rates and number of days in the ICU (Intensive Care Unit after admission. Statistical analyses utilized the Kruskall-Wallis complemented by the "a posteriori" d.m.s. test, Spearman correlation and Chi-squared test, with a level of significance of 5% (p Results We reviewed 779 patient records that fulfilled inclusion criteria. The patients were divided into 5 groups: group (1 diabetic with normal glycemic levels according to American Diabetes Association criteria for in-hospital patients (n = 123; group (2 diabetics with hyperglycemia (n = 76; group (3 non-diabetics with hyperglycemia (n = 225; group (4diabetics and non-diabetics with persistent hyperglycemia during 3 consecutive days (n = 57 and group (5 those with normal glucose control (n = 298. Compared to patients in groups 1 and 5, patients in groups 2, 3 and 4 had significantly higher mortality rates (17.7% vs. 2.8% and Intensive Care Unit admissions with complications (23.3% vs. 4.5%. Patients in group 4 had the longest hospitalizations (mean 15.5 days, and group 5 had the lowest re-hospitalization rate (mean of 1.28 hospitalizations. Only

  5. In a niche of time: do specialty hospitals outperform general services hospitals?

    Science.gov (United States)

    Poole, LeJon; Davis, Jullet A; Gunby, Norris W

    2013-01-01

    Niche hospitals represent a growing segment in the health care industry. Niche facilities are primarily engaged in the treatment of cardiac or orthopedic conditions. The effectiveness of this strategy is of interest because niche hospitals focus on only the most profitable services. The purpose of this research was to assess the financial effectiveness of the niche strategy. We theorize that firm and market-level factors concomitantly with the strategy of the hospital-niche versus traditional-are associated with financial performance. This research used 2 data sources, the 2003 Medicare Cost Report and the 2003 Area Resource File. The sample was limited to only for-profit, urban, nongovernmental hospitals (n = 995). The data were analyzed using hierarchical least squares regression. Financial performance was operationalized using the hospital's return on assets. The principal finding of this project is that niche hospitals had significantly higher performance than traditional facilities. From the organizational perspective, the niche strategy leads to better financial performance. From a societal perspective, the niche strategy provides increased focus and efficiencies through repetition. Despite the limited focus of this strategy, patients who can access these providers may experience better outcomes than patients in more traditional hospitals.

  6. Mental hospital reform in Asia: the case of Yuli Veterans Hospital, Taiwan

    OpenAIRE

    Lin, Chih-Yuan; Huang, Ai-Ling; Minas, Harry; Cohen, Alex

    2009-01-01

    Abstract Background Yuli Veterans Hospital (YVH) has been the largest mental hospital for the patients with chronic and severe mental illness in Taiwan for the past 50 years. While this hospital used to be a symbol of hopelessness among patients and their families and an unspoken shame among Taiwan psychiatry and mental health circles it now represents an example of how an old, custodial hospital can be transformed into a very different institution. In this case study we will describe the fea...

  7. Additional funding mechanisms for Public Hospitals in Greece: the case of Chania Mental Health Hospital.

    Science.gov (United States)

    Rentoumis, Anastasios; Mantzoufas, Nikolaos; Kouris, Gavriil; Golna, Christina; Souliotis, Kyriakos

    2010-11-10

    To investigate whether the long term lease of public hospital owned land could be an additional financing mechanism for Greek public (mental) health hospitals. We performed a financial analysis of the official 2008 data of a case - study hospital (Mental Health Hospital of Chania). We used a capital budgeting approach to investigate whether value is created for the public hospital by engaging its assets in a project for the development of a private renal dialysis Unit. The development of the private unit in hospital owned land is a good investment decision, as it generates high project Net Present Value and Internal Rate of Return. When the project commences generating operating cash flows, nearly €400.000 will be paid annually to the Mental Health Hospital of Chania as rent, thereby gradually decreasing the annual deficit of the hospital. Revenue generated from the long term lease of public hospital land is crucial to gradually eliminate hospital deficit. The Ministry of Health should encourage similar forms of Public Private Partnerships in order to ensure the sustainability of public (mental) hospitals.

  8. Intersetorialidade e potenciais conflitos de interesse entre governos e setor privado comercial no âmbito das ações de alimentação e nutrição para o enfrentamento de doenças crônicas não transmissíveis | Intersectoriality and potential conflicts of interest between governments and private, commercial sector within the context of food and nutrition actions to deal with chronic non-communicable diseases

    OpenAIRE

    Luciene Burlandy; Fabio S Gomes; Camila MP Carvalho; Patricia Camacho Dias; Patricia Henriques

    2014-01-01

    Neste artigo foram analisados os potenciais conflitos entre interesses governamentais e privados de caráter comercial em torno das ações de alimentação e nutrição (AN) no âmbito de propostas intersetoriais de enfrentamento das DCNT no Brasil. Para tal, foram identificados artigos acadêmicos e documentos institucionais publicados a partir de 2000 que abordassem as ações de AN em políticas de DCNT pautadas pela intersetorialidade. Foram priorizados elementos que contribuíssem para a compreensão...

  9. 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 ...

  10. Risk of malnutrition of hospitalized children in a university public hospital.

    Science.gov (United States)

    Muñoz-Esparza, Nelly Carolina; Vásquez-Garibay, Edgar Manuel; Romero-Velarde, Enrique; Troyo-Sanromán, Rogelio

    2017-02-01

    The study aimed to demonstrate that the duration of hospitalization has a significant effect on the nutritional status of children treated in a university hospital. A longitudinal study was conducted during 2014, with a non-random sampling site concentration in children from birth to 19 years who were admitted to the hospital in the past 24 hours and who met the inclusion criteria and had signed informed consent. Upon entering, at 7 days, and at discharge, anthropometric indices, including weight/age, height/age, weight/height, BMI/age, head circumference/age, triceps and subscapular skin folds, and fat percentage, were obtained. Student's t-test, U Mann-Whitney, ANOVA, chi square, Wilcoxon, and odds ratios were used to analyze the data. In total, 206 patients were included: 40% infants, 25% preschoolers, 15% schoolchildren, and 20% teenagers. Infants had a significant improvement from admission to discharge in the indices weight/length (p = 0.042) and BMI (p = 0.002); adolescents showed decreased BMI from admission to discharge from the hospital (p = 0.05). Patients with longer hospitalization (more than 10 days) had an increased deficit in anthropometric indices at admission (p malnutrition and require greater monitoring of nutritional status during hospitalization.

  11. Hospital Medicine (Part 1): what is wrong with acute hospital care?

    LENUS (Irish Health Repository)

    Kellett, John

    2009-09-01

    Modern hospitals are facing several challenges and, over the last decade in particular, many of these institutions have become dysfunctional. Paradoxically as medicine has become more successful the demand for acute hospital care has increased, yet there is no consensus on what conditions or complaints require hospital admission and there is wide variation in the mortality rates, length of stay and possibly standards of care between different units. Most acutely ill patients are elderly and instead of one straightforward diagnosis are more likely to have a complex combination of multiple co-morbid conditions. Any elderly patient admitted to hospital is at considerable risk which must be balanced against the possible benefits. Although most of the patients in hospital die from only approximately ten diagnoses, obvious life saving treatment is often delayed by a junior doctor in-training first performing an exhaustive complete history and physical, and then ordering a number of investigations before consulting a senior colleague. Following this traditional hierarchy delays care with several "futile cycles" of clinical activity thoughtlessly directed at the patient without any benefit being delivered. If acute hospital medicine is to be improved changes in traditional assumptions, attitudes, beliefs and practices are needed.

  12. Padrões e mudanças no financiamento e regulação do Sistema de Saúde Brasileiro: impactos sobre as relações entre o público e privado Patterns and changes in the financing and regulation of Brazilian Health System: impacts on public and private relationships

    Directory of Open Access Journals (Sweden)

    Ligia Bahia

    2005-08-01

    Full Text Available O trabalho sistematiza as matrizes interpretativas envolvidas no debate sobre o sistema de saúde brasileiro e avança hipóteses sobre as extensas e dinâmicas fronteiras de interseção público-privadas que o caracterizam. Considerando que o hiato entre as concepções sobre o sistema de saúde baseadas em modelos puros e a realidade brasileira, na qual predominam as formas híbridas de prestação e organização de redes de serviços, constitui, per se, um foco permanente de tensões, o estudo destaca e dimensiona: a utilização de fontes públicas de financiamento à demanda e a oferta dos planos de saúde; o afluxo de clientes de planos a uma capacidade instalada de recursos físicos e humanos constituída e reproduzida com recursos públicos; a inserção público-privada de profissionais de saúde e as franquias para dirigentes de empresas privadas assumirem cargos públicos e vice-versa. Os reflexos da estrutura e formas de articulação entre o público e o privado nas agendas dos mais importantes fóruns de debate e formulação de diretrizes para o sistema de saúde, as Conferências de Saúde (previstas pela Lei 8142-90 como instâncias de avaliação e elaboração de diretrizes para a saúde nas três esferas de governo, e das instituições governamentais relacionadas diretamente com o SUS são analisados. Conclui-se que as tensões, conflitos e proposições, sobre o considerado componente público do sistema de saúde, estão direcionadas a arenas específicas de debate. Paralelamente renovaram-se e constituíram-se outros fóruns de negociação sobre o componente privado. Portanto, a segmentação das demandas reflete-se, de maneira quase automática, no âmbito setorial, na definição de "pautas especializadas" - ou no público ou no privado.This article systematizes the interpretative matrixes used in the debate about the Brazilian Unified Health System and formulates hypothesis about the extensive and dynamic frontiers

  13. Medicare Payment Penalties and Safety Net Hospital Profitability: Minimal Impact on These Vulnerable Hospitals.

    Science.gov (United States)

    Bazzoli, Gloria J; Thompson, Michael P; Waters, Teresa M

    2018-02-08

    To examine relationships between penalties assessed by Medicare's Hospital Readmission Reduction Program and Value-Based Purchasing Program and hospital financial condition. Centers for Medicare and Medicaid Services, American Hospital Association, and Area Health Resource File data for 4,824 hospital-year observations. Bivariate and multivariate analysis of pooled cross-sectional data. Safety net hospitals have significantly higher HRRP/VBP penalties, but, unlike nonsafety net hospitals, increases in their penalty rate did not significantly affect their total margins. Safety net hospitals appear to rely on nonpatient care revenues to offset higher penalties for the years studied. While reassuring, these funding streams are volatile and may not be able to compensate for cumulative losses over time. © Health Research and Educational Trust.

  14. 78 FR 15882 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

    Science.gov (United States)

    2013-03-13

    ... Payment Systems for Acute Care Hospitals and the Long Term Care Hospital Prospective Payment System and... Register entitled ``Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long Term Care Hospital Prospective Payment System and Fiscal Year 2013 Rates; Hospitals...

  15. Results of a hospital waste survey in private hospitals in Fars province, Iran

    International Nuclear Information System (INIS)

    Askarian, Mehrdad; Vakili, Mahmood; Kabir, Gholamhosein

    2004-01-01

    Hospital waste is considered dangerous because it may possess pathogenic agents and can cause undesirable effects on human health and the environment. In Iran, neither rules have been compiled nor does exact information exist regarding hospital waste management. The survey presented in this article was carried out in all 15 private hospitals of Fars province (Iran) from the total numbers of 50 governmental and private hospitals located in this province, in order to determine the amount of different kinds of waste produced and the present situation of waste management. The results indicated that the waste generation rate is 4.45 kg/bed/day, which includes 1830 kg (71.44%) of domestic waste, 712 kg (27.8%) of infectious waste, and 19.6 kg (0.76%) of sharps. Segregation of the different types of waste is not carried out perfectly. Two (13.3%) of the hospitals use containers without lids for on-site transport of wastes. Nine (60%) of the hospitals are equipped with an incinerator and six of them (40%) have operational problems with the incinerators. In all hospitals municipal workers transport waste outside the hospital premises daily or at the most on alternative days. In the hospitals under study, there aren't any training courses about hospital waste management and the hazards associated with them. The training courses that are provided are either ineffective or unsuitable. Performing extensive studies all over the country, compiling and enacting rules, establishing standards and providing effective personnel training are the main challenges for the concerned authorities and specialists in this field

  16. Preventing hospital malnutrition: a survey on nutritional policies in an Italian University Hospital.

    Science.gov (United States)

    Annetta, M G; Pittiruti, M; De Rosa, S; Franchi, P; Pintaudi, G; Caricato, A; Antonelli, M

    2015-11-01

    A proper strategy for fighting hospital malnutrition should include nutritional screening of all hospitalized patients, adequate utilization of the Hospital facilities - such as Clinical Nutrition Services or Nutrition Teams - and an adequate algorithm for the adoption of proper nutrition support (oral, enteral or parenteral) with proper timing. The main aim of the present study was to investigate the current policies of different non-intensive wards of our institution (a 1100 beds University Hospital) in terms of prevention of hospital malnutrition. We conducted a one-day survey to verify the current policies of nutritional screening and the indication to nutritional support in adult patients, interviewing nurses and physicians of our non-intensive hospital wards. A total of 29 wards were considered, which sum up to 755 hospitalized patients. We found that nutritional screening at admission is routinely assessed only in 41% of wards and that oral nutrient intake is controlled regularly only in 72%. Indication to clinical nutrition support and specifically to artificial nutrition is not consistent with the current international guidelines. Only 14% of patients were receiving artificial nutrition at the moment of the survey and the majority of them were given parenteral nutrition rather than enteral feeding. Our survey confirmed that in large hospitals the main barriers to the fight against hospital malnutrition are the lack of knowledge and/or commitment by nurses and physicians as well as the lack of well-defined hospital policies on early nutritional screening, surveillance of nutritional status and indication to nutrition support.

  17. Sistema de salud de Argentina The health system of Argentina

    Directory of Open Access Journals (Sweden)

    Mariana Belló

    2011-01-01

    Full Text Available En este artículo se describe el sistema de salud de Argentina, que está compuesto por tres sectores: público, de seguridad social y privado. El sector público está integrado por los ministerios nacional y provincial, y la red de hospitales y centros de salud públicos que prestan atención gratuita a toda persona que lo demande, fundamentalmente a personas sin seguridad social y sin capacidad de pago. Se financia con recursos fiscales y recibe pagos ocasionales de parte del sistema de seguridad social cuando atiende a sus afiliados. El sector del seguro social obligatorio está organizado en torno a las Obras Sociales (OS, que aseguran y prestan servicios a los trabajadores y sus familias. La mayoría de las OS operan a través de contratos con prestadores privados y se financian con contribuciones de los trabajadores y patronales. El sector privado está conformado por profesionales de la salud y establecimientos que atienden a demandantes individuales, a los beneficiarios de las OS y de los seguros privados. Este sector también incluye entidades de seguro voluntario llamadas Empresas de Medicina Prepaga que se financian sobre todo con primas que pagan las familias y/o las empresas. En este trabajo también se describen las innovaciones recientes en el sistema de salud, incluyendo el Programa Remediar.This paper describes the health system of Argentina.This system has three sectors: public, social security and private.The public sector includes the national and provincial ministries as well as the network of public hospitals and primary health care units which provide care to the poor and uninsured population. This sector is financed with taxes and payments made by social security beneficiaries that use public health care facilities. The social security sector or Obras Sociales (OS covers all workers of the formal economy and their families. Most OS operate through contracts with private providers and are financed with payroll

  18. Service Robots for Hospitals: A Case Study of Transportation Tasks in a Hospital

    DEFF Research Database (Denmark)

    Özkil, Ali Gürcan; Fan, Zhun; Dawids, Steen

    2009-01-01

    In this paper, the need for automated transportation systems for hospitals is investigated. Among other alternatives, mobile robots stand out as the most prominent means of automation of transportation tasks in hospitals. Existing transportation routines of a hospital are analyzed in order...... to verify the need for automation and identify possible areas of improvement. The analysis shows that most of the existing transportation is carried out manually, and hospitals can greatly benefit from automated transportation. Based on the results of the analysis, three alternatives are derived...... for implementing mobile service robots for transportation tasks in hospitals....

  19. Distribuição dos recursos humanos em oito hospitais gerais de São Paulo Distribution of human resources in eight general hospitals in São Paulo

    Directory of Open Access Journals (Sweden)

    Olímpio J. Nogueira V. Bitta

    1997-07-01

    Full Text Available O desenvolvimento tecnológico e o aparecimento de novas especialidades médicas motivaram um aumento na divisão de trabalho nos hospitais, com conseqüente criação de subáreas. A redistribuição dos recursos humanos nos hospitais passa, então, a ser uma meta importante para o alcance da eficiência. Através de entrevistas realizadas entre maio e outubro de 1993, com diretores e superintendentes de oito hospitais em São Paulo, Brasil, o presente estudo descreveu e analisou a distribuição dos recursos humanos em quatro grandes áreas: infra-estrutura; internação clínico-cirúrgica; área complementar de diagnóstico e terapêutica; ambulatório e emergência. O estudo analisou também a proporção de funcionários por leito, além de traçar uma comparação entre hospitais públicos e privados. Os resultados revelaram que, em média, a relação funcionários/leito é igual a 6,8. A distribuição percentual de funcionários por grandes áreas, conforme o estudo, foi de 46,9% na infra-estrutura, 10,7% na área complementar de diagnóstico e terapêutica, 32,0% na internação e 10,3% na área de ambulatório/emergência.Technological development and the appearance of new medical specialties have led to increased division of labor in hospitals, with the resultant creation of subareas. Therefore, the redistribution of human resources in hospitals has become an important aim in order to achieve efficiency. On the basis of interviews conducted between May and October 1993 with the directors and superintendents of eight hospitals in São Paulo, Brazil, this study describes and analyzes the distribution of human resources in four broad areas: infrastructure, clinico-surgical inpatient care, the complementary area of diagnostics and therapeutics, and emergency and outpatient care. The study also analyzed the ratio of employees per bed, besides outlining a comparison of public and private hospitals. The results revealed that, on average

  20. Additional funding mechanisms for Public Hospitals in Greece: the case of Chania Mental Health Hospital

    Directory of Open Access Journals (Sweden)

    Golna Christina

    2010-11-01

    Full Text Available Abstract Objectives To investigate whether the long term lease of public hospital owned land could be an additional financing mechanism for Greek public (mental health hospitals. Methods We performed a financial analysis of the official 2008 data of a case - study hospital (Mental Health Hospital of Chania. We used a capital budgeting approach to investigate whether value is created for the public hospital by engaging its assets in a project for the development of a private renal dialysis Unit. Results The development of the private unit in hospital owned land is a good investment decision, as it generates high project Net Present Value and Internal Rate of Return. When the project commences generating operating cash flows, nearly €400.000 will be paid annually to the Mental Health Hospital of Chania as rent, thereby gradually decreasing the annual deficit of the hospital. Conclusions Revenue generated from the long term lease of public hospital land is crucial to gradually eliminate hospital deficit. The Ministry of Health should encourage similar forms of Public Private Partnerships in order to ensure the sustainability of public (mental hospitals.

  1. The Influence of Employee Ability, Hospital???s Ethic and Leadership to Satisfaction through the Employee Commitment: A Study on Indonesian Type A Government Hospital

    OpenAIRE

    Mardiana, Ria; Djabir Hamzah; Syamsul Bahri

    2013-01-01

    Aims: The aims of this study is to confirm the direct and indirect influence of employee ability, perceived of hospital???s ethic and leadership to the satisfaction of customer through employee commitment. Sample are hospital???s stakeholders that consist of paramedics (frontliners, doctors, and nurses) and inpatient of healthcare insurance. Study design: A survey instrument comprising a construct of employee ability, perceived hospital ethic, lead...

  2. 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.

  3. Logistics in hospitals: a case study of some Singapore hospitals.

    Science.gov (United States)

    Pan, Zhi Xiong; Pokharel, Shaligram

    2007-01-01

    The purpose of this paper is to investigate logistics activities in Singapore hospitals. It defines various types of activities handled by a logistics division. Inventory management policy and the use of information and communication technologies (ICT) for logistics purposes are also discussed. The study identifies the nature of strategic alliances in Singapore's health care industry. This study was conducted by utilizing a framework for data collection, pre-testing the questionnaire and conducting interviews. Various relevant literature was reviewed to design the questionnaire. This study finds that logistics division carry out many related activities and some of them also provide engineering services. The hospitals make use of ICT. The hospitals are clustered under various groups to minimize the cost of operation, including the logistics related costs. However, hospitals do not see alliances with suppliers as a strategic option; rather they focus on outsourcing of logistics services. The findings also show that Singapore hospitals have a good stocking policy for both medical and non-medical items so that changes in patient mix can be easily handled. Singapore is continuously improving its health care industry and therefore, the findings will help hospitals in other regions to adopt some of the practices, like concentrating on local vendors, outsourcing, clustering, and maximum use of information technology as competitive factors that can improve the service and reduce the cost of operation. The paper suggests motivators and barriers to the use of ICT in logistics in the health care industry.

  4. Hospital medicine (Part 2): what would improve acute hospital care?

    LENUS (Irish Health Repository)

    Kellett, John

    2009-09-01

    There are so many obvious delays and inefficiencies in our traditional system of acute hospital care; it is clear that if outcomes are to be improved prompt accurate assessment immediately followed by competent and efficient treatment is essential. Early warning scores (EWS) help detect acutely ill patients who are seriously ill and likely to deteriorate. However, it is not known if any EWS has universal applicability to all patient populations. The benefit of Rapid Response Systems (RRS) such as Medical Emergency Teams has yet to be proven, possibly because doctors and nurses are reluctant to call the RRS for help. Reconfiguration of care delivery in an Acute Medical Assessment Unit has been suggested as a "proactive" alternative to the "reactive" approach of RRS. This method ensures every patient is in an appropriate and safe environment from the moment of first contact with the hospital. Further research is needed into what interventions are most effective in preventing the deterioration and\\/or resuscitating seriously ill patients. Although physicians expert in hospital care decrease the cost and length of hospitalization without compromising outcomes hospital care will continue to be both expensive and potentially dangerous.

  5. Hospital boards and hospital strategic focus: the impact of board involvement in strategic decision making.

    Science.gov (United States)

    Ford-Eickhoff, Karen; Plowman, Donde Ashmos; McDaniel, Reuben R

    2011-01-01

    Despite pressures to change the role of hospital boards, hospitals have made few changes in board composition or director selection criteria. Hospital boards have often continued to operate in their traditional roles as either "monitors" or "advisors." More attention to the direct involvement of hospital boards in the strategic decision-making process of the organizations they serve, the timing and circumstances under which board involvement occurs, and the board composition that enhances their abilities to participate fully is needed. We investigated the relationship between broader expertise among hospital board members, board involvement in the stages of strategic decision making, and the hospital's strategic focus. We surveyed top management team members of 72 nonacademic hospitals to explore the participation of critical stakeholder groups such as the board of directors in the strategic decision-making process. We used hierarchical regression analysis to explore our hypotheses that there is a relationship between both the nature and involvement of the board and the hospital's strategic orientation. Hospitals with broader expertise on their boards reported an external focus. For some of their externally-oriented goals, hospitals also reported that their boards were involved earlier in the stages of decision making. In light of the complex and dynamic environment of hospitals today, those charged with developing hospital boards should match the variety in the external issues that the hospital faces with more variety in board makeup. By developing a board with greater breadth of expertise, the hospital responds to its complex environment by absorbing that complexity, enabling a greater potential for sensemaking and learning. Rather than acting only as monitors and advisors, boards impact their hospitals' strategic focus through their participation in the strategic decision-making process.

  6. Sociodemographic profile and hospitalization process of elderly assisted at a emergency hospital

    Directory of Open Access Journals (Sweden)

    Maria Luciene Nobre Coutinho

    2015-12-01

    Full Text Available Objectives: to investigate the sociodemographic profile and the process of hospitalization of elderly assisted in an emergency hospital. Methods: descriptive epidemiological study conducted at an emergency hospital with 300 elderly patients using a form with hospitalization process and sociodemographic variables. Results: there was a predominance of females (56.0%, between 80 and 89 years old (45.4%, illiterate or with elementary education (86.7%, married or living in stable union (42.6%, with non-communicable chronic disease (54.7% and regular use of medications. The main reason for hospitalization was fall (54.7% at home and in the morning hours (42.4%, with admission in the afternoon, transported by ambulance. Conclusion: the findings contribute to the development of strategies directed to assist and care of the healthy elderly and in vulnerable situations.

  7. Hospital-acquired malnutrition in children at a tertiary care hospital

    African Journals Online (AJOL)

    Del-Rossi Sean Quadros

    As such, there is a need for hospitals to monitor its occurrence using cost- effective but accurate tools. Table 1: General .... Malades Hospital, France.2. Our study ... daily weight loss, which is the critical threshold for an adverse clinical outcome ...

  8. Hospital Acquisitions Before Healthcare Reform.

    Science.gov (United States)

    McCue, Michael J; Thompson, Jon M; Kim, Tae Hyun

    2015-01-01

    The hospital industry has experienced increased consolidation in the past 20 years. Since 2010, in particular, there has been a large rise in the number of hospital acquisitions, and observers have suggested this is due in part to the expected impact of federal healthcare reform legislation. This article reports on a study undertaken to identify the market, management, and financial factors affecting acute care, community hospitals acquired between 2010 and 2012. We identified 77 such hospitals and compared them to other acute care facilities. To assess how different factors were associated with acquisitions, the study used multiple logistic regressions whereby market factors were included first, followed by management and financial factors. Study findings show that acquired hospitals were located in markets with lower rates of preferred provider organization (PPO) penetration compared with nonacquired hospitals. Occupancy rate was found to be inversely related to acquisition rate; however, case-mix index was significantly and positively related to a hospital's being acquired. Financial factors negatively associated with a hospital's being acquired included age of plant and cash flow margin. In contrast to the findings from earlier studies of hospital acquisitions, our results showed that acquired hospitals possessed newer assets. However, similar to the findings of other studies, the cash flow margin of acquired hospitals was lower than that of nonacquired facilities.

  9. 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...

  10. Hospital staff education on severe sepsis/septic shock and hospital mortality: an original hypothesis

    Directory of Open Access Journals (Sweden)

    Capuzzo Maurizia

    2012-11-01

    Full Text Available Abstract Background Signs of serious clinical events overlap with those of sepsis. We hypothesised that any education on severe sepsis/septic shock may affect the outcome of all hospital patients. We designed this study to assess the trend of the mortality rate of adults admitted to hospital for at least one night in relationship with a hospital staff educational program dedicated to severe sepsis/septic shock. Methods This study was performed in six Italian hospitals in the same region. Multidisciplinary Sepsis Teams members were selected by each hospital management among senior staff. The education included the following steps: i the Teams were taught about adult learning, problem based learning, and Surviving Sepsis guidelines, and provided with educational material (literature, electronic presentations, scenarios of clinical cases for training and booklets; ii they started delivering courses and seminars each to their own hospital staff in the last quarter of 2007. To analyse mortality, we selected adult patients, admitted for at least one night to the wards or units present in all the study hospitals and responsible for 80% of hospital deaths. We fitted a Poisson model with monthly hospital mortality rates from December 2003 to August 2009 as dependent variable. The effect of the educational program on hospital mortality was measured as two dummy variables identifying a first (November 2007 to December 2008 and a second (January to August 2009 education period. The analysis was adjusted for a linear time trend, seasonality and monthly average values of age, Charlson score, length of stay in hospital and urgent/non-urgent admission. Results The hospital staff educated reached 30.6% at the end of June 2009. In comparison with the pre-education period, the Relative Risk of death of the patient population considered was 0.93 (95% confidence interval [CI] 0.87-0.99; p 0.025 for in-patients in the first, and 0.89 (95% CI 0.81-0.98; p 0.012 for

  11. Surveillance for hospital-acquired infections on surgical wards in a Dutch university hospital

    NARCIS (Netherlands)

    Kamp-Hopmans, Titia E. M.; Blok, Hetty E. M.; Troelstra, Annet; Gigengack-Baars, Ada C. M.; Weersink, Annemarie J. L.; Vandenbroucke-Grauls, Christina M. J. E.; Verhoef, Jan; Mascini, Ellen M.

    2003-01-01

    OBJECTIVES: To determine incidence rates of hospital-acquired infections and to develop preventive measures to reduce the risk of hospital-acquired infections. METHODS: Prospective surveillance for hospital-acquired infections was performed during a 5-year period in the wards housing general and

  12. 42 CFR 419.20 - Hospitals subject to the hospital outpatient prospective payment system.

    Science.gov (United States)

    2010-10-01

    ... prospective payment system. 419.20 Section 419.20 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEM FOR HOSPITAL... Outpatient Prospective Payment System § 419.20 Hospitals subject to the hospital outpatient prospective...

  13. Using In-Hospital Mortality as an Indicator of Quality Care and Hospital Performance

    Directory of Open Access Journals (Sweden)

    Badia BISBIS

    2016-06-01

    Full Text Available The in-hospital mortality (MIH is used as a performance indicator and quality healthcare in hospital. However, the majority of deaths resulted from an inevitable disease process (severity of cases and / or co-morbidity, and not medical errors or changes in the quality of care. This work aims to make a distribution of deaths in the Regional Hospital of Eastern, Al Farabi hospital and to highlight that more studies on the MIH are required consistently with detailed clinical data at the admission. The MIH showed its limitation as a health care  indicator. The overall rate of in-hospital deaths within the Al Farabi hospital has averaged 2.4%, with 8.4% in the emergency unit, 28% in intensive care unit, 22% Neonatology unit, 1.6% in pediatric unit. The MIH may depend, firstly, on the condition of patients before hospitalization and secondly, on the conditions of their transfer from one institution to another that supports them as a last resort. Al Farabi hospital supports patients transferred from the provinces of the eastern region. Thus, 6% of patients who died in 2014 come from Berkane, 2% from  Nador, 2% from Bouarfa, 4% from  Taourirt and 2% from Jerrada. One might question about  the procedures and the conditions of such transfers. In conclusion, the overall MIH measured from routine data do not allow proper comparison between hospitals or the assessment of the quality of care and patient safety in the hospital. To do so, we should ideally have detailed clinical data on admission (e.g. type of admission, age of patient, sex, comorbidity, .... The MIH is however an important indicator to consider as a tool to detect potential  problems related to admission procedures and to suspect an area of "non-quality" in healthcare . The MIH is interesting for the patient and for the hospital because it serves the improvement of quality healthcare.

  14. How to govern physician-hospital exchanges: contractual and relational issues in Belgian hospitals.

    Science.gov (United States)

    Trybou, Jeroen; Gemmel, Paul; Annemans, Lieven

    2014-07-01

    Our aim was to investigate contractual mechanisms in physician-hospital exchanges. The concepts of risk-sharing and the nature of physician-hospital exchanges - transactional versus relational - were studied. Two qualitative case studies were performed in Belgium. Hospital executives and physicians were interviewed to develop an in-depth understanding of contractual and relational issues that shape physician-hospital contracting in acute care hospitals. The underlying theoretical concepts of agency theory and social exchange theory were used to analyse the data. Our study found that physician-hospital contracting is highly complex. The contract is far more than an economic instrument governing financial aspects. The effect of the contract on the nature of exchange - whether transactional or relational - also needs to be considered. While it can be argued that contractual governance methods are increasingly necessary to overcome the difficulties that arise from the fragmented payment framework by aligning incentives and sharing financial risk, they undermine the necessary relational governance. Relational qualities such as mutual trust and an integrative view on physician-hospital exchanges are threatened, and may be difficult to sustain, given the current fragmentary payment framework. Since health care policy makers are increasing the financial risk borne by health care providers, it can be argued that this also increases the need to share financial risk and to align incentives between physician and hospital. However, our study demonstrates that while economic alignment is important in determining physician-hospital contracts, the corresponding impact on working relationships should also be considered. Moreover, it is important to avoid a relationship between hospital and physician predominantly characterized by transactional exchanges thereby fostering an unhealthy us-and-them divide and mentality. Relational exchange is a valuable alternative to contractual

  15. The impact of non-IPA HMOs on the number of hospitals and hospital capacity.

    Science.gov (United States)

    Chernew, M

    1995-01-01

    Concentration in the hospital market could limit the success of health care reform strategies that rely on managed care to constrain costs. Hospital market capacity also is important because capacity affects both costs and the degree of price competition. Because managed care plans, particularly non-individual practice association (non-IPA) model HMOs, practice a less hospital-intensive style of care, consolidation and downsizing in the hospital market potentially will accompany managed care growth, influencing the long-run effectiveness of managed care cost-containment strategies. Using Standard Metropolitan Statistical Area (SMSA) data from 1982 and 1987, a 10-percentage point increase in non-IPA HMO market share is estimated to reduce the number of hospitals by about 4%, causing an approximate 5% reduction in the number of hospital beds. No statistically significant relationship is found between non-IPA HMO penetration rates and hospital occupancy rates.

  16. Improvement of hospital performance through innovation: toward the value of hospital care.

    Science.gov (United States)

    Dias, Casimiro; Escoval, Ana

    2013-01-01

    The perspective of innovation as the strategic lever of organizational performance has been widespread in the hospital sector. While public value of innovation can be significant, it is not evident that innovation always ends up in higher levels of performance. Within this context, the purpose of the article was to critically analyze the relationship between innovation and performance,taking into account the specificities of the hospital sector. This article pulls together primary data on organizational flexibility, innovation, and performance from 95 hospitals in Portugal,collected through a survey, data from interviews to hospital administration boards, and a panel of 15 experts. The diversity of data sources allowed for triangulation. The article uses mixed methods to explore the relationship between innovation and performance in the hospital sector in Portugal. The relationship between innovation and performance is analyzed through cluster analysis, supplemented with content analysis of interviews and the technical nominal group. The main findings reveal that the cluster of efficient innovators has twice the level of performance than other clusters. Organizational flexibility and external cooperation are the 2 major factors explaining these differences. The article identifies various organizational strategies to use innovation in order to enhance hospital performance. Overall, it proposes the alignment of perspectives of different stakeholders on the value proposition of hospital services, the embeddedness of information loops, and continuous adjustments toward high-value services.

  17. Nutritional Assessment in Elderly Hospitalized Patients in Qazvin Teaching Hospitals in 2011

    Directory of Open Access Journals (Sweden)

    Azam Ghorbani

    2013-04-01

    Full Text Available Objectives: Nutritional status in the elderly is an important issue in developing countries has been little attention to it. It results from complex interaction between personal and environmental factors that have a considerable effect on mortality, morbidity and quality of life of elderly people especially the hospitalized ones. The aim of this study was to investigate nutritional status in elderly hospitalized patients in Qazvin Teaching Hospitals and know Influential factors to plan appropriate programs for improving their health. Methods & Materials: In this cross-sectional study 233 elderly (151 women and 171 men aging more than 60 years, hospitalized in two hospitals in Qazvin city were studied. Nutritional status were evaluated using Mini Nutritional Assessment, The nutritional status was classified into: malnourished, risk of malnutrition and without malnutrition (adequate. Results: Among the assessed elderly 29.8% were well nourish, 13.4% malnourished and 42.95 at risk of malnutrition. There was more malnutrition in females compared to males (25.8% vs 7.2 P=23(62.5% vs. 12.6% P<0.001, Statistical analysis of the studied variables showed that nutritional status were significantly associated with Age, BMI, WC and WHR Conclusion: This study confirms a high prevalence of malnutrition risk in hospitalized elderly patients. The assessment of nutritional status with MNA that can facilitate evaluation of the nutritional status of elderly individuals in hospitals

  18. Differences in hospital casemix, and the relationship between casemix and hospital costs.

    Science.gov (United States)

    Söderlund, N; Milne, R; Gray, A; Raftery, J

    1995-03-01

    The aim of the study was to examine the relationship between hospital costs and casemix, and after adjustment for casemix differences, between cost and institutional size, number of specialties, occupancy and teaching status. A retrospective analysis of all admissions to nine acute-care NHS hospitals in the Oxford region during the 1991-1992 financial year was undertaken. All episodes were assigned to a diagnosis-related group (DRG) and a cost weight assigned accordingly. Costs per finished consultant episode, before and after adjustment for casemix differences, were analysed at the hospital and specialty level. Casemix differences were significant, and accounted for approximately 77 per cent of the difference in costs between providers. Costs per casemix-adjusted episode were not significantly associated with differences in hospital size, scope, occupancy levels or teaching status, but sample size was insufficient to investigate these relationships adequately. Specialty costs were poorly correlated with specialty casemix. This was probably due to poor apportionment of specialty costs in hospital accounting returns. Casemix differences need to be taken into account when comparing providers for the purposes of contracting, as unadjusted unit costs may be misleading. Although the methods used may currently be applied to most NHS hospitals, widespread use would be greatly facilitated by the development of indigenous cost weights and better routine hospital data coding and collection.

  19. Pre-hospitalization, hospitalization, and post-hospitalization costs of patients with neurocysticercosis treated at the Instituto Nacional de Neurologia y Neurocirugia (INNN in Mexico City, Mexico

    Directory of Open Access Journals (Sweden)

    Rachana Bhattarai

    2018-05-01

    Full Text Available ABSTRACT The objective of this study was to estimate the direct costs associated with the diagnosis and treatment of neurocysticercosis (NCC during pre-hospitalization, hospitalization, and post-hospitalization periods for 108 NCC patients treated at the Instituto Nacional de Neurologia y Neurocirugia (INNN in Mexico City, Mexico. Information on clinical manifestations, diagnostic tests, hospitalizations, surgical procedures, prescription medication, and other treatments was collected via medical chart reviews. Uncertain values for costs and frequency of treatments were imputed using bootstrap techniques. The average per-patient pre-hospitalization and hospitalization costs were US$ 257 (95% CI: 185 – 329 and US$ 2,576 (95% CI: 2,244 – 2,908, respectively. Post-hospitalization costs tended to decrease over time, with estimates for the first five years post-hospitalization of US$ 475 (95% CI: 423 – 527, US$ 228 (95% CI: 167 – 288, US$ 157 (95% CI: 111 – 202, US$ 150 (95% CI: 106 – 204, and US$ 91 (95% CI: 27 – 154, respectively. NCC results in a significant economic burden for patients requiring hospitalization, with this burden continuing years post-hospitalization.

  20. The impact of medical tourism on Thai private hospital management: informing hospital policy.

    Science.gov (United States)

    James, Paul T J

    2012-01-01

    The purpose of this paper is to help consolidate and understand management perceptions and experiences of a targeted group (n=7) of Vice-Presidents of international Private Thai hospitals in Bangkok regarding medical tourism impacts. The method adopted uses a small-scale qualitative inquiry. Examines the on-going development and service management factors which contribute to the establishment and strengthening of relationships between international patients and hospital medical services provision. Develops a qualitative model that attempts to conceptualize the findings from a diverse range of management views into a framework of main (8) - Hospital Management; Hospital Processes; Hospital Technology; Quality Related; Communications; Personnel; Financial; and Patients; and consequent sub-themes (22). Outcomes from small-scale qualitative inquiries cannot by design be taken outside of its topical arena. This inevitably indicates that more research of this kind needs to be carried out to understand this field more effectively. The evidence suggests that Private Thai hospital management have established views about what constitutes the impact of medical tourism on hospital policies and practices when hospital staff interact with international patients. As the private health service sector in Thailand continues to grow, future research is needed to help hospitals provide appropriate service patterns and appropriate medical products/services that meet international patient needs and aspirations. Highlights the increasing importance of the international consumer in Thailand's health industry. This study provides insights of private health service providers in Bangkok by helping to understand more effectively health service quality environments, subsequent service provision, and the integrated development and impacts of new medical technology.

  1. 75 FR 60640 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

    Science.gov (United States)

    2010-10-01

    ...; RIN 0938-AP33 Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System Changes and FY 2011 Rates; Provider... Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective...

  2. 77 FR 4908 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

    Science.gov (United States)

    2012-02-01

    ... Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal... the final rule entitled ``Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal Year 2012 Rates...

  3. 77 FR 65495 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

    Science.gov (United States)

    2012-10-29

    ... Payment Systems for Acute Care Hospitals and the Long Term Care Hospital Prospective Payment System and... Federal Register entitled ``Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long Term Care Hospital Prospective Payment System and Fiscal Year 2013 Rates...

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

    Science.gov (United States)

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

    2018-01-30

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

  5. The performance of Hospital Corporation of America and Healthtrust hospitals after leveraged buyouts.

    Science.gov (United States)

    Clement, J P; McCue, M J

    1996-07-01

    The authors examine performance changes after two leveraged buyouts (LBOs) in the hospital industry, one an employee stock ownership plan (ESOP) and the other a managed buyout (MBO). The findings show that hospitals owned by HCA, the MBO firm, and Health Trust, the ESOP firm, did not increase revenues, decrease operating expenses, or improve profitability after the LBOs, relative to other hospitals in their local markets. Nor were the numbers or salaries of employees at these facilities decreased. Although performance incentives associated with LBOs did not change performance at the hospital level, incentives to meet debt payments did result in corporate changes. More specifically, the LBOs led to corporate downsizing through the sale of hospitals and subsidiaries.

  6. Does a hospital's quality depend on the quality of other hospitals? A spatial econometrics approach.

    Science.gov (United States)

    Gravelle, Hugh; Santos, Rita; Siciliani, Luigi

    2014-11-01

    We examine whether a hospital's quality is affected by the quality provided by other hospitals in the same market. We first sketch a theoretical model with regulated prices and derive conditions on demand and cost functions which determine whether a hospital will increase its quality if its rivals increase their quality. We then apply spatial econometric methods to a sample of English hospitals in 2009-10 and a set of 16 quality measures including mortality rates, readmission, revision and redo rates, and three patient reported indicators, to examine the relationship between the quality of hospitals. We find that a hospital's quality is positively associated with the quality of its rivals for seven out of the sixteen quality measures. There are no statistically significant negative associations. In those cases where there is a significant positive association, an increase in rivals' quality by 10% increases a hospital's quality by 1.7% to 2.9%. The finding suggests that for some quality measures a policy which improves the quality in one hospital will have positive spillover effects on the quality in other hospitals.

  7. Do More Hospital Beds Lead to Higher Hospitalization Rates? A Spatial Examination of Roemer’s Law

    Science.gov (United States)

    Delamater, Paul L.; Messina, Joseph P.; Grady, Sue C.; WinklerPrins, Vince; Shortridge, Ashton M.

    2013-01-01

    Background Roemer’s Law, a widely cited principle in health care policy, states that hospital beds that are built tend to be used. This simple but powerful expression has been invoked to justify Certificate of Need regulation of hospital beds in an effort to contain health care costs. Despite its influence, a surprisingly small body of empirical evidence supports its content. Furthermore, known geographic factors influencing health services use and the spatial structure of the relationship between hospital bed availability and hospitalization rates have not been sufficiently explored in past examinations of Roemer’s Law. We pose the question, “Accounting for space in health care access and use, is there an observable association between the availability of hospital beds and hospital utilization?” Methods We employ an ecological research design based upon the Anderson behavioral model of health care utilization. This conceptual model is implemented in an explicitly spatial context. The effect of hospital bed availability on the utilization of hospital services is evaluated, accounting for spatial structure and controlling for other known determinants of hospital utilization. The stability of this relationship is explored by testing across numerous geographic scales of analysis. The case study comprises an entire state system of hospitals and population, evaluating over one million inpatient admissions. Results We find compelling evidence that a positive, statistically significant relationship exists between hospital bed availability and inpatient hospitalization rates. Additionally, the observed relationship is invariant with changes in the geographic scale of analysis. Conclusions This study provides evidence for the effects of Roemer’s Law, thus suggesting that variations in hospitalization rates have origins in the availability of hospital beds. This relationship is found to be robust across geographic scales of analysis. These findings suggest

  8. Escolarização da criança hospitalizada sob a ótica da família

    Directory of Open Access Journals (Sweden)

    Eliane Rolim de Holanda

    2012-01-01

    Full Text Available Este estudio tuvo como objetivo investigar el significado de la experiencia del proceso educativo de los niños hospitalizados con enfermedades crónicas desde la perspectiva de la familia. Se trata de una investigación cualitativa, llevada a cabo en la clínica pediátrica de un hospital universitario. El estudio incluyó a diez familias de niños hospitalizados con edades comprendidas entre siete y 16 años. Se utilizó una entrevista semi-estructurada y los principios temáticos de interpretación para el análisis. Los resultados mostraron que las familias se sienten angustiados por la situación de retiro del niño en la escuela debido a las hospitalizaciones periódicas y asistir a la escuela es un deseo manifestado por los niños. Se concluyó que la clase hospital representa una estrategia de atención importante. Mediante el mantenimiento del proceso educativo, el niño replantea su experiencia en el hospital, ha conservado su desarrollo, mejorando su autoestima y su calidad de vida.

  9. Mental hospital reform in Asia: the case of Yuli Veterans Hospital, Taiwan.

    Science.gov (United States)

    Lin, Chih-Yuan; Huang, Ai-Ling; Minas, Harry; Cohen, Alex

    2009-01-02

    Yuli Veterans Hospital (YVH) has been the largest mental hospital for the patients with chronic and severe mental illness in Taiwan for the past 50 years. While this hospital used to be a symbol of hopelessness among patients and their families and an unspoken shame among Taiwan psychiatry and mental health circles it now represents an example of how an old, custodial hospital can be transformed into a very different institution. In this case study we will describe the features of this transformation, which, over the past 20 years, has aimed to help extended stay inpatients with severe mental illness to integrate into the local community of Yuli even though it is not their original home. Using historical documents and oral narratives from Yuli inhabitants, workers and patients of YVH, we will offer a case study of the Yuli model. There are four main components of the Yuli model: holistic medical support, vocational rehabilitation, case management, and the residential program. The four components help patients recover two essential features of their lives: vocational life and ordinary daily routines. As the process of recovery evolves, patients gradually regain inner stability, dignity, self-confidence, and a sense of control. The four components are critical to rebuild the structure and order of life of the patients and are indispensable and interdependent parts of one service package. They operate simultaneously to benefit the patients to the greatest degree possible. There are many challenges to the further development and financial viability of the model of services developed at YVH. There are also important questions concerning the replicability of the Yuli model in other sociocultural and service system contexts. This case study reveals the possibility of transforming a custodial mental hospital into a hospital providing high quality care. Hospital and community are not in opposition. They are part of a continuum of care for the patients. We reinterpret and

  10. Demographic factors and hospital size predict patient satisfaction variance--implications for hospital value-based purchasing.

    Science.gov (United States)

    McFarland, Daniel C; Ornstein, Katherine A; Holcombe, Randall F

    2015-08-01

    Hospital Value-Based Purchasing (HVBP) incentivizes quality performance-based healthcare by linking payments directly to patient satisfaction scores obtained from Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys. Lower HCAHPS scores appear to cluster in heterogeneous population-dense areas and could bias Centers for Medicare & Medicaid Services (CMS) reimbursement. Assess nonrandom variation in patient satisfaction as determined by HCAHPS. Multivariate regression modeling was performed for individual dimensions of HCAHPS and aggregate scores. Standardized partial regression coefficients assessed strengths of predictors. Weighted Individual (hospital) Patient Satisfaction Adjusted Score (WIPSAS) utilized 4 highly predictive variables, and hospitals were reranked accordingly. A total of 3907 HVBP-participating hospitals. There were 934,800 patient surveys by the most conservative estimate. A total of 3144 county demographics (US Census) and HCAHPS surveys. Hospital size and primary language (non-English speaking) most strongly predicted unfavorable HCAHPS scores, whereas education and white ethnicity most strongly predicted favorable HCAHPS scores. The average adjusted patient satisfaction scores calculated by WIPSAS approximated the national average of HCAHPS scores. However, WIPSAS changed hospital rankings by variable amounts depending on the strength of the predictive variables in the hospitals' locations. Structural and demographic characteristics that predict lower scores were accounted for by WIPSAS that also improved rankings of many safety-net hospitals and academic medical centers in diverse areas. Demographic and structural factors (eg, hospital beds) predict patient satisfaction scores even after CMS adjustments. CMS should consider WIPSAS or a similar adjustment to account for the severity of patient satisfaction inequities that hospitals could strive to correct. © 2015 Society of Hospital Medicine.

  11. Legitimacy of hospital reconfiguration: the controversial downsizing of Kidderminster hospital.

    Science.gov (United States)

    Oborn, Eivor

    2008-04-01

    This paper examines the contested organizational legitimacy of hospital reconfiguration, which continues to be a central issue in health care management. A qualitative study which focuses on the controversial downsizing of Kidderminster Hospital, a highly publicized landmark case of district general hospital closure. Rhetorical strategies are analysed to examine how legitimacy was constructed by stakeholder groups and how these strategies were used to support or resist change. Stakeholders promoting change legitimized re-organization pragmatically and morally arguing the need for centralization as a rational necessity. Stakeholders resisting change argued for cognitive and moral legitimacy in current service arrangements, contrasting local versus regionalized aspects of safety and provision. Groups managed to talk past each other, failing to establish a dialogue, which led to significant conflict and political upheaval. Stakeholders value hospitals in different ways and argue for diverse accounts of legitimacy. Broader discourses of medical science and democratic participation were drawn into rhetorical texts concerning regionalization to render them more powerful.

  12. Lower Mortality in Magnet Hospitals

    Science.gov (United States)

    McHugh, Matthew D.; Kelly, Lesly A.; Smith, Herbert L.; Wu, Evan S.; Vanak, Jill M.; Aiken, Linda H.

    2014-01-01

    Background Although there is evidence that hospitals recognized for nursing excellence—Magnet hospitals—are successful in attracting and retaining nurses, it is uncertain whether Magnet recognition is associated with better patient outcomes than non-Magnets, and if so why. Objectives To determine whether Magnet hospitals have lower risk-adjusted mortality and failure-to-rescue compared with non-Magnet hospitals, and to determine the most likely explanations. Method and Study Design Analysis of linked patient, nurse, and hospital data on 56 Magnet and 508 non-Magnet hospitals. Logistic regression models were used to estimate differences in the odds of mortality and failure-to-rescue for surgical patients treated in Magnet versus non-Magnet hospitals, and to determine the extent to which differences in outcomes can be explained by nursing after accounting for patient and hospital differences. Results Magnet hospitals had significantly better work environments and higher proportions of nurses with bachelor's degrees and specialty certification. These nursing factors explained much of the Magnet hospital effect on patient outcomes. However, patients treated in Magnet hospitals had 14% lower odds of mortality (odds ratio 0.86; 95% confidence interval, 0.76–0.98; P = 0.02) and 12% lower odds of failure-to-rescue (odds ratio 0.88; 95% confidence interval, 0.77–1.01; P = 0.07) while controlling for nursing factors as well as hospital and patient differences. Conclusions The lower mortality we find in Magnet hospitals is largely attributable to measured nursing characteristics but there is a mortality advantage above and beyond what we could measure. Magnet recognition identifies existing quality and stimulates further positive organizational behavior that improves patient outcomes. PMID:24022082

  13. As mulheres no mundo do trabalho: ação das mulheres, no setor fabril, para a ocupação e democratização dos espaços público e privado

    Directory of Open Access Journals (Sweden)

    Cíntia Maria Teixeira

    Full Text Available Este trabalho consiste em fragmentos de um estudo sobre os sentidos do trabalho e do curso técnico de vestuário na vida das mulheres da cidade de Divinópolis/MG, cuja profissionalização está vinculada ao curso pós-técnico de vestuário do CEFET/EnED - Divinópolis/MG. Foram feitos três grupos focais, sendo um com estudantes do primeiro ano do curso de técnico de vestuário do CEFET-UnED/Divinópolis-MG, o segundo com técnicas formadas no curso e o terceiro com integrantes dos grupos citados anteriormente. As transcrições das discussões de grupo foram submetidas à análise do discurso. As análises apontam que a feminização da profissão e a desvalorização do trabalho feminino perpassam a divisão clássica entre os espaços público e privado. Perceber a feminização como produto de construções sociais pode inviabilizar a organização de um movimento das mulheres trabalhadoras, inclusive do setor de vestuário, na busca de remuneração adequada e reconhecimento de seu trabalho.

  14. Direito internacional privado das sucessões na União Europeia: a determinação do direito aplicável no novo Regulamento 650/2012, de 4 de julho de 2012

    Directory of Open Access Journals (Sweden)

    Carl Friedrich Nordmeier

    2014-03-01

    Full Text Available Com a entrada em vigor do Regulamento 650/2012, de 4 de julho de 2012, no âmbito da União Europeia, o direito internacional das sucessões foi harmonizado naquele processo de integração. O presente artigo analisa as regras de Direito Internacional Privado stricto sensu contidas no Regulamento. A residência habitual como principal fator de conexão é discutida, bem como o princípio da unidade da sucessão e a admissão do reenvio. Quanto a uma possível escolha da lei, cabe distinguir entre a escolha em si e a disposição por morte na qual ela está contida. A nacionalidade do defunto como ponto de conexão tem relevância particular neste contexto. As disposições por morte, sobretudo o testamento de mão comum e o pacto sucessório, são analisadas. A maioria das questões quanto a uma disposição por morte é respondida pelo estatuto sucessório hipotético. A escolha da lei aplicável a uma disposição por morte, bem como a sua forma, merecem atenção especial. Por fim, são debatidos dois problemas particulares que encontraram uma solução com o surgimento do Regulamento, quais sejam, o dos comorientes e o da herança vaga.

  15. Hospital information system institutionalization processes in indonesian public, government-owned and privately owned hospitals.

    Science.gov (United States)

    Handayani, P W; Hidayanto, A N; Ayuningtyas, Dumilah; Budi, Indra

    2016-11-01

    The Hospital Information System (HIS) could help hospitals as a public entity to provide optimal health services. One of the main challenges of HIS implementation is an institutional change. Using institutional theory as the analytical lens, this study aims to explain the institutionalization of HIS as an instance of e-health initiatives in Indonesia. Furthermore, this paper aims for hospital management and researchers to improve the understanding of the social forces that influence hospital personnel's HIS acceptance within an organizational context. We use case studies from four public, government-owned hospitals and four privately owned (public and specialty) hospitals to explain the HIS institutionalization process by exploring the three concepts of institutional theory: institutional isomorphism, institutional logic, and institutional entrepreneurship. This study reveals that differences exist between public, government-owned and private hospitals with regard to the institutionalization process: public, government-owned hospitals' management is more motivated to implement HIS to comply with the regulations, while private hospitals' management views HIS as an urgent requirement that must be achieved. The study findings also reveal that various institutional isomorphism mechanisms and forms of institutional logic emerge during the process. Finally, three factors-self-efficacy, social influence, and management support-have a significant influence on the individual acceptance of HIS. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  16. 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?

  17. 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' ...

  18. Statin Use and Hospital Length of Stay Among Adults Hospitalized With Community-acquired Pneumonia.

    Science.gov (United States)

    Havers, Fiona; Bramley, Anna M; Finelli, Lyn; Reed, Carrie; Self, Wesley H; Trabue, Christopher; Fakhran, Sherene; Balk, Robert; Courtney, D Mark; Girard, Timothy D; Anderson, Evan J; Grijalva, Carlos G; Edwards, Kathryn M; Wunderink, Richard G; Jain, Seema

    2016-06-15

    Prior retrospective studies suggest that statins may benefit patients with community-acquired pneumonia (CAP) due to antiinflammatory and immunomodulatory effects. However, prospective studies of the impact of statins on CAP outcomes are needed. We determined whether statin use was associated with improved outcomes in adults hospitalized with CAP. Adults aged ≥18 years hospitalized with CAP were prospectively enrolled at 3 hospitals in Chicago, Illinois, and 2 hospitals in Nashville, Tennessee, from January 2010-June 2012. Adults receiving statins before and throughout hospitalization (statin users) were compared with those who did not receive statins (nonusers). Proportional subdistribution hazards models were used to examine the association between statin use and hospital length of stay (LOS). In-hospital mortality was a secondary outcome. We also compared groups matched on propensity score. Of 2016 adults enrolled, 483 (24%) were statin users; 1533 (76%) were nonusers. Statin users were significantly older, had more comorbidities, had more years of education, and were more likely to have health insurance than nonusers. Multivariable regression demonstrated that statin users and nonusers had similar LOS (adjusted hazard ratio [HR], 0.99; 95% confidence interval [CI], .88-1.12), as did those in the propensity-matched groups (HR, 1.03; 95% CI, .88-1.21). No significant associations were found between statin use and LOS or in-hospital mortality, even when stratified by pneumonia severity. In a large prospective study of adults hospitalized with CAP, we found no evidence to suggest that statin use before and during hospitalization improved LOS or in-hospital mortality. Published by Oxford University Press for the Infectious Diseases Society of America 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  19. Electronic Cigarettes on Hospital Campuses

    Directory of Open Access Journals (Sweden)

    Clare Meernik

    2015-12-01

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

  20. Electronic Cigarettes on Hospital Campuses.

    Science.gov (United States)

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

    2015-12-29

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

  1. Hidden Costs of Hospital Based Delivery from Two Tertiary Hospitals in Western Nepal.

    Directory of Open Access Journals (Sweden)

    Jeevan Acharya

    Full Text Available Hospital based delivery has been an expensive experience for poor households because of hidden costs which are usually unaccounted in hospital costs. The main aim of this study was to estimate the hidden costs of hospital based delivery and determine the factors associated with the hidden costs.A hospital based cross-sectional study was conducted among 384 post-partum mothers with their husbands/house heads during the discharge time in Manipal Teaching Hospital and Western Regional Hospital, Pokhara, Nepal. A face to face interview with each respondent was conducted using a structured questionnaire. Hidden costs were calculated based on the price rate of the market during the time of the study.The total hidden costs for normal delivery and C-section delivery were 243.4 USD (US Dollar and 321.6 USD respectively. Of the total maternity care expenditures; higher mean expenditures were found for food & drinking (53.07%, clothes (9.8% and transport (7.3%. For postpartum women with their husband or house head, the total mean opportunity cost of "days of work loss" were 84.1 USD and 81.9 USD for normal delivery and C-section respectively. Factors such as literate mother (p = 0.007, employed house head (p = 0.011, monthly family income more than 25,000 NRs (Nepalese Rupees (p = 0.014, private hospital as a place of delivery (p = 0.0001, C-section as a mode of delivery (p = 0.0001, longer duration (>5days of stay in hospital (p = 0.0001, longer distance (>15km from house to hospital (p = 0.0001 and longer travel time (>240 minutes from house to hospital (p = 0.007 showed a significant association with the higher hidden costs (>25000 NRs.Experiences of hidden costs on hospital based delivery and opportunity costs of days of work loss were found high. Several socio-demographic factors, delivery related factors (place and mode of delivery, length of stay, distance from hospital and travel time were associated with hidden costs. Hidden costs can be a

  2. Hidden Costs of Hospital Based Delivery from Two Tertiary Hospitals in Western Nepal.

    Science.gov (United States)

    Acharya, Jeevan; Kaehler, Nils; Marahatta, Sujan Babu; Mishra, Shiva Raj; Subedi, Sudarshan; Adhikari, Bipin

    2016-01-01

    Hospital based delivery has been an expensive experience for poor households because of hidden costs which are usually unaccounted in hospital costs. The main aim of this study was to estimate the hidden costs of hospital based delivery and determine the factors associated with the hidden costs. A hospital based cross-sectional study was conducted among 384 post-partum mothers with their husbands/house heads during the discharge time in Manipal Teaching Hospital and Western Regional Hospital, Pokhara, Nepal. A face to face interview with each respondent was conducted using a structured questionnaire. Hidden costs were calculated based on the price rate of the market during the time of the study. The total hidden costs for normal delivery and C-section delivery were 243.4 USD (US Dollar) and 321.6 USD respectively. Of the total maternity care expenditures; higher mean expenditures were found for food & drinking (53.07%), clothes (9.8%) and transport (7.3%). For postpartum women with their husband or house head, the total mean opportunity cost of "days of work loss" were 84.1 USD and 81.9 USD for normal delivery and C-section respectively. Factors such as literate mother (p = 0.007), employed house head (p = 0.011), monthly family income more than 25,000 NRs (Nepalese Rupees) (p = 0.014), private hospital as a place of delivery (p = 0.0001), C-section as a mode of delivery (p = 0.0001), longer duration (>5days) of stay in hospital (p = 0.0001), longer distance (>15km) from house to hospital (p = 0.0001) and longer travel time (>240 minutes) from house to hospital (p = 0.007) showed a significant association with the higher hidden costs (>25000 NRs). Experiences of hidden costs on hospital based delivery and opportunity costs of days of work loss were found high. Several socio-demographic factors, delivery related factors (place and mode of delivery, length of stay, distance from hospital and travel time) were associated with hidden costs. Hidden costs can be a

  3. Attitudes and expectations regarding exercise in the hospital of hospitalized older adults: a qualitative study.

    Science.gov (United States)

    So, Cynthia; Pierluissi, Edgar

    2012-04-01

    To describe expectations of, and perceived motivators and barriers to, in-hospital exercise of hospitalized older adults. Qualitative study using the framework theory. Public hospital general medical wards. Twenty-eight English- or Spanish-speaking inpatients aged 65 to 103. Semistructured interviews were conducted at the bedside. Questions explored attitudes and expectations regarding in-hospital exercise. Interviews were tape recorded and transcribed, and content analysis was performed to identify major themes. For most participants (71%), exercise in the hospital meant walking. Only 29% of participants expected to be exercising in the hospital, although three-quarters perceived it to be appropriate. Major themes included motivating factors and barriers to in-hospital exercise. Motivating factors included avoiding the negative effects of prolonged bed rest, promoting a sense of well-being, promoting functional recovery, and being asked to exercise. Barriers included symptoms related to one's illness, institutional barriers, and fear of injury. Most respondents (85%) felt that if the physician suggested exercise, it would influence their decision to do so, yet few (27%) reported that they had spoken to their physician about exercise. Hospitalized older adults have positive perceptions about in-hospital exercise, although they must overcome significant barriers to do so. Medical professionals have a strong influence over the exercise behavior of elderly adults in the hospital yet infrequently address the issue. Incorporating motivating factors and removing barriers may increase the effectiveness of in-hospital exercise programs. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

  4. 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...

  5. The effects of hospital reforms on the management of public hospitals in Tanzania: Challenges and lessons learnt.

    Science.gov (United States)

    Shwekerela, Byera

    2014-01-01

    Although hospital reforms are being advocated internationally as part of a solution to hospital management problems in developing countries, studies have shown that they do give rise to some challenges. A study was undertaken that used in-depth interviews, focus group discussion and document review to examine hospital reforms. The article examines the effects of reforms on the management of Level II public hospitals in Tanzania and documents the related challenges and lessons Learnt. It is shown that hospital reforms have mixed effects in resource-strained hospitals, and that hospital reform actions may have replaced the bureaucratic inefficiencies associated with hospitals being managed from the central level (MoHSW) with the equally bureaucratic inefficiencies that characterize the management of these hospitals from a supposedly local level, the office of the Regional Administrative Secretary (RAS). Managing hospitals from this level seems to cause many hospital management problems to be left unattended.

  6. HOSPITAL IMAGE AS A MODERATING VARIABLE ON THE EFFECT OF HOSPITAL SERVICE QUALITY ON THE CUSTOMER PERCEIVED VALUE, CUSTOMER TRUST AND CUSTOMER LOYALTY IN HOSPITAL SERVICES

    Directory of Open Access Journals (Sweden)

    Indrianawati Usman

    2017-12-01

    Full Text Available This is an explanatory research, analyzing the hospital image as a moderating variable on the effect of hospital service quality on customer perceived value and trust. Research was conducted at several hospitals in Surabaya Indonesia, especially to outpatients. Data was collected by survey to the outpatients of the hospitals. The purpose of this research was empirically examining the effects of hospital service quality on customer perceived value and customer trust, examine effects of customer perceived value and customer trust on customer loyalty. Moreover This research also examined the variable of hospital image as a moderating variable in the effects of hospital service quality on customer perceived value and customer trust. The result of this research gave a perspective to hospital management about the importance of building patient trust, since trust is very important, even more important than satisfaction level. Further studies with more emphasis on identifying the factors building patient trust to the hospital in order to raise customer loyalty should be conducted.

  7. 75 FR 34614 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and...

    Science.gov (United States)

    2010-06-17

    ... Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and Fiscal Year 2010 Rates and to the Long- Term Care Hospital Prospective Payment System and Rate Year 2010 Rates... Prospective Payment Systems for Acute Care Hospitals and Fiscal Year 2010 Rates and to the Long-Term Care...

  8. Evaluation of the frequency of Candida spp. in hospitalized and non-hospitalized subjects

    Directory of Open Access Journals (Sweden)

    J. N. Vieira

    2018-02-01

    Full Text Available Abstract The aim of this study was to evaluate the frequency of Candida species between a non-hospitalized and a hospitalized population. For this purpose, samples of saliva were sampled through sterile swabs, moistened in peptone water and rubbed in the oral cavity of 140 individuals, from which, 70 were hospitalized patients from the Medical Clinic of a Teaching Hospital and the other 70 were non-hospitalized subjects. All saliva samples were plated in Sabouraud Dextrose agar added with Chloramphenicol and incubated at 36 °C for 48 hours. The morphology identification was performed through macroscopic and microscopic characterization, the CHROMagar Candida medium and the VITEK® system Yeast Biochemical Card (bio Mérieux SA, France. The results showed a colonization of Candida spp. in 85.7% the hospitalized individuals, where the species found were C. albicans (60%, C. tropicalis (23.4%, C. krusei (3.3% and Candida spp. (13.3%. In the non-hospitalized individuals the colonization by Candida spp was 47.1%, and the species found were: C. albicans (45.5%, C.krusei (9.1%, C. guilliermondii (9.1% %, C. tropicalis (3.0%, C. famata (3.0% and Candida spp. (30.3%. In spite of their presence in oral cavity in both groups, Candida spp. was more frequently isolated in hospitalized individuals, who were 6.73 times more likely to have this fungus in the oral cavity and were 3.88 times more likely to have Candida albicans.

  9. Segmentation in local hospital markets.

    Science.gov (United States)

    Dranove, D; White, W D; Wu, L

    1993-01-01

    This study examines evidence of market segmentation on the basis of patients' insurance status, demographic characteristics, and medical condition in selected local markets in California in the years 1983 and 1989. Substantial differences exist in the probability patients may be admitted to particular hospitals based on insurance coverage, particularly Medicaid, and race. Segmentation based on insurance and race is related to hospital characteristics, but not the characteristics of the hospital's community. Medicaid patients are more likely to go to hospitals with lower costs and fewer service offerings. Privately insured patients go to hospitals offering more services, although cost concerns are increasing. Hispanic patients also go to low-cost hospitals, ceteris paribus. Results indicate little evidence of segmentation based on medical condition in either 1983 or 1989, suggesting that "centers of excellence" have yet to play an important role in patient choice of hospital. The authors found that distance matters, and that patients prefer nearby hospitals, moreso for some medical conditions than others, in ways consistent with economic theories of consumer choice.

  10. Mobile Robots for Hospital Logistics

    OpenAIRE

    Özkil, Ali Gürcan

    2012-01-01

    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 services to maintain the quality of healthcare provided. Logistics 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...

  11. 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

  12. Hospital waste management in Lebanon

    International Nuclear Information System (INIS)

    Chaker, Alissar

    1999-01-01

    Hospital wastes comprises approximately 80% domestic waste components, also known as non-risk waste and 20% hazardous or risk waste. The 20% of the hospital waste stream or the risk waste (also known as infectious, medical, clinical wastes) comprises components which could be potentially contaminated with infections, chemical or radioactive agents. Therefore, it should be handled and disposed of in such a manner as to minimize potential human exposure and cross-contamination. Hospital risk waste and be subdivided into seven general categories as follows: infections, anatomical/pathological, chemical, pharmaceutical, radioactive waste, sharps and pressurised containers. These waste categories are generated by many types of health care establishments, including hospitals, clinics, infirmaries.... The document presents also tables of number of hospitals and estimated bed number in different regions in Lebanon; estimated hospital risk and non-risk waste generation per tonnes per day for the years 1998 until 2010 and finally sensitivity analysis of estimated generation of hospital risk waste in Lebanon per tonnes per day for the years 1998 until 2010. The management, treatment and disposal of hospital risk waste constitute important environmental and public safety issues. It is recognised that there is alack of infrastructure for the safe and environmentally acceptable disposal of hospital waste in Lebanon

  13. The impact of managed care penetration and hospital quality on efficiency in hospital staffing.

    Science.gov (United States)

    Mobley, Lee R; Magnussen, Jon

    2002-01-01

    The state of California has recently mandated minimum nurse-staffing ratios, raising concerns about possible affects on hospital efficiency. In this study, we examine how market factors and quality were related to staffing levels in California hospitals in 1995 (prior to implementation of the new law). We are particularly interested in the affect of managed care penetration on this aspect of hospital efficiency because the call to legislative action was predicated on fears that hospitals were reducing staffing below optimal levels in response to managed care pressures. We derive a unique measure of excess staffing in hospitals based on a data envelopment analysis (DEA) production function model, which explicitly includes ancillary care among the inputs and outputs. This careful specification of production is important because ancillary care use has risen relative to daily hospital services, with the spread of managed care and advances in medical technology. We find that market share (adjusted for size) and market concentration are the major determinants of excess staffing while managed care penetration is insignificant. We also find that poor quality (outcomes worse than expected) is associated with less efficient staffing. These findings suggest that the larger, more efficient urban hospitals will be penalized more heavily under binding staffing ratios than smaller, less-urban hospitals.

  14. 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...

  15. 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...

  16. Population versus hospital controls for case-control studies on cancers in Chinese hospitals.

    Science.gov (United States)

    Li, Lin; Zhang, Min; Holman, D'Arcy

    2011-12-15

    Correct control selection is crucial to the internal validity of case-control studies. Little information exists on differences between population and hospital controls in case-control studies on cancers in Chinese hospital setting. We conducted three parallel case-control studies on leukemia, breast and colorectal cancers in China between 2009 and 2010, using population and hospital controls to separately match 540 incident cases by age, gender and residency at a 1:1 ratio. Demographic and lifestyle factors were measured using a validated questionnaire in face-to-face interview. Odds ratios (ORs) and 95% confidence intervals (CIs) were obtained using conditional logistic regression analyses. The two control groups had closely similar exposure distributions of 15 out of 16 factors, with the only exception being that hospital controls were less likely to have a BMI ≥ 25 (OR = 0.71, 95% CI: 0.54, 0.93). For exposure of green tea drinking, the adjusted ORs (95% CIs) comparing green tealeaves intake ≥ 1000 grams annually with non-drinkers were 0.51 (0.31, 0.83) and 0.21 (0.27, 0.74) for three cancers combined, 0.06 (0.01, 0.61) and 0.07 (0.01, 0.47) for breast cancer, 0.52 (0.29, 0.94) and 0.45 (0.25, 0.82) for colorectal cancer, 0.65 (0.08, 5.63) and 0.57 (0.07, 4.79) for leukemia using hospital and population controls respectively. The study found that hospital controls were comparable with population controls for most demographic characteristics and lifestyle factors measured, but there was a slight difference between the two control groups. Hospital outpatients provide a satisfactory control group in hospital-based case-control study in the Chinese hospital setting.

  17. Population versus hospital controls for case-control studies on cancers in Chinese hospitals

    Directory of Open Access Journals (Sweden)

    Li Lin

    2011-12-01

    Full Text Available Abstract Background Correct control selection is crucial to the internal validity of case-control studies. Little information exists on differences between population and hospital controls in case-control studies on cancers in Chinese hospital setting. Methods We conducted three parallel case-control studies on leukemia, breast and colorectal cancers in China between 2009 and 2010, using population and hospital controls to separately match 540 incident cases by age, gender and residency at a 1:1 ratio. Demographic and lifestyle factors were measured using a validated questionnaire in face-to-face interview. Odds ratios (ORs and 95% confidence intervals (CIs were obtained using conditional logistic regression analyses. Results The two control groups had closely similar exposure distributions of 15 out of 16 factors, with the only exception being that hospital controls were less likely to have a BMI ≥ 25 (OR = 0.71, 95% CI: 0.54, 0.93. For exposure of green tea drinking, the adjusted ORs (95% CIs comparing green tealeaves intake ≥ 1000 grams annually with non-drinkers were 0.51 (0.31, 0.83 and 0.21 (0.27, 0.74 for three cancers combined, 0.06 (0.01, 0.61 and 0.07 (0.01, 0.47 for breast cancer, 0.52 (0.29, 0.94 and 0.45 (0.25, 0.82 for colorectal cancer, 0.65 (0.08, 5.63 and 0.57 (0.07, 4.79 for leukemia using hospital and population controls respectively. Conclusions The study found that hospital controls were comparable with population controls for most demographic characteristics and lifestyle factors measured, but there was a slight difference between the two control groups. Hospital outpatients provide a satisfactory control group in hospital-based case-control study in the Chinese hospital setting.

  18. 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...

  19. Mental hospital reform in Asia: the case of Yuli Veterans Hospital, Taiwan

    Directory of Open Access Journals (Sweden)

    Minas Harry

    2009-01-01

    Full Text Available Abstract Background Yuli Veterans Hospital (YVH has been the largest mental hospital for the patients with chronic and severe mental illness in Taiwan for the past 50 years. While this hospital used to be a symbol of hopelessness among patients and their families and an unspoken shame among Taiwan psychiatry and mental health circles it now represents an example of how an old, custodial hospital can be transformed into a very different institution. In this case study we will describe the features of this transformation, which, over the past 20 years, has aimed to help extended stay inpatients with severe mental illness to integrate into the local community of Yuli even though it is not their original home. Methods Using historical documents and oral narratives from Yuli inhabitants, workers and patients of YVH, we will offer a case study of the Yuli model. Results There are four main components of the Yuli model: holistic medical support, vocational rehabilitation, case management, and the residential program. The four components help patients recover two essential features of their lives: vocational life and ordinary daily routines. As the process of recovery evolves, patients gradually regain inner stability, dignity, self-confidence, and a sense of control. The four components are critical to rebuild the structure and order of life of the patients and are indispensable and interdependent parts of one service package. They operate simultaneously to benefit the patients to the greatest degree possible. Discussion There are many challenges to the further development and financial viability of the model of services developed at YVH. There are also important questions concerning the replicability of the Yuli model in other sociocultural and service system contexts. Conclusion This case study reveals the possibility of transforming a custodial mental hospital into a hospital providing high quality care. Hospital and community are not in opposition

  20. Early discharge hospital at home.

    Science.gov (United States)

    Gonçalves-Bradley, Daniela C; Iliffe, Steve; Doll, Helen A; Broad, Joanna; Gladman, John; Langhorne, Peter; Richards, Suzanne H; Shepperd, Sasha

    2017-06-26

    Early discharge hospital at home is a service that provides active treatment by healthcare professionals in the patient's home for a condition that otherwise would require acute hospital inpatient care. This is an update of a Cochrane review. To determine the effectiveness and cost of managing patients with early discharge hospital at home compared with inpatient hospital care. We searched the following databases to 9 January 2017: the Cochrane Effective Practice and Organisation of Care Group (EPOC) register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, and EconLit. We searched clinical trials registries. Randomised trials comparing early discharge hospital at home with acute hospital inpatient care for adults. We excluded obstetric, paediatric and mental health hospital at home schemes.   DATA COLLECTION AND ANALYSIS: We followed the standard methodological procedures expected by Cochrane and EPOC. We used the GRADE approach to assess the certainty of the body of evidence for the most important outcomes. We included 32 trials (N = 4746), six of them new for this update, mainly conducted in high-income countries. We judged most of the studies to have a low or unclear risk of bias. The intervention was delivered by hospital outreach services (17 trials), community-based services (11 trials), and was co-ordinated by a hospital-based stroke team or physician in conjunction with community-based services in four trials.Studies recruiting people recovering from strokeEarly discharge hospital at home probably makes little or no difference to mortality at three to six months (risk ratio (RR) 0.92, 95% confidence interval (CI) 0.57 to 1.48, N = 1114, 11 trials, moderate-certainty evidence) and may make little or no difference to the risk of hospital readmission (RR 1.09, 95% CI 0.71 to 1.66, N = 345, 5 trials, low-certainty evidence). Hospital at home may lower the risk of living in institutional setting at six months (RR 0.63, 96% CI

  1. Analysis of hospital logistics and costs of the Clinical Engineering Sector in a Philanthropic Hospital

    Directory of Open Access Journals (Sweden)

    Antônio Artur de Souza

    2014-12-01

    Full Text Available Hospitals are considered complex organizations mainly due to the high cost of the health care structure employed for care. Reducing operating costs is a challenge for hospital managers. Particularly in the clinical engineering sector, adequate hospital logistics can reduce costs. In this context, the aim of the research was to analyze the activities of hospital logistics of the Clinical Engineering department at a charity hospital, focusing on cost reduction. The paper presents a case study in a large charity hospital located in the metropolitan region of Belo Horizonte, MG. The analysis focuses on the activities of hospital logistics at this hospital clinical engineering sector. The work in this sector is concentrated in the realization and implementation of equipment maintenance, to the detriment of efforts to reduce costs and increase safety for all streams managed by the sector. It was also found that there are risks of increased costs with inadequate routines: (i acquisition of new and large equipment; (ii maintenance and release schedule for use; and (iii the theft of equipment.

  2. Early examples of art in Scottish hospitals, 2: Crichton Royal Hospital, Dumfries.

    Science.gov (United States)

    Park, Maureen

    2003-12-01

    Fine art has been used in hospitals for centuries. However, Crichton Royal Hospital in Dumfries pioneered the use of art activity in the treatment of its patients. This article is the second of two which look at examples of art created for, and in, Scottish hospitals in the 19th century. It is suggested that the importance of Scotland's contribution to this movement is unrecognized by many of its modern-day practitioners.

  3. Baldrige Award cites two hospitals. Baptist, Saint Luke's hospitals honored for quality, performance.

    Science.gov (United States)

    Rees, Tom

    2004-01-01

    Baptist Hospital Inc., Pensacola, Fla.; and Saint Luke's Hospital, Kansas City, Mo., have received the prestigious Malcolm Baldrige National Quality Award in the category of healthcare. Named for a former secretary of commerce, the award recognizes efficiency, effectiveness and excellence. The two hospitals are among only seven companies in the U.S. to be so recognized this year.

  4. Does outsourcing affect hospital profitability?

    Science.gov (United States)

    Danvers, Kreag; Nikolov, Pavel

    2010-01-01

    Organizations outsource non-core service functions to achieve cost reductions and strategic benefits, both of which can impact profitability performance. This article examines relations between managerial outsourcing decisions and profitability for a multi-state sample of non-profit hospitals, across 16 states and four regions of the United States. Overall regression results indicate that outsourcing does not necessarily improve hospital profitability. In addition, we identify no profitability impact from outsourcing for urban hospitals, but somewhat positive effects for teaching hospitals. Our regional analysis suggests that hospitals located in the Midwest maintain positive profitability effects with outsourcing, but those located in the South realize negative effects. These findings have implications for cost reduction efforts and the financial viability of non-profit hospitals.

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

    Science.gov (United States)

    Nimptsch, Ulrike; Wengler, Annelene; Mansky, Thomas

    2016-11-01

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

  6. The diffusion of Magnet hospital recognition.

    Science.gov (United States)

    Abraham, Jean; Jerome-D'Emilia, Bonnie; Begun, James W

    2011-01-01

    Magnet recognition is promoted by many in the practice community as the gold standard of nursing care quality. The Magnet hospital population has exploded in recent years, with about 8% of U.S. general hospitals now recognized. The purpose of this study was to identify the characteristics that distinguish Magnet-recognized hospitals from other hospitals within the framework of diffusion theory. We conceptualize Magnet recognition as an organizational innovation and Magnet-recognized hospitals as adopters of the innovation. We hypothesize that adoption is associated with selected characteristics of hospitals and their markets. The study population consists of the 3,657 general hospitals in the United States in 2008 located in metropolitan or micropolitan areas. We used logistic regression analysis to estimate the association of Magnet recognition with organizational and market characteristics. Empirical results support hypotheses that adoption is positively associated with hospital complexity and specialization, as measured by teaching affiliation, and with hospital size, slack resources, and not-for-profit or public ownership (vs. for-profit). Adopters also are more likely to be located in markets that are experiencing population growth and are more likely to have competitor hospitals within the market that also have adopted Magnet status. A positive association of adoption with baccalaureate nursing school supply is contrary to the hypothesized relationship. Because of its rapid recent growth, consideration of Magnet program recognition should be on the strategic planning agenda of hospitals and hospital systems. Hospital administrators, particularly in smaller, for-profit hospitals, may expect more of their larger not-for-profit competitors, particularly teaching hospitals, to adopt Magnet recognition, increasing competition for baccalaureate-prepared registered nurses in the labor market.

  7. Trends in diarrhea hospitalizations among infants at three hospitals in Tanzania before and after rotavirus vaccine introduction.

    Science.gov (United States)

    Lyamuya, Faraja; Michael, Fausta; Jani, Bhavin; Fungo, Yohana; Chambo, Alfred; Chami, Inviolatha; Bulali, Regina; Mpamba, Amina; Cholobi, Happy; Kallovya, Dotto; Kamugisha, Christopher; Mwenda, Jason M; Cortese, Margaret M

    2018-04-11

    The Tanzania Ministry of Health introduced monovalent human rotavirus vaccine in January 2013, to be administered at ages 6 and 10 weeks. Data suggest there was high vaccine uptake. We used hospital ward registers from 3 hospitals to examine trends in diarrhea hospitalizations among infants before and after vaccine introduction. Ward registers from Dodoma Regional Referral Hospital (Central Tanzania), and two hospitals in Mbeya (Southwest area), Mbeya Zonal Referral Hospital and Mbalizi Hospital, were used to tally admissions for diarrhea among children by age group, month and year. Rotavirus surveillance had started at these hospitals in early 2013; the proportion of infants enrolled and rotavirus-EIA positive were examined by month to determine peak periods of rotavirus disease post-vaccine introduction. Registers were available for 2-4 prevaccine years and 2-3 post introduction years. At Dodoma Regional Referral Hospital, compared with the mean of 2011 and 2012, diarrhea hospitalizations among infants were 26% lower in 2015 and 58% lower in 2016. The diarrhea peak shifted later in the year first by 1 and then by 2-3 months from prevaccine. At the Mbeya hospitals, the number of diarrhea admissions in prevaccine period varied substantially by year. At Mbeya Referral Hospital, diarrhea hospitalizations among infants were lower by 25-37% in 2014 and 11-26% in 2015, while at Mbalizi Hospital, these hospitalizations were 4% lower in 2014 and 14% higher in 2015. Rotavirus testing data demonstrated a lowering of the prevaccine peak, a shift in timing of the peak months and indicated that other diarrheal peaks in post-introduction years were not due to rotavirus. In this ecological evaluation, total diarrhea hospitalizations among infants were lower (≥25% lower in ≥1 year) following introduction in 2 of 3 hospitals. There are challenges in using ward registers to ascertain possible impact of rotavirus vaccine introduction on trends in hospitalizations for

  8. Strategic management for university hospitals

    Directory of Open Access Journals (Sweden)

    Martha Isabel Riaño-Casallas

    2016-10-01

    Full Text Available Introduction: There are several approaches and schools that support strategic management processes. University hospitals require the implementation of a strategic approach to their management, since they are a particular type of organization with the triple mission of providing health care, education and research. Objective: To propose a strategic profile for a university hospital. Materials and methods: The theoretical framework of strategic management was analyzed and some particular components of hospital management were studied; based on these criteria, the strategic management process in three high complexity hospitals of Bogotá, D.C. was examined and a profile of both the objectives and the functional strategies for the hospital was proposed. Results: The main strategic thinking schools are presented; the processes and components of strategic management are described, and a strategic management profile for a university hospital is proposed. Conclusion: The strategic orientation of management for an institution with the characteristics of a university hospital facilitates achieving organizational objectives.

  9. Health promoting hospitals: a study on educational hospitals of Isfahan, Iran

    Directory of Open Access Journals (Sweden)

    Atefeh Afshari

    2016-03-01

    Conclusion: It seems that some of the health promoting hospitals (HPS duties carried out by hospitals. So, to improve the quality of health services, it seems useful to encourage policymakers and health service managers to create coherent policies and guidelines in HPS.

  10. How a hospital must face a massive emergency: the case of Martini Hospital, Turin

    Directory of Open Access Journals (Sweden)

    Antonio Morra

    2008-09-01

    Full Text Available The terms “disaster” or “surge capability”, referred to hospitals, are often used to define a massive casualty admission. This may be a misleading concept, because emergency may as well arise from inside hospitals, and the last years high figures related to fires in the about 2,000 italian hospitals should suggest a different point of view. In this article the authors describe their experience in hospital preparedness at Ospedale Martini in Turin. Hospital operators regularly attend basic (GOM and advanced (HDM© courses about disaster response and organization, and a specific course is dedicated to operators involved in internal safety (fire emergency. In this courses, computer simulations are widely used, associated with conventional didactic. If education is one of the two cornerstones of disaster preparedness at Ospedale Martini, well designed emergency plans and an effective disaster management are the other one. The Internal Emergency Plan (Fire and Evacuation is aimed to give a proper response to fires and other events arising from inside the hospital and potentially requiring its partial or total evacuation. The Massive Casualties Admission Emergency Plan increases the surge capability of the hospital allowing to take care of a great number of injured people, and at the same time avoiding a dramatic fall in the treatment quality. The “Hospital Disaster Management©” system, created by the authors, is an organizational scheme based on team work. Its aim is to “put order in chaos” when hospitals are facing a disaster. Properly trained physicians and nurses, assigned to key positions, act in this system as Hospital Disaster Managers: their tasks are to coordinate the teams, to manage critical resources and to use the emergency plans as powerful instruments.

  11. ¿Una promesa incumplida? La calidad de la educación superior universitaria y el subempleo profesional en el Perú

    OpenAIRE

    Gustavo Yamada; Pablo Lavado; Joan Martínez

    2014-01-01

    A pesar del elevado crecimiento de la economía peruana en los últimos diez años, los profesionales universitarios se enfrentan a dificultades cada vez mayores para desempeñarse en ocupaciones laborales acorde a su formación educativa superior, habilidades e inversiones educativas. Este panorama se concreta en la condición «subempleo profesional» por la cual cuatro de cada diez profesionales universitarios al 2012 se encuentran sobre-educados, ocupando vacantes no profesionales y sub remunerad...

  12. HOSPITAL IMAGE AS A MODERATING VARIABLE ON THE EFFECT OF HOSPITAL SERVICE QUALITY ON THE CUSTOMER PERCEIVED VALUE, CUSTOMER TRUST AND CUSTOMER LOYALTY IN HOSPITAL SERVICES

    OpenAIRE

    Indrianawati Usman

    2017-01-01

    This is an explanatory research, analyzing the hospital image as a moderating variable on the effect of hospital service quality on customer perceived value and trust. Research was conducted at several hospitals in Surabaya Indonesia, especially to outpatients. Data was collected by survey to the outpatients of the hospitals. The purpose of this research was empirically examining the effects of hospital service quality on customer perceived value and customer trust, examine eff...

  13. Distinguishing in-hospital and out-of-hospital status epilepticus: clinical implications from a 10-year cohort study.

    Science.gov (United States)

    Sutter, R; Semmlack, S; Spiegel, R; Tisljar, K; Rüegg, S; Marsch, S

    2017-09-01

    The aim was to determine differences of clinical, treatment and outcome characteristics between patients with in-hospital and out-of-hospital status epilepticus (SE). From 2005 to 2014, clinical data were assessed in adults with SE treated in an academic medical care centre. Clinical characteristics, treatment and outcomes were compared between patients with in-hospital and out-of-hospital SE. Amongst 352 patients, 213 were admitted with SE and 139 developed in-hospital SE. Patients with in-hospital SE had more acute/fatal aetiologies (60% vs. 35%, P Status Epilepticus Severity Score (STESS) was an independent predictor for death in both groups, increased Charlson Comorbidity Index and treatment refractory SE were associated with death only in patients with in-hospital SE. Continuous anaesthesia for refractory SE was associated with increased mortality only in patients with out-of-hospital SE. The area under the receiver operating curve was 0.717 for prediction of death by STESS in patients with in-hospital SE and 0.811 in patients with out-of-hospital SE. Patients with in-hospital SE had more fatal aetiologies and comorbidities, refractory SE, less return to functional baseline, and increased mortality compared to patients with out-of-hospital SE. Whilst the STESS was a robust predictor for death in both groups, the association between continuous anaesthesia and death was limited to out-of-hospital SE. © 2017 EAN.

  14. Severe maternal morbidity in Zanzibar's referral hospital: Measuring the impact of in-hospital care

    NARCIS (Netherlands)

    Herklots, T.; Acht, L. van; Meguid, T.; Franx, A.; Jacod, B.C.

    2017-01-01

    OBJECTIVE: to analyse the impact of in-hospital care on severe maternal morbidity using WHO's near-miss approach in the low-resource, high mortality setting of Zanzibar's referral hospital. SETTING: Mnazi Mmoja Hospital, a tertiary care facility, in Zanzibar, Tanzania. METHODS: We identified all

  15. Multiple sclerosis and alcohol use disorders: In-hospital mortality, extended hospital stays, and overexpenditures.

    Science.gov (United States)

    Gili-Miner, M; López-Méndez, J; Vilches-Arenas, A; Ramírez-Ramírez, G; Franco-Fernández, D; Sala-Turrens, J; Béjar-Prado, L

    2016-10-22

    The objective of this study was to analyse the impact of alcohol use disorders (AUD) in patients with multiple sclerosis (MS) in terms of in-hospital mortality, extended hospital stays, and overexpenditures. We conducted a retrospective observational study in a sample of MS patients obtained from minimal basic data sets from 87 Spanish hospitals recorded between 2008 and 2010. Mortality, length of hospital stays, and overexpenditures attributable to AUD were calculated. We used a multivariate analysis of covariance to control for such variables as age and sex, type of hospital, type of admission, other addictions, and comorbidities. The 10,249 patients admitted for MS and aged 18-74 years included 215 patients with AUD. Patients with both MS and AUD were predominantly male, with more emergency admissions, a higher prevalence of tobacco or substance use disorders, and higher scores on the Charlson comorbidity index. Patients with MS and AUD had a very high in-hospital mortality rate (94.1%) and unusually lengthy stays (2.4 days), and they generated overexpenditures (1,116.9euros per patient). According to the results of this study, AUD in patients with MS results in significant increases in-hospital mortality and the length of the hospital stay and results in overexpenditures. Copyright © 2016 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. [Current status of "hospital-clinic" and "hospital-pharmacy" cooperation for inhalation therapy -based on hospital surveys throughout Japan].

    Science.gov (United States)

    Yoshimura, Chie; Momose, Yasuyuki; Horie, Takeo; Komase, Yuko; Niimi, Akio; Dobashi, Kunio; Fujimoto, Keisaku; Tohda, Yuuji; Ohta, Ken; Adachi, Mitsuru

    2014-02-01

    The "zero death from asthma strategy" in the medical treatment for bronchial asthma has been promoted by the Ministry of Health, Labour, and Welfare from 2006, and it indicates that medical and non-medical specialists, as well as pharmacists, should cooperate, and strives to build cooperation which is suited the actual conditions of an area. It is also important for COPD. Although hospitals in some areas cooperate with clinics and pharmacies, the overall concept of cooperation appears to be absent in most Japanese hospitals. A questionnaire was administered in early March, 2012 to 477 allergology institutions, and was authorized by an educational establishment. Among 246 replies from the institutions, cooperation between hospitals and clinics was carried out by 98 institutions (39.8%) specializing in bronchial asthma, and in 64 institutions (37.2%) specializing in COPD. However, cooperation tools were used in only 37 of these institutions (15.0%). The ability to fill prescriptions outside the hospital was available in 209 institutions (85.0%). One-hundred and seventeen institutions (47.6%) replied that they have no tools for hospital-pharmacy cooperation. Direct indications were written in prescriptions by 82 institutions (33.3). In order to build inter-regional association and to equalize medical treatment, we suggest that developing tools and organization for cooperation between health professionals who treat patients with bronchial asthma and COPD is necessary.

  17. Sociotechnical factors influencing unsafe use of hospital information systems: A qualitative study in Malaysian government hospitals.

    Science.gov (United States)

    Salahuddin, Lizawati; Ismail, Zuraini; Hashim, Ummi Rabaah; Raja Ikram, Raja Rina; Ismail, Nor Haslinda; Naim Mohayat, Mohd Hariz

    2018-03-01

    The objective of this study is to identify factors influencing unsafe use of hospital information systems in Malaysian government hospitals. Semi-structured interviews with 31 medical doctors in three Malaysian government hospitals implementing total hospital information systems were conducted between March and May 2015. A thematic qualitative analysis was performed on the resultant data to deduce the relevant themes. A total of five themes emerged as the factors influencing unsafe use of a hospital information system: (1) knowledge, (2) system quality, (3) task stressor, (4) organization resources, and (5) teamwork. These qualitative findings highlight that factors influencing unsafe use of a hospital information system originate from multidimensional sociotechnical aspects. Unsafe use of a hospital information system could possibly lead to the incidence of errors and thus raises safety risks to the patients. Hence, multiple interventions (e.g. technology systems and teamwork) are required in shaping high-quality hospital information system use.

  18. Strategic management process in hospitals.

    Science.gov (United States)

    Zovko, V

    2001-01-01

    Strategic management is concerned with strategic choices and strategic implementation; it provides the means by which organizations meet their objectives. In the case of hospitals it helps executives and all employees to understand the real purpose and long term goals of the hospital. Also, it helps the hospital find its place in the health care service provision chain, and enables the hospital to coordinate its activities with other organizations in the health care system. Strategic management is a tool, rather than a solution, that helps executives to identify root causes of major problems in the hospital.

  19. 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.

  20. Hospital management structures in Maltese hospital through the ages

    OpenAIRE

    Savona-Ventura, Charles

    2001-01-01

    The spreading cult of Christ the Healer during the Medieval period led to sick-nursing being viewed as a Christian duty. This encouraged royal dignitaries and philantrophic individuals to donate funds towards the institution and maintenance of a hospital or hospice, the management of these institutions being often shared with religious authorities. The Maltese Islands have been serviced by a series of hospitals, the earliest dating to the fourteenth century. In line with the ch...

  1. 77 FR 63751 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

    Science.gov (United States)

    2012-10-17

    ... [CMS-1588-F2] RIN 0938-AR12 Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal Year 2013 Rates..., 2012 Federal Register entitled ``Medicare Program; Hospital Inpatient Prospective Payment Systems for...

  2. 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

  3. Indicators of healthcare results: analysis of adverse events during hospital stays Indicadores de resultados para la asistencia: análisis de situaciones adversas durante la hospitalización Indicadores de resultados da assistência: análise dos eventos adversos durante a internação hospitalar

    Directory of Open Access Journals (Sweden)

    Camila Cristina Pires Nascimento

    2008-08-01

    Full Text Available This quantitative, retrospective study aimed to characterize adverse events (AE in Intensive Care Units (ICU, Semi-Intensive Care Units (SCU and Inpatient Units (IU, regarding nature, type, day of the week and nursing professionals / patient ratio at the moment of occurrence; as well as to identify nursing interventions after the event and AE rates. The study was performed at a private hospital in the city of São Paulo, Brazil. Two hundred twenty-nine AE were notified. The predominant events were related to nasogastric tubes (NGT (57.6%, followed by patient fall (16.6% and medication errors (14.8%. The nursing professionals /patient ratio at the moment of the event was 1:2 for the ICU, 1:3 for the SCU and 1:4 for the IU. A similar distribution was observed for the other days of the week. The nursing interventions were: repositioning the NGT (83.2% and communication of the occurrence to the physician in case of medication errors (47.6% and falls (55.2%. The highest AE rate was related to NGT.Estudio cuantitativo, retrospectivo que determinó las características de las situaciones adversas (SA en la Unidad de Cuidados Intensivos (UCI, Unidad de Cuidados Semi-intensivos (UCS y Servicio de Hospitalización (SH, en cuanto su naturaleza, tipo, día de la semana y la relación numérica trabajador / paciente. Asimismo, se identificó las intervenciones de enfermería y se calculo la tasa para SA. Realizado en un hospital privado de la ciudad de São Paulo. Se notificaron 229 SA, predominando los relacionados con la sonda nasogástrica (SNG (57,6%, caídas (16,6% y administración de medicamento (14,8%. La relación trabajador / paciente por día fue de 1:2 en UCI, 1:3 en UCS y 1:4 en SH. Las intervenciones de enfermería frente a estas situaciones fueron la recolocación de SNG (83,3%, la información al médico tanto en los casos de errores de medicación (47,6%, como en caídas (55,2%. La mayores tasas fueron observadas para los casos de SNG

  4. Estimating inpatient hospital prices from state administrative data and hospital financial reports.

    Science.gov (United States)

    Levit, Katharine R; Friedman, Bernard; Wong, Herbert S

    2013-10-01

    To develop a tool for estimating hospital-specific inpatient prices for major payers. AHRQ Healthcare Cost and Utilization Project State Inpatient Databases and complete hospital financial reporting of revenues mandated in 10 states for 2006. Hospital discharge records and hospital financial information were merged to estimate revenue per stay by payer. Estimated prices were validated against other data sources. Hospital prices can be reasonably estimated for 10 geographically diverse states. All-payer price-to-charge ratios, an intermediate step in estimating prices, compare favorably to cost-to-charge ratios. Estimated prices also compare well with Medicare, MarketScan private insurance, and the Medical Expenditure Panel Survey prices for major payers, given limitations of each dataset. Public reporting of prices is a consumer resource in making decisions about health care treatment; for self-pay patients, they can provide leverage in negotiating discounts off of charges. Researchers can also use prices to increase understanding of the level and causes of price differentials among geographic areas. Prices by payer expand investigational tools available to study the interaction of inpatient hospital price setting among public and private payers--an important asset as the payer mix changes with the implementation of the Affordable Care Act. © Published 2013. This article is a U.S. Government work and is in the public domain in the USA.

  5. 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.

  6. Predictors of Hospitalization in Patients with Syncope Assisted in Specialized Cardiology Hospital

    Energy Technology Data Exchange (ETDEWEB)

    Fischer, Leonardo Marques; Dutra, João Pedro Passos [Instituto de Cardiologia, Fundação Universitária de Cardiologia do Rio Grande do Sul, Porto Alegre, RS (Brazil); Mantovani, Augusto [UFCSPA - Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS (Brazil); Lima, Gustavo Glotz de [Instituto de Cardiologia, Fundação Universitária de Cardiologia do Rio Grande do Sul, Porto Alegre, RS (Brazil); UFCSPA - Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS (Brazil); Leiria, Tiago Luiz Luz, E-mail: drleiria@cardiol.br [Instituto de Cardiologia, Fundação Universitária de Cardiologia do Rio Grande do Sul, Porto Alegre, RS (Brazil)

    2013-12-15

    Risk stratification of a syncopal episode is necessary to better differentiate patients needing hospitalization of those who can be safely sent home from the emergency department. Currently there are no strict guidelines from our Brazilian medical societies to guide the cardiologist that evaluate patients in an emergency setting. To analyze the criteria adopted for defining the need for hospitalization and compare them with the predictors of high risk for adverse outcome defined by the OESIL score that is already validated in the medical literature for assessing syncope. A cross-sectional study of patients diagnosed with syncope during emergency department evaluation at our institution in the year 2011. Of the 46,476 emergency visits made in that year, 216 were due to syncope. Of the 216 patients analyzed, 39% were hospitalized. The variables associated with the need of hospital admission were - having health care insurance, previous known cardiovascular disease, no history of prior stroke, previous syncope and abnormal electrocardiograms during the presentation. Patients classified in OESIL scores of 0-1 had a greater chance of emergency discharge; 2-3 scores showed greater association with the need of hospitalization. A score ≥ 2 OESIL provided an odds ratio 7.8 times higher for hospitalization compared to score 0 (p <0.001, 95% CI:4,03-15,11). In approximately 39% no etiological cause for syncope was found and in 18% cardiac cause was identified. Factors such as cardiovascular disease, prior history of syncope, health insurance, no previous stroke and abnormal electrocardiograms, were the criteria used by doctors to indicate hospital admission. There was a good correlation between the clinical judgment and the OESIL criteria for high risk described in literature.

  7. Predictors of Hospitalization in Patients with Syncope Assisted in Specialized Cardiology Hospital

    International Nuclear Information System (INIS)

    Fischer, Leonardo Marques; Dutra, João Pedro Passos; Mantovani, Augusto; Lima, Gustavo Glotz de; Leiria, Tiago Luiz Luz

    2013-01-01

    Risk stratification of a syncopal episode is necessary to better differentiate patients needing hospitalization of those who can be safely sent home from the emergency department. Currently there are no strict guidelines from our Brazilian medical societies to guide the cardiologist that evaluate patients in an emergency setting. To analyze the criteria adopted for defining the need for hospitalization and compare them with the predictors of high risk for adverse outcome defined by the OESIL score that is already validated in the medical literature for assessing syncope. A cross-sectional study of patients diagnosed with syncope during emergency department evaluation at our institution in the year 2011. Of the 46,476 emergency visits made in that year, 216 were due to syncope. Of the 216 patients analyzed, 39% were hospitalized. The variables associated with the need of hospital admission were - having health care insurance, previous known cardiovascular disease, no history of prior stroke, previous syncope and abnormal electrocardiograms during the presentation. Patients classified in OESIL scores of 0-1 had a greater chance of emergency discharge; 2-3 scores showed greater association with the need of hospitalization. A score ≥ 2 OESIL provided an odds ratio 7.8 times higher for hospitalization compared to score 0 (p <0.001, 95% CI:4,03-15,11). In approximately 39% no etiological cause for syncope was found and in 18% cardiac cause was identified. Factors such as cardiovascular disease, prior history of syncope, health insurance, no previous stroke and abnormal electrocardiograms, were the criteria used by doctors to indicate hospital admission. There was a good correlation between the clinical judgment and the OESIL criteria for high risk described in literature

  8. Demographic Factors and Hospital Size Predict Patient Satisfaction Variance- Implications for Hospital Value-Based Purchasing

    Science.gov (United States)

    McFarland, Daniel C.; Ornstein, Katherine; Holcombe, Randall F.

    2016-01-01

    Background Hospital Value-Based Purchasing (HVBP) incentivizes quality performance based healthcare by linking payments directly to patient satisfaction scores obtained from Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys. Lower HCAHPS scores appear to cluster in heterogeneous population dense areas and could bias CMS reimbursement. Objective Assess nonrandom variation in patient satisfaction as determined by HCAHPS. Design Multivariate regression modeling was performed for individual dimensions of HCAHPS and aggregate scores. Standardized partial regression coefficients assessed strengths of predictors. Weighted Individual (hospital) Patient Satisfaction Adjusted Score (WIPSAS) utilized four highly predictive variables and hospitals were re-ranked accordingly. Setting 3,907 HVBP-participating hospitals. Patients 934,800 patient surveys, by most conservative estimate. Measurements 3,144 county demographics (U.S. Census), and HCAHPS. Results Hospital size and primary language (‘non-English speaking’) most strongly predicted unfavorable HCAHPS scores while education and white ethnicity most strongly predicted favorable HCAHPS scores. The average adjusted patient satisfaction scores calculated by WIPSAS approximated the national average of HCAHPS scores. However, WIPSAS changed hospital rankings by variable amounts depending on the strength of the predictive variables in the hospitals’ locations. Structural and demographic characteristics that predict lower scores were accounted for by WIPSAS that also improved rankings of many safety-net hospitals and academic medical centers in diverse areas. Conclusions Demographic and structural factors (e.g., hospital beds) predict patient satisfaction scores even after CMS adjustments. CMS should consider WIPSAS or a similar adjustment to account for the severity of patient satisfaction inequities that hospitals could strive to correct. PMID:25940305

  9. Hospitals with higher nurse staffing had lower odds of readmissions penalties than hospitals with lower staffing.

    Science.gov (United States)

    McHugh, Matthew D; Berez, Julie; Small, Dylan S

    2013-10-01

    The Affordable Care Act's Hospital Readmissions Reduction Program (HRRP) penalizes hospitals based on excess readmission rates among Medicare beneficiaries. The aim of the program is to reduce readmissions while aligning hospitals' financial incentives with payers' and patients' quality goals. Many evidence-based interventions that reduce readmissions, such as discharge preparation, care coordination, and patient education, are grounded in the fundamentals of basic nursing care. Yet inadequate staffing can hinder nurses' efforts to carry out these processes of care. We estimated the effect that nurse staffing had on the likelihood that a hospital was penalized under the HRRP. Hospitals with higher nurse staffing had 25 percent lower odds of being penalized compared to otherwise similar hospitals with lower staffing. Investment in nursing is a potential system-level intervention to reduce readmissions that policy makers and hospital administrators should consider in the new regulatory environment as they examine the quality of care delivered to US hospital patients.

  10. The financial performance of rural hospitals and implications for elimination of the Critical Access Hospital program.

    Science.gov (United States)

    Holmes, George M; Pink, George H; Friedman, Sarah A

    2013-01-01

    To compare the financial performance of rural hospitals with Medicare payment provisions to those paid under prospective payment and to estimate the financial consequences of elimination of the Critical Access Hospital (CAH) program. Financial data for 2004-2010 were collected from the Healthcare Cost Reporting Information System (HCRIS) for rural hospitals. HCRIS data were used to calculate measures of the profitability, liquidity, capital structure, and financial strength of rural hospitals. Linear mixed models accounted for the method of Medicare reimbursement, time trends, hospital, and market characteristics. Simulations were used to estimate profitability of CAHs if they reverted to prospective payment. CAHs generally had lower unadjusted financial performance than other types of rural hospitals, but after adjustment for hospital characteristics, CAHs had generally higher financial performance. Special payment provisions by Medicare to rural hospitals are important determinants of financial performance. In particular, the financial condition of CAHs would be worse if they were paid under prospective payment. © 2012 National Rural Health Association.

  11. [Psychopathology of anxiety-phobic disorders that led to hospitalization in a psychiatric hospital].

    Science.gov (United States)

    Chugunov, D A; Schmilovitch, A A

    To study the psychopathology of anxiety-phobic disorders and motives of hospitalization of patients in a psychiatric hospital. One hundred and thirty-two patients were examined, 72 patients of the main group were admitted to general psychiatric departments, 60 patients of the control group in the sanatorium psychiatric departments. Clinical-psychopathological, follow-up, psychometric and statistical methods were used. Patients with hospital anxiety-phobic disorders had agoraphobia with panic disorder, social phobias, hypochondriacal phobias, specific phobias and multiple phobias. The main reasons for hospitalization were: the intensity of anxiety-phobic disorders, contrast content of phobias, multiplicity of anxiety-phobic disorders, ambulance calls, personality accentuations and rental aims.

  12. Incidences and variations of hospital acquired venous thromboembolism in Australian hospitals: a population-based study.

    Science.gov (United States)

    Assareh, Hassan; Chen, Jack; Ou, Lixin; Hillman, Ken; Flabouris, Arthas

    2016-09-22

    Data on hospital-acquired venous thromboembolism (HA-VTE) incidence, case fatality rate and variation amongst patient groups and health providers is lacking. We aim to explore HA-VTE incidences, associated mortality, trends and variations across all acute hospitals in New South Wales (NSW)-Australia. A population-based study using all admitted patients (aged 18-90 with a length of stay of at least two days and not transferred to another acute care facility) in 104 NSW acute public and private hospitals during 2002-2009. Poisson mixed models were used to derive adjusted rate ratios (IRR) in presence of patient and hospital characteristics. Amongst, 3,331,677 patients, the incidence of HA-VTE was 11.45 per 1000 patients and one in ten who developed HA-VTE died in hospital. HA-VTE incidence, initially rose, but subsequently declined, whereas case fatality rate consistently declined by 22 % over the study period. Surgical patients were 128 % (IRR = 2.28, 95 % CI: 2.19-2.38) more likely to develop HA-VTE, but had similar case fatality rates compared to medical patients. Private hospitals, in comparison to public hospitals had a higher incidence of HA-VTE (IRR = 1.76; 95 % CI: 1.42-2.18) for medical patients. However, they had a similar incidence (IRR = 0.91; 95 % CI: 0.75-1.11), but a lower mortality (IRR = 0.59; 95 % CI: 0.47-0.75) amongst surgical patients. Smaller public hospitals had a lower HA-VTE incidence rate compared to larger hospitals (IRR  1.71). Hospitals with a lower reported HA-VTE incidence tended to have a higher HA-VTE case fatality rate. Despite the decline in HA-VTE incidence and case fatality, there were large variations in incidents between medical and surgical patients, public and private hospitals, and different hospital groups. The causes of such differences warrant further investigation and may provide potential for targeted interventions and quality improvement initiatives.

  13. 78 FR 38679 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

    Science.gov (United States)

    2013-06-27

    ... Systems for Acute Care Hospitals and the Long Term Care Hospital Prospective Payment System and Proposed... Payment Systems for Acute Care Hospitals and the Long Term Care Hospital Prospective Payment System and... regarding MS-DRG classifications and new technology add-on payments. Eva Fung (410) 786-7539, for...

  14. [Communication between the primary care physician, hospital staff and the patient during hospitalization].

    Science.gov (United States)

    Menahem, Sasson; Roitgarz, Ina; Shvartzman, Pesach

    2011-04-01

    HospitaL admission is a crisis for the patient and his family and can interfere with the continuity of care. It may lead to mistakes due to communication problems between the primary care physician and the hospital medical staff. To explore the communication between the primary care physician, the hospital medical staff, the patient and his family during hospitalization. A total of 269 questionnaires were sent to all Clalit Health Services-South District, primary care physicians; 119 of these questionnaires (44.2%) were completed. Half of the primary care physicians thought that they should, always or almost always, have contact with the admitting ward in cases of internal medicine, oncology, surgery or pediatric admissions. However, the actual contact rate, according to their report, was only in a third of the cases. A telephone contact was more common than an actual visit of the patient in the ward. Computer communication between the hospital physicians and the primary care physicians is still insufficiently developed, although 96.6% of the primary care physicians check, with the aid of computer software, for information on their hospitalized patients. The main reasons to visit the hospitalized patient were severe medical conditions or uncertainty about the diagnosis; 79% of the physicians thought that visiting their patients strengthened the level of trust between them and their patients. There are sometimes communication difficulties and barriers between the primary care physicians and the ward's physicians due to partial information delivery and rejection from the hospital physicians. The main barriers for visiting admitted patients were workload and lack of pre-allocated time on the work schedule. No statistically significant differences were found between communication variables and primary care physician's personal and demographic characteristics. The communication between the primary care physician and the hospital physicians should be improved through

  15. Hospital-Level Variation in Practice Patterns and Patient Outcomes for Pediatric Patients Hospitalized With Functional Constipation.

    Science.gov (United States)

    Librizzi, Jamie; Flores, Samuel; Morse, Keith; Kelleher, Kelly; Carter, Jodi; Bode, Ryan

    2017-06-01

    Constipation is a common pediatric condition with a prevalence of 3% to 5% in children aged 4 to 17 years. Currently, there are no evidence-based guidelines for the management of pediatric patients hospitalized with constipation. The primary objective was to evaluate practice patterns and patient outcomes for the hospital management of functional constipation in US children's hospitals. We conducted a multicenter, retrospective cohort study of children aged 0 to 18 years hospitalized for functional constipation from 2012 to 2014 by using the Pediatric Health Information System. Patients were included by using constipation and other related diagnoses as classified by International Classification of Diseases, Ninth Revision . Patients with complex chronic conditions were excluded. Outcome measures included percentage of hospitalizations due to functional constipation, therapies used, length of stay, and 90-day readmission rates. Statistical analysis included means with 95% confidence intervals for individual hospital outcomes. A total of 14 243 hospitalizations were included, representing 12 804 unique patients. The overall percentage of hospitalizations due to functional constipation was 0.65% (range: 0.19%-1.41%, P hospitalization included: electrolyte laxatives: 40% to 96%; sodium phosphate enema: 0% to 64%; mineral oil enema: 0% to 61%; glycerin suppository: 0% to 37%; bisacodyl 0% to 47%; senna: 0% to 23%; and docusate 0% to 11%. Mean length of stay was 1.97 days (range: 1.31-2.73 days, P hospitalized with functional constipation across US children's hospitals. Collaborative initiatives to adopt evidence-based best practices guidelines could help standardize the hospital management of pediatric functional constipation. Copyright © 2017 by the American Academy of Pediatrics.

  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. Hospitality and Collegial Community: An Essay.

    Science.gov (United States)

    Bennett, John B.

    2000-01-01

    Explains a collegial ethic of hospitality as a cardinal academic virtue and suggests a way of building a "collegium," the covenantal community of academe. Discusses how academicians can develop hospitable teaching, hospitable scholarship, and hospitable service. (Author/SLD)

  18. 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...

  19. 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...

  20. 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...

  1. Endocarditis infecciosa, experiencia de diez años en un centro de referencia nacional

    Directory of Open Access Journals (Sweden)

    Elsa Fleitas Ruisánchez

    2011-12-01

    Full Text Available Objetivo: estudiar las características clínicas, epidemiológicas y microbiológicas, así como el tratamiento médico quirúrgico de los pacientes ingresados con el diagnóstico de endocarditis infecciosa, con el propósito de profundizar en su estudio y contribuir a un mejor tratamiento a estos pacientes. Métodos: se estudiaron 24 pacientes procedentes de todo el país, egresados con el diagnóstico de endocarditis infecciosa. Los datos fueron recogidos de las historias clínicas procedentes del archivo del Hospital "William Soler", y de la base de datos del servicio de cirugía del cardiocentro. Se determinó la frecuencia de las diferentes manifestaciones de la endocarditis infecciosa según: grupos etarios, factores de riesgo, y los datos clínicos, de laboratorio y microbiológicos más frecuentes. Además, se determinó la toma valvular predominante, la etiología y su respuesta a los antibióticos. Resultados: el grupo de edad más afectado fue entre 5 y 18 años; la cardiopatía previa fue el factor de riesgo predominante; los síntomas y signos más frecuentes fueron la fiebre, la anorexia y la pérdida de peso. La insuficiencia cardiaca y el embolismo pulmonar fueron complicaciones frecuentes. La mayoría de los pacientes tuvo una eritrosedimentación acelerada, y la cuarta parte de los casos presentaron hemocultivos negativos. Las válvulas aórtica y mitral resultaron las más afectadas, y el curso clínico que predominó fue el subagudo. En casi la mitad de los pacientes la infección tuvo un origen nosocomial. Los antimicrobianos más utilizados fueron la amikacina, la vancomicina y la ceftriaxona. Conclusiones: la endocarditis infecciosa es poco frecuente en nuestra institución, ocurre más a menudo en relación con las cardiopatías congénitas. Los hechos clínicos más constantes fueron la fiebre y el antecedente de cardiopatía previa.

  2. Measuring cost efficiency in the Nordic hospitals--a cross-sectional comparison of public hospitals in 2002.

    Science.gov (United States)

    Linna, Miika; Häkkinen, Unto; Peltola, Mikko; Magnussen, Jon; Anthun, Kjartan S; Kittelsen, Sverre; Roed, Annette; Olsen, Kim; Medin, Emma; Rehnberg, Clas

    2010-12-01

    The aim of this study was to compare the performance of hospital care in four Nordic countries: Norway, Finland, Sweden and Denmark. Using national discharge registries and cost data from hospitals, cost efficiency in the production of somatic hospital care was calculated for public hospitals. Data were collected using harmonized definitions of inputs and outputs for 184 hospitals and data envelopment analysis was used to calculate Farrell efficiency estimates for the year 2002. Results suggest that there were marked differences in the average hospital efficiency between Nordic countries. In 2002, average efficiency was markedly higher in Finland compared to Norway and Sweden. This study found differences in cost efficiency that cannot be explained by input prices or differences in coding practices. More analysis is needed to reveal the causes of large efficiency disparities between Nordic hospitals.

  3. A Decomposition of Hospital Profitability

    Directory of Open Access Journals (Sweden)

    Jason Turner

    2015-06-01

    Full Text Available Objectives: This paper evaluates the drivers of profitability for a large sample of U.S. hospitals. Following a methodology frequently used by financial analysts, we use a DuPont analysis as a framework to evaluate the quality of earnings. By decomposing returns on equity (ROE into profit margin, total asset turnover, and capital structure, the DuPont analysis reveals what drives overall profitability. Methods: Profit margin, the efficiency with which services are rendered (total asset turnover, and capital structure is calculated for 3,255 U.S. hospitals between 2007 and 2012 using data from the Centers for Medicare & Medicaid Services’ Healthcare Cost Report Information System (CMS Form 2552. The sample is then stratified by ownership, size, system affiliation, teaching status, critical access designation, and urban or non-urban location. Those hospital characteristics and interaction terms are then regressed (OLS against the ROE and the respective DuPont components. Sensitivity to regression methodology is also investigated using a seemingly unrelated regression. Results: When the sample is stratified by hospital characteristics, the results indicate investor-owned hospitals have higher profit margins, higher efficiency, and are substantially more leveraged. Hospitals in systems are found to have higher ROE, margins, and efficiency but are associated with less leverage. In addition, a number of important and significant interactions between teaching status, ownership, location, critical access designation, and inclusion in a system are documented. Many of the significant relationships, most notably not-for-profit ownership, lose significance or are predominately associated with one interaction effect when interaction terms are introduced as explanatory variables. Results are not sensitive to the alternative methodology. Conclusion: The results of the DuPont analysis suggest that although there appears to be convergence in the behavior of

  4. A Decomposition of Hospital Profitability

    Science.gov (United States)

    Broom, Kevin; Elliott, Michael; Lee, Jen-Fu

    2015-01-01

    Objectives: This paper evaluates the drivers of profitability for a large sample of U.S. hospitals. Following a methodology frequently used by financial analysts, we use a DuPont analysis as a framework to evaluate the quality of earnings. By decomposing returns on equity (ROE) into profit margin, total asset turnover, and capital structure, the DuPont analysis reveals what drives overall profitability. Methods: Profit margin, the efficiency with which services are rendered (total asset turnover), and capital structure is calculated for 3,255 U.S. hospitals between 2007 and 2012 using data from the Centers for Medicare & Medicaid Services’ Healthcare Cost Report Information System (CMS Form 2552). The sample is then stratified by ownership, size, system affiliation, teaching status, critical access designation, and urban or non-urban location. Those hospital characteristics and interaction terms are then regressed (OLS) against the ROE and the respective DuPont components. Sensitivity to regression methodology is also investigated using a seemingly unrelated regression. Results: When the sample is stratified by hospital characteristics, the results indicate investor-owned hospitals have higher profit margins, higher efficiency, and are substantially more leveraged. Hospitals in systems are found to have higher ROE, margins, and efficiency but are associated with less leverage. In addition, a number of important and significant interactions between teaching status, ownership, location, critical access designation, and inclusion in a system are documented. Many of the significant relationships, most notably not-for-profit ownership, lose significance or are predominately associated with one interaction effect when interaction terms are introduced as explanatory variables. Results are not sensitive to the alternative methodology. Conclusion: The results of the DuPont analysis suggest that although there appears to be convergence in the behavior of NFP and IO

  5. Status of hospital infection control measures at seven major tertiary care hospitals of northern Punjab

    International Nuclear Information System (INIS)

    Ikram, A.; Shah, S.I.H.; Naseem, S.; Absar, S.A.; Safi-Ullah; Ambreen, T.

    2010-01-01

    To determine the availability and implementation of various hospital infection control measures at tertiary care hospitals. Study Design: Survey. Place and Duration of Study: National Institute of Science and Technology, Islamabad, from June through August 2008. Methodology: Seven tertiary care very busy hospitals were selected; one from Islamabad, 5 from Rawalpindi, and one from Lahore. A detailed proforma was designed addressing all the issues pertaining to hospital infection control measures. Air sampling was done and growth yielded was identified by standard methods. Results: Analyses revealed that all of the hospitals had an Infection Control Committee. Microbiological diagnostic facilities were adequate at all the hospitals and overall microorganism yield was very high. Antibiotic policy was claimed by most, not available on ground. Majority of the operation theatres were without proper air flow system and autoclaves were not being regularly monitored. There was no proper disposal for sharps and needles. Incineration was not the usual mode for infectious waste. Conclusion: The results of the present study imply availability of proper hospital infection control policies with need of strict implementation of such measures. (author)

  6. 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

  7. Psychiatric referrals in two general hospitals.

    Directory of Open Access Journals (Sweden)

    Doongaji D

    1989-07-01

    Full Text Available A prospective study was undertaken to compare the patterns of psychiatric referrals in two general hospitals in Bombay viz. the King Edward Memorial Hospital (64 cases and the Jaslok Hospital and Research Centre (62 cases. It was observed that depressive symptoms were the most common presenting symptoms in these patients attending either of the hospitals. Similarly, the commonest diagnoses were depression and organic mental disorder. Attempted suicide with organophosphorous compounds was the commonest reason for hospitalization at K.E.M. Hospital (p less than 0.001. A significant number of these patients were females (p less than 0.05. The psychiatric referrals at Jaslok had been hospitalized mainly for suspected medical or neurological illness (p less than 0.001. These patients belonged to higher economic strata and hence had a better paying capacity compared to patients at KEM hospital, a significant number of whom were unemployed (p less than 0.001. The duration of pre-referred illness of patients and their stay at Jaslok hospital were longer as compared to those at KEM Hospital (p less than 0.01. The number of non-relevant special investigations carried out on patients in Jaslok was more (p less than 0.01. Further analysis of diagnoses revealed that a significant number of patients at KEM Hospital were admitted as primary psychiatric illness (p less than 0.05.

  8. Electronic Cigarettes on Hospital Campuses

    OpenAIRE

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

    2015-01-01

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

  9. Gender Differences in Hospital CEO Compensation: A National Investigation of Not-for-Profit Hospitals.

    Science.gov (United States)

    Song, Paula H; Lee, Shoou-Yih Daniel; Toth, Matthew; Singh, Simone R; Young, Gary J

    2018-01-01

    Gender pay equity is a desirable social value and an important strategy to fill every organizational stratum with gender-diverse talent to fulfill an organization's goals and mission. This study used national, large-sample data to examine gender difference in CEO compensation among not-for-profit hospitals. Results showed the average unadjusted annual compensation for female CEOs in 2009 was $425,085 compared with $581,121 for male CEOs. With few exceptions, the difference existed across all types of not-for-profit hospitals. After controlling for hospital- and area-level characteristics, female CEOs of not-for-profit hospitals earned 22.6% less than male CEOs of not-for-profit hospitals. This translates into an earnings differential of $132,652 associated with gender. Explanations and implications of the results are discussed.

  10. Rise of the dormant: Simulated disturbance improves culturable abundance, diversity, and functions of deep-sea bacteria of Central Indian Ocean Basin

    Digital Repository Service at National Institute of Oceanography (India)

    LokaBharathi, P.A.; Nair, S.

    are formed in response to biotic stress (Burgeot et al. 1996; Gonzalez-Lama and Diez-del-Pino 1996; Angel et al. 1999) as it defends the cell against oxidation that ultimately leads to cytotoxicity. In the present study, an increase in organic content would... eutrophic lake. Archives of Hydrobiology 128(1). Gonzalez-lama, Z. and A. Diez-del-Pino. 1996. Super oxide dismutase and catalase in marine bioluminescent bacteria. Boletin del Instito Espanol del Oceanografia 12(2): 131–137. Gordon, D. A. and S. J...

  11. Terapia con metformina y embarazo en pacientes con síndrome de ovario poliquístico

    OpenAIRE

    Arias E.,María C.; Reid S. de O.,Iván; Acuña S.M.,Margot; Muster O.,Hugo

    2004-01-01

    Estudio prospectivo de seguimiento de 15 pacientes con síndrome de ovario poliquístico (SOP) e hiperinsulinemia que se embarazaron con el uso de metformina, y que se siguieron hasta el parto. Diez continuaron metformina durante el embarazo, hasta las 14 semanas y cinco hasta las 32 semanas. Las 5 pacientes que usaron más tiempo el medicamento no desarrollaron diabetes gestacional a diferencia de las que lo tomaron hasta las 14 semanas que presentaron diabetes gestacional en tres de diez. No e...

  12. Admission of people with dementia to psychiatric hospitals in Japan: factors that can shorten their hospitalizations.

    Science.gov (United States)

    Morikawa, Takako; Maeda, Kiyoshi; Osaki, Tohmi; Kajita, Hiroyuki; Yotsumoto, Kayano; Kawamata, Toshio

    2017-11-01

    People exhibiting serious behavioural and psychological symptoms of dementia are usually voluntarily or involuntarily committed to psychiatric hospitals for treatment. In Japan, the average hospital stay for individuals with dementia is about 2 years. Ideally, individuals should be discharged once their symptoms have subsided. However, we see cases in Japan where individuals remain institutionalized long after behavioural and psychological symptoms of dementia are no longer apparent. This study will attempt to identify factors contributing to shorter stays in psychiatric hospitals for dementia patients. Questionnaires consisting of 17 items were mailed to 121 psychiatric hospitals with dementia treatment wards in western Japan. Out of 121 hospitals that received the questionnaires, 45 hospitals returned them. The total number of new patient admissions at all 45 hospitals during the month of August 2014 was 1428, including 384 dementia patients (26.9%). The average length of stay in the dementia wards in August 2014 was 482.7 days. Our findings revealed that the rate of discharge after 2 months was 35.4% for the dementia wards. In addition, we found that the average stay in hospitals charging or planning to charge the rehabilitation fee to dementia patients was significantly shorter than in hospitals not charging the rehabilitation fee. In Japan, dementia patients account for over 25% of new admissions to psychiatric hospitals with dementia wards. The average length of stay in a psychiatric hospital dementia ward is more than 1 year. A discharge after fewer than 2 months is exceedingly rare for those in a dementia ward compared with dementia patients in other wards. If institutions focus on rehabilitation, it may be possible to shorten the stay of dementia patients in psychiatric hospitals. © 2017 Japanese Psychogeriatric Society.

  13. State of malnutrition in hospitals of Ecuador

    OpenAIRE

    Sylvia Gallegos Espinosa; Marcelo Nicolalde Cifuentes; Sergio Santana Porbén

    2014-01-01

    Rationale: Hospital malnutrition is a global health problem affecting 30-50% of hospitalized patients. There are no estimates of the size of this problem in Ecuadorian hospitals. Hospital malnutrition might influence the quality of medical assistance provided to hospitalized populations. Objectives: To estimate the current frequency of malnutrition among patients admitted to Ecuadorian public hospitals. Materials and methods: The Ecuadorian Hospital Malnutrition Study was conducted between No...

  14. CMS penalizes 758 hospitals for safety incidents

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2015-12-01

    Full Text Available No abstract available. Article truncated after 150 words. The Centers for Medicare and Medicaid Services (CMS is penalizing 758 hospitals with higher rates of patient safety incidents, and more than half of those were also fined last year, as reported by Kaiser Health News (1. Among the hospitals being financially punished are some well-known institutions, including Yale New Haven Hospital, Medstar Washington Hospital Center in DC, Grady Memorial Hospital, Northwestern Memorial Hospital in Chicago, Indiana University Health, Brigham and Womens Hospital, Tufts Medical Center, University of North Carolina Hospital, the Cleveland Clinic, Hospital of the University of Pennsylvania, Parkland