El estudiante de Salamanca. Time and Narration

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Ulpiano Lada Ferreras

2015-02-01

Full Text Available The peculiar treatment of time by Espronceda in The Student of Salamanca entails the conjunction of traditional elements and elements that belong to modernity, which in turn leads to the subversion of the formal and ethical values of this work, in connection with the heterodox aesthetic trend that is characteristic of Romanticism.

La Escuela de Salamanca y la interpretación histórica del Humanismo renacentista español

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Jorge Roaro

2014-12-01

Full Text Available [ES] El presente escrito es una parte de una obra mayor sobre el humanismo renacentista español y su relación con la historia de la cultura hispánica. Trata, desde la perspectiva del desarrollo de las ideas fundamentales que sustentaron su historia, los siguientes temas: nuestra relación moderna con la historia de la filosofía hispánica; el desarrollo historiográfico del concepto «Escuela de Salamanca»; la interpretación de los saberes salmantinos como una escuela de pensamiento humanista; las semejanzas y diferencias entre el Humanismo renacentista español y el italiano; y la proyección de la Escuela de Salamanca en América. [EN] This writing is part of a larger work on the Spanish Renaissance humanism and its relationship to the history of Hispanic culture. It deals, from the perspective of the development of the fundamental ideas that underpinned its history, with the following themes: our modern relationship with the history of Hispanic philosophy; the development of the historiographical concept «School of Salamanca»; the interpretation of the School of Salamanca knowledge as a school of humanist thought; the similarities and differences between the Spanish and Italian Renaissance humanism; and the projection of the School of Salamanca in America.

Acessibilidade e utilização dos espaços verdes urbanos nas cidades de Coimbra (Portugal e Salamanca (Espanha

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Alejandro Gómez

2014-06-01

Full Text Available ACCESSIBILITY AND USE OF URBAN GREEN SPACES IN THE CITIES OF COIMBRA (PORTUGAL AND SALAMANCA (SPAIN. In a society that values more and more wellbeing, health and free time, the introduction of urban green spaces (UGS next to residential areas has become a citizen’s right and requirement. This paper analyses the distribution and accessibility of UGS in the cities of Coimbra and Salamanca and evaluates their influence on the needs of the resident populations, in terms of users’ age, frequency of usage, as well as of motivation and ways to enjoy the facilities. In Coimbra there is a concentration of UGS, whereas in Salamanca there is a dispersion of such spaces, which has resulted in the different usage that people make of them. In fact, although Coimbra offers more urban green space (per inhabitant, their usage is reduced as people go there mainly by car, contrary to what happens in Salamanca. Consequently, Coimbra’s inhabitants choose these green spaces because of the activities they can be used for, whereas Salamanca’s inhabitants choose them for their proximity.

Organ builders, musicians and entrepreneurs: the De- Bernardi’s family in Salamanca, 1903-1932

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Judith Helvia García Martín

2018-01-01

Full Text Available In the early 20th century, Salamanca hosted one of the most culturally and musically active families of the city during the first three decades of the century: the De- Bernardis. Their activities as organ builders, musicians, teachers and music entrepreneurs, focused on the figures of Juan De-Bernardi and his son Luis, left a mark not only in the town, through their involvement in numerous cultural events, but also building and reparing various instruments in an area that covers from the North of Portugal to the South of Cáceres. Here we reconstruct, through the information given by local hemerographic sources, their trajectory from their arrival in Salamanca in 1903 until 1932.

MOOCs to internationalize Masters. A case study at the University of Salamanca

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Pereira, Dolores; Recio, Marian; Perez, Ana Victoria; López, Santiago; Palacios, Esther

2015-04-01

Current major objectives of Master's degrees taught at the University of Salamanca are to incorporate multidisciplinary skills and to address international issues. It is important to ensure that students and early career scientists have all of the necessary skills to deal with professional development before career planning whether in academic research, professional practices or alternative careers, whether in Spain or elsewhere. However, many students choose a Master's programme without sufficient understanding of what they might need to deal with. A multidisciplinary degree course at the University of Salamanca, linked to the Institute of Social Studies for Science and Technology, focuses on training potential experts equipped to mediate between participants in science and technology and the wider public. Students participating in this course currently come from Spanish speaking countries. Because the course is taught mainly in Spanish, subsequent outreach might also be confined to Spanish speaking communities. Even so, it is essential to properly explain, at the outset, the aims of the Master's programme and the international potential of the qualification to attract more. Here we propose the use of MOOCs (Massive Open Online Courses) both to help students to know about the content and other details of the Master program before they join in and to internationalize the course to reach more potential interested students in the subject. This will be the first experience implementing MOOCs in the teaching of masters at the University of Salamanca and, if successful, the experience can be applied to other masters and courses in need of students and internationalization.

Memorias Estancia Española (I: Mi Salamanca

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Eduardo Carranza

1968-05-01

Full Text Available Hemos regresado después de una semana realmente mágica en Salamanca. Yo me sentí viviendo, otra vez, antiguos días de juventud, de iluminación y de delirio: en el sentido de vivir la vida como más de prisa en alegría, ilusión y belleza. En el sentido de recordar y descubrir a un tiempo. La ciudad de piedra dorada, como caída de la luna, a la que yo amo tanto, estaba en la plenitud de su vida universitaria.

A review of Spanish uranium resources and recent developments in the province of Salamanca

International Nuclear Information System (INIS)

Gonzalez Granda, J.A.; Ruiz Sanchez-Porro, J.; Aranaiz Guezala, J. De

1997-01-01

Uranium exploration activities in Spain carried out during the 1950-1992 period, led to the discovery of a number of deposits in different geological environments. Presently there is only activity at the FE area in Salamanca province, where the only remaining mining centre is located. A new dynamic leaching processing plant with a capacity of up to 950 t U 3 O 8 t/year began operation in 1993, at FE mine. The development and planning of the mining in the open pits of ENUSA (province of Salamanca, Spain) under the present low market prices, has led to the implementation of a working scheme, based on the following concepts: Detailed knowledge of the distribution and quality of the mineralization by sufficiently close spaced drilling, with 3D positioning and grade estimation by deviation and gamma ray probing. Use of either geostatistical or arithmetical grade interpolation techniques, properly validated with production, adapted to the density of the information available. Economic optimization of the open pit, by means of the 3D Lerchs-Grossmann technique, as a guide for the final pit design. Calculation of the optimal pit shapes and recoverable resources under different price conditions. These techniques implemented by means of computerized data acquisition and processing systems, are used to face with versatility, the present economic conditions. A full review of the uranium deposits in the province of Salamanca is being carried out with these means. (author). 18 figs

El liberalismo económico de la escuela de Salamanca y su influencia en el desarrollo institucional y organizacional

OpenAIRE

Vargas-Hernández, José G.; Castillo Girón, Víctor Manuel

2017-01-01

El objetivo de este trabajo es analizar la influencia que tiene el liberalismo económico de la llamada escuela de Salamanca en el desarrollo de las instituciones y organizaciones de su época. Se concluye que toda esta orientación de los teólogos morales de la escuela de Salamanca metidos a economistas, tratando asuntos de la economía, tenían como fi nalidad lograr un desarrollo institucional y organizacional que responde a las demandas de la época. Contrariamente al liberali...

La publicidad emocional y su presencia en el ámbito urbano de Salamanca

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Domínguez Rodríguez, Ana

2014-01-01

Una vez desarrollado el marco conceptual en relación a la publicidad ligada con las emociones y el branding emocional, la autora se centra en la publicidad gráfica y en el análisis de 17 carteles repartidos por el centro de la ciudad de Salamanca

Las mineralizaciones litiniferas del oeste de Salamanca y Zamora

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Palero, F.

1992-04-01

Full Text Available The aim of this paper is to describe the most important geological, mineralogical and geochemical features of the Li ores (bouth pegmatites and quartz veins located in the west part of the Salamanca and Zamora provinces. The pegmatites mostly belong to the lepidolite type and they are complex and zoned. In one case, the ore in the pegmatite is litiophilite, and the pegmatite is simple. The veins are quartz rich with ambligonite and sorne feldspar and sulphides. They appear always related to granitic rocks. All these bodies are also mineralized with cassiterite, and sorne of them contain columbite tantalite too.El objeto de este trabajo es el describir las características geológicas, mineralógicas y geoquímicas más importantes de las mineralizaciones de Li (pegmatitas y filones localizadas en el oeste de las provincias de Salamanca y Zamora. La mayor parte de las pegmatitas son de lepidolita como mena de Li, resultando todas éstas ser complejas y zonadas. En un caso, la mineralización es de litiofilita y la pegmatita que la alberga es simple. Los filones son de cuarzo con ambligonita y algo de feldespato y sulfuros. Todos los yacimientos aparecen siempre en relación con rocas graníticas. A su vez, todos los cuerpos estudiados están mineralizados en casiterita, y algunos de ellos en columbo-tantalita también.

Características físicas y alterabilidad de la piedra de Villamayor (Salamanca

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Ordaz, Jorge

1983-09-01

Full Text Available Physical properties of Villamayor sandstone (Salamanca, and especially porosity, water absorption and capillary flow through rock are studied in relation to its lithological characteristics. Laboratory weatherability tests (wetting-drying, freezing-thawing, and salt crystallisation shows the susceptibility to destructive effects of frost and humidity fluctuations, and provides estimated data about the potential durability of this building stone.

Las propiedades físicas de la arenisca de Villamayor (Salamanca, y, en especial, la porosidad, la absorción de agua y el movimiento capilar a través de la roca, son estudiadas en relación con sus características litológicas. Los ensayos de alterabilidad de laboratorio (humedad-sequedad, heladicidad y cristalización de sales ponen de manifiesto su susceptibilidad a los efectos destructivos de las heladas y de las fluctuaciones de humedad, y suministran datos estimativos sobre la durabilidad potencial de esta piedra de construcción.

Atmospheric stability analysis and its relationship with the atmospheric pollution in Salamanca

International Nuclear Information System (INIS)

Fidalgo, M.R.; Garmendia, J.

1989-01-01

In this paper we have studied the relationship between the sulphur dioxide and suspended particulate matter concentrations and the atmospheric stability in Salamanca over 4 year (1978-1982). Of the various indices cited in the bibliography for estimating stratification stability, two were used. First, the Pasquill categories and later a method based on Montgomery's potential, which was the one that gave the best results. (Author)

Diego de León Pinedo, universitario de Salamanca y de San Marcos de Lima

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Águeda RODRÍGUEZ CRUZ

2010-04-01

Full Text Available RESUMEN: La Universidad de Salamanca fue el modelo institucional de las Universidades hispanoamericanas, apoyado en no pocas pruebas documentales1. La descubrimos presente a lo largo de la trayectoria histórica de estas universidades hijas, desde la primera piedra del trasplante del régimen universitario español al Nuevo Mundo, la Universidad de Santo Domingo, en la Isla Española, hasta la última del período hispánico, fundada por las Cortes de Cádiz en León de Nicaragua, en 1812. Desde su gestación y a lo largo de todo su desarrollo histórico no dejan de mirar a Salamanca, para inspirarse continuamente en ella. Al menos el ochenta y cinco por ciento de la legislación universitaria hispanoamericana, hunde sus raíces en el viejo tronco salmantino.

La reforma educativa de Juan de Zúñiga en la Universidad de Salamanca

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Francisco Javier ALEJO MONTES

2010-03-01

Full Text Available RESUMEN: Una ciudad, Salamanca, que, como no podría ser menos, reúne todos los requisitos exigidos por el Rey Sabio para las poblaciones que hubieren de albergar estudios; estos son, que sean «de buen ayre et de fermosas salidas... porque los maestros que muestren los saberes, e los escolares que los aprendan, vivan sanos en él, e puedan folgar, e rescibir placer en la tarde cuando se levantaren cansados del estudio; et otrosí debe ser abondada de pan, e de vino, e de buenas posadas en que puedan morar e pasar su tiempo sin grant costa». Todo esto lo tiene Salamanca: Tranquilidad, buen aire, hermosas salidas... para que maestros y alumnos puedan concentrarse en los saberes, vivan sanos y puedan holgar y descansar del estudio. Y ¿cómo no? Pan, vino y posadas. Una ciudad que, como el mismo Cervantes cantaba, «enhechiza la voluntad de volver a ella a todos los que de la apacibilidad de su vivienda han gustado».

Analysis of climatic variations in seasonal precipitation and temperature in Salamanca (Spain); Analisis de las variaciones climaticas en series estacionales de temperatura y precipitacion en Salamanca (Espana)

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Garcia Casado, A.; Encinas, A.H.; Rodriguez Puebla, C. [Dpto. de Fisica General y de la Atmosfera Universidad de Salamanca, Salamanca (Spain)

1996-12-31

This paper describes the seasonal precipitation and temperature variability in Salamanca. The objectives of the study are: to determine the climate signals on inter annual time-scale within the time series; to redefine the series as a function of the significant oscillation components and to predict local precipitation and temperature variables. The methods used are spectral analysis to obtain the periods of the significant components, linear and nonlinear regression models to obtain the analytical functions that best fit the data. (Author) 14 refs.

Public monuments of Juan Cristóbal in Salamanca: the one to the poet Gabriel y Galán

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Laura Muñoz Pérez

2011-01-01

Full Text Available The article reviews the role of the sculptor Juan Cristóbal González Quesada in the monument dedicated to José María Gabriel y Galán in Salamanca, which was made in the 1920s and represents an important contribution to the public art collection of the city during the twentieth century. We also analyze the aesthetic, technical and procedural components of the project, the social impact at that time, what contributes to expand the cultural spectrum of this paper to the field of Sociology. This perspective helps to get a broader picture of Salamanca and its artistic reality in the first half of the last century.

Geoquímica de las aguas subterráneas en rocas metamórficas al SE de Salamanca

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García, A.

1991-08-01

Full Text Available This paper describes the results of 77 chemical analyses of groundwater from springs and wells in the «Complejo Esquisto Grauváquico» and other paleozoic materials from the south of Salamanca province. The types of groundwater are very diverse, usually bicarbonate dominant, with TDS (Total Dissolved Solids between 0.6 and 16 milimoles/l. Salinity is shown to be greater in the drilled wells than in the dug wells and springs, which confirms the existence of deep flow. Principal Component Analysis indicates that the chemical composition of groundwater must be the result of multiple reactions between the water and the minerals that occur in parallel, with none of the reactions being specially predominant. The organization and geographic distribution of sorne of the elements suggest the existence of regional flow systems.Se presentan los resultados de 77 análisis químicos de aguas subterráneas procedentes de manantiales, pozos excavados y sondeos en el Complejo Esquisto Grauváquico y otros materiales paleozoicos al Sur de la provincia de Salamanca. Se trata de aguas muy dispares, en general bicarbonatadas mixtas, con TSD (total de sólidos disueltos entre 0,6 y 16 milimoles/l. Se pone de manifiesto una mayor salinidad de las aguas de sondeos en relación con las de pozos y manantiales, lo que demuestra la existencia de una circulación a cierta profundidad. El análisis de componentes principales muestra que la composición química de las aguas debe ser el resultado de múltiples reacciones entre el agua y los minerales que se producen en paralelo, sin que destaque ninguna en especial. La distribución geográfica ordenada de algunos elementos obliga a plantear como posible la hipótesis de la existencia de un flujo regional.

Characterization of the vegetation of the park road, Island of Salamanca, Magdalena - Colombia

International Nuclear Information System (INIS)

Tavera Escobar, Hector Arsenio; Gamba Cubides, Nestor Javier

2001-01-01

In Colombia, the natural national parks are par excellence the scenarios to protect the ecological integrity of the ecosystems and consequently for the conservation of the fauna, flora, diversity, genetic resources and values cultural and historical associates. Contrarily, these protected areas are subjected to the degradation caused by anthropic processes and natural that which goes in detriment of the benefits and services that provide to the society. The same as the other protected areas belonging to the system of natural national parks (SNNP), the park road Island of Salamanca (VPIS) it has been subject to the degradation, which has been generated mainly by factors of anthropic character that they have caused an environmental imbalance of great space and temporary magnitude whose repercussion is significant for the fragility of the ecosystems of the protected area in its particular context and for the importance of its function in the region of the complex estuary of the Magdalena River

Villamayor stone (Golden Stone) as a Global Heritage Stone Resource from Salamanca (NW of Spain)

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Garcia-Talegon, Jacinta; Iñigo, Adolfo; Vicente-Tavera, Santiago

2013-04-01

Villamayor stone is an arkosic stone of Middle Eocene age and belongs to the Cabrerizos Sandstone Formation that comprising braided fluvial systems and paleosoils at the top of each stratigraphic sequence. The sandstone is known by several names: i) the Villamayor Stone because the quarries are located in Villamayor de Armuña village that are situated at 7 km to the North from Salamanca city; ii) the Golden Stone due to its patina that produced a ochreous/golden color on the façades of monuments of Salamanca (World Heritage City,1988) built in this Natural stone (one of the silicated rocks utilised). We present in this work, the Villamayor Stone to be candidate as Global Heritage Stone Resource. The Villamayor Stone were quarrying for the construction and ornamentation of Romanesque religious monuments as the Old Cathedral and San Julian church; Gothic (Spanish plateresc style) as the New Cathedral, San Esteban church and the sculpted façade of the Salamanca University, one of the oldest University in Europe (it had established in 1250); and this stone was one of the type of one of the most sumptuous Baroque monuments is the Main Square of the its galleries and arcades (1729). Also, this stone was used in building palaces, walls and reconstruction of Roman bridge. Currently, Villamayor Stone is being quarried by small and family companies, without a modernized processing, for cladding of the façades of the new buildings until that the construction sector was burst (in 2008 the international economic crisis). However, Villamayor Stone is the main stone material used in the city of Salamanca for the restoration of monuments and, even in small quantities when compared with just before the economic crisis, it would be of great importance for future generations protect their quarries and the craft of masonry. Villamayor Stone has several varieties from channels facies to floodplains facies, in this work the selected varieties are: i) the fine-grained stone

Mining and processing of uranium deposits in Salamanca, Spain

International Nuclear Information System (INIS)

Gomez Jaen, J.P.; Otero, J.; Serrano, J.R.; Membrillera, J.R.; Josa, J.M.

1977-01-01

In July, 1974, Empresa Nacional del Uranio, S.A. (ENUSA), took the decision to mine uranium in the province of Salamanca, based on geological and processing studies carried out by the Junta de Energia Nuclear (JEN). The milling plant was designed by JEN and assembled by ENUSA, and operations were begun on 22 May, 1975. The orebody, FE-1, is composed of slate of Cambrain age and the fissures are filled by primary minerals. Secondary minerals are impregnated in the zone affected by the hydrostatic level. The orebody is of the stockwork type in which carbonaceous matter has acted as a reducing agent. The average grade of the ore is 0.09% U 3 O 8 at a cutoff grade of 0.02% U 3 O 8 : the deposit is therefore among the lowest-grade deposits that are currently mined. Annual production is 1 200 000 t of rock, of which 200 000 t is ore-bearing. The milling plant uses a static heap-leaching method, followed by solvent extraction (tertiary amines) and precipitation by ammonia. Joint studies by JEN and ENUSA have led to the introduction of modifications that have increased the production capacity from 75 to 112 t U 3 O 8 per annum with no significant alteration in the initial planned investment. The total recovery after processing is 75% of the U 3 O 8 contained in the ore. Approximately 100 people are employed in the overall operation. ENUSA has decided to expand operations in Salamanca with the construction of a new milling plant (technological aid by JEN), which will be capable of processing 825 000 t of ore per year, with an annual production of 500 t U 3 O 8 . The new plant is expected to begin operations in 1979. (author)

[Pervasive developmental disorders screening program in the health areas of Salamanca and Zamora in Spain].

Science.gov (United States)

García Primo, P; Santos Borbujo, J; Martín Cilleros, M V; Martínez Velarte, M; Lleras Muñoz, S; Posada de la Paz, M; Canal Bedia, R

2014-05-01

To evaluate the results of the Pervasive Developmental Disorders (PDD) screening program currently ongoing in the public health services in the health area of Salamanca and Zamora, Spain, in terms of feasibility, reliability and costs, with the purpose of extending the program at regional and national levels. A total of 54 paediatric teams (nurses and paediatricians) from the provinces of Salamanca and Zamora participated in the training sessions for the PDD Screening Programme in September 2005, and agreed to administer the questionnaire M-CHAT(1) to all parents attending their clinics in any of these two visits: 18 months and/or 24 months within the Well-baby Check-up Program. A total of 9,524 children have participated up to December 2012. Additionally, we evaluated the participation and opinions of the paediatric teams using questionnaires, and costs per positive case have estimated. Out of a total of 852 (8.9%) children determined as PDD high-risk with the M-CHAT questionnaire results, 61 (7.1%) were confirmed as positive with the M-CHAT follow-up interview. Of these, 22 were diagnosed with a PDD and 31 other disorders of childhood onset according to DSM-IV-TR(2). Almost three-quarters (74%) of respondents felt the program was totally feasible, and 22% viable, but with reservations (n=54). This study has been able to show for the first time in Spain, the feasibility of a population-based PDD screening program within the public health system. Training in social and communicative development, and dissemination of the early signs of PDD among paediatricians, as well as the use of the M-CHAT, is essential for progress in the early detection of these disorders. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

Roman Togatus Statue Found in Salamanca

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Manuel Carlos JIMÉNEZ GONZÁLEZ

2016-11-01

Full Text Available We disclose the finding, during a recent archaeological work in the city of Salamanca, of two marble fragments belonging to a statue of a togatus, which we believe could have been part of the decorative and propagandistic program of the forum in the time of the Early Empire. The data that we have about the location and layout of the forum and the various public spaces and buildings that formed it are indeed very limited. The location of this sculpture would confirm and might even provide some more information in this regard. The discovery was made out of archaeological context, because there is no historical stratigraphic sequence in the basement of the site where it appeared, the material and formal characteristics that can be seen in sculpture, along with the space in which it was found, as well as the archaeological context of the area in a broader sense, allow some clarifications on a number of aspects of formal, chronological and interpretive order relating to it.

Influence which masses of clouds have on the global solar radiation at Salamanca (Spain). Estudio de la interaccin nubosidad-radiacion solar en Salamanca

Energy Technology Data Exchange (ETDEWEB)

Pablo-Davila, F. de, Labajo, J.L.; Tomas-Sanchez, C

1991-01-01

It has been shown the influence which masses of clouds, (and more specifically for each group of cloud types: high, middle and low clauds), has on the global solar radiation recorded at Matacan (Salamanca), within the period 1977-1985. For this purpose, cloud observation were made every three hours; daily records of sunshine and solar radiation were continually taken too. It has also been, both graphically and numerically, the influence of each cloud type for monthly and seasonal periods. Futhermore, different statistical parameters have been presented in order to describe the method developed. Finally, the results have been analysed and evaluated. They have been explaines according to the composition, structure and radiative properties of clouds.(Author)

Resistencias al cambio en la Universidad de Salamanca, en tiempos de Felipe IV

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Teodoro MARTÍN MARTÍN

2009-12-01

Full Text Available Realizando una labor de investigación en la Biblioteca del Real Monasterio de San Lorenzo del Escorial me encontré con un códice encuadernado en pergamino que, con el título en el lomo de «Allegatio iuris», encerraba un documento de enorme interés.El mismo lleva por título: «Los Cuatro Colegios Mayores de la Universidad de Salamanca, obedientes al nuevo orden que el Consejo han dado en la provisión de las Cátedras, y para su más suave ejecución, suplican a V. Magestad vea estos apuntamientos».Se trata, pues, de una alegación que los Colegios Mayores de Salamanca elevan al Rey Felipe IV tras la reforma de las oposiciones a cátedra llevada a cabo en su reinado. La referida alegación me va a servir para abordar el estudio de dos temas: uno conceptual, en torno al significado y «reducción» del concepto de apuntamiento; el otro de política educativa, al referirme a la citada reforma del siglo XVII.Estos son, pues, los aspectos que voy analizar: de un lado, la evolución del concepto.de apuntamiento como vocablo histórico; de otro, la reforma educativa del Conde Duque y el porqué de su «fracaso».

Regional cost differences of hospital supply in Germany

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Lauterbach, Karl W.

2005-04-01

Full Text Available The intended adoption of a global reimbursement system for inpatient care in Germany envisions identical payments for identical treatments at different hospitals. This may lead to losses in some hospitals and may cause problems for the supply with health care facilities in the long run if there a important regional cost differences. Cost and performance data of 1112 hospitals in Germany have been analysed for regional differences in 2001: As regional categorizations we used official classification schemes based on centrality. The investigation does not support the postulation of additional payments for selected regions in Germany accounting for level cost-differences between hospitals. Confounding influence factors like ownership and hospital size seem to be more important. We recommend further investigations to evaluate regional cost-differences on the level of medical wards and using more risk-adjusted data. The examination of the individual case is necessary.

Analysis of the size of sandstone particles from the Cathedrals of Salamanca. Independence between granulometry and deterioration

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Martín Patino, M. T.

1994-03-01

Full Text Available 11 sandstone samples from the cathedrals of Salamanca were analysed granulometrically. The study was to establish whether there is a direct connection between the particle size of such stone and the surface deterioration of some of the ashlars in the facades. This was carried out with the help of diffraction spectrometry by laser beams. The results show that there is no connection between the nature of the stone texture and their degree of surface deterioration.

Se analizan granulométricamente 11 muestras de arenisca de las Catedrales de Salamanca. El objetivo del estudio es establecer si existe relación directa entre el tamaño de las partículas de tales piedras y el deterioro superficial de alguno de los sillares de las fachadas. Esto se lleva a cabo con la ayuda de la espectrometría de difracción por rayos láser. Los resultados muestran que no hay conexión entre la finura textural de las piedras estudiadas y el grado de deterioro superficial que éstas presentan.

La Universidad de Salamanca en el siglo XVI: la reforma educativa de D. Juan de Zúñiga (1594

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Francisco Javier ALEJO MONTES

2009-12-01

Full Text Available Salamanca, tímidamente, despierta al amanecer de un nuevo día. Al fondo se recortan las siluetas de las torres de la catedral semejando saetas que se clavan en el cielo. Por allá aparece un estudiante, vestido con su hábito, que se dirige, madrugador, a escuchar su clase de prima. ¡No puede perderse a su maestro preferido! Luego viene otro, y otro, y otro. Por fin, la gran riada; la calle parece un hormiguero de diferentes hormigas: negras, pardas, blancas, verdes, azules... Por último, aquellos más perezosos que se han quedado rezagados. Todos, llevados de la mano de los dioses, han dejado sus citas con Morfeo para encontrarse frente a frente con Minerva.Año de gracia del Señor de mil y quinientos y noventa y cuatro. Salamanca alberga a un personaje ilustre, heraldo de su Majestad Felipe II, D. Juan de Zúñiga, enviado para reformar la universidad.

The urban climate: urban heat island of Salamanca El clima de las ciudades: isla de calor de Salamanca

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Mª Salud Alonso García

2004-12-01

Full Text Available We have determined the existence of the urban heat island (UHI in a medium-sized city, with an extreme climate and few important foci of industrial pollution. It was seen that urban warming can arise in cities of these characteristics, being able to influence in the alive beings of the zone. By comparing the temperature series in an urban area and those from a nearby rural area, we studied the temporal evolution of the intensity of the UHI for the three-year period between 1996 and 1998. We detected two phenomenons: nocturnal heat island, when the difference of temperature between city and rural zone is positive, and diurnal heat island, when is negative. The most intense nocturnal heat island was seen in autumn, and the most intense diurnal heat island was seen in spring. Statistical study of the annual series corresponding to the night-time heat island permits a definition for Salamanca: a weak island, such as the one showing an intensity lower than 2.0 oC, a moderate island, if the intensity lies between 2.0 oC and 4.0 oC, and an intense island when a values greater than 4.0 oC is passed.En este trabajo se ha determinado la existencia de la isla de calor urbana (ICU, en una ciudad de tamaño medio, con un clima extremado y focos industriales de poca actividad. Con lo que se puede comprobar cómo afecta el calentamiento urbano a ciudades de estas características, pudiendo influir en los seres vivos de la zona. La existencia del fenómeno isla de calor, y su evolución en el tiempo, se han observado comparando los datos de temperatura registrados en una estación meteorológica situada en la ciudad, con los de otra estación fuera del radio de acción de la urbe, durante el período 1996-1998. Se han detectado dos fenómenos: la isla de calor nocturna, cuando la diferencia térmica entre la ciudad y la zona rural es positiva, que presenta sus valores más altos en otoño, y la isla de calor diurna, cuando la diferencia es negativa, que

Características físicas y alterabilidad de la piedra de Villamayor (Salamanca)

OpenAIRE

Ordaz, Jorge

1983-01-01

Las propiedades físicas de la arenisca de Villamayor (Salamanca), y, en especial, la porosidad, la absorción de agua y el movimiento capilar a través de la roca, son estudiadas en relación con sus características litológicas. Los ensayos de alterabilidad de laboratorio (humedad-sequedad, heladicidad y cristalización de sales) ponen de manifiesto su susceptibilidad a los efectos destructivos de las heladas y de las fluctuaciones de humedad, y suministran datos estimativos sobre la durabilidad ...

La devolución de las tierras usurpadas al Concejo de Salamanca en los inicios de la Edad Moderna. Aproximación a su estudio

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Clara Isabel LÓPEZ BENITO

2009-12-01

Full Text Available La importancia de las usurpaciones de tierras sufridas por el Concejo de Salamanca en sus términos y jurisdicción a lo largo del siglo XV quedó claramente demostrada con la publicación de N. Cabrillana, quien a partir de una rica documentación procedente del Archivo de la Biblioteca Nacional de Madrid, sacó a la luz un problema prácticamente desconocido hasta ese momento. Otras publicaciones posteriores, basadas en noticias aportadas por el Archivo Municipal de Salamanca, han complementado aquella aportación decisiva, aunque sin poder disponer nunca de un documento del alcance de la Pesquisa utilizada por Cabrillana; ni siquiera de un cuerpo de documentos homogéneo que permita medir y valorar de forma global la incidencia del fenómeno usurpador. Sin embargo, nadie duda de la trascendencia que éste tiene para la historia socioeconómica, e incluso paisajística, de la provincia de Salamanca. Este interés nos mueve a presentar ciertos datos y documentos recogidos en el siempre sorprendente Archivo de nuestro municipio, para intentar llegar un poco más allá en el conocimiento de las enajenaciones de tierras concejiles.

Pollen calendar of the city of Salamanca (Spain). Aeropalynological analysis for 1981-1982 and 1991-1992.

Science.gov (United States)

Hernández Prieto, M; Lorente Toledano, F; Romo Cortina, A; Dávila González, I; Laffond Yges, E; Calvo Bullón, A

1998-01-01

We report a study on the contents of airborne pollen in the city of Salamanca (Spain) aimed at establishing a pollen calendar for the city for the yearly periods of maximum concentrations, relating these with quantifiable atmospheric variables over two two-year periods with an interval of 10 years between them: 1981-82 and 1991-92. The pollen was captured with Burkard spore-traps, based on Hirst's volumetric method. Determinations were made daily and were used to make preparations, previously stained with basic fuscin, for study under light microscopy at x 1,000 magnification. 946 preparations were analyzed, corresponding to the same number of days distributed over 150 weeks of the periods studied. The results afforded the identification of 48 different types of pollen grain: Grasses (Poaceae), Olea europea (olive), Quercus rotundifolia (Holm-oak), other Quercus spp. (Q. pyrenaica, Q. suber, Q. faginea, etc.), Cupressaceae (Cupressus sempervivens, C. arizonica, Juniperus communis etc.), Plantago (Plantago lanceolata, Plantago media, etc.), Pinaceae (Pinus communis, Abies alba, etc.), Rumex sp. (osier), Urtica dioica (nettle), Parietaria (Parietaria officinalis, P. judaica), Chenopodio-Amaranthaceae (Chenopodium sp., Amaranthus sp., Salsola kali, etc.), Artemisia vulgaris (Artemisia), other Compositae (Taraxacum officinalis, Hellianthus sp. etc.), Castanea sativa (Chestnut), Ligustrum sp. (privet), Betula sp. (birch), Alnus sp. (common alder), Fraxinus sp (ash), Populus sp. (poplar), Salix sp. (willow), Ulmus sp. (elm), Platanus sp. (plantain, plane), Carex sp. (sweet flag), Erica sp. (common heather), Leguminosae or Fabaceae:--Papillionaceae (Medicago sp.; Cercis sp., Robina sp.)--Cesalpinoideae Acacia sp. (Acacia),--Mimosoideae: Sophora japonica, Umbelliferae (Foeniculum sp., Cirsium sp., etc.), Centaurea sp., Cistus sp. (rock rose), Typha sp (bulrush), Mirtaceae (Myrtus communis), Juglans regia (Walnut), Galium verum, Filipendula sp. (spirea/drop wort), Rosaceae

Investidura de doctores Honoris Causa de Albert Bandura y José del Castillo Nicolau. Universidad de Salamanca, 17 de julio de 1992

OpenAIRE

Sánchez López, Cándido, Candy

1992-01-01

Cincuenta y siete fotografías de la ceremonia de investidura de doctores Honoris Causa de Albert Bandura y José del Castillo Nicolau. Acto celebrado en el Paraninfo de la Universidad de Salamanca el 17 de julio de 1992.

La quiebra de José Ojesto y Puerto (Santander, c. 1801- Salamanca, 1871

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Javier INFANTE MIGUEL-MOTTA

2010-02-01

Full Text Available RESUMEN: En este artículo abordo un aspecto concreto sólo apuntado en una reciente investigación mía, en curso de publicación, sobre la biografía de José Ojesto que llegó a ser uno de los principales negociantes de la Salamanca de las décadas centrales del siglo XIX. Se trata de estudiar su ruina o, mejor dicho, el final de ésta que adoptó la forma jurídica del concurso de acreedores instado por el propio interesado. A falta de la pertinente documentación judicial, examino la cuestión en el Registro de la Propiedad y, a través de sus inscripciones, en las escrituras notariales de la época. Palabras clave: Ojesto, ruina, acreedores, concurso de acreedores, comisión liquidadora y administradora, bienes y fincas. ABSTRACT: In this article I deal with a specific aspect, which has only been approached by myself in a recent investigation, which has not been publisshed yet, the mencioned article is about José Ojesto’s biography, he became one of the main businessmen in Salamanca in the middle of the XIX century. The aim of this article is José Ojesto’s bankruptcy or to be more accurate, the end of it, which adopted the legal form of competitive tendenring of creditors, which was urged by Ojesto himself. Since there are not any legal data about it, I examined this matter in land register and through its notarial inscriptions of the time. Keywords: Ojesto, bankruptcy, creditors, competitive tendering creditors, liquidation and administration committee, goods and farms.

René Andioc tenía razón: la Continuación del Semanario de Salamanca (1800

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Pedro ÁLVAREZ DE MIRANDA

2012-05-01

Full Text Available Este trabajo está destinado a resolver uno de los «enigmas histórico- literarios» que René Andioc planteó en uno suyo de 1992. Había indicios de que el Semanario de Salamanca, publicación supuestamente concluida en 1798 (no se conocían ejemplares posteriores, había tenido una continuidad posterior, puesto que esos indicios sugerían que un artículo relacionado con Moratín se había publicado en el número del 19 de abril de 1800 de dicho periódico. Aquí se da a conocer la existencia de tres ejemplares (uno de ellos de desigual extensión frente a los otros dos de una Continuación del Semanario de Salamanca (enero a junio de 1800, en cuyo número del 19 de abril figura, en efecto, un escrito firmado por «P. OzerínJáuregui y Z.» que es una réplica al Examen en que Cristóbal Cladera había criticado la traducción del Hamlet por Moratín

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

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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.

Granites of Salamanca. A perfect example for the recognition of natural stone as a heritage resource and their use in restoration

International Nuclear Information System (INIS)

González, C.; Pereira, D.; Baltuille, J.M.

2017-01-01

In the province of Salamanca (Spain) there are several quarries that used to be the source of natural stone used in the construction of historic buildings and that are today recognized by UNESCO as World Heritage Sites. In this study we investigated the granites used in the construction and restoration of the lower ashlars of the walls of different buildings in Salamanca, Alba de Tormes, Ciudad Rodrigo and Ledesma. The characterization of the different types of granite and their current state of preservation may serve to adopt specific measures for their possible use in the restoration of the architectural heritage of the province, if this should become necessary. Despite the variety of materials observed in the lower parts of the buildings (ranging from sandstone to conglomerate to granite), the stone most frequently used was the granite from Los Santos and the Martinamor granite, followed by the vaugneritic granites from Ledesma. In general the granite materials are in a good state of conservation but the existence of certain pathologies that have given rise to processes of flaking and discoloration of the rock suggests that it will be necessary to make a consistent assessment when deciding about possible actions aimed at replacing materials in these historic buildings Moreover, the various granites differ from one another and pieces should not be replaced without perfect identification of the specific type to which they belong. A detailed study of these granites is crucial for the nomination of some of them as candidates for the denomination Global Heritage Stone Resource and the whole set of Salamanca province lithologies as a Global Heritage Stone Province. [es

Science and stewardship to protect and sustain wilderness values: Tenth World Wilderness Congress symposium; 2013, 4-10 October, Salamanca, Spain

Science.gov (United States)

Alan Watson; Stephen Carver; Zdenka Krenova; Brooke McBride

2015-01-01

The Tenth World Wilderness Congress (WILD10) met in Salamanca, Spain in 2013. The symposium on science and stewardship to protect and sustain wilderness values was the largest of multiple symposia held in conjunction with the Congress. This symposium was organized and sponsored by the Aldo Leopold Wilderness Research Institute, the Wildland Research Institute of the...

Unamuno, mensajero poético de Salamanca. Lnterés didáctico de las estampas salmantinas

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Fernando E. GÓMEZ MARTÍN

2009-11-01

Full Text Available Se cumplieron recientemente los cien años de la venida de don Miguel de Unamuno a Salamanca. Al cabo de este centenario queremos rendir nuestro pequeño homenaje al rector del Estudio salmantino evocando las relaciones entre el escritor vasco y su tierra adoptiva. Por otra parte, sugerimos el aprovechamiento didáctico en el aula de un buen número de páginas de recuerdos, andanzas, visiones y querencias íntimas dedicadas por don Miguel a la ciudad y al campo de Salamanca. Niños y adolescentes de nuestra tierra pueden llegar a conocer literariamente a tan insigne escritor por medio de poemas y textos en prosa llamados a sellar con letras de oro la muy peculiar relación de Unamuno con los rincones y callejas de la ciudad, con las llanuras y cimas de su Castilla o con las verduras del Tormes. El autor de Niebla es también el hombre volcado en el paisaje que lo mece, el paisano que se lanza en busca de las gentes sencillas del campo procurando, al menos, su consuelo. Si la misión de despertar al dormido, ligada a obras mayores, queda especialmente reservada a los adultos, otros textos de don Miguel nos permiten llegar hasta los más jóvenes con versos y párrafos que hablan y cantan a los múltiples protagonistas de la intrahistoria. De este modo, podemos dar cuenta, con diligencia y sencillez, de un autor ilustre al tiempo que conocemos creaciones literarias concordantes temáticamente con la realidad que nos envuelve. La misma satisfacción halagadora que sentía Unamuno charlando con los viejos campesinos o leyendo a los gañanes consejas, cuentos y poesías, puede continuar en nosotros al proyectar en el aula sus estampas poéticas, su andanzas y visiones. A los deseos del rector de ser útil a la Escuela Normal de Salamanca, añadimos hogaño los nuestros propios de aprovechar pedagógicamente los lienzos literarios del poeta y paseante. Acaso, así, aprendamos todos a ver y sentir mejor los paisajes urbanos de la ciudad charra y sus

Granites of Salamanca. A perfect example for the recognition of natural stone as a heritage resource and their use in restoration; Granitos de Salamanca. Un ejemplo perfecto para el reconocimiento de la piedra natural como recurso patrimonial y su uso en restauración

Energy Technology Data Exchange (ETDEWEB)

González, C.; Pereira, D.; Baltuille, J.M.

2017-09-01

In the province of Salamanca (Spain) there are several quarries that used to be the source of natural stone used in the construction of historic buildings and that are today recognized by UNESCO as World Heritage Sites. In this study we investigated the granites used in the construction and restoration of the lower ashlars of the walls of different buildings in Salamanca, Alba de Tormes, Ciudad Rodrigo and Ledesma. The characterization of the different types of granite and their current state of preservation may serve to adopt specific measures for their possible use in the restoration of the architectural heritage of the province, if this should become necessary. Despite the variety of materials observed in the lower parts of the buildings (ranging from sandstone to conglomerate to granite), the stone most frequently used was the granite from Los Santos and the Martinamor granite, followed by the vaugneritic granites from Ledesma. In general the granite materials are in a good state of conservation but the existence of certain pathologies that have given rise to processes of flaking and discoloration of the rock suggests that it will be necessary to make a consistent assessment when deciding about possible actions aimed at replacing materials in these historic buildings Moreover, the various granites differ from one another and pieces should not be replaced without perfect identification of the specific type to which they belong. A detailed study of these granites is crucial for the nomination of some of them as candidates for the denomination Global Heritage Stone Resource and the whole set of Salamanca province lithologies as a Global Heritage Stone Province. [Spanish] En la provincia de Salamanca se encuentran diversas canteras que fueron origen de la piedra natural para la construcción de edificios históricos que hoy forman parte de lugares reconocidos como Patrimonio de la Humanidad por la UNESCO. Para este trabajo se han investigado los granitos utilizados

Estudio de los niveles de plomo, cadmio, zinc y arsénico, en aguas de la provincia de Salamanca

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Blanco Hernández Angel Luis

1998-01-01

Full Text Available FUNDAMENTOS: Conocer el grado de contaminación por plomo, cadmio, cinc y arsénico de las aguas de la provincia de Salamanca y su relación con la zona de procedencia de las muestras y el punto de recogida de las mismas. MÉTODO: Estudio epidemiológico transversal, observacional y descriptivo. Se han estudiado aguas procedentes de redes de abastecimiento, fuentes, manantiales, pozos, ríos, riveras y lagunas de la provincia de Salamanca, analizándose los contenidos de plomo, cadmio, zinc y arsénico de 180 muestras, mediante espectroscopía de absorción atómica. Se han comparado los niveles de contaminación por los cuatro elementos de las muestras de agua entre las cuatro unidades comarcales de la provincia. Se han comparado los niveles de contaminación por los cuatro elementos entre las aguas procedentes de redes de abastecimiento y aquellas muestras de pozos, fuentes, manantiales y aguas de superficie. RESULTADOS: Los resultados indican que un 56% de las muestras analizadas superan las concentraciones máximas admisibles de cadmio, y un 28% del total de muestras analizadas supera las concentraciones máximas admisibles de plomo, según la legislación vigente presentando niveles tolerables de zinc y arsénico. No se han observado diferencias importantes en el grado de contaminación de las aguas por los elementos estudiados entre las cuatro unidades comarcales de la provincia. No se han observado diferencias en los niveles de contaminación por los cuatro elementos entre las aguas procedentes de redes de abastecimientos y aquellas muestras de pozos, fuentes, manantiales y aguas de superficie. CONCLUSIONES: Los resultados sugieren que las aguas de la provincia de Salamanca presentan de forma "natural" altos contenidos de cadmio y plomo, probablemente debido a las características geológicas del terreno.

La Biblioteca Universitaria de Salamanca en el siglo XVI: entre tradición y renovación

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Marta de la MANO GONZÁLEZ

2009-12-01

Full Text Available RESUMEN: Con el Humanismo surgió una nueva idea del saber que dio lugar también a una nueva concepción de las bibliotecas. A lo largo del siglo XVI esta concepción se concretará en nuevas clasificaciones del saber, en tratados sobre la historia, funciones y organización de las bibliotecas, en nuevas soluciones arquitectónicas y de instalaciones. Presentamos el ejemplo de la biblioteca de la Universidad de Salamanca, que a mediados de la centuria emprendió el camino hacia la modernización. Sin embargo, los avatares que jalonaron su trayectoria, desde su construcción física e intelectual hasta su funcionamiento interno, pasando por los procesos de recolocación y ordenamiento de los libros, le impidieron alcanzarla en plenitud.ABSTRACT: Humanism brought a new idea about knowledge that made appear a new library concept. Along sixteenth century this concept will origin new knowledge classifications, treatise about library history, functions and organization, new architectural and installations solutions We present Salamanca University Library case which, around the middle of the century, began the way to its modernization. However, the difficulties that it found on this way, from its physical and conceptual building, to its internal functioning, through books placing and classification process, hindered it to get completely its new image.

The Defence of Moratín’s «Hamlet» in the «Continuación del Semanario de Salamanca»

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Philip DEACON

2015-05-01

Full Text Available In volume 12 of Cuadernos Dieciochistas Professor Pedro Álvarez de Miranda revealed the existence of an issue of the Continuación del Semanario de Salamanca, dated 19 April 1800, which included a Letter in defence of the translation by Leandro Fernández de Moratín of Shakespeare’s tragedy Hamlet.The Letter, signed by a mysterious P. Ozerín-Jáuregui y Z., attacks the Examen of Moratín’s volume published by the Mallorcan man of letters Cristóbal Cladera and sets out a series of objections which in effect defend the quality of the translation and the historical information accompanying it. The present article attempts to place the newly-discovered critical text in its literary and historical contexts, analyzing its arguments and approach, and evaluating its contribution to the on-going debate over the quality of Moratín’s Hamlet. The article includes, by way of appendix, an annotated transcription of the complete Letter as published in the Continuación del Semanario de Salamanca.

Inclusión del alumnado con síndrome de Asperger en la Universidad de Salamanca

OpenAIRE

Martín Hernández, Manuel Jesús

2017-01-01

El presente trabajo comienza con la adecuada fundamentación del Trastorno del Espectro Autista y sus criterios de diagnóstico, así como la conceptualización del Síndrome de Asperger y los rasgos característicos del colectivo. Partiendo de esta base, se realiza un análisis del Servicio de Asuntos Sociales que la Universidad de Salamanca ofrece a los estudiantes con dicho diagnóstico, para su posterior reflexión sobre su sistema de actuación y reflejar así las demandas que requiera este recurso...

Las salamancas mestizas: de las religiones indígenas a la hechicería colonial. Santiago del Estero, siglo XVIII

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Judith Farberman

2005-12-01

Full Text Available La mayoría de los folcloristas ha coincidido en el origen hispano del estereotipo de escuela de magia conocida como salamanca, de amplia difusión en el noroeste argentino. Este trabajo postula la configuración mestiza del mismo y su desarrollo a partir de la hibridación de elementos religiosos y culturales entre los siglos XVI y XVIII. Como fuentes principales me he valido de dos procesos civiles contra hechiceras sustanciados en Santiago del Estero y, secundariamente, de materiales como Cartas Anuas jesuíticas, catecismos y confesionarios de indios.In general folklore studies agreed upon the Spanish origins of the magic school known as Salamanca, widely spread in the northwest of Argentina. Based on the existence of hybrid elements, found in culture and religion, this article poses the existence of a mestizo influence in its development in Santiago del Estero during the XVI and XVII centuries. The main sources analyzed were judicial processes held against witches in the area under study, and secondarily some material such us the Jesuits' Cartas Anuas, and Indian catechisms and confessionaries.

Influence which masses of clouds have on the global solar radiation at Salamanca (Spain)

International Nuclear Information System (INIS)

Pablo-Davila, F. de; Labajo, J.L.; Tomas-Sanchez, C.

1991-01-01

It has been shown the influence which masses of clouds, (and more specifically for each group of cloud types: high, middle and low clauds), has on the global solar radiation recorded at Matacan (Salamanca), within the period 1977-1985. For this purpose, cloud observation were made every three hours; daily records of sunshine and solar radiation were continually taken too. It has also been, both graphically and numerically, the influence of each cloud type for monthly and seasonal periods. Futhermore, different statistical parameters have been presented in order to describe the method developed. Finally, the results have been analysed and evaluated. They have been explaines according to the composition, structure and radiative properties of clouds.(Author)

Measuring Job Satisfaction Patterns in Saudi ArabiaÕs Southern Regions Hospitals: Implications for Hospital Staff Retention

OpenAIRE

Alshahrani Bander Sayaf

2015-01-01

Saudi Arabia Southern Region hospitals have shortage of health professionals especially doctors. Retention of quality doctors and minimizing staff turnover has, therefore, become a major priority for hospitals. Job satisfaction is recognized as key factor influencing retention of doctors. In our paper special emphasis is put on doctors working is Southern Region hospitals of Saudi Arabia. By conducting correlation analysis we determine the most important factors conducive to job satisfaction....

Inter-regional competition and quality in hospital care.

Science.gov (United States)

Aiura, Hiroshi

2013-06-01

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

Increasing incidence of colorectal cancer in the province of Salamanca: comparison of two periods: 2004-2006 and 2010-2012

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Héctor Miguel Marcos-Prieto

Full Text Available Objectives: To compare incidence, mortality and epidemiological characteristics of patients diagnosed with colorectal cancer (CRC in the province of Salamanca over two different periods: 2010-2012 and 2004-2006. Methods: Retrospective observational study. We include all diagnosed cases of CRC according to histopathological criteria from 01/01/2004 to 31/12/2006 and from 01/01/2010 to 31/12/2012. The studied variables were sex, age, date of diagnosis and tumor location. Cumulative incidence and specific incidence in different age groups were measured and compared between the two periods. The age rates were adjusted to the standard world population so that the results could be compared with those of other populations. Results: We detected 38% more cases of CRC in the 2010-2012 period than in 2004-2006. Variables distribution (sex, age at diagnosis and location was similar in both groups. More than twice as many colonoscopies were performed in 2010-2012 than in 2004-2006. Population mortality due to CRC also increased, although much less importantly than the incidence of this condition. Conclusions: There has been a clear increase in CRC incidence in the province of Salamanca from 2004-2006 to 2010-2012 which is not related to the ageing of the population. The remarkable increase in colonoscopies may have been an important factor for the increased detection.

[Information needs of the health and diseases in users of healthcare services in Primary Care at Salamanca, Spain].

Science.gov (United States)

Bernad Vallés, Mercedes; Maderuelo Fernández, José Ángel; Moreno González, Pilar

2016-01-01

To learn, interpret and understand the information needs of health and disease in users of the healthcare services of the urban Primary Care of Salamanca. Qualitative research corresponding an exploratory qualitative/structural perspective. Primary Care. Urban area, Salamanca in 2007. Ten discussion groups, 2 composed of members of health-related associations and 8 primary care users, involved a total of 83 people. The structural variables considered are: gender, age, educational level and membership or not associations. Generate information to achieve information saturation in the discussion groups. Upon obtaining their informed consent, all subjects in the study participated in videotaped conversations, which were transcribed verbatim. Four researchers categorized the content, intentionality of discourse and developed the concept map. After categorization, triangulation and coding, content obtained was analysed with the NudistQ6 program. Informative content suggest four information needs: health and prevention, early diagnosis, first aid and disease. Different intentions (information needs, watching, claim and improvement) and needs profiles are detected as structural variables. Major information needs are relate to diagnosis, prognosis and therapeutic options. There is agreement between the groups that the information transmitted to the patient must be intelligible, updated and coordinated among the different professionals and care levels. Participants require information of a clinical nature to exercise their right to autonomy translating tendency to empower users as part of the social change. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

[Cardiovascular risk, occupation and exposure to occupational carcinogens in a group of workers in Salamanca].

Science.gov (United States)

González-Sánchez, Jesús

2015-01-01

Identify the cardiovascular risk factors in a group of workers in the province of Salamanca, protected by external prevention services, as regards exposure to occupational carcinogens, by sector of activity and gender. An observational descriptive epidemiological study was conducted. The sample selection was by stratified random sampling in each entity. The variables collected by questionnaire were, sociodemographic characteristics, exposure to occupational carcinogens, and cardiovascular risk factors (smoking, hypertension, dyslipidemia, and diabetes), using the clinical-work histories as a source of information. Statistically significant differences were observed in cardiovascular risk according to the exposure to occupational carcinogens (p cardiovascular risk in the work place. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

Contribución a la epigrafía del Oeste de la provincia de Salamanca : el conjunto de Medina del Campo (Valladolid

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A. Jiménez de Furundarena

1993-01-01

Full Text Available A finales del verano de 1991 estudiamos una colección particular de 28 epígrafes romanos depositados en una casa de campo próxima a la localidad de Medina del Campo'. Los epígrafes proceden de una gran necrópolis romana situada en un cerro llamado Cabeza de San Pedro, en el término municipal de Hinojosa de Duero (Salamanca junto al salto de Saucelle, durante cuya construcción —fue inaugurado en 1956— pasaron estas lápidas a manos de particulares. El objetivo de este trabajo es, pues, hacer algunas referencias y puntualizaciones sobre todo el conjunto de epígrafes de Hinojosa de Duero, relacionándolo con la epigrafía de algunas localidades, como Astorga o Chaves, y de algunas regiones, como la comprendida entre los ríos Duero y Sabor, la zona zamorana y el occidente salmantino.

Los orígenes del Colegio Menor de la Concepción de Huérfanos de Salamanca

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Miguel A. MARTÍN SÁNCHEZ

2009-12-01

Full Text Available RESUMEN: El Colegio Menor de la Concepción de Huérfanos de la Universidad de Salamanca es uno más de la gran cantidad de colegios que se fundaron al amparo del estudio salmantino en el siglo XVI. Fundado por Francisco de Solís, obispo de Bagnorea y secretario de Paulo III, durante tres siglos facilitó y proporcionó amparo y educación a multitud de estudiantes pobres que no tenían recursos para ello. Fundado en la primera mitad del siglo XVI, durante esta centuria se asentó y comenzó su andadura, que terminaría en el siglo XIX. Este trabajo realiza un análisis sobre los primeros años de vida del Colegio, analizando cuestiones tan importantes como su fundación, las bulas fundacionales, el fundador, las primeras constituciones o la matrícula durante el siglo XVI, entre otras. Fue el siglo XVI el siglo de su nacimiento y consolidación, realizando durante esta centuria un gran esfuerzo institucional, como demuestra el hecho de la elaboración de las primeras constituciones, la construcción del edificio, o la incorporación a la Universidad de Salamanca, por ejemplo. A lo largo de estas páginas realizaremos un recorrido por los orígenes del primer colegio universitario que se crea para el amparo de niños pobres y huérfanos, permitiéndoles estudiar desde la gramática hasta graduarse en la ciencia que mejor les pareciere. La obra social y educativa del Colegio permitió la progresión y ascenso social de multitud de estudiantes pobres y huérfanos con talento, que de otra forma nunca hubieran podido realizar estudios en la Universidad, puesto que carecían de recursos para ello.ABSTRACT: The Conception of Orphans Minor College of the University of Salamanca is one more of the great quantity of colleges that were founded under protection of Salamancan Study in the 16th century. It was founded by Francisco de Solís, bishop of Bagnorea and secretary of Paulo III, provided protection and education to many poor students without

Hospital management training for the Eastern Mediterranean Region: time for a change?

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Rabbani, Fauziah; Hashmani, Farah Naz; Mukhi, Aftab A Ali; Gul, Xaher; Pradhan, Nousheen; Hatcher, Peter; Farag, Mounir; Abbas, Farhat

2015-01-01

The WHO Eastern Mediterranean Regional Office has emphasized health system strengthening among the top five strategic priorities. One of the integral elements of health systems are the hospitals. The purpose of this paper is to review the need for formalized training in hospital management to improve the quality of care. Literature review and hands on experience of conducting a regional training in hospital management for Eastern Mediterranean Region (EMR) countries. Majority of patients in EMR bypass Primary Health Care facilities due to inadequate quality of services and prefer seeking specialized care at a tertiary level. There is mounting evidence of mediocre to poor patient satisfaction due to inefficient health care practices in hospitals of EMR. Strengthening the management capacity of the hospitals through a formal training programme is therefore necessary for improving the performance of health care delivery and the overall health system. Hospital management encompasses hospital planning and operational activities including development and implementation of organizational strategies to ensure adequate numbers and quality of trained human resources and effective financial management, disaster management, health management information system utilization, support services, biomedical engineering, transport and waste management. Such training will prepare health care professionals with leadership skills to deliver quality hospital services. This is one of the first papers emphasizing the need for a formal structured regional training in hospital management for the countries of EMR. A modular incremental training approach developing an EMR Credit Transfer and Accumulation system is proposed.

Estatutos de la Universidad de Salamanca: la reforma de 1550-1551

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María FERNÁNDEZ UGARTE

2009-12-01

Full Text Available La Universidad de Salamanca está en el siglo XVI, en permanente estado de cambio. Desde principios del siglo, con los Reyes Católicos, hasta finales, bajo Felipe II, ese espíritu de renovación se hará patente de un modo continuo. Del interés de Isabel, reflejado en su visita de 1487, no vamos aquí a tratar; pero sí hemos de recordar que Fernando el Católico envió en 1512 al Obispo de Cuenca, Ramírez de Villaescusa, para tantear una reforma. En 1529, bajo el rectorado de Pérez de Oliva, asistimos a un proceso similar, cuya profundidad aun está discutiéndose. En 1538, en pleno reinado de Carlos V, se establecerán los famosos Estatutos que estarán vigentes durante más de veinte años. En 1550, el Consejo Real envía al Obispo de Coria, Diego Enríquez de Almansa, con el mismo intento reformador, como en el presente trabajo podremos comprobar.

[Humanization through the art of environment of children's emergency in a hospital].

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Ullán, Ana M; Fernández, Esperanza; Belver, Manuel H

2011-09-01

This article aims to present and discuss a case-study of human betterment through the arts applied to a children's hospital. The experience related to the betterment of these environments took place in the Children's Emergency Service of the University Hospital in Salamanca. After describing the context of the case-study some attention will be devoted to the phases of the process, emphasizing those aspects linked to children's care culture and their families as well as the symbolic dimension of the space and the participation of different professionals in the experience. The case-study is assessed from different standpoints but special importance is given to parents' opinions. 51 parents of children in the emergency unit were interweaved during a month. Parents valued positively the service and stated that artists' intervention had been beneficial for the children's emotional state. The article concludes with a debate about the meaning of the hospital environment and the quality associated with its physical premises.

Provision of general paediatric surgical services in a regional hospital.

LENUS (Irish Health Repository)

Zgraj, O

2012-01-31

BACKGROUND: In Ireland, specialist paediatric surgery is carried out in paediatric hospitals in Dublin. General surgeons\\/consultants in other surgical specialities provide paediatric surgical care in regional centres. There has been a failure to train general surgeons with paediatric skills to replace these surgeons upon retirement. AIM: To assess paediatric surgical workload in one regional centre to focus the debate regarding the future provision of general paediatric surgery in Ireland. METHODS: Hospital in-patient enquiry (HIPE) system was used to identify total number of paediatric surgical admissions and procedures. Cases assessed requiring hospital transfer. RESULTS: Of 17,478 surgical patients treated, 2,584 (14.8%) were under 14 years. A total of 2,154 procedures were performed. CONCLUSION: Regional centres without dedicated paediatric surgeons deliver care to large numbers of paediatric patients. The demand for care highlights the need for formal paediatric services\\/appropriate surgical training for general surgical trainees.

Pinturas rupestres esquemáticas del Bonete del Cura (Ciudad Rodrigo, Salamanca

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Julián BÉCARES PÉREZ

2009-10-01

Full Text Available RESUMEN: Con este trabajo damos a conocer un nuevo abrigo de arte rupestre esquemático en la provincia de Salamanca, término de Ciudad Rodrigo. Se ha comenzado por una descripción de las figuras que contiene el abrigo y que son en su mayoría arboriformes y antropomorfos, algunos de ellos con tocados u otros elementos suplementarios. En menor número: barras, ancoriformes, un cuadrúpedo y la aparición de cuatro motivos compuestos por elementos triangulares o subtriangulares y la parte superior de un antropomorfo. A continuación, estos motivos se han encuadrado en el resto del conjunto del arte esquemático, resaltando los elementos que poseen una mayor importancia, sea por representar motivos nuevos o característicos dentro del arte esquemático, sea por ser un elemento mayoritario del abrigo. Hemos terminado haciendo una correlación de este abrigo con los que a nuestro parecer poseen un mayor número de elementos de comparación en el resto de la Península.RÉSUMÉ: Nous faisons connaître par ce travail un nouvel abri d'art rupestre schématique dans la province de Salamanca, commune de Ciudad Rodrigo. On a commencé par une description des figures de l'abri et qui sont, la plupart des arboriformes et des antropomorphes, quelques uns avec des coiffes ou d'autres éléments supplémentaires. En nombre inférieur: des barres, des ancoriformes, un cuadrúpede et l'apparition de quatre motifs composés par des éléments triangulaires ou sous-triangulaires et la partie supérieure d'un antropomorphe. Ensuite, on a intégré ces motifs dans le reste de l'ensemble de l'art schématique, tout en faisant ressortir les éléments de plus grande importance, soit parce qu'ils représentent des motifs nouveaux ou caractéristiques de l'art schématique, soit parce que ce sont les éléments majoritaires de l'abri. Nous avons fini par faire une corrélation de cet abri avec ceux qui á notre avis possèdent un plus grand nombre d'éléments de

Effect of Regional Hospital Competition and Hospital Financial Status on the Use of Robotic-Assisted Surgery.

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Wright, Jason D; Tergas, Ana I; Hou, June Y; Burke, William M; Chen, Ling; Hu, Jim C; Neugut, Alfred I; Ananth, Cande V; Hershman, Dawn L

2016-07-01

Despite the lack of efficacy data, robotic-assisted surgery has diffused rapidly into practice. Marketing to physicians, hospitals, and patients has been widespread, but how this marketing has contributed to the diffusion of the technology remains unknown. To examine the effect of regional hospital competition and hospital financial status on the use of robotic-assisted surgery for 5 commonly performed procedures. A cohort study of 221 637 patients who underwent radical prostatectomy, total nephrectomy, partial nephrectomy, hysterectomy, or oophorectomy at 1370 hospitals in the United States from January 1, 2010, to December 31, 2011, was conducted. The association between hospital competition, hospital financial status, and performance of robotic-assisted surgery was examined. The association between hospital competition was measured with the Herfindahl-Hirschman Index (HHI), hospital financial status was estimated as operating margin, and performance of robotic-assisted surgery was examined using multivariate mixed-effects regression models. We identified 221 637 patients who underwent one of the procedures of interest. The cohort included 30 345 patients who underwent radical prostatectomy; 20 802, total nephrectomy; 8060, partial nephrectomy; 134 985, hysterectomy; and 27 445, oophorectomy. Robotic-assisted operations were performed for 20 500 (67.6%) radical prostatectomies, 1405 (6.8%) total nephrectomies, 2759 (34.2%) partial nephrectomies, 14 047 (10.4%) hysterectomies, and 1782 (6.5%) oophorectomies. Use of robotic-assisted surgery increased for each procedure from January 2010 through December 2011. For all 5 operations, increased market competition (as measured by the HHI) was associated with increased use of robotic-assisted surgery. For prostatectomy, the risk ratios (95% CIs) for undergoing a robotic-assisted procedure were 2.20 (1.50-3.24) at hospitals in moderately competitive markets and 2.64 (1.84-3.78) for highly competitive markets

De nuevo sobre la Compassio Mariae: A propósito de las pinturas murales del sepulcro de don Alfonso Vidal en la catedral vieja de Salamanca

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Gutiérrez Baños, Fernando

2002-03-01

Full Text Available En el verano de 1999 quedaron al descubierto tras su restauración las pinturas murales de estilo gótico lineal de los siglos XIII y XIV que se encontraron en noviembre de 1997 en el brazo meridional del crucero de la catedral vieja de Salamanca. Por su cantidad, por su calidad y por la riqueza de su iconografía estos descubrimientos consolidan la importancia de Salamanca en el panorama de la pintura de estilo gótico lineal. No pretendo abordar en este momento un estudio de conjunto acerca de estas pinturas, que reservo para otra ocasión, sino estudiar un aspecto iconográfico relevante de estos descubrimientos que entronca con el objeto de interés de la profesora Domínguez Rodríguez en un artículo publicado no hace mucho tiempo en las páginas de esta revista.…

A comparison of antibiotic point prevalence survey data from four Irish regional/general hospitals.

LENUS (Irish Health Repository)

Naughton, C

2011-06-01

Point prevalence surveys (PPS) are increasingly used to examining and compare hospital antibiotic consumption. The aim of this study was to identify the (1) point prevalence of antibiotic use in one regional hospital and (2) compare PPS data from similar regional\\/general hospitals.

[After the Action T4 : "Regionalized euthanasia" in the Günzburg Psychiatric Hospital].

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Söhner, F; V Cranach, M; Fangerau, H; Becker, T

2017-09-01

In Bavarian psychiatric hospitals approximately 15,000 people with mental handicaps and mental illnesses were killed after the so-called Action T4. The Heil- und Pflegeanstalt (psychiatric hospital) Günzburg was a so-called Zwischenanstalt (interim institution). The aim of the study was to analyze its role in carrying out "regionalized euthanasia". Based on defined criteria the patient records of deceased patients at the Günzburg Psychiatric Hospital between July 1941 and December 1943 were analyzed to establish whether criteria for "regionalized euthanasia" were fulfilled. During the study period 45 patients at the Günzburg Psychiatric Hospital probably died following actions by direct or indirect intention to kill using malnutrition, neglect, medication overdose or a combination of these actions. The Günzburg Psychiatric Hospital was involved in "regionalized euthanasia".

Creación de juegos personalizados para niños y adolescentes hospitalizados = The creation of personalized toys for children and adolescent hospitalized

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Daniel Zapatero Guillén

2012-09-01

Full Text Available Resumen Desde el año 2003, el Departamento de Didáctica de la Expresión Plástica de la Universidad Complutense de Madrid, el Museo Pedagógico de Arte Infantil y Departamento de Psicología Social de la Universidad de Salamanca están desarrollando una serie de investigaciones en torno a las posibilidades de mejora de los niños y adolescentes hospitalizados a través del juego, la creatividad y el arte, enmarcadas en el proyecto curArte. En este proyecto, desde 2008, se ha trabajado en el diseño de materiales de juego creativo especialmente adaptados para el contexto hospitalario. Entre otras actividades, los talleres “Tuning” se han centrado en el diseño y creación de un muñeco estándar susceptible de ser tuneado en donde han participado adolescentes hospitalizados, educadores, investigadores y diseñadores1. Palabras clave: Talleres creativos, diseño juguetes, niños hospitalizados Abstract From 2003, the Didactic Department of art education of the Universidad Complutense de Madrid, the pedagogical museum of children art and the department of social psychology of the Universidad de Salamanca are developing investigations (Curarte Project around the possibilities to improve the stay of children hospitalized through games, creativity and art. In this project, from 2008, they have been working in the materials designs for creative toys specially adapted into a hospital context. The “tuning” workshops were focus on the design and creation of a standard doll that hospitalized children, educators, researchers and designers could modify. Key words: Creative workshops, toys design, children hospitalized.

El yacimiento tardorromano de «El Soto» Calvarrasa de Abajo (Salamanca

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Carlos PIÑEL

2009-12-01

Full Text Available RESUMEN: Damos a conocer un yacimiento tardorromano inédito, destruido recientemente y que se localiza a orillas del Tormes, en Calvarrasa de Abajo. Los materiales hallados en superficie son esencialmente dos estelas funerarias, así como cerámicas sigillatas lisas —algún ejemplar con grafito— y fragmentos de otras decoradas, amén de algunos objetos de bronce y hueso que nos permiten situarlo cronológicamente a finales del siglo III y con su mayor desarrollo en el IV d.C.ABSTRACT: We make known a late Roman deposit, which has been destroyed recenrly. It is situated on the borders of the river Tormes, near Calvarrasa de Abajo (Salamanca. Two gravestones, «sigillata» pottery without reliefs (some specimens with graffiti, other ones with decoration and some objects of bronze and bone have been found on surface. We can date the deposit, as result of our study of the various objets, from the late III Century a.D.; it culminated in the IV Century.

Pylephlebitis: incidence and prognosis in a tertiary hospital.

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Belhassen-García, Moncef; Gomez-Munuera, Mercedes; Pardo-Lledias, Javier; Velasco-Tirado, Virginia; Perez-Persona, Ernesto; Galindo-Perez, Inmaculada; Alvela-Suárez, Lucia; Romero-Alegría, Angela; Muñoz-Bellvis, Luis; Cordero-Sánchez, Miguel

2014-01-01

Septic thrombophlebitis of the portal vein or its branches, most often secondary to intra-abdominal infection is known as pylephlebitis. The frequency and the prognosis of this complication are unknown. The aim of this study was to determine the global and relative incidence of the most frequent intra-abdominal infections and the real prognosis of this disease. An observational retrospective study was conducted in a tertiary care hospital (University Hospital of Salamanca, Spain) from January 1999 to December 2008. A total of 7796 patients with intra-abdominal infection were evaluated, of whom 13 (0.6%) had been diagnosed with pylephlebitis. Diverticulitis was the most frequent underlying process, followed by biliary infection. Early mortality was 23%. Survivors had no recurrences, but one of them developed portal cavernomatosis. Pylephlebitis is a rare complication of intra-abdominal infection, with a high early mortality, but with a good prognosis for survivors. Copyright © 2013 Elsevier España, S.L. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

La guerra de sucesión española en los pliegos poéticos de la biblioteca universitaria de Salamanca

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María José RODRÍGUEZ SÁNCHEZ DE LEÓN

2009-11-01

Full Text Available RESUMEN: En el siglo XVIII un significativo número de pliegos poéticos sueltos fueron protagonizados por la monarquía, sobresaliendo por su número y devoción los dedicados a Felipe V. A este respecto, en la Biblioteca Universitaria de Salamanca se encuentra un volumen facticio constituido por un total de treinta y una obras en las que se refieren los sucesos más relevantes de la guerra de Sucesión. Su interés radica en que, además de ofrecer la interpretación popular de la contienda, su estudio permite, a través del Catálogo bibliográfico que aquí se ofrece, recuperar un material esencial para mejorar nuestro conocimiento de la literatura popular y de la imprenta dieciochesca.ABSTRACT: In the eighteenth century a significant number of blindman’s ballads had as their subject the monarchy, the large number of those dedicated to Philip V and their devotion to him being outstanding. ln this respect, the University Library of Salamanca has a factitious volume made up of a total of thirty-one works which relate the most relevant events of the War of the Spanish Succession. lts interest lies in the fact that, besides offering the popular interpretation of the conflict, its study makes it possible, through the bibliographic catabogue offered here, to recover essential material for improving our knowledge of the popular literature and eighteenth century printing.

Hospital-Based Coalition to Improve Regional Surge Capacity

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James M. Learning

2012-12-01

Full Text Available Introduction: Surge capacity for optimization of access to hospital beds is a limiting factor in response to catastrophic events. Medical facilities, communication tools, manpower, and resource reserves exist to respond to these events. However, these factors may not be optimally functioning to generate an effective and efficient surge response. The objective was to improve the function of these factors.Methods: Regional healthcare facilities and supporting local emergency response agencies developed a coalition (the Healthcare Facilities Partnership of South Central Pennsylvania; HCFP¬SCPA to increase regional surge capacity and emergency preparedness for healthcare facilities. The coalition focused on 6 objectives: (1 increase awareness of capabilities and assets, (2 develop and pilot test advanced planning and exercising of plans in the region, (3 augment written medical mutual aid agreements, (4 develop and strengthen partnership relationships, (5 ensure National Incident Management System compliance, and (6 develop and test a plan for effective utilization of volunteer healthcare professionals.Results: In comparison to baseline measurements, the coalition improved existing areas covered under all 6 objectives documented during a 24-month evaluation period. Enhanced communications between the hospital coalition, and real-time exercises, were used to provide evidence of improved preparedness for putative mass casualty incidents.Conclusion: The HCFP-SCPA successfully increased preparedness and surge capacity through a partnership of regional healthcare facilities and emergency response agencies.

Elevación de una cúpula de hormigón en el palacio de congresos de Salamanca. España

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Díaz-Romeral, Pablo

1989-01-01

It's described in this joint the elevation of a rigid dome, kind of baldaquino, with a weight of a 1,400 t, and built separately of the building remainder of the Congress and Expositions Salamanca's Palace. The dome has an area of 1,100 m² inside a square of 33 m each side, it has been hoisted by means of sixteen hidraulic cats of 84 t of load power each one. The author is the architect Juan Navarro Baldeweg who won the first price in a competition.

Se describe ...

Paleolithic rock art in the open air place of La Salud (Tormes valley, Salamanca

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Diego GARATE MAIDAGAN

2016-07-01

Full Text Available In 2013 a new open air rock art site was discovered in the place called La Salud in the city of Salamanca. In 2014 we carried out an intensive survey to have a better knowledge. As a result, in three decorated sectors were distinguished containing in total four animal representations –two horses, a cervico-dorsal line and a possible goat– and several non figurative motives composed by crossed lines. Different preservation issues affecting the site, such as landslide and erosion, have probably hampered the conservation of more representations all along the valley. Despite the low number of figures, the technical and the formal procedures used in for these representations link directly La Salud site with other open air rock-art sites as Siega Verde and Foz Côa. This extents considerably the territory of these kind of representations revealing the necessity of more intense work to investigate the Upper Paleolithic habitat in the Meseta.

Temperature profiles from XBT casts from the CIUDAD DE SALAMANCA and other platforms as part of the International Decade of Ocean Exploration (IDOE) from 1966-06-02 to 1974-08-29 (NODC Accession 7500613)

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National Oceanic and Atmospheric Administration, Department of Commerce — Temperature profiles were collected from XBT casts from the CIUDAD DE SALAMANCA and other platforms from 02 June 1966 to 29 August 1974. Data were collected by the...

[Research of regional medical consumables reagent logistics system in the modern hospital].

Science.gov (United States)

Wu, Jingjiong; Zhang, Yanwen; Luo, Xiaochen; Zhang, Qing; Zhu, Jianxin

2013-09-01

To explore the modern hospital and regional medical consumable reagents logistics system management. The characteristics of regional logistics, through cooperation between medical institutions within the region, and organize a wide range of special logistics activities, to make reasonable of the regional medical consumable reagents logistics. To set the regional management system, dynamic management systems, supply chain information management system, after-sales service system and assessment system. By the research of existing medical market and medical resources, to establish the regional medical supplies reagents directory and the initial data. The emphasis is centralized dispatch of medical supplies reagents, to introduce qualified logistics company for dispatching, to improve the modern hospital management efficiency, to costs down. Regional medical center and regional community health service centers constitute a regional logistics network, the introduction of medical consumable reagents logistics services, fully embodies integrity level, relevance, purpose, environmental adaptability of characteristics by the medical consumable reagents regional logistics distribution. Modern logistics distribution systems can increase the area of medical consumables reagent management efficiency and reduce costs.

Selective sandstone deterioration in the cathedrals of Salamanca, Textural anisotropy as a cause

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Martín Patino, María Teresa

1994-09-01

Full Text Available Textural sandstone anisotropy is related to the selective deterioration of such stone in buildings. The samples studied come from the Cathedrals of Salamanca. Stone fragments, cut in different directions with regard to the base supporting the ashlars in the wall, are studied by means of a binocular magnifying glass and the Scanning Electron Microscopy (SEM. This shows that the sandstone microfabric has a granular and a laminar microtexture, which correspond to different directions in the plane in question as regards the position of the ashlar. Either of these circumstances coincides with the stone surface on the outside of the building and affect its surface deterioration in a different way. The SEM images of deteriorated stone were compared with those of unaffected stone, with both types coming from differently orientated cuts as regards the position of the ashlar. In conclusion, the position given to the block of stone in the building is of importance for the preservation of the stone. The speed of ultrasound transmission measured in samples from commercial quarries confirms the textural sandstone anisotropy to a greater or lesser extent.

La anisotropía textural de las areniscas se relaciona con la selectividad de su deterioro en los edificios. Las muestras estudiadas pertenecen a las Catedrales de Salamanca. Fragmentos de piedra, cortados en direcciones diferentes respecto a la base sobre la que se asientan los sillares en el muro, son estudiados por medio de la lupa binocular y del microscopio electrónico de barrido (SEM. De éstos se deduce que la microfábrica de las areniscas tiene una microtextura granular y otra laminar, que corresponden a direcciones diferentes del plano respecto al asiento del sillar. Una u otra de estas situaciones coincide con la superficie de la piedra expuesta al exterior en el edificio, y afectan a su deterioro superficial de forma diferente. Las capas externas en las que predomina la arcilla

Elevación de una cúpula de hormigón en el palacio de congresos de Salamanca. España

OpenAIRE

Díaz-Romeral, Pablo

1989-01-01

Se describe en este artículo el izado de una cúpula rígida, tipo baldaquino, de 1.400 t de peso y construida separadamente del resto del edificio del Palacio de Congresos y Exposiciones de Salamanca. La cúpula, que ocupa una superficie aproximada de 1.100 m² dentro de un cuadrado de 33 m de lado, fue izada mediante dieciséis gatos hidráulicos de 84 t da carga cada uno. El proyecto es obra del Arquitecto Juan Navarro Baldeweg, con el cual obtuvo el primer premio en el Concurso de Proye...

El clima de las ciudades: isla de calor de Salamanca

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Mª Salud Alonso García

2004-12-01

Full Text Available En este trabajo se ha determinado la existencia de la isla de calor urbana (ICU, en una ciudad de tamaño medio, con un clima extremado y focos industriales de poca actividad. Con lo que se puede comprobar cómo afecta el calentamiento urbano a ciudades de estas características, pudiendo influir en los seres vivos de la zona. La existencia del fenómeno isla de calor, y su evolución en el tiempo, se han observado comparando los datos de temperatura registrados en una estación meteorológica situada en la ciudad, con los de otra estación fuera del radio de acción de la urbe, durante el período 1996-1998. Se han detectado dos fenómenos: la isla de calor nocturna, cuando la diferencia térmica entre la ciudad y la zona rural es positiva, que presenta sus valores más altos en otoño, y la isla de calor diurna, cuando la diferencia es negativa, que presenta sus valores más altos en primavera. Realizando un estudio estadístico de la evolución anual de la isla de calor nocturna en Salamanca, podemos definir isla de calor débil si su intensidad es inferior a 2 oC, moderada si se encuentra entre 2 oC y 4 oC e intensa si supera los 4 oC.

El sistema educativo liberal y la formación de maestros. Origen y primer desarrollo de la Escuela Normal de Salamanca (1842- 1868

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José María HERNÁNDEZ DÍAZ

2010-03-01

Full Text Available RESUMEN: Desde hace aproximadamente una década asistimos a una feliz floración de estudios de historia de la educación centrados en la formación del magisterio en España y las instituciones de su acogida inicial, las Escuelas Normales. Su mera enumeración y referencia bibliográfica llenaría varias páginas, por lo que cabe afirmar que no es un tema desconocido para el especialista. Además, acoge la práctica totalidad de Escuelas Normales de toda la geografía hispana. En cuanto a la institución de referencia para este trabajo, la de Salamanca, es preciso afirmar que también va siendo estudiada en visiones de conjunto dentro del ámbito de Castilla y León, o en otras etapas históricas diferentes a la que ahora abordamos. Esta es, expresada de forma breve, la justificación de lo escrito a continuación: cubrir en cierta manera una pequeña laguna, al tiempo que contribuye a explicitar el rico movimiento pedagógico y normalista que vive la España liberal del tercio central del XIX. Podrá advertirse que se trata de un estudio institucional de carácter local, aunque encuadrado en la etapa histórica que venimos considerando de emergencia del sistema nacional-liberal de educación en España, y, por tanto, de creación y primera consolidación de las Escuelas Normales. Por ello, queremos aquí poner de manifiesto cómo el caso de Salamanca, situándose en un plano de realizaciones oscilantes, aunque comparativamente dignas, nace y subsiste en este período histórico dentro de un contexto mucho más amplio. También hemos de informar en este preámbulo sobre la dificultad en la búsqueda y tratamiento de fuentes. Las particulares del establecimiento son, para esta primera etapa de su vida, escasas y de no mucha significación documental. Sin embargo, aunque muy dispersas, sí son abundantes en otros archivos como el de la Diputación de Salamanca y el Archivo General de la Administración, o en boletines, prensa e informaciones

1788: un año significativo en la Salamanca de la Ilustración

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Manuel FERNÁNDEZ ÁLVAREZ

2009-12-01

Full Text Available El siglo XVIII empezó mal para Salamanca (como para toda España, con la tremenda sacudida de la Guerra de Sucesión. Lentamente se fue recuperando, a lo largo del siglo. En 1769 se le calculaban 15.319 habitantes, según nos indica Villar y Macías, en su conocida Historia,que sigue siendo tan valiosa. Eso quería decir que aún no había alcanzado las cifras de fines del siglo XVI, ya que en 1504, el censo encontrado por José Luis Martín Martín en Simancas, daba ya esa misma cifra (exactamente, 15.271 habitantes mientras que el de calle hita de 1561, estudiado por Ana Díaz Medina, arrojaba la cuantía de 4.936 vecinos (que con el prudente coeficiente de 3,5 daría ya más de 17.000 habitantes. A fines del siglo XVI yo mismo pude constatar que esos vecinos superaban la cifra de 4.000.

[Regional differences in the development of hospitalizations : An effect of different demographic trends?

Science.gov (United States)

Nowossadeck, Enno; Prütz, Franziska

2018-03-01

Population aging and population decline in many regions of the Federal Republic of Germany are key elements of demographic change. In the regions concerned there is a rising number of older people and, simultaneously, a declining population. So far, the consequences of regional shrinkage and growth for inpatient care don't seem to have been analysed very well. This paper analyses the influence of population aging and declining/increasing population (demographic factors) as well as other, non-demographic factors on the number of hospitalizations in Germany and the Federal States since 2000.One result of the analysis is that there are major differences between the Federal States. The analysis shows, for example, an increase of hospitalizations in Berlin while in Saxony-Anhalt the number of hospitalizations declines. The increase in Berlin was the result of population aging and, to a lower extent, an increase in population. In Saxony-Anhalt the declining population resulted in a decreasing number of hospitalizations. Population aging and non-demographic factors were not able to compensate this trend.Overall, the effect of demographic factors on the number of hospitalizations remains constant over time. Short-term changes of hospitalizations are due to non-demographic factors, such as epidemiological trends, (for example trends of incidence or prevalence), or structural changes of health care service (for example patients shifting between different sectors of health care or the introduction of new reimbursement systems).

Geriatric injuries among patients attending a regional hospital in ...

African Journals Online (AJOL)

Data was collected using a pre-tested, coded questionnaire and analyzed using SPSS computer system. A total of 94 geriatric trauma patients constituting 22.7% of all trauma admissions ... Pre-hospital care was recorded in 5.3% of cases. The musculoskeletal (72.3%) and head (66.0%) regions were commonly affected.

Regional variation in hospital admission rates in the Netherlands, Belgium, Northern France and Nordrhein-Westfalen.

NARCIS (Netherlands)

Noordt, M. van; Zee, J. van der; Groenewegen, P.P.

1992-01-01

For the analysis of regional variations in hospital admission rates a model was set up, including both supply and demand indicators. Data were gathered for regions in four health care systems (the Dutch, Belgian, French and German), for 1982, 1979, 1974 (France 1982 only). Hospital bed supply proved

The southern region renal transplant program at armed forces hospital, khamis mushayt.

Science.gov (United States)

Mohammed, A S; Al-Hashemy, A; Addous, A J; Ismail, G

1996-01-01

The Southern Region renal transplant program was established in February 1989. The appointment of a transplant co-ordinator and creation of a waiting list for the Southern Region as well as tissue typing of all patients in the region were important early steps. Between February 1989 and December 1995, 155 transplants were performed on 152 patients at the Armed Forces Hospital, Southern Region (AFHSR). Of them, 52 were cadaveric donor transplants and the remaining were from living related donors. The overall five-year actuarial patient and graft survival was 93% and 78% respectively. Of the 152 patients who were transplanted, 79 patients were from other hospitals in the region and 73 were from AFHSR. Maintenance immunosuppression consisted of cyclosporin, azathioprine and prednisolone. Use of the spouse as a donor was an early feature of this program. Our results compare favorably with results published from other centers. To cope with the increasing demand of transplantation in the Southern Region, we have to look into ways of increasing our transplant numbers to match the needs.

Anotaciones Críticas sobre el Proyecto de una Ciudadela Industrial en el Parque Natural Isla de Salamanca

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Lema Tapias Álvaro

1980-09-01

Full Text Available Preservada hasta hace pocos años por condiciones naturales, la Isla de Salamanca es condenada a morir por un insensato proyecto que autorizó la creación de una ciudadela industrial y que destruirá uno de los pocos lugares que aún quedan en el país y en el mundo con unas características ecológicas muy especiales por su ubicación geográfica y por sus condiciones especiales que la hacen paso obligado de muchas especies migratorias entre el Norte y el Sur del continente americano, asiento de otras -algunas en vía de extinción--y otras únicas del lugar; con cuya desaparición sólo se acerca el hombre a este mismo proceso como especie.

Science, Technology and University in the XIXth Century. The Free-Faculty of Sciences of the University of Salamanca (1875-1902

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Joaquín PÉREZ MELERO

2013-11-01

Full Text Available The Free-Faculty of Sciences of the University of Salamanca was established in 1875 as the only way to continue Science studies in the University. Poorly financed, with little resources and academic acceptance, it survives helped by financial support from the City Hall and the Provincial Deputation, and to the Rector Esperabé5 s will, against the High Education centralization trend which concentres the studies at the Central University of Madrid. That economic and technical poverty provides just only an approach to the physico-chemical sciences in the framework of a provincial University, but helps it to stay alive until its recongnition as «official» faculty in 1902.

Factors associated with induced abortion at selected hospitals in the Volta Region, Ghana

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Klutsey EE

2014-08-01

Full Text Available Ellen Eyi Klutsey,1 Augustine Ankomah2 1School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Volta Region, 2Department of Population, Family and Reproductive Health School of Public Health, University of Ghana, Legon, Accra, Ghana Background: Induced abortion rates remained persistently high in the Volta Region of Ghana in the 5 years from 2006 to 2011. Some hospitals, both rural and urban, report induced abortion-related complications as one of the top ten conditions in hospital admissions. This study explored demographic and other factors associated with induced abortion, and also assessed awareness of abortion-related complications among women of reproductive age in the Volta Region. Methods: A quantitative, hospital-based, unmatched case-control study was performed. The Volta Region was stratified into two health administration zones, ie, north and south. For each zone, hospitals were stratified into government and private hospitals. Employing simple random sampling, one private and three government hospitals were selected from each zone. This study is therefore based on eight hospitals, ie, six government hospitals and two private hospitals. Results: Marital status, employment status, number of total pregnancies, and knowledge about contraception were found to be associated with induced abortion. Multiple logistic regression showed a 4% reduction in the odds of induced abortion in married women compared with women who were single (odds ratio [OR] 0.11, 95% confidence interval [CI] 0.07–0.22. Unemployed women of reproductive age were found to be 0.35 times less likely to seek induced abortion compared with their employed counterparts (OR 0.35, CI 0.19–0.65. It was also observed that women with their second pregnancies were 3.8 times more likely to seek induced abortion and women with more than two pregnancies were 6.6 times more likely to do so (OR 3.81, CI 1.94–7.49 and OR 6.58, CI 2.58–16.79, respectively

Soil Properties Database of Spanish Soils. Volume X.- Castilla-Leon (a): Leon, Zamora and Salamanca; Base de datos de propiedades edafologicas de los suelos espanoles. volumen X. Castilla-Leon (a): Leon, Zamora y Salamanca

Energy Technology Data Exchange (ETDEWEB)

Trueba, C.; Millan, R.; Schmid, T.; Lago, C. [CIEMAT. Madrid (Spain); Roquero, C.; Magister, M. [UPM. Madrid (Spain)

1999-09-01

The soil vulnerability determines the sensitivity of the soil after an accidental radioactive contamination due to Cs-137 and Sr-90. The Departamento de Impacto Ambiental de la Energia of CIEMAT is carrying out an assessment of the radiological vulnerability of the different Spanish soils found on the Iberian Peninsula. This requires the knowledge of the soil properties for the various types of existing soils. In order to achieve this aim, a bibliographical compilation of soil profiles has been made to characterize the different soil types and create a database of their properties. Depending on the year of publication and the type of documentary source, the information compiled from the available bibliography is very heterogeneous. Therefore, an important effort has been made to normalize and process the information prior to its incorporation to the database. This volume presents the criteria applied to normalize and process the data as well as the soil properties of the various soil types belonging to the provinces of Leon, Zamora and Salamanca of the Comunidad Autonoma de Castilla-Leon. (Author)

El colegio de la compañía y la Universidad de Salamanca en el siglo XVI. Desde los orígenes hasta la incorporación a la Universidad

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Benigno HERNÁNDEZ MONTES

2009-12-01

Full Text Available San Ignacio de Loyola, fundador de la Compañía de Jesús, decidió venir a estudiar a la Universidad de Salamanca en el verano de 1527, una vez que vio cerradas para él las puertas de la Universidad de Alcalá. El arzobispo Fonseca le ofreció un puesto en el Colegio Mayor de Santiago el Cebedeo por él fundado. No aceptó el santo el ofrecimiento, por lo que, llegado a la ciudad del Tormes vestido como un pobre estudiante, se aposentó en una posada.Lo más probable es que ni siquiera llegase a matricularse en la academia salmantina, por más que el tardío claustro pleno de la Universidad del 4-VII-1624 llame a Ignacio «hijo de esta Vniversidad». Una iniciativa de los dominicos de San Esteban hizo que aquel candidato a estudiante de Salamanca diera pronto con sus huesos en la cárcel episcopal. Salido de ella, abandonó para siempre la ciudad camino de la Sorbona parisiense «llevando algunos libros en un asnillo».

Consideraciones Acerca de la Educación a Distancia en la Unidad de Extensión del Campus Salamanca en Yuriria Consideraciones Acerca de la Educación a Distancia en la Unidad de Extensión del Campus Salamanca en Yuriria

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Mónica Trejo Durán

2012-02-01

Full Text Available Educación a distancia es un concepto que se comenzó a utilizar en México en la década de los 50’s, al insertar el material audiovisual al ámbito educativo. La Universidad de Guanajuato, siempre a la vanguardia educativa, incursionó en esta modalidad dentro de un ambiente de aprendizaje en línea ofreciendo, de esta manera, la universidad virtual en el área de Ingenierías del Campus Salamanca. Su objetivo es atender la demanda, en este rubro, de la población con escasos recursos que radica o que labora lejos de las unidades académicas. Esta modalidad educativa es ofrecida en localidades en las que tiene presencia en la escuela de Nivel Medio Superior como es Yuriria y, próximamente, Pénjamo, convirtiendo a éstas en unidades de extensión. Este documento presenta el análisis de una encuesta aplicada a los alumnos inscritos en esta modalidad en la unidad de extensión Yuriria. Distance Education is a concept that started to be used in Mexico in the 1950s, by using audiovisual tools and materials in the educational environment. The University of Guanajuato, always seeking to be in the vanguarde in education is has entered into this on-line learning modality, resulting in the creation of a virtual university in the areas of Engineering through its Campus Salamanca. This is to satisfy the demand for studies in these specialties from the population with limited resources that either resides or works far from the academic campuses of the UG. This educational modality is currently offered in different cities at high school level, such as Yuriria, and in the near future Pénjamo, transforming them into university extension units. This document presents the analysis of a questionnaire applied to the students of the Southern Campus in Yuriria.

Tripartite Evolutionary Game Analysis on Selection Behavior of Trans-Regional Hospitals and Patients in Telemedicine System

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Yuxuan Gao

2017-01-01

Full Text Available This study applies the game theory to the discussion and analysis of trans-regional Telemedicine System, builds the game model of the selection strategies of trans-regional hospitals and patients and analyzes evolving paths, equilibrium states and influencing factors of the three parties. It is derived that medical insurance reimbursement proportion of specialized hospitals, government support for general hospitals and medical expenses in specialized hospitals, operating costs of general hospitals are the influential factors in the Telemedicine System. Finally, a numerical stimulation is conducted with Matlapb based on the data from ligChina Health and Family Planning Statistical Yearbook 2015l/ig.

PHARMACOEPIDEMIOLOGIC ANALYSIS OF ST-ELEVATION MYOCARDIAL INFARCTION REPERFUSION THERAPY AT SARATOV REGION HOSPITALS OF DIFFERENT TYPES

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O. V. Reshetko

2016-01-01

Full Text Available Aim. To evaluate the real practice of thrombolytic therapy of patients with ST-elevation myocardial infarction (STEMI at cardiological departments of Saratov and Saratov region hospitals.Material and methods. Retrospective pharmacoepidemiologic study was carried out. Case histories of STEMI patients discharged from cardiologic departments of several central district hospitals (CDH of Saratov region, cardiologic department of one of Saratov general municipal hospitals (MH and urgent cardiology department of Saratov clinical hospital (CH in 2006 were analyzed.Results. In CH all patients received thrombolytic therapy given they did not have contraindications and were admitted to the hospital timely. Few patients received thrombolytic therapy in MH and CDH in 2006.Conclusion. Correlation between hospital type and quality of STEMI management has been revealed.

Soil Properties Database of Spanish Soils. Volume X.- Castilla-Leon (a): Leon, Zamora and Salamanca

International Nuclear Information System (INIS)

Trueba, C; Millan, R.; Schmid, T.; Lago, C.; Roquero, C; Magister, M.

1999-01-01

The soil vulnerability determines the sensitivity of the soil after an accidental radioactive contamination due to Cs-137 and Sr-90. The Departamento de Impacto Ambiental de la Energia of CIEMAT is carrying out an assessment of the radiological vulnerability of the different Spanish soils found on the Iberian Peninsula. This requires the knowledge of the soil properties for the various types of existing soils. In order to achieve this aim, a bibliographical compilation of soil profiles has been made to characterize the different soil types and create a database of their properties. Depending on the year of publication and the type of documentary source, the information compiled from the available bibliography is very heterogeneous. Therefore, an important effort has been made to normalize and process the information prior to its incorporation to the database. This volume presents the criteria applied to normalize and process the data as well as the soil properties of the various soil types belonging to the provinces of Leon, Zamora and Salamanca of the Comunidad Autonoma de Castilla-Leon. (Author) 41 refs

Survey of safety practices among hospital laboratories in Oromia Regional State, Ethiopia.

Science.gov (United States)

Sewunet, Tsegaye; Kebede, Wakjira; Wondafrash, Beyene; Workalemau, Bereket; Abebe, Gemeda

2014-10-01

Unsafe working practices, working environments, disposable waste products, and chemicals in clinical laboratories contribute to infectious and non-infectious hazards. Staffs, the community, and patients are less safe. Furthermore, such practices compromise the quality of laboratory services. We conducted a study to describe safety practices in public hospital laboratories of Oromia Regional State, Ethiopia. Randomly selected ten public hospital laboratories in Oromia Regional State were studied from Oct 2011- Feb 2012. Self-administered structured questionnaire and observation checklists were used for data collection. The respondents were heads of the laboratories, senior technicians, and safety officers. The questionnaire addressed biosafety label, microbial hazards, chemical hazards, physical/mechanical hazards, personal protective equipment, first aid kits and waste disposal system. The data was analyzed using descriptive analysis with SPSS version16 statistical software. All of the respondents reported none of the hospital laboratories were labeled with the appropriate safety label and safety symbols. These respondents also reported they may contain organisms grouped under risk group IV in the absence of microbiological safety cabinets. Overall, the respondents reported that there were poor safety regulations or standards in their laboratories. There were higher risks of microbial, chemical and physical/mechanical hazards. Laboratory safety in public hospitals of Oromia Regional State is below the standard. The laboratory workers are at high risk of combined physical, chemical and microbial hazards. Prompt recognition of the problem and immediate action is mandatory to ensure safe working environment in health laboratories.

[Team cohesiveness: opinions of a group of primary health care professionals from Salamanca].

Science.gov (United States)

González, F J; de Cabo, A; Morán, M J; Manzano, J M

1993-04-01

To assess the view of a group of Primary care professionals on their level of perception of group cohesiveness in their teams' work dynamic. A descriptive and sectional study. Four urban health centres in Salamanca with a recognised teaching activity. Both health professionals and those outside the Health Service, working in Primary Care, who had been members of their teams for more than a year (N = 90). Descriptive statistics and "Chi squared" tests were employed. 72%. A high level of agreement on the need for team work (95.23%). They perceived their group cohesiveness as being very low (84.21% affirmed that they encounter problems of cohesiveness). The main statements concerning this lack of cohesiveness were: "lack of common objectives" (25.5%), "intolerance between workers" (20.13%), "work not shared" (19.46%) and "the taking of decisions individually" (19.44%). The main causes given were: lack of support from Management (23.74%) and too little training for team work (21.58%). There is a high degree of conviction that the team work model is the most efficacious way of developing Primary Care. However in three of the four teams questioned, there were serious problems preventing the teams' reaching an adequate level of group cohesiveness.

Regional hospital improves efficiency with co-generation retrofit.

Science.gov (United States)

Knutson, D; Anderson, L

1999-11-01

Feasibility analysis of the co-generation retrofit of the Red Deer Regional Hospital pointed to a reasonable payback of capital cost and increased efficiency in operation of the facility. Budget restrictions nearly stopped the project from proceeding. Innovative construction procedures proposed by the Facility Management Group, in particular, Mr Keith Metcalfe, Director of Maintenance, allowed a worthwhile project to reach successful completion. We feel that this model can perhaps be used by similar facilities in the future to achieve their energy efficiency goals.

Prólogo arameo y anotaciones hebreas de Alfonso de Zamora para una copia manuscrita del Targum a los Profetas encargada por la Universidad de Salamanca

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Fontela, Carlos Alonso

2009-12-01

Full Text Available University Library Ms. Or. 645, f. 110r (ol. Warner 65 F contains, besides a draft for an Aramaic prologue to the work on Targum written by Alonso de Zamora ca. 1532, additional notes written by himself dealing with the comission he received to copying Targumic texts. The present article improves the edition of the Aramaic prologue, previously published by Neubauer (1895, offering a Spanish translation and the edition of the marginal notes, that contain a draft of the prayers (תפלותופיהספדים for the partial colophons of the books of Ezekiel, Hosea and Joel’s Targums. These pa - tial colophons in the Leiden Ms. coincide with the clean drafts by Zamora preserved in an autograph manuscript, Salamanca University Library Ms. M-3 (Est.-1, Cajón I-Núm. 2. An explanation concerning additional annotations (the incipit of Isaiah 57, that spoiled the folio, and led it to its being re-used by Alonso de Zamora as a draft.

El ms. Or. 645, f.º 110r (ol. Warner 65 F de la Leiden University Library, además del borrador de un prólogo arameo a la obra de Targum escrito por Alfonso de Zamora hacia el año 1532 por encargo de la Universidad de Salamanca, contiene otras anotaciones del mismo autor que aquí se publican por primera vez y que también formaban parte del mismo encargo de copia de textos targúmicos. En el presente artículo, además de mejorar el texto arameo del prólogo ya publicado por Neubauer en 1895, se ofrece su traducción española por primera vez. Asimismo, se publica y traduce una anotación marginal que consiste en un borrador de las jaculatorias o doxologías (תפלותופיהספדים para los colofones parciales de los libros del Targum de Ezequiel, Oseas y Joel. Estos colofones parciales del ms. de Leiden coinciden con los pasados a limpio que se conservan en el manuscrito autógrafo de Alfonso de Zamora ms. M-3 (Est.-1, Cajón I-Núm. 2 de la Biblioteca Universitaria de Salamanca. Se

Variation in Surgical Quality Measure Adherence within Hospital Referral Regions: Do Publicly Reported Surgical Quality Measures Distinguish among Hospitals That Patients Are Likely to Compare?

Science.gov (United States)

Safavi, Kyan C; Dai, Feng; Gilbertsen, Todd A; Schonberger, Robert B

2014-01-01

Objective To determine whether surgical quality measures that Medicare publicly reports provide a basis for patients to choose a hospital from within their geographic region. Data Source The Department of Health and Human Services' public reporting website, Medicare Claims Processing Manual Baltimore, MD CMS http://www.medicare.gov/hospitalcompare. Study Design We identified hospitals (n = 2,953) reporting adherence rates to the quality measures intended to reduce surgical site infections (Surgical Care Improvement Project, 1–3) in 2012. We defined regions within which patients were likely to compare hospitals using the hospital referral regions (HRRs) from the Dartmouth Atlas of Health Care Project. We described distributions of reported SCIP adherence within each HRR, including medians, interquartile ranges (IQRs), skewness, and outliers. Principal Findings Ninety-seven percent of HRRs had median SCIP-1 scores ≥95 percent. In 93 percent of HRRs, half of the hospitals in the HRR were within 5 percent of the median hospital's score. In 62 percent of HRRs, hospitals were skewed toward the higher rates (negative skewness). Seven percent of HRRs demonstrated positive skewness. Only 1 percent had a positive outlier. SCIP-2 and SCIP-3 demonstrated similar distributions. Conclusions Publicly reported quality measures for surgical site infection prevention do not distinguish the majority of hospitals that patients are likely to choose from when selecting a surgical provider. More studies are needed to improve public reporting's ability to positively impact patient decision making. PMID:24611578

Job stress and burnout in hospital employees: comparisons of different medical professions in a regional hospital in Taiwan

Science.gov (United States)

Chou, Li-Ping; Li, Chung-Yi; Hu, Susan C

2014-01-01

Objectives To explore the prevalence and associated factors of burnout among five different medical professions in a regional teaching hospital. Design Cross-sectional study. Setting Hospital-based survey. Participants A total of 1329 medical professionals were recruited in a regional hospital with a response rate of 89%. These voluntary participants included 101 physicians, 68 physician assistants, 570 nurses, 216 medical technicians and 374 administrative staff. Primary and secondary outcome measures Demographic data included gender, age, level of education and marital status, and work situations, such as position, work hours and work shifts, were obtained from an electronic questionnaire. Job strain and burnout were measured by two validated questionnaires, the Chinese version of the Job Content Questionnaire and the Copenhagen Burnout Inventory. Results Among the five medical professions, the prevalence of high work-related burnout from highest to lowest was nurses (66%), physician assistants (61.8%), physicians (38.6%), administrative staff (36.1%) and medical technicians (31.9%), respectively. Hierarchical regression analysis indicated that job strain, overcommitment and low social support explained the most variance (32.6%) of burnout. Conclusions Physician assistant is an emerging high burnout group; its severity is similar to that of nurses and far more than that of physicians, administrative staff and medical technicians. These findings may contribute to the development of feasible strategies to reduce the stress which results in the burnout currently plaguing most hospitals in Taiwan. PMID:24568961

Diabetic patients served at a regional level hospital: What is their ...

African Journals Online (AJOL)

Objectives: We describe the demographics, diabetic characteristics, diabetic control and complications in the diabetes service in Edendale Regional Hospital, Pietermaritzburg, in this study. Diabetes mellitus, together with its complications, is increasing at an alarming rate worldwide. Good glycaemic control translates into ...

Factors associated with induced abortion at selected hospitals in the Volta Region, Ghana.

Science.gov (United States)

Klutsey, Ellen Eyi; Ankomah, Augustine

2014-01-01

Induced abortion rates remained persistently high in the Volta Region of Ghana in the 5 years from 2006 to 2011. Some hospitals, both rural and urban, report induced abortion-related complications as one of the top ten conditions in hospital admissions. This study explored demographic and other factors associated with induced abortion, and also assessed awareness of abortion-related complications among women of reproductive age in the Volta Region. A quantitative, hospital-based, unmatched case-control study was performed. The Volta Region was stratified into two health administration zones, ie, north and south. For each zone, hospitals were stratified into government and private hospitals. Employing simple random sampling, one private and three government hospitals were selected from each zone. This study is therefore based on eight hospitals, ie, six government hospitals and two private hospitals. Marital status, employment status, number of total pregnancies, and knowledge about contraception were found to be associated with induced abortion. Multiple logistic regression showed a 4% reduction in the odds of induced abortion in married women compared with women who were single (odds ratio [OR] 0.11, 95% confidence interval [CI] 0.07-0.22). Unemployed women of reproductive age were found to be 0.35 times less likely to seek induced abortion compared with their employed counterparts (OR 0.35, CI 0.19-0.65). It was also observed that women with their second pregnancies were 3.8 times more likely to seek induced abortion and women with more than two pregnancies were 6.6 times more likely to do so (OR 3.81, CI 1.94-7.49 and OR 6.58, CI 2.58-16.79, respectively). Women with no knowledge of contraceptive methods were 4.6 times likely to seek induced abortion (OR 4.64, CI 1.39-15.4). Compared with women who had not had induced abortion, women with a high number of pregnancies and no contraceptive knowledge were more likely to have induced abortion. It was found that lack

Mining of the uraniferous shales of Saelices el Chico (Salamanca)

International Nuclear Information System (INIS)

Serrano, J.R.; Membrillera, J.R.; Criado, M.; Gomez Jaen, J.P.; Artieda, J.; Grande, L.

1980-01-01

In July 1974 ENUSA (the National Uranium Company) started mining operations in the FE-1 deposit in the municipal district of Saelices el Chico, Salamanca province. This is a deposit of the Stockwork type and is embedded in Cambrian shales of a distinct degree of metamorphism. The primary mineralization is found filling fissures and fractures of only slight longitudinal development. The secondary minerals were deposited in the zones affected by the hydrostatic level. The investigation of the deposit was carried out by the Spanish Nuclear Energy Board (JEN). In its final phases it consisted of a control drilling campaign and a wagon-drill campaign. The deposit was evaluated by the zone-of-influence method in accordance with the control drillings and the wagon drillings. The overall rate of production was 1,200,000 t per annum, of which 200,000 t were ore with a U 2 O 8 content of 0.08%. The output of the processing plant was 130 t U 3 O 8 . In 1976 ENUSA undertook a mining project of much greater scope in consequence of the decision to expand the ore processing plant (objective of the Quercus project). The annual output of the plant in question will be 600 t U 3 O 8 . For this the production of ore will be increased to 825,000 t/a (average grade 0.075%) and the total amount removed will be 9 million tonnes per annum. Account is taken of the whole of the FE deposit, which includes FE-1 and FE-3 and their respective extensions. The evaluation of the deposit was made both on the basis of the results of the control- and wagon-drillings and by the Kriging statistical method. (author)

Investigating Performance Installation of Hospital Room Surgery of Six Hospitals in Special Region of Yogyakarta by Using Data Envelopment Analysis Model Constant Return to Scale

OpenAIRE

Bhimo Rizky Samudro; Yogi Pasca Pratama

2018-01-01

This study aims to investigate the efficiency level of hospital surgery hospital installation in Special Region of Yogyakarta Province. Research conceptual constructs are based on input and output performance in institutional performance processes. This research approach uses positivist pattern and is derived by quantitative method. This is to explain the efficiency pattern of the installation of hospital and private hospital surgery rooms. The quantitative method chosen is the concept of Dat...

Salamanca como referente simbólico: la urbe del siglo XXI en Tierra Violenta de Luciano G. Egido

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Ana Eva Rodríguez Valentín

2017-02-01

Full Text Available El propósito de este artículo es examinar el material simbólico y los vínculos sociales entre la memoria colectiva, la identidad y el espacio de Salamanca, en el siglo XXI a través de la novela, Tierra Violenta, de Luciano G. Egido. Desde esta perspectiva, propongo una lectura del texto que nos ayude a entender cómo las circunstancias políticas y económicas determinan la estructura de la ciudad; que cambia, a su vez,  la vida de sus habitantes. Se trata de una ciudad que, aparentemente, vive en el pasado, pero que no es inmune a los mecanismos que rigen el siglo XXI. En esta aproximación, el texto literario es una fuente de distintas líneas de análisis para entender las temporalidades urbanas y la dialéctica de ambos, el proyecto público y  la herencia urbana.

Tradición y modernización en torno a la cuestión educativa de la segunda mitad del siglo XVIII: Avances de secularización en el Plan General de Estudios para la Universidad de Salamanca (1771 // Tradition and modernization around the education issue in the second half of the eighteenth century: Progress of secularization in the University of Salamanca General Curriculum (1771.

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Sebastián Perrupato

2014-06-01

Full Text Available (ES Durante el reinado de Carlos III se operan una serie de reformas tendientes a modernizar la sociedad. En este contexto la reforma de la universidad fue una preocupación fundamental. Sin embargo, el predominio de la escolástica dentro de los claustros universitarios hacía de la intrusión de la corona en las altas casas de estudio una empresa difícil. El objetivo del trabajo es analizar estos procesos de reforma a partir del Plan de estudios para la Universidad de Salamanca. Entendemos que el mismo se encuentra dentro de un contexto de reformas mucho más amplio en el que la dialéctica tradición-modernización pone de manifiesto la progresiva tendencia hacia la secularización. (EN During the reign of Carlos III, a series of reforms aimed at modernizing society arose. In this context, the reform of the university was a major concern. However, the dominance of scholasticism within university faculties was a difficulty for the aim of the crown. The objective of this work is to analyze these reform processes from the University of Salamanca Curriculum. We point out that this task is within the context of a much broader reform where the confrontation between the binomial tradition-modernization shows the progressive trend toward secularization.

Impact of a pharmaceutical care program on clinical evolution and antiretroviral treatment adherence: a 5-year study

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Hernández Arroyo MJ

2013-08-01

Full Text Available María Jesús Hernández Arroyo,1 Salvador Enrique Cabrera Figueroa,2 Rosa Sepúlveda Correa,3 María de la Paz Valverde Merino,1 Alicia Iglesias Gómez,4 Alfonso Domínguez-Gil Hurlé5 On behalf of the Tormes Team 1Pharmacy Service, University Hospital of Salamanca, Salamanca, Spain; 2Pharmacy Institute, University Austral of Chile, Valdivia, Chile; 3Department of Statistics, University of Salamanca, Salamanca, Spain; 4Infectious Disease Service, University Hospital of Salamanca, Salamanca, Spain; 5Department of Pharmacy and Pharmaceutical Technology, University of Salamanca, Salamanca, Spain Background: Antiretroviral treatments (ART form the basis of adequate clinical control in human immunodeficiency virus-infected patients, and adherence plays a primary role in the grade and duration of the antiviral response. The objectives of this study are: (1 to determine the impact of the implementation of a pharmaceutical care program on improvement of ART adherence and on the immunovirological response of the patients; and (2 to detect possible correlations between different adherence evaluation measurements. Methods: A 60-month long retrospective study was conducted. Adherence measures used were: therapeutic drug monitoring, a simplified medication adherence questionnaire, and antiretroviral dispensation records (DR. The number of interviews and interventions related to adherence made for each patient in yearly periods was related to the changes in the adherence variable (measured with DR in these same yearly periods. The dates when the laboratory tests were drawn were grouped according to proximity with the study assessment periods (February–May, 2005–2010. Results: A total of 528 patients were included in the study. A significant relationship was observed between the simplified medication adherence questionnaire and DR over the 60-month study period (P < 0.01. Improvement was observed in the mean adherence level (P < 0.001, and there was a

Las oposiciones a cátedra en la Universidad de Salamanca y en las Universidades Hispanoamericanas: época moderna

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Águeda María RODRÍGUEZ CRUZ

2010-03-01

Full Text Available RESUMEN: A manera de «elogio fúnebre» voy a dedicar estas páginas al muy antiguo y famoso sistema de oposiciones a cátedras universitarias en nuestro mundo hispánico. En Salamanca, desde época muy antigua, las cátedras se obtenían por oposición, que se realizaba según reglas muy complicadas. Es uno de los aspectos de la vida académica que más apasionaba los ánimos de los universitarios. Vibraba todo el cuerpo académico y hacía vibrar a la ciudad entera, que vivía al ritmo de la célebre Escuela. En ello la siguieron casi todas sus universidades hijas de Hispanoamérica, que heredaron las costumbres, virtudes y vicios de la Alma Mater. Al fin y al cabo «de tal palo tal astilla».

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

African Journals Online (AJOL)

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

Under-reporting of notifiable infectious disease hospitalizations in a health board region in Ireland: room for improvement?

LENUS (Irish Health Repository)

Brabazon, E D

2008-02-01

Rapid notification of infectious diseases is essential for prompt public health action and for monitoring of these diseases in the Irish population at both a local and national level. Anecdotal evidence suggests, however, that the occurrence of notifiable infectious diseases is seriously underestimated. This study aims to assess the level of hospitalization for notifiable infectious diseases for a 6-year period in one health board region in Ireland and to assess whether or not there was any under-reporting during this period. All hospital in-patient admissions from 1997 to 2002 inclusive with a principal diagnosis relating to \\'infectious and parasitic diseases\\' (ICD codes 001-139) of residents from a health board region in Ireland were extracted from the Hospital In-Patient Enquiry System (HIPE). All notifiable infectious diseases were identified based on the 1981 Irish Infectious Disease Regulations and the data were analysed in the statistical package, JMP. These data were compared with the corresponding notification data. Analysis of the hospital in-patient admission data revealed a substantial burden associated with notifiable infectious diseases in this health board region: there were 2758 hospitalizations by 2454 residents, 17,034 bed days and 33 deaths. The statutory notification data comprises both general practitioner and hospital clinician reports of infectious disease. Therefore, only in cases where there are more hospitalizations than notifications can under-reporting be demonstrated. This occurred in nine out of 22 notifiable diseases and amounted to an additional 18% of notifications (or 572 cases) which were \\'missed\\' due to hospital clinician under-reporting. The majority of these under-reported cases were for viral meningitis (45%), infectious mononucleosis (27%), viral hepatitis C unspecified (15%) and acute encephalitis (5.8%). This study has highlighted the extent of under-reporting of hospitalized notifiable infectious diseases, in a

Valoración de hábitos de vida saludables de los trabajadores expuestos a cancerígenos laborales de la provincia de Salamanca

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Jesús González Sánchez

2014-06-01

Full Text Available Objetivos: Conocer los hábitos de vida de los trabajadores cubiertos por los servicios de prevención ajenos de la provincia de Salamanca. Comparar grupos de trabajadores expuestos y no expuestos a cancerígenos laborales. Método: Se ha realizado un estudio epidemiológico observacional, de carácter descriptivo transversal. La selección de la muestra fue mediante muestreo aleatorio estratificado en los trabajadores pertenecientes a los servicios de prevención ajenos de la provincia de Salamanca. Las variables recogidas mediante cuestionario: características sociodemográficas, de exposición a cancerígenos laborales y hábitos de vida, utilizando como fuente de información las historias clínico-laborales. Resultados: Un 32% de los 835 trabajadores estudiados se encontraba expuesto a algún cancerígeno laboral. Los trabajadores expuestos a cancerígenos y que pertenecen al sector servicios refieren un mayor hábito tabáquico (44,7%, sin embargo, los trabajadores no expuestos y que pertenecen al sector agricultura y ganadería refieren un mayor consumo de alcohol (58,8%. En global, los trabajadores no expuestos a cancerígenos realizan de forma habitual una dieta equilibrada (74,6% en comparación con los trabajadores expuestos (61,8%. La realización de actividad física es similar en ambos grupos de trabajadores. Conclusiones: La exposición a cancerígenos laborales es un factor que puede influir en ciertos hábitos de vida en los trabajadores, como en el hábito tabáquico, el consumo de alcohol y la realización de dieta equilibrada de forma habitual.

Prevention of hospital-onset Clostridium difficile infection in the New York metropolitan region using a collaborative intervention model.

Science.gov (United States)

Koll, Brian S; Ruiz, Rafael E; Calfee, David P; Jalon, Hillary S; Stricof, Rachel L; Adams, Audrey; Smith, Barbara A; Shin, Gina; Gase, Kathleen; Woods, Maria K; Sirtalan, Ismail

2014-01-01

The incidence, severity, and associated costs of Clostridium difficile (C. difficile) infection (CDI) have dramatically increased in hospitals over the past decade, indicating an urgent need for strategies to prevent transmission of C. difficile. This article describes a multifaceted collaborative approach to reduce hospital-onset CDI rates in 35 acute care hospitals in the New York metropolitan region. Hospitals participated in a comprehensive CDI reduction intervention and formed interdisciplinary teams to coordinate their efforts. Standardized clinical infection prevention and environmental cleaning protocols were implemented and monitored using checklists. Monthly data reports were provided to hospitals for facility-specific performance evaluation and comparison to aggregate data from all participants. Hospitals also participated in monthly teleconferences to review data and highlight successes, challenges, and strategies to reduce CDI. Incidence of hospital-onset CDI per 10,000 patient days was the primary outcome measure. Additionally, the incidence of nonhospital-associated, community-onset, hospital-associated, and recurrent CDIs were measured. The use of a collaborative model to implement a multifaceted infection prevention strategy was temporally associated with a significant reduction in hospital-onset CDI rates in participating New York metropolitan regional hospitals. © 2013 National Association for Healthcare Quality.

Reducing Ambulance Diversion at Hospital and Regional Levels: Systemic Review of Insights from Simulation Models

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M Kit Delgado

2013-09-01

Full Text Available Introduction: Optimal solutions for reducing diversion without worsening emergency department (ED crowding are unclear. We performed a systematic review of published simulation studies to identify: 1 the tradeoff between ambulance diversion and ED wait times; 2 the predicted impact of patient flow interventions on reducing diversion; and 3 the optimal regional strategy for reducing diversion.Methods: Data Sources: Systematic review of articles using MEDLINE, Inspec, Scopus. Additional studies identified through bibliography review, Google Scholar, and scientific conference proceedings. Study Selection: Only simulations modeling ambulance diversion as a result of ED crowding or inpatient capacity problems were included. Data extraction: Independent extraction by two authors using predefined data fields.Results: We identified 5,116 potentially relevant records; 10 studies met inclusion criteria. In models that quantified the relationship between ED throughput times and diversion, diversion was found to only minimally improve ED waiting room times. Adding holding units for inpatient boarders and ED-based fast tracks, improving lab turnaround times, and smoothing elective surgery caseloads were found to reduce diversion considerably. While two models found a cooperative agreement between hospitals is necessary to prevent defensive diversion behavior by a hospital when a nearby hospital goes on diversion, one model found there may be more optimal solutions for reducing region wide wait times than a regional ban on diversion.Conclusion: Smoothing elective surgery caseloads, adding ED fast tracks as well as holding units for inpatient boarders, improving ED lab turnaround times, and implementing regional cooperative agreements among hospitals. [West J Emerg Med. 2013;14(5:489-498.

A hospital-based survey of primary hyperparathyroidism in the AsirRegion: Low prevalence or underdiagnosis

International Nuclear Information System (INIS)

Al-Shehri, Mohammed Y.

1999-01-01

The number of patients with primary hyperparathyroidism (PHP) seen at theAsir Central Hospital (ACH) is remarkably low. This observation has raisedthe question of whether there is a low prevalence of PHP in the Asir region,whether it is underdiagnosed, or perhaps a combination of other both factors.A survey of 15 hospitals in the Asir region was conducted for the cases ofPHP. All case notes of the patients with PHP are seen at ACH were reviewed.Also a sample of patients seen at ACH was chosen randomly. The charts ofthose found to have hypercalcemia were reviewed for the inclusion of PHP inthe diagnostic work-up. Only 13 patients with PHP were discovered. The eightpatients with PHP seen at ACH had advanced bone manifestations and seven ofthem had renal manifestations. Hypercalcemia was found in 39 out of 655patients seen at ACH. None of these had been investigated for PHP. The numberof patients with PHP seen in hospitals in the Asir region is very low.Underdiagnosis seems to be an important factor. Therefore, it is felt thatthere is a need for greater awareness of disease in the region. Furthermore,there is a need for national survey to measure the prevalence of PHP in SaudiArabia. (author)

Investigating Performance Installation of Hospital Room Surgery of Six Hospitals in Special Region of Yogyakarta by Using Data Envelopment Analysis Model Constant Return to Scale

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Bhimo Rizky Samudro

2018-03-01

Full Text Available This study aims to investigate the efficiency level of hospital surgery hospital installation in Special Region of Yogyakarta Province. Research conceptual constructs are based on input and output performance in institutional performance processes. This research approach uses positivist pattern and is derived by quantitative method. This is to explain the efficiency pattern of the installation of hospital and private hospital surgery rooms. The quantitative method chosen is the concept of Data Envelopment Analysis (DEA. The results showed that 1 the installation of a private hospital surgery room tends to be more efficient than government property; 2 the installation of a special hospital surgical hospital is not absolutely more efficient than a public hospital. As a recommendation, this research provides scenario for setting input usage for efficient performance.

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

Science.gov (United States)

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

2018-01-01

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

[Culto a María Santísima y ordenaciones del rezo del Santo Rosario en las parroquias de Salamanca, aprobados por su Obispo Francisco Calderón de la Barca.

OpenAIRE

2015-01-01

"No ha avido en el mundo hombre de sangre cristiana que no creyera [...]" Impreso 2 h. Papel 210x305mm. Conservación mala: hs. muy deterioradas, manchas abundantes, dobleces marcadas, oxidación, bordes envejecidos. Texto en: Castellano. Letra bastarda. Párr. num.: 1-10. Vivas Moreno, Agustín. “Fondos documentales del Archivo Histórico de la Universidad de Salamanca. La colección de Papeles Varios: análisis descriptivo, tesauro y gestión documental automatizada”. Tesis...

Specialized consultant in radiological safety to the Villahermosa regional hospital, PEMEX. III. - September and October of 2002; Asesoria especializada en seguridad radiologica al hospital regional Villahermosa, PEMEX, III.- Septiembre y Octubre de 2002

Energy Technology Data Exchange (ETDEWEB)

Angeles C, A.; Rodriguez A, F.; Garcia A, J

2003-02-15

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

Specialized consultant in radiological safety to the Villahermosa regional hospital, PEMEX. IV. - November and December of 2002; Asesoria especializada en seguridad radiologica al Villahermosa hospital regional, PEMEX, IV.- Noviembre y Diciembre de 2002

Energy Technology Data Exchange (ETDEWEB)

Angeles C, A.; Hernandez C, J.E.; Rodriguez A, F.; Garcia A, J

2003-02-15

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

ASSESSING PATHOLOGIES ON VILLAMAYOR STONE (SALAMANCA, SPAIN BY TERRESTRIAL LASER SCANNER INTENSITY DATA

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J. García-Talegón

2015-02-01

Full Text Available This paper deals with the assessing of pathologies in façades using a variety of intensity data provided by different terrestrial laser scanner. In particular, a complex building built in the Villamayor Stone that is to be candidate as a Global Heritage Stone Resource has been chosen as study case. The Villamayor Stone were quarrying for the construction and ornamentation of monuments in Salamanca, declared World Heritage City by UNESCO in 1988. The objective of this paper is to assess the pathologies of Villamayor Stone and compare the results obtained through the laser techniques with the classical techniques of mapped pathologies (i.e. visual inspection. For that intensity data coming from laser scanners will be used as non-destructive techniques applied to the façades and several retired plaques (after of building restoration of Villamayor Stone with pathologies (fissures, scales, loss of matter, humidity/biological colonization carried to the laboratory. Subsequently it will perform different comparisons between the accuracy reached with the different sensors and a high precision model setup on laboratory which performs as “ground truth”. In particular, the following objectives will be pursued: i accuracy assessment of the results obtained in in situ and laboratory; ii an automation or semi-automation of the detection of pathologies in Villamayor Stone; iii discriminate the different types of Villamayor Stone used in the façades in function of the radiometric response; iv establish a methodology for detection and assessing of pathologies based on laser scanner intensity data applied to monuments and modern buildings built in Villamayor Stone.

Air pollution exposure, cause-specific deaths and hospitalizations in a highly polluted Italian region.

Science.gov (United States)

Carugno, Michele; Consonni, Dario; Randi, Giorgia; Catelan, Dolores; Grisotto, Laura; Bertazzi, Pier Alberto; Biggeri, Annibale; Baccini, Michela

2016-05-01

The Lombardy region in northern Italy ranks among the most air polluted areas of Europe. Previous studies showed air pollution short-term effects on all-cause mortality. We examine here the effects of particulate matter with aerodynamic diameter ≤10µm (PM10) and nitrogen dioxide (NO2) exposure on deaths and hospitalizations from specific causes, including cardiac, cerebrovascular and respiratory diseases. We considered air pollution, mortality and hospitalization data for a non-opportunistic sample of 18 highly polluted and most densely populated areas of the region in the years 2003-2006. We obtained area-specific effect estimates for PM10 and NO2 from a Poisson regression model on the daily number of total deaths or cause-specific hospitalizations and then combined them in a Bayesian random-effects meta-analysis. For cause-specific mortality, we applied a case-crossover analysis. Age- and season-specific analyses were also performed. Effect estimates were expressed as percent variation in mortality or hospitalizations associated with a 10µg/m(3) increase in PM10 or NO2 concentration. Natural mortality was positively associated with both pollutants (0.30%, 90% Credibility Interval [CrI]: -0.31; 0.78 for PM10; 0.70%, 90%CrI: 0.10; 1.27 for NO2). Cardiovascular deaths showed a higher percent variation in association with NO2 (1.12%, 90% Confidence Interval [CI]: 0.14; 2.11), while the percent variation for respiratory mortality was highest in association with PM10 (1.64%, 90%CI: 0.35; 2.93). The effect of both pollutants was more evident in the summer season. Air pollution was also associated to hospitalizations, the highest variations being 0.77% (90%CrI: 0.22; 1.43) for PM10 and respiratory diseases, and 1.70% (90%CrI: 0.39; 2.84) for NO2 and cerebrovascular diseases. The effect of PM10 on respiratory hospital admissions appeared to increase with age. For both pollutants, effects on cerebrovascular hospitalizations were more evident in subjects aged less than

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

Science.gov (United States)

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

2018-01-01

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

Auditing stillbirths at Lower Umfolozi War Memorial Regional Hospital: A 12-month review.

Science.gov (United States)

Govender, I

2017-11-27

Although the total number of stillbirths worldwide was estimated at 2.6 million in 2009, there is currently a dearth of literature on stillbirths in developing countries and rural settings, where the majority of such births occur. The 'Hands Up' Mortality and Morbidity Extraction Tool (HUMMET), developed at Lower Umfolozi War Memorial Regional Hospital (LUWMRH) in 2010, outlines a systematic approach to summarising individual cases of adverse perinatal outcomes. To depict the HUMMET form by describing the detailed demographic and obstetric profile of patients who delivered a stillborn infant at LUWMRH, as well as risk factors associated with these stillbirths between 1 April 2014 and 31 March 2015. The findings add to a global initiative advanced by the Lancet series on stillbirths, aimed at raising awareness of stillbirth statistics in low- and middle-income countries. A total of 310 detailed stillbirth case summaries of 305 patients were collected during the study period, representing 90% of the total number of stillborn infants delivered at LUWMRH. A retrospective audit of the HUMMET forms was conducted and the cases were further summarised in a Microsoft Excel spreadsheet that allowed for a univariate analysis of the variables. The stillbirth rate at LUWMRH is much higher than that at other regional hospitals owing to the number of at-risk referrals and emergency cases from surrounding clinics and district hospitals. Referrals were from local clinics (49%) and district hospitals (45%), 35% of stillbirths were due to abruptio placentae and a large proportion were associated with gestational hypertension, pre-eclampsia and/or eclampsia. Avoidable factors were predominantly a late patient response to reduced fetal movements and delays in transfer to hospital. Twenty percent of stillbirths were associated with inappropriate monitoring or management of the obstetric condition at the district hospital. The HUMMET form provides a systematic approach to analysing cases

Regional supply of outreach service and length of stay in psychiatric hospital among patients with schizophrenia: National case mix data analysis in Japan.

Science.gov (United States)

Niimura, Junko; Nakanishi, Miharu; Yamasaki, Syudo; Nishida, Atsushi

2017-12-01

Several clinical trials have demonstrated that linkage to an outreach service can prevent prolonged length of stay of patients at psychiatric hospitals. However, there has been no investigation of the association between length of stay in psychiatric hospital and regional supply of outreach services using national case mix data. The aim of this study was to clarify the relationship between length of stay in psychiatric hospital and regional supply of outreach services. We used data from the National Patient Survey in Japan, a nationally representative cross-sectional survey of inpatient care conducted every three years from 1996 to 2014. Data from 42,268 patients with schizophrenia who had been admitted to psychiatric hospitals were analyzed. After controlling for patient and regional characteristics, patients in regions with fewer number of visits for psychiatric nursing care at home had significantly longer length of stay in psychiatric hospitals. This finding implies that enhancement of the regional supply of outreach services would prevent prolonged length of stay in psychiatric hospitals. Copyright © 2017 Elsevier B.V. All rights reserved.

The learning curve for laparoscopic colectomy in colorectal cancer at a new regional hospital

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Kuei-Yen Tsai

2016-01-01

Conclusion: Laparoscopic colectomy for colorectal cancer in a new regional hospital is feasible and safe. It does not need additional time for learning. Laparoscopic sigmoidectomy can be considered as the initial surgery for a trainee.

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

Extracorporeal cardiopulmonary resuscitation after out-of-hospital cardiac arrest in a Danish health region.

Science.gov (United States)

Fjølner, J; Greisen, J; Jørgensen, M R S; Terkelsen, C J; Ilkjaer, L B; Hansen, T M; Eiskjaer, H; Christensen, S; Gjedsted, J

2017-02-01

Extracorporeal Cardiopulmonary Resuscitation (ECPR) has emerged as a feasible rescue therapy for refractory, normothermic out-of-hospital cardiac arrest (OHCA). Reported survival rates vary and comparison between studies is hampered by heterogeneous study populations, differences in bystander intervention and in pre-hospital emergency service organisation. We aimed to describe the first experiences, treatment details, complications and outcome with ECPR for OHCA in a Danish health region. Retrospective study of adult patients admitted at Aarhus University Hospital, Denmark between 1 January 2011 and 1 July 2015 with witnessed, refractory, normothermic OHCA treated with ECPR. OHCA was managed with pre-hospital advanced airway management and mechanical chest compression during transport. Relevant pre-hospital and in-hospital data were collected with special focus on low-flow time and ECPR duration. Survival to hospital discharge with Cerebral Performance Category (CPC) of 1 and 2 at hospital discharge was the primary endpoint. Twenty-one patients were included. Median pre-hospital low-flow time was 54 min [range 5-100] and median total low-flow time was 121 min [range 55-192]. Seven patients survived (33%). Survivors had a CPC score of 1 or 2 at hospital discharge. Five survivors had a shockable initial rhythm. In all survivors coronary occlusion was the presumed cause of cardiac arrest. Extracorporeal cardiopulmonary resuscitation is feasible as a rescue therapy in normothermic refractory OHCA in highly selected patients. Low-flow time was longer than previously reported. Survival with favourable neurological outcome is possible despite prolonged low-flow duration. © 2016 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Institutional traps in the hospitality industry financing (by the example of Krasnodar region

Directory of Open Access Journals (Sweden)

Alla Yu. Baranova

2016-09-01

Full Text Available Objective to determine and classify the institutional traps in financing the hospitality industry in Russia. Methods abstractlogical generalization and observation. Results basing on the analysis of statistics and regional program of tourism development in Krasnodar region the challenges and obstacles were identified to the development and improvement of tourist services quality. The research result is the identification and systematization of institutional traps in the financing of tourism expressed in the increased public support of the sector. In particular a significant proportion of touristrecreational sector funding is still taken from the budget though the specific weight of profitable health resort organizations amounted to 60 over the past three years. In the process of research the author formulated a general concept of the institutional structure of the hospitality industry in Russia and the model of the sector financing through a system of incentives and benefits for vacationers forming the tourist clusters and forming a mechanism of dialogue between the authorities and representatives of tourist business. Scientific novelty the institutional traps are defined and systematized which are formed in the system of tourism financing measures to overcome them are proposed. Practical significance the proposed recommendations can be used by the entities of the hospitality industry to enhance business activities and by authorities to implement tasks outlined in the state programs.

Analysis of the Hazard, Vulnerability, and Exposure to the Risk of Flooding (Alba de Yeltes, Salamanca, Spain

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Sergio Veleda

2017-02-01

Full Text Available The present work has developed a method using GIS technology to evaluate the danger, vulnerability, and exposure to the risk of flooding in the Alba de Yeltes area (Salamanca, Spain. It is a non-structural measure for the prevention and mitigation of the risk of extraordinary flooding. After completing a full analysis of the physical environment (climate, geology, geomorphology, hydrology, hydrogeology, and land use, hydrological-hydraulic modeling was carried out using the GeoHecRas river analysis software. The results obtained from the analysis and the models have generated a danger map that facilitates the efficient evaluation of the spatial distribution of the different severity parameters (depth of the watersheet, current flow rate, and flood-prone areas. Also, map algebra and the databases associated with GIS tools, together with the vulnerability and exposure cartography, have allowed the risk to be analyzed in an integrate manner and the production of an environmental diagnostic map. The results of this study propose that there are inhabited areas close to the Yeltes-Morasverdes riverbed that have a high risk of flooding, indicating the need for proper land planning and the implementation of a series of measures that will help to reduce the risk of flooding and its impact.

ANALYSIS OF PREVALENCE, HOSPITALIZATION RATE AND MORTALITY LEVELS RELATED TO GASTROINTESTINAL DISORDERS IN THE MOSCOW REGION

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A. N. Gurov

2015-01-01

Full Text Available Rationale: According to prognosis made by World Health Organization experts, by mid-21st century gastrointestinal disorders will be among the leaders, partially due to lifestyle of a modern man (stress, unhealthy diet, lack of physical exercise, unhealthy habits, environmental pollution, genetically modified and low quality foods.Aim: To provide informational support of activities aimed at improvement of organization of medical care to patients with gastrointestinal disorders and at further development of specialized gastroenterological care to the population of the Moscow Region, its better availability and higher efficacy and quality.Materials and methods: We calculated and analyzed gastrointestinal morbidity in 2014 (according to referrals among the main age categories (children, adolescents, adults of the population of the Moscow Region, as well as hospitalization rates and in-hospital mortality. The information was taken from the Federal Statistical Surveillance report forms # 12 and # 14.Results: In 2014, the highest prevalence of gastrointestinal disorders was registered in adolescents, being by 42.7% higher than that in adults and by 11.7% higher than that in children. The leading causes of referrals in all age categories were gastritis and duodenitis, as well as gall bladder and bile tract disorders. The structure of morbidity was characterized by a high proportion of pancreatic disorders, stomach and duodenal ulcers in adults. The rate of hospitalizations due to gastrointestinal disorders was 17.8 cases per 1000 patients, being 17.4‰ in adults and 19.8‰ in children and adolescents. The main reasons for hospitalization in adults were diseases of pancreas (23.9% of all hospitalization due to gastrointestinal disorders, gall bladder and bile tract disorders (16.3%. In children and adolescents, the main reasons for hospitalizations were intestinal disorders (36.4%, gastritis and duodenitis (17.9%. In-hospital mortality from

Radiological impact due to natural radionuclides (U and Th-isotopes) in soils from Salamanca, Mexico

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Mandujano G, C. D.; Sosa, M. [Universidad de Guanajuato, Division de Ciencias e Ingenierias, Loma del Bosque 103, Col. Lomas del Campestre, 37150 Leon, Guanajuato (Mexico); Mantero, J.; Manjon, G.; Garcia T, R. [Universidad de Sevilla, Grupo en Fisica Nuclear Aplicada, Av. Reina Mercedes No. 2, 41012 Sevilla (Spain); Costilla, R., E-mail: cmandujano@fisica.ugto.mx [Universidad de Guanajuato, Division de Ciencias de la Vida, Departamento de Ciencias Ambientales, Ex-Hacienda El Copal Km 9 Irapuato-Silao, 36500 Irapuato, Guanajuato (Mexico)

2015-10-15

Full text: Activity concentrations of U ({sup 238}U, {sup 234}U) and Th ({sup 232}Th, {sup 230}Th) radionuclides in samples of superficial urban soils surrounding an industrial complex in Salamanca, Mexico have been determined. Levels of naturally occurring radionuclides (Norm) in the environment may be affected due to the presence of different industrial activities in this zone, representing a potential radiological risk for the population which should be evaluated. Alpha-particle Spectrometry with Pips detectors has been used for the radiometric characterization. A well established radiochemical procedure was used for the isolation of the radionuclides of interest. Alkali fusion for sample digestion, liquid-liquid extraction with Tbp (tri-butyl-phosphate) for U and Th isolation and electrodeposition in stainless steel dishes for measurement conditioning has been used. The results cover the ranges of 10-42, 12-60, 12-52 and 11-51 Bq·kg{sup -1} for {sup 238}U, {sup 234}U, {sup 230}Th, and {sup 232}Th respectively, being not observed any clear anthropogenic increments in relation with the values normally found in unaffected soils. Although there is disequilibrium between U isotopes and {sup 230}Th in some soil samples, it can be attributed to natural processes. The radiological impact of the industrial activities in the surrounding soils can be then evaluated as very low. Hence, from the Radiological Protection point of view, the soils studied do not represent a radiological risk for the health of the population. (Author)

“Ego misera et peccatrix…”: El Liber mozarabicus canticorum et horarum (Salamanca, ms. 2668

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Emmanuelle Klinka

2012-06-01

Full Text Available El Liber canticorum et horarum, compuesto para la reina doña Sancha de León y conservado en la Biblioteca General Universitaria de Salamanca (ms. 2668, es un códice de gran interés para estudiar los cambios político-religiosos y culturales que tuvieron lugar a partir de la segunda mitad del siglo XI en el Reino de León. De hecho, sus folios revelan tanto la evolución artística del momento, como la lucha ideológica entre los partidarios del antiguo rito mozárabe y Roma– que terminó por imponer la reforma gregoriana.Le Liber canticorum et horarum, composé pour la reine Sancie de León et conservé à la Bibliothèque générale universitaire de Salamanque (ms. 2668, est un manuscrit d’un grand intérêt quand il s'agit d'étudier les changements politico-religieux et culturels qui ont eu lieu à partir de la seconde moitié du XIe siècle dans le royaume de León. De fait, ses folios révèlent tout autant l'évolution artistique du moment, que la lutte idéologique entre partisans de l'ancien rite isidorien et Rome – qui finit par imposer la réforme grégorienne.

Epidemiological study of Paget's disease of bone in a zone of the Province of Salamanca (spain)

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Mironon-Canelo, J.A.; Del Pino-Montes, J.; Vicente-Arroyo, M.; Saenz-Gonzalez, M.C.

1997-01-01

Bone Paget's disease is heterogeneously distributed and several foci of high prevalence have been reported in Spain. The aim of the present work was to determine the prevalence of the disease in a zone situated in the northwestern sector of the Province of Salamanca (Spain) using a cross sectional epidemiological study. Sample choice was based on a stratified sampling according to the residence, age and sex of the inhabitants of the zone. A sampling error of 5% and a confidence level of 95% were considered; these afforded a sample of 378 units. Final choice of the subjects was based on a random pathway method. Data collection was accomplished with a personal interview using a 31-item questionnaire and analytical screening (AP and GGT). The field work was carried out over a one-year period. The data were input onto a calculation sheet for analysis and epidemiological interpretation. Finally, clinico-radiological confirmation of the cases deemed positive in the screening was accomplished. The prevalence of PBD in the zone studied is 5.7% (95% CI: 4.5-6.9). The highest percentage of patients lies within the age group between 70-79 years; most of these patients were women. The mean residence time in the zone was 66 years. According to the findings, this geographic zone has a high prevalence of PBD

Three cases of Capnocytophaga canimorsus meningitis seen at a regional hospital in one year

DEFF Research Database (Denmark)

Monrad, Rikke Nygaard; Hansen, Dennis Schrøder

2012-01-01

Three cases of meningitis caused by the fastidious Gram-negative rod Capnocytophaga canimorsus have been observed at a regional hospital in 1 y. The difficulties connected with the correct diagnosis by classical culturing methods in contrast to molecular methods, as well as possible reasons...

The change in capacity and service delivery at public and private hospitals in Turkey: a closer look at regional differences.

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Aksan, Hediye A D; Ergin, Işıl; Ocek, Zeliha

2010-11-01

Substantial regional health inequalities have been shown to exist in Turkey for major health indicators. Turkish data on hospitals deserves a closer examination with a special emphasis on the regional differences in the context of the rapid privatization of the secondary or tertiary level health services.This study aims to evaluate the change in capacity and service delivery at public and private hospitals in Turkey between 2001-2006 and to determine the regional differences. Data for this retrospective study was provided from Statistical Almanacs of Inpatient Services (2001-2006). Hospitals in each of the 81 provinces were grouped into two categories: public and private. Provinces were grouped into six regions according to a development index composed by the State Planning Organisation. The number of facilities, hospital beds, outpatient admissions, inpatient admissions (per 100 000), number of deliveries and surgical operations (per 10 000) were calculated for public and private hospitals in each province and region. Regional comparisons were based on calculation of ratios for Region 1(R1) to Region 6(R6). Public facilities had a fundamental role in service delivery. However, private sector grew rapidly in Turkey between 2001-2006 in capacity and service delivery. In public sector, there were 2.3 fold increase in the number of beds in R1 to R6 in 2001. This ratio was 69.9 fold for private sector. The substantial regional inequalities in public and private sector decreased for the private sector enormously while a little decrease was observed for the public sector. In 2001 in R1, big surgical operations were performed six times more than R6 at the public sector whereas the difference was 117.7 fold for the same operations in the same regions for the private sector. These ratios decreased to 3.6 for the public sector and 13.9 for the private sector in 2006. The private health sector has grown enormously between 2001-2006 in Turkey including the less developed

The change in capacity and service delivery at public and private hospitals in Turkey: A closer look at regional differences

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Ergin Işıl

2010-11-01

Full Text Available Abstract Background Substantial regional health inequalities have been shown to exist in Turkey for major health indicators. Turkish data on hospitals deserves a closer examination with a special emphasis on the regional differences in the context of the rapid privatization of the secondary or tertiary level health services. This study aims to evaluate the change in capacity and service delivery at public and private hospitals in Turkey between 2001-2006 and to determine the regional differences. Methods Data for this retrospective study was provided from Statistical Almanacs of Inpatient Services (2001-2006. Hospitals in each of the 81 provinces were grouped into two categories: public and private. Provinces were grouped into six regions according to a development index composed by the State Planning Organisation. The number of facilities, hospital beds, outpatient admissions, inpatient admissions (per 100 000, number of deliveries and surgical operations (per 10 000 were calculated for public and private hospitals in each province and region. Regional comparisons were based on calculation of ratios for Region 1(R1 to Region 6(R6. Results Public facilities had a fundamental role in service delivery. However, private sector grew rapidly in Turkey between 2001-2006 in capacity and service delivery. In public sector, there were 2.3 fold increase in the number of beds in R1 to R6 in 2001. This ratio was 69.9 fold for private sector. The substantial regional inequalities in public and private sector decreased for the private sector enormously while a little decrease was observed for the public sector. In 2001 in R1, big surgical operations were performed six times more than R6 at the public sector whereas the difference was 117.7 fold for the same operations in the same regions for the private sector. These ratios decreased to 3.6 for the public sector and 13.9 for the private sector in 2006. Conclusions The private health sector has grown

[A Survey of the Perception of Nurses Toward the Practice Environment at a Regional Teaching Hospital in Central Taiwan].

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Hung, Jui-Tai; Lin, Ching-Wen; Wen, Wei-Chun; Lin, Esther Ching-Lan

2015-08-01

The nursing practice environment has been shown to wield significant influence on nursing retention and nursing quality of care. Because a large percentage of Taiwan nurses currently work at regional teaching hospitals, exploring the perception toward the practice environment of nurses working at this type of hospital is important. This study explored the perception of nurses working at a regional teaching hospital in central Taiwan toward their practice environment. A cross-sectional research design with a sample of 474 nurses from a regional hospital in central Taiwan was conducted. Instruments including the demographic data and the Chinese-version Practice Environment Scale-Nursing Work Index (CPES-NWI) were anonymously self-administered. Overall, participants were moderately satisfied with their practice environment, with the greatest dissatisfaction focused on staffing and resource adequacy. Work unit and nursing level, respectively, had significant impacts on perceptions regarding the practice environment. Furthermore, discriminant analysis identified two new compound variables: 1) adequate staffing resources and partnership in the workplace and 2) supportive administrative management environment. Participants who worked in medical and surgical units were significantly more dissatisfied with the adequacy of staffing resources and partnership in the workplace than participants who worked in acute/intensive and special units. Participants at the N2 level were significantly more dissatisfied with the supportive nature of the administrative management environment. These findings support that the nursing practice environment of regional hospitals may be improved using several measures, including: modifying the staffing and resource adequacy of nurses, fostering collaborative nurse-physician relationships, and further involving nurses in administrative management and decision-making.

Morbidade Materna Grave e Near Misses em Hospital de Referência Regional

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Márcia Lait Morse

2011-06-01

Full Text Available OBJETIVO: Analisar perfil epidemiológico da morbidade materna grave/near miss em uma maternidade pública de referência regional, utilizando diferentes critérios identificadores. MÉTODOS: Trata-se de um estudo descritivo de corte transversal dos casos de morbidade materna grave/near miss realizado em Hospital de referência regional entre junho e outubro de 2009, identificados a partir dos livros de registro de internação da maternidade e análise dos prontuários clínicos. Foram estudadas mulheres que, durante a gestação, parto ou puerpério, apresentaram qualquer quadro clínico compatível com os critérios definidores de morbidade materna grave/near miss de Waterstone et al., Mantel et al. e Organização Mundial de Saúde. RESULTADOS: Entre as 1.544 internações foram identificadas 89 mulheres com morbidade materna grave, considerando os critérios adotados. As razões de morbidade materna grave/near miss variaram entre 81,4 a 9,4 por 1.000 NV, dependendo do critério utilizado. O índice de Mortalidade foi de 3,2%, chegando a 23% no critério da OMS. Das 89 mulheres, apenas 40% fizeram mais de seis consultas de pré-natal e 10% não realizaram qualquer consulta. Os marcadores mais encontrados foram a pré-eclâmpsia grave seguida de hemorragia grave, internação em UTI, Síndrome HELLP e eclâmpsia. Ocorreram três mortes maternas por causas obstétricas com RMM de 280/100.000 NV e uma morte tardia. O critério da OMS se mostrou mais específico, identificando os casos mais graves, enquanto o de Waterstone foi mais sensível. CONCLUSÃO: O estudo da morbidade materna grave/near miss em um hospital de referência regional pode contribuir para o conhecimento da magnitude deste evento, como também identificar suas características e condições clínicas mais frequentes, sendo extremamente importante para o enfrentamento da morbi-mortalidade materna.OBJECTIVE: To investigate severe maternal morbidity/near misses in a tertiary

Paludismo grave y complicado en niños. Hospital regional de Bata. Guinea Ecuatorial. 2003 Severe and complicated malaria in children at “Bata” Regional Hospital- Equatorial Guinea

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Sandra Hernández García

2005-09-01

Full Text Available El paludismo grave es el causado por el Plasmodium falciparum, que cada año cobra millones de vidas en los países del tercer mundo, siendo los niños los más afectados, por este motivo se realizó estudio prospectivo, descriptivo transversal de los pacientes pediátricos que ingresaron con gota gruesa positiva a plasmodium falciparum, del mes de enero a julio del año 2003 en el hospital regional de Bata en Guinea Ecuatorial. Se encontró que el 49% de los ingresos correspondieron a los niños de 1-4 años, siguiendoles los menores de un año con 34,5% de casos. Se encontró que el 24% de los niños solo permanecieron un día en el hospital y el 67% de 2-5 días. Presentaron complicaciones 35,5% de los ingresados, la anemia severa fue la complicación que más se presentó (17,3%, los trastornos hidroelectrolíticos le siguieron con un 10%. Fallecieron 16 niños, de ellos con anemia severa 10 para (62,5%, con estadía de menos de un día fallecieron 7 pacientes y de 2-5 días otros 7 niños y entre los 6-13 días hubo 2 muertes. La principal recomendación fue que los niños con sospecha de paludismo deben ser atendidos inmediatamente para evitar las graves complicaciones de ésta enfermedad.Severe malaria is caused by Plasmodium falciparum taken millions of lives in Third World countries every year and being children the most affected. A descriptive, prospective, cross "sectional and correlational-casual study was carried out with pediatric patients who were admitted at Bata Regional Hospital in Equatorial Guinea after practicing a thick" film method test with positive results of plasmodium falciparum from January to July 2003, aimed at establishing clinical features of children affected by plasmodium falciparum determining the number of admissions, stay in hospital, complications and mortality, scientific methods used were empiric; analyzing documents and verbal interviews, statistic methods were: parametric samples and percentage

Depression and Associated Factors among Adult Inpatients at Public Hospitals of Harari Regional State, Eastern Ethiopia

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Haile Tilahun

2018-01-01

Full Text Available Introduction. Globally, depression is one of the three leading causes of disease and it will be the second leading cause of world disability by 2030. The prevalence of depression in Sub-Saharan Africa ranges from 15 to 30%. In Ethiopia, depression was found to be the seventh leading cause of disease burden and its prevalence has been increased in hospital compared to community setting because hospital environment itself is stressful. Yet, no study was done in Eastern Ethiopia, where substance use like Khat is very rampant. Objective. To assess depression and associated factors among adult inpatients at public hospitals of Harari Regional State, Eastern Ethiopia, from February 01 to 28, 2017. Methodology. Hospital based cross-sectional study design was employed on 492 admitted adult patients in Harari region hospitals. Consecutive sampling method was used to include study population. The data were collected by interviewee and analyzed by SPSS version 20.0. Bivariate and multivariate logistic regression analyses were employed. p value of 0.05 or less was considered to be statistically significant. Result. A total of 489 patients were interviewed with response rate of 99.4%. Having duration of 1-2 weeks in the hospital [AOR = 2.02, 95% CI: (1.28, 3.19], being diagnosed with chronic morbidity [AOR = 4.06, 95% CI: (2.23, 7.40], being users of psychoactive drugs [AOR = 2.24, 95% CI: (1.18, 4.24], and having been admitted to surgical ward [AOR = 0.50, 95% CI: (0.31, 0.81] were significantly associated with depression. Conclusion and Recommendation. Prevalence of depression among admitted inpatients was high. Therefore, increasing the awareness of benefits of early diagnosis of patients to prevent major form of depression and strengthening the clinical set-up and establishing good referral linkage with mental health institutions was considered to be cost-effective method to reduce its prevalence.

[Regional anaesthesia as advantage in competition between hospitals. Strategic market analysis].

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Heller, A R; Bauer, K R; Eberlein-Gonska, M; Albrecht, D M; Koch, T

2009-05-01

The German Social Act V section sign 12 is aimed towards competition, efficiency and quality in healthcare. Because surgical departments are billing standard diagnosis-related group (DRG) case costs to health insurance companies, they claim best value for money for internal services. Thus, anaesthesia concepts are being closely scrutinized. The present analysis was performed to gain economic arguments for the strategic positioning of regional anaesthesia procedures into clinical pathways. Surgical procedures, which in 2005 had a relevant caseload in Germany, were chosen in which regional anaesthesia procedures (alone or in combination with general anaesthesia) could routinely be used. The structure of costs and earnings for hospital services, split by types and centres of cost, as well as by underlying procedures are contained in the annually updated public accessible dataset (DRG browser) of the German Hospital Reimbursement Institute (InEK). For the year 2005 besides own data, national anaesthesia staffing costs are available from the German Society of Anaesthesiology (DGAI). The curve of earnings per DRG can be calculated from the 2005 InEK browser. This curve intersects by the cost curve at the point of national mean length of stay. The cost curve was calculated by process-oriented distribution of cost centres over the length of stay and allows benchmarking within the national competitive environment. For comparison of process times data from our local database were used. While the InEK browser lacks process times, the cost positions 5.1-5.3 (staffing costs anaesthesia) and the national structure adjusted anaesthesia staffing costs 2005 as published by the DGAI, were used to calculate nationwide mean available anaesthesia times which were compared with own process times. Within the portfolio diagram of lengths of stay for each DRG and process times most procedures are located in the economic lower left, in particular those with high case mix (length of stay and

[Integration of district psychiatric hospitals into the development of regional community psychiatry networks--the actual state. Results of a survey among medical directors of Bavarian district hospitals].

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Welschehold, Michael; Kraus, Eva

2004-11-01

In this study, the medical directors of all Bavarian district psychiatric hospitals evaluated certain aspects of the integration of their hospitals into the development of regional community psychiatry networks ("Gemeindepsychiatrische Verbunde" - GPVs). They were asked to rate the actual quantity of cooperation between their hospitals and diverse community based services and to express their requests concerning the quality of cooperation. An estimation of possible advantages of the hospitals' integration in GPVs and expectations to future perspectives of GPV development were also investigated. The data were collected by a written questionnaire. The results of the survey indicate that a high relevance is attached to GPV: inspite of current heterogenous developments and inspite of existing skepticism concerning the feasibility of a complete GPV structure, medical directors strongly approve of seeing their hospitals actively engaged in the further development of community psychiatry networks.

Cephalic region war injuries in children: Experience in French NATO hospital in Kabul Afghanistan.

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Chehab, Hussam El; Agard, Emilie; Dot, Corinne

2018-06-09

The NATO KAIA Hospital (Kabul International Airport), under French command, provided medical support for NATO forces in the Kabul region from 2009 to 2014. Medical assistance to civilians was an additional mission which included support for children who were war injured. The objective of this study was to analyze characteristics of cephalic injuries in children victims of war trauma. A retrospective study was conducted and commenced with the hospital opening (July 2009) to March 2012 on all children (<15years) with war trauma. We distinguished cephalic lesions in cranial (neuro-surgical), ophthalmological and neck regions. We analyzed mechanism, region, severity score, surgeries and resuscitation efforts. 217 children were operated on with 81 war traumas (mean age 10.2years). 36 children (44.4%) had a cephalic injury. 52.9% of the injured had an ophthalmological injury, 38.2% a cranial region injury and 29.4% a neck lesion. Mortality rate was 5.6% (1 hemorrhagic shock and 1 cerebral wound) in this cephalic lesion group. Ophthalmic injuries were the most common of cephalic injuries; 19 children of which 7 had a bilateral injury (26 eyes). In this group, fragmentary injuries were the most frequent (64% of eyes). In cerebral lesion group, the lesions were linked to a bullet or a shrapnel in 9 of 13 children. This mechanism systematically caused a crania-cerebral wound. Explosion (fragmentary and shrapnel) was the most important in the neck lesions (7 children of 10). The cephalic lesions were the second most common region in children during our experience in Afghanistan. Lack of protection (helmet) in children may explain the frequency of cephalic wounds. Copyright © 2018 Elsevier Ltd. All rights reserved.

Condición somática de la almeja Polymesoda solida (Veneroidea: Corbiculidae durante el periodo lluvioso, enel Parque Natural Isla de Salamanca, Caribe colombiano

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María Virginia De La Hoz Aristizábal

2010-03-01

Full Text Available Se evaluó la condición somática de la almeja Polymesoda solida en tres lagunas del Parque Isla de Salamanca (abril a noviembre de 2004, durante el periodo lluvioso. En 60 individuos por laguna, se analizaron mensualmente índices de condición, rendimiento, relación talla-peso y madurez gonadal en fresco. También se midió salinidad, temperatura, pH, oxígeno disuelto, transparencia y profundidad del agua. Los mayores índices de condición coincidieron con descensos en el nivel del río Magdalena, especialmente en Poza Verde y El Torno. Estos índices fueron más altos en tallas entre 27mm y 33mm, donde también se ubicó la talla media de madurez sexual. En Poza Verde, laguna con mayor influencia del río, se presentaron los mayores índices de condición, rendimiento, peso húmedo y frecuencia de madurez, revelando una mejor condición de los organismos. El índice de condición (peso cuerpo/ peso concha presentó mayor coeficiente de regresión múltiple con la salinidad, pH y transparencia, sugiriendo la importancia del régimen hidrológico en su regulación. Las diferencias espaciales en las variables evaluadas, resaltan la necesidad de tener en cuenta la heterogeneidad de este tipo de estuarios para la conservación y manejo adecuado de la pesquería de P. solida.Somatic condition of the clam Polymesoda solida (Veneroidea: Corbiculidae in the rainy season of the Salamanca Island Natural Park, Colombian Caribbean. The estuarine clam Polymesoda solida is the main fishery resource in the Salamanca Island Natural Park. I sampled the clam in three interconnected lagoons (Poza Verde, El Torno and Atascosa during the rainy period (April to November 2004. Sixty individuals were monthly collected by hand on each lagoon; 30 to analyze two condition indexes (relationship between body and shell weight and between soft dry and wet weight, yield (meat percentage and length-weight relationships. Maturity of female gonad smears was assessed on the

Safe injections and waste management among healthcare workers at a regional hospital in northern Tanzania.

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Nilsson, Josefine; Pembe, Andrea B; Urasa, Miriam; Darj, Elisabeth

2013-01-01

Unsafe injections and substandard waste management are public health issues exposing healthcare workers and the community to the risk of infections. The objective of this study was to assess the knowledge and practice of safe injections and health care waste management among healthcare workers at a regional hospital in northern Tanzania. This cross sectional descriptive study was conducted in a regional hospital in northern Tanzania. Data was collected through a self-administered questionnaire with additional observations of the incinerator, injections, waste practices, and the availability of medical supplies. Data was analysed in SPSS descriptive statistics and chi-square tests were performed. A total of 223 of 305 (73%) healthcare workers from different cadres were included in the study. The majority of healthcare workers had adequate knowledge and practice of safe injections, but inadequate knowledge about waste management. The majority of the staff reported knowledge of HIV as a risk factor, however, had less knowledge about other blood-borne infections. Guidelines and posters on post exposure prophylaxes and waste management -were present at the hospital, however, the incinerator had no fence or temperature gauge. In conclusion, healthcare workers reported good knowledge and practice of injections, and high knowledge of HIV transmission routes. However, the hospital is in need of a well functioning incinerator and healthcare workers require sufficient medical supplies. There was a need for continual training about health care waste management and avoidance of blood-borne pathogens that may be transmitted through unsafe injections or poor health care waste management.

Evaluation of hospital-learning environment for pediatric residency in eastern region of Saudi Arabia

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Waleed H. BuAli

2015-04-01

Full Text Available Purpose: No study had been conducted to assess the hospitals’ environment for learning purposes in multicenter sites in Saudi Arabia. It aims to evaluate the environment of hospitals for learning purposes of pediatric residents. Methods: We applied Postgraduate Hospital Educational Environment Measure (PHEEM to measure the learning environment at six teaching hospitals in the Eastern Region of Saudi Arabia from September to December 2013. Results: The number of respondents was 104 (86.7% out of 120 residents and 37 females and 67 male residents have responded. The residents’ response scored 100 out of 160 maximum score in rating of PHEEM that showed overall learning environment is favorable for training. There were some items in the social support domain suggesting improvements. There was no significant difference between male and female residents. There was a difference among the participant teaching hospitals (p<0.05. Conclusion: The result pointed an overall positive rating. Individual item scores suggested that their social life during residency could be uninspiring. They have the low satisfactory level and they feel racism, and sexual discrimination. Therefore, there is still a room for improvement.

Advancing obstetric and neonatal care in a regional hospital in Ghana via continuous quality improvement.

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Srofenyoh, Emmanuel; Ivester, Thomas; Engmann, Cyril; Olufolabi, Adeyemi; Bookman, Laurel; Owen, Medge

2012-01-01

To reduce maternal and neonatal death at a large regional hospital through the use of quality improvement methodologies. In 2007, Kybele and the Ghana Health Service formed a partnership to analyze systems and patient care processes at a regional hospital in Accra, Ghana. A model encompassing continuous assessment, implementation, advocacy, outputs, and outcomes was designed. Key areas for improvement were grouped into "bundles" based on personnel, systems management, and service quality. Primary outcomes included maternal and perinatal mortality, and case fatality rates for hemorrhage and hypertensive disorders. Implementation and outcomes were evaluated tri-annually between 2007 and 2009. During the study period, there was a 34% decrease in maternal mortality despite a 36% increase in patient admission. Case fatality rates for pre-eclampsia and hemorrhage decreased from 3.1% to 1.1% (Pcontinuous quality improvement were developed and employed. Copyright © 2011 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Benefits of an ISO 9001 certification--the case of a Swiss regional hospital.

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Staines, A

2000-01-01

This paper reports the experience of a quality management project leading to an ISO 9001 certification in a Swiss regional hospital. It describes the motivations for the project, the process that was followed and the benefits of the approach. It also shows its limitations, problems encountered as well as costs and resources involved. The emphasis is on practical issues. Choices that were made are discussed and lessons are drawn.

Specialized consultant in radiological safety to the Villahermosa regional hospital, PEMEX. III. - September and October of 2002

International Nuclear Information System (INIS)

Angeles C, A.; Rodriguez A, F.; Garcia A, J.

2003-02-01

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

Specialized consultant in radiological safety to the Villahermosa regional hospital, PEMEX. IV. - November and December of 2002

International Nuclear Information System (INIS)

Angeles C, A.; Hernandez C, J.E.; Rodriguez A, F.; Garcia A, J.

2003-02-01

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

Rotavirus Infection in the Auckland Region After the Implementation of Universal Infant Rotavirus Vaccination: Impact on Hospitalizations and Laboratory Implications.

Science.gov (United States)

McAuliffe, Gary N; Taylor, Susan L; Drinković, Dragana; Roberts, Sally A; Wilson, Elizabeth M; Best, Emma J

2018-01-01

In July 2014, New Zealand introduced universal infant vaccination with RotaTeq (Merk & Co.) administered as 3 doses at 6 weeks, 3 and 5 months of age. We sought to assess the impact of rotavirus vaccination on gastroenteritis (GE) hospitalizations in the greater Auckland region and analyze changes in rotavirus testing in the period around vaccine introduction. Hospitalizations, laboratory testing rates and methods were compared between the pre-vaccine period (2009-2013), post-vaccine period (January 2015 to December 2015) and year of vaccine introduction (2014). There was a 68% decline in rotavirus hospitalizations of children Auckland region. However, continued rotavirus testing at pre-vaccine rates risks generating false positive results. Laboratories and clinicians should consider reviewing their testing algorithms before vaccine introduction.

The acceptability of volunteer, repeat blood donations in a hospital setting in the Adamaoua region of Cameroon.

Science.gov (United States)

Rolseth, S; Stange, P; Adamou, D; Roald, B; Danki-Sillong, F; Jourdan, P

2014-12-01

The knowledge of factors that may influence blood donation in Cameroon is limited. The objectives of this study are to assess the characteristics of previous and potential blood donors by exploring the religious beliefs, and knowledge and understanding of blood donations among individuals present at a district hospital. Forty-nine in-depth, semi-structured interviews were conducted among consenting, randomly selected 18 years or older community members present at a district hospital in the Adamaoua region during October and November 2011. Ninety-eight per cent (48/49) of the individuals present at this district hospital had heard of blood transfusions. Forty-seven per cent (23/49) had not previously been asked to donate blood; however, 94% (44/47) said that they would donate if given the opportunity. Thirty-three per cent (16/49) had previously donated blood to family members or for replacement, and 81% of these said they would repeat donations. The majority of both donors and non-donors were motivated to donate blood for altruistic reasons. The findings suggest that community members present at this district hospital in Cameroon may be recruited for repeat blood donations. Although the altruistic motivation to donate blood suggests that donors could be recruited from a district hospital population, targeted information about blood donations and accessible blood transfusion services need to be put in place. The study may add to the understanding of the preconditions for blood donations and the possibility to establish sustainable blood transfusion services in the Adamaoua region in Cameroon. © 2014 British Blood Transfusion Society.

Register study of migrants' hospitalization in Norway: world region origin, reason for migration, and length of stay.

Science.gov (United States)

Elstad, Jon Ivar

2016-07-26

The proportion of migrants and refugees increase in many populations. Health planners have to consider how migration will influence demand for health care. This study explores how migrants' geographical origin, reason for migration, and duration of residence are associated with admission rates to somatic hospitals in Norway. Sociodemographic information on all individuals residing in Norway at the start of 2008 was linked to data on all admissions to somatic hospitals during 2008-2011. Migrants, age 30-69, who had come to Norway during 1970-2007 (N = 217,907), were classified into seven world region origins and compared with native Norwegians of the same age (N = 2,181,948). Any somatic hospital stay 2008-2011 and number of hospital admissions 2008-2011 per 1000 personyears for a set of somatic diagnoses were analyzed by age and gender standardized rates, linear probability models, and Poisson regression. In the native Norwegian sample, 28.7 % had at least one admission 2008-2011, and there were 116 admissions per 1000 personyears. Corresponding age and gender adjusted figures for the migrant sample were 27.0 % and 103 admissions. Admission rates varied with migrants' geographical origin, with relatively many admissions among migrants from West and South Asia and relatively few admissions among migrants from Western, East European, and Other Asian countries. Hospitalization varied strongly with reason for migration, with low admission rates for recent work migrants and high admission rates for recent refugees. Admission rates tended to move towards the level among native Norwegians with increasing length of stay. Among longstanding migrants (arrival period 1970-1989), admission rates were close to the levels of native Norwegians for most analyzed migrant categories. Both world region origin, reason for migration, and duration of residence are important sources for variations in migrants' utilization of somatic hospitals. Forecasts about migrants' use of

Estrés Laboral en Médicos Residentes del Hospital Nacional Carlos Alberto Seguín Escobedo y del Hospital Regional Honorio Delgado Espinosa. Arequipa, 2015

OpenAIRE

Mazeyra Guillén, Alvaro Augusto

2017-01-01

El presente estudio tuvo como objetivos determinar el estrés laboral en los médicos residentes del Hospital “Carlos Alberto Seguín Escobedo” de EsSalud (HNCASE). y del Hospital Regional “Honorio Delgado Espinosa” (HRHDE) y establecer las semejanzas y diferencias del estrés laboral de los médicos residentes de ambos hospitales. La población estuvo conformada por 220 médicos residentes de primero, segundo y tercer año de residencia. Se aplicó el muestreo al azar estratifica...

[Hospital emergencies arising from nursing homes in a region: evolution, characteristics and appropriateness].

Science.gov (United States)

Sánchez-Pérez, Inma; Comes Garcia, Nuri; Romero Piniella, Lola; Prats Martos, Gemma; Arnau Bataller, Gemma; Coderch, Jordi

Hospital emergencies (HE) arising from nursing homes (NH) are on the rise. We analyse the evolution, characteristics and appropriateness of HE of NH residents in a region, as well as resulting hospital admissions. Retrospective descriptive study between 2010 and 2013 of institutionalised residents of 11 NH located in Baix Empordà (704 beds) and Palamós Hospital. Gender, age, morbidity and relative weight according to clinical risk groups (CRG), NH, length of stay, diagnosis of the emergency, appropriateness of HE according to Bermejo's criteria and the HE appropriateness protocol (HEAP), and appropriateness of hospitalisations according to the Appropriateness Evaluation Protocol (AEP). Sample to evaluate appropriateness: 159 HE and 91 hospitalisations. frequency, mean, standard deviation, percentiles, Fisher's exact test and ANOVA, with a confidence interval of 95% and using IBM SPSS Statistics 23. 1,474 people were enrolled, of which 73% were women. Group ≥85 years increased to 60.3% and the mean weight of morbidity was 3.2 to 4.0 (p <0.001). 1,805 HE were generated. The annual rate per 1,000 stays arising from NH increased from 1.64 to 2.05, of which 90.6% were appropriate according to Bermejo's criteria and 93.7% according to the HEAP. Of these, 502 involved hospitalisation. The annual rate per 10 emergencies fell from 2.96 to 2.64 and 98.9% were appropriate according to the AEP. Hospital emergencies and hospitalisations of NH residents are increasing and are appropriate. Increasing age and disease burden could explain this phenomenon. NH and hospitals should react appropriately, considering the specific needs of this population sector. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Electronic health record use in an affluent region in India: Findings from a survey of Chandigarh hospitals.

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Powell, Adam C; Ludhar, Jasmine K; Ostrovsky, Yuri

2017-07-01

To characterize the electronic health record (EHR) systems in use in an affluent region of India in order to understand the state-of-the-art within the Indian market. A survey on EHR features was created by combining an instrument developed by the Organisation for International Cooperation and Development and an instrument developed by an American team of researchers. An interviewer directly administered the survey to leaders from hospitals in greater Chandigarh which possessed electronic health information systems. Summary statistics from the survey are reported. 24 hospitals offering multi-specialty inpatient care were identified in greater Chandigarh. 18 of these hospitals had electronic health information systems, 17 of which were interviewed. Of the hospitals with systems, 17 (100%) could access patient demographic information internally, but 12 (71%) could not access vital sign, allergy, or immunization data internally. 11 (65%) of the systems were capable of sharing patient summaries internally, but 13 (76%) could not send electronic referrals internally. Among organizations which have adopted systems, major barriers tend to have been around financial and staff matters. Concerns over interoperability, privacy, and security were infrequently cited as barriers to adoption. EHRs are ubiquitous in at least one region of India. Systems are more likely to have capabilities for intra-organizational information sharing than for inter-organizational information sharing. The availability of EHR data may foster clinical research. Copyright © 2017 Elsevier B.V. All rights reserved.

Determinants of regional labour productivity growth: A study for the hospitality sector in Spain

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Bienvenido Ortega Aguaza

2013-01-01

Full Text Available The aim of this paper is to analyze the determinants of labour productivity growth in the hospitality industry in Spain using regional data over the period 1996-2004. The results obtained suggest that the increase in the number of 3-star hotels and the reduction process in the stock of physical capital per worker are factors which may have contributed to the fall in productivity growth. However, increased regional tourism intensity has a positive impact on the growth of labour productivity. Nonetheless, changes in demand-related factors, such as average length of stay and the seasonality of demand, have not had a significant aggregate impact on labour productivity growth during this period.

Hospital pharmacy workforce in Brazil.

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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.

National and Regional Representativeness of Hospital Emergency Department Visit Data in the National Syndromic Surveillance Program, United States, 2014

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Coates, Ralph J.; Pérez, Alejandro; Baer, Atar; Zhou, Hong; English, Roseanne; Coletta, Michael; Dey, Achintya

2016-01-01

Objective We examined the representativeness of the nonfederal hospital emergency department (ED) visit data in the National Syndromic Surveillance Program (NSSP). Methods We used the 2012 American Hospital Association Annual Survey Database, other databases, and information from state and local health departments participating in the NSSP about which hospitals submitted data to the NSSP in October 2014. We compared ED visits for hospitals submitting 15 data with all ED visits in all 50 states and Washington, DC. Results Approximately 60.4 million of 134.6 million ED visits nationwide (~45%) were reported to have been submitted to the NSSP. ED visits in 5 of 10 regions and the majority of the states were substantially underrepresented in the NSSP. The NSSP ED visits were similar to national ED visits in terms of many of the characteristics of hospitals and their service areas. However, visits in hospitals with the fewest annual ED visits, in rural trauma centers, and in hospitals serving populations with high percentages of Hispanics and Asians were underrepresented. Conclusions NSSP nonfederal hospital ED visit data were representative for many hospital characteristics and in some geographic areas but were not very representative nationally and in many locations. Representativeness could be improved by increasing participation in more states and among specific types of hospitals. PMID:26883318

Strategies to promote health and prevent musculoskeletal injuries in students from the high conservatory of music of Salamanca, Spain.

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Martín López, Tomás; Farías Martínez, Joaquín

2013-06-01

The present investigation was intended to evaluate the effectiveness of a course on health and the prevention of musculoskeletal injuries in future professional musicians, specifically designed for superior-grade students at the High Conservatory of Music of Salamanca, Spain. Students were taught how to evaluate the possible risks associated with the practice of their instruments. They were provided with information about the most frequent medical problems of musicians, warm-up habits, postural hygiene, effective prevention strategies, and different treatment options for these pathologies. The students were randomly divided into two groups: a control group (n=56) who did not take the course and was evaluated with a questionnaire at the beginning of the academic year and 1 year later, and an experimental group (n=90) who did take the course and was evaluated with three questionnaires (at the beginning of the course, 6 months later, and 12 months after the start of the course). While the students in the experimental group improved their body awareness by 91% and the frequency of their injuries decreased by 78%, there was no improvement in the students from the control group at the end of the experiment. The results of our study have demonstrated the effectiveness of this type of course and show that such courses should be included in the academic curriculum of superior conservatories.

Fraud Prevention A Study In Regional Public Service Agency BLUD For Hospital In Malang Regency Indonesia

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Koenta Adji Koerniawan

2017-04-01

Full Text Available This study aims to understand the effect of management perceptions in Regional Public Service Agency BLUD for Hospital in Malang regency Indonesia on the role of the Independent Auditor and their understanding towards Good Governance the General Audit Engagement and its implications for the prevention of corruption. This research is quantitative which placed latent variables General Audit Engagements as intervening variables. Partial Least Square PLS is used to confirm the model created in order to explain the relationship between variables. The results show that the perception of BLUD hospital management on the role of independent auditors and their understanding of good governance to give effect to the implementation of the audit engagement and the implications for the prevention of fraud in BLUDs hospital. This is consistent with the theory of auditing and fraud prevention concepts. JEL Classification M420 K420

Why does it take so long? ‘Lean processing’ in the aseptic compounding unit at the Midland Regional Hospital Tullamore

LENUS (Irish Health Repository)

Greene, C

2011-06-01

Increasing numbers of oncology\\/haematology patients attending Midland Regional Hospital Tullamore (MRHT) has increased the workload of the Regional Oncology Haematology Pharmacy (ROHP) compounding unit. Staff restrictions require optimisation of current workflow practices. This audit (November 2010 and June 2011) focused on workflow in the aseptic compounding unit.\\r\

Tissue banking in a regional hospital: a promising future concept? First report on fresh frozen tissue banking in a hospital without an integrated institute of pathology.

Science.gov (United States)

von Strauss und Torney, Marco; Güller, Ulrich; Rezaeian, Farid; Brosi, Philippe; Terracciano, Luigi; Zuber, Markus

2012-10-01

Vital tissue provided by fresh frozen tissue banking is often required for genetic tumor profiling and tailored therapies. However, the potential patient benefits of fresh frozen tissue banking are currently limited to university hospitals. The objective of the present pilot study--the first one in the literature--was to evaluate whether fresh frozen tissue banking is feasible in a regional hospital without an integrated institute of pathology. Patients with resectable breast and colon cancer were included in this prospective study. Both malignant and healthy tissue were sampled using isopentan-based snap-freezing 1 h after tumor resection and stored at -80 °C before transfer to the main tissue bank of a University institute of pathology. The initial costs to set up tissue banking were 35,662 US$. Furthermore, the running costs are 1,250 US$ yearly. During the first 13 months, 43 samples (nine samples of breast cancer and 34 samples of colon cancer) were collected from 41 patients. Based on the pathology reports, there was no interference with standard histopathologic analyses due to the sample collection. This is the first report in the literature providing evidence that tissue banking in a regional hospital without an integrated institute of pathology is feasible. The interesting findings of the present pilot study must be confirmed by larger investigations.

Neglected roots of regionalism? The Commissioners for the special areas and grants to hospital services in the 1930s.

Science.gov (United States)

Mohan, J

1997-08-01

The inter-war years in the UK were notable for debates about the extent to which an extension of state intervention in hospital provision was desirable and necessary, and about the limits to and future of the voluntary hospital system which relied largely on various forms of private charity. These themes were intertwined in the UK's 'Special Areas', locations recognized as having suffered adversely from the inter-war depression, with consequent effects on their ability to finance desirable investments in social infrastructures. Grant aid was offered to hospitals in these locations under the terms of the Special Areas legislation of 1934, but there were extensive debates about the principle and practice of such subsidies to hospital development. This paper reviews these debates and considers whether the measures taken by the Commissioners can be seen as neglected antecedents of the regionalism detected in British hospital policy by several commentators.

Making regional facility location decisions: the example of Hospital do Oeste Norte, Portugal

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Jorge Gonçalves

2014-11-01

Full Text Available This paper seeks to contribute to the debate on the decision-making process for the location of large public facilities, responding to the growing demand for greater rationality in public investment whilst still offering services of quality and addressing the problem of spatial friction. The specific problem analysed in this paper is the need to define the best location for a public hospital in a particular region of Portugal. The singularity of the approach adopted lies above all in the seg- mentation into macro-location and micro-location.

Hospital Workers' Awareness of Health and Environmental Impacts of Poor Clinical Waste Disposal in the Northwest Region of Cameroon

DEFF Research Database (Denmark)

Mochungong, Peter I K; Gulis, Gabriel; Sodemann, Morten

2010-01-01

a survey to evaluate hospital workers' awareness of health and environmental impacts of poor clinical waste disposal in Cameroon. We randomly distributed 500 questionnaires to hospital workers in three hospitals in the Northwest Region of Cameroon in April 2008. In addition, we observed collection......Due to the infectious nature of some clinical waste, poor disposal practices have sparked concern regarding the impact on public health and the environment. Lack of sufficient knowledge of the associated risks may be a strong factor contributing to inadequate disposal practices. We conducted......, segregation, transportation, and disposal of clinical waste at the three hospitals. Of 475 total respondents, most lacked sufficient awareness of any environmental or public health impacts of poor clinical waste disposal and had never heard of any policy--national or international--on safe clinical waste...

[Public health impact of a remote diagnosis system implemented in regional and district hospitals in Paraguay].

Science.gov (United States)

Galván, Pedro; Velázquez, Miguel; Benítez, Gualberto; Ortellado, José; Rivas, Ronald; Barrios, Antonio; Hilario, Enrique

2017-06-08

Determine the viability of a remote diagnosis system implemented to provide health care to remote and scattered populations in Paraguay. The study was conducted in all regional and general hospitals in Paraguay, and in the main district hospitals in the country's 18 health regions. Clinical data, tomographic images, sonography, and electrocardiograms (ECGs) of patients who needed a diagnosis by a specialized physician were entered into the system. This information was sent to specialists in diagnostic imaging and in cardiology for remote diagnosis and the report was then forwarded to the hospitals connected to the system. The cost-benefit and impact of the remote diagnosis tool was analyzed from the perspective of the National Health System. Between January 2014 and May 2015, a total of 34 096 remote diagnoses were made in 25 hospitals in the Ministry of Health's telemedicine system. The average unit cost of remote diagnosis was US$2.6 per ECG, tomography, and sonography, while the unit cost of "face-to-face" diagnosis was US$11.8 per ECG, US$68.6 per tomography, and US$21.5 per sonography. As a result of remote diagnosis, unit costs were 4.5 times lower for ECGs; 26.4 times lower for tomography, and 8.3 times lower for sonography. In monetary terms, implementation of the remote diagnosis system during the 16 months of the study led to average savings of US$2 420 037. Paraguay has a remote diagnosis system for electrocardiography, tomography, and sonography, using low-cost information and communications technologies (ICTs) based on free software that is scalable to other types of remote diagnostic studies of interest for public health. Implementation of remote diagnosis helped to strengthen the integrated network of health services and programs, enabling professionals to optimize their time and productivity, while improving quality, increasing access and equity, and reducing costs.

The Factors Influencing Economic Efficiency of the Hospital Bed Care in Terms of the Regional Allowance Organizations

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Vaňková Ivana

2014-09-01

Full Text Available This paper aims to provide an efficiency evaluation of selected hospital bed care providers during years 2010 -2012 with respect to selected factors: The size of the hospital establishment according to number of beds, number of hospitalized patients, the average length of stay per a patient in care, total staff cost calculated per bed, total revenues calculated per bed, and total costs calculated per bed. For this purpose, hospitals providing primarily acute bed care were chosen. From the legal point of view, they are allowance organizations of a particular region. The evaluation concerns both allocative efficiency and technical efficiency. The allocative efficiency is treated from the proper algorithm point of view and it compares total costs calculated per bed with total revenues calculated per bed. A method denominated Data Envelopment Analysis was applied for the calculation of the technical efficiency of units. To be more specific, it was input-oriented model with constant returns to scale (CCR. The input parameters involve the number of beds, the average length of stay and costs per day of stay. Output parameters were as follows: Bed occupancy in days and the number of hospitalized patients. The data published by the Institute of Health Information and Statistic of the Czech Republic and by ÚFIS system (the Data Base of Ministry of Finance of the Czech Republic were used as the source of data. The evaluation implies that only three hospitals were economically-effective: Silesian Hospital in Opava, Hospital Jihlava, and TGM Hospital Hodonín. The most significant factor influencing the efficiency was determined - the average length of stay.

[Analysis of hospital mortality at a regional hospital].

Science.gov (United States)

Sánchez Bisonó, J R; Gómez Rosich, A; Amor Gea, J F; García Sánchez, M J; Campoy Domene, L F; Peña Migallón-Sánchez, P

1997-02-01

The hospital mortality rate in our centre es 2.34% (264 deaths from a total of 11,336 discharges between 1991 and 1993). The most frequent causes are acute myocardial infarction and cerebrovascular accidents, followed in descending order by pneumonia, chronic bronchitis, congestive heart failure, upper GI haemorrhage, GI tumours, liver cirrhosis, lung tumours and arrhythmias. Our analysis reflects a mortality pattern of a rural population with an age pyramid in which 52% of the patients are older than 45 years. The pattern also reflects the little impact of accidents on our mortality. A 87% of the deaths were older than 65 years with a male to female ratio of 1, 6 and a Swaroop index of 93% and 94% for males and females respectively.

Retrospective audit of antimicrobial prescribing practices for acute exacerbations of chronic obstructive pulmonary diseases in a large regional hospital.

Science.gov (United States)

Brownridge, D J; Zaidi, S T R

2017-06-01

Chronic obstructive pulmonary disease (COPD) is associated with significant morbidity and mortality, and frequent exacerbations are associated with an increased risk of death, deterioration in lung function and reduced quality of life. Current Australian guidelines developed by the Lung Foundation of Australia (the COPD-X Plan) recommends the use of a short course of corticosteroids and oral antibiotics (amoxycillin or doxycycline) as part of the treatment of an AECOPD; however, it was noted that clinical practice at the study hospital had deviated from these guidelines. To evaluate the antibiotic prescribing practices in acute exacerbations of chronic obstructive pulmonary disease (AECOPD) patients, and to compare the differences in clinical outcomes (primarily mean length of stay and the rate of unplanned readmissions) between patients who received broad- vs. narrow-spectrum antibiotics in a large regional hospital. Retrospective audit of medical records for patients admitted with uncomplicated AECOPD during January-September, 2014 in a 224 acute bed regional hospital in Victoria, Australia. Fifty-nine per cent of patients received broad-spectrum antibiotics (ceftriaxone), whereas only 10% of prescriptions were concordant with current Australian guideline recommendations. Patients receiving a broad-spectrum regimen were more likely to be older (74·9 vs. 69·9 years; P = 0·009), have a higher COPD severity score (i.e. BAP-65 score, 1·55 vs. 1·06; P = 0·002) and a higher CRP (59·2 vs. 25·5 mg/L; P = 0·003) on admission. The mean LOS was not significantly different between those who received ceftriaxone and those who did not (5·09 vs. 4·55 days; P = 0·47). There was no significant difference between the groups in rates of readmissions. The antibiotic prescribing patterns for AECOPD in rural and regional Australian hospitals have not previously been examined in the current literature. In the study hospital, the majority of patients received broad

Impact of an antimicrobial stewardship intervention on appropriateness of prescribing for community-acquired pneumonia in an Australian regional hospital.

Science.gov (United States)

Bond, Stuart E; Boutlis, Craig S; Yeo, Wilfred W; Miyakis, Spiros

2017-05-01

Community-acquired pneumonia (CAP) is the second commonest indication for antibiotic use in Australian hospitals and is therefore a frequent target for antimicrobial stewardship. A single-centre prospective study was conducted in a regional referral hospital comparing management of adult patients with CAP before and after an educational intervention. We demonstrated a reduction in duration of therapy and reduced inappropriate use of ceftriaxone-based regimens for non-severe CAP. © 2017 Royal Australasian College of Physicians.

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

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Yallew WW

2016-08-01

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

Classification of hospital pathways in the management of cancer: application to lung cancer in the region of burgundy.

Science.gov (United States)

Nuemi, G; Afonso, F; Roussot, A; Billard, L; Cottenet, J; Combier, E; Diday, E; Quantin, C

2013-10-01

The evaluation of national cancer plans is an important aspect of their implementation. For this evaluation, the principal actors in the field (doctors, nurses, etc.) as well as decision-makers must have access to information that is reliable, synthetic and easy to interpret, and which reflects the implementation process in the field. We propose here a methodology to make this type of information available in the context of reducing inequalities with regard to access to healthcare for patients with lung cancer in the region of Burgundy. We used the national medico-administrative DRG-type database, which gathers together all hospital stays. By using this database, it was possible to identify and reconstruct the care management history of these patients. That is, by linking together all attended hospitals, sorted chronologically. Eligible patients were at least 18 years old, whatever the gender and had undergone surgery for their lung cancer. They had to be residents of Burgundy at the time of the first operation between 2006 and 2008. Patient's pathway was defined as the sequence of all attended hospitals (hospital stays) during the year of follow up linked together using an anonymised patient identifier. We then constructed a pathway typology of pathway using an unsupervised clustering method, and conducted a spatial analysis of this typology. Between 2006 and 2008, we selected 495 patients in the 4 administrative departments of the Burgundy region. They accounted for a total of 3821 stays during the year of follow-up. There were 393 men (79%) and the mean age was 64 (95% confidence interval: 63-65) years. We reconstructed 94 pathways (about five per patient). Here, neighbourhood's cares accounted for 41% of them, while 44% included a surgical intervention outside the region of Burgundy. We constructed a pathway typology with five classes. Spatial analysis showed that the vast majority of initial surgeries took place in the major regional centres. The construction

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.

Prevalence, Clinical Presentation, and Factors Associated With Diabetic Foot Ulcer in Two Regional Hospitals in Cameroon.

Science.gov (United States)

Tindong, Maxime; Palle, John N; Nebongo, Daniel; Aminde, Leopold Ndemnge; Mboue-Djieka, Yannick; Mbarga, Nicole T Fouda; Dehayem, Mesmin Y; Choukem, Siméon-Pierre

2018-03-01

This study aimed to determine the prevalence of diabetic foot ulcer and high risk for ulceration, describe the clinical presentation, and identify factors associated with diabetic foot ulcer in the Southwest regional hospitals of Cameroon. In this cross-sectional study, data were collected using a structured questionnaire administered to consecutive patients with diabetes. Findings from detailed foot examination were recorded. Diabetic foot ulcer was diagnosed according to the International Working Group on Diabetic Foot (IWGDF) definition. Data were analyzed with Stata IC version 12. Of the 203 participants included, 63.1% were females. Age ranged from 26 to 96 years. The median duration of diabetes was 4.0 years (interquartile range 1.0-8.0 years). The prevalence of diabetic foot ulcer was 11.8% (24), of whom 29.2% (7) had high grade (grades 2 to 4), and most of the ulcers 58.3% (14) were located at the plantar region. The prevalence of high risk for ulceration was 21.8% (39). Loss of protective sensation (OR = 3.73, 95% CI = 1.43-9.71; P = .007), and peripheral arterial disease (OR = 3.48, 95% CI = 1.14-10.56; P = .028) were independently associated with diabetic foot. Diabetic foot ulcer is a common complication among patients with diabetes attending these regional hospitals. Loss of protective sensation, and peripheral arterial disease increase the odds of having diabetic foot ulcer, and we suggest them as the main target of interest for prevention.

No apparent transmission of livestock-associated methicillin-resistant Staphylococcus aureus CC398 in a survey of staff at a regional Danish hospital

Directory of Open Access Journals (Sweden)

Else Toft Würtz

2017-12-01

Full Text Available Abstract Background In recent years, livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA multi locus sequence type CC398 has spread widely in the livestock production in Europe. The rates of LA-MRSA in hospitals have been found to be largely determined by contact to and density of livestock in the area. Methods This is a cross sectional study of the prevalence of LA-MRSA among hospital staff in a Danish hospital situated in a livestock production region. We analysed nasal swabs, air and dust samples for the presence of MRSA using PCR and mass spectrometry. Results Of 1745 employees, 545 (31% contributed nasal swabs. MRSA was not detected in any participant, nor was it detected in air or dust at the hospital or in houses of employees living on farms. Four percent of the participants had contact to pigs either directly or through household members. LA-MRSA was detected in two of 26 samples from animal sheds, both of them from pig farms. The participation rate was relatively low, but participants were representative for the source population with regards to animal contact and job titles. Conclusions The study suggests a low point prevalence of LA-MRSA carriage in Danish hospital staff even in regions where livestock production is dense. Should more studies confirm our findings we see no need for additional hospital precautions towards LA-MRSA in Denmark at the moment. We think that our data might reduce potential stigmatization of hospital workers with contact to LA-MRSA positive farms at their work places and in their communities.

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

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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.

The Role of the Nobles-Philanthropists in the Activities of Hospitals in the Danube Region

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Nataliya Goncharova

2015-08-01

Full Text Available Reviews the legal and regulatory basis in the sphere of the guardianship treatment centres in the Russian Empire in the middle of the XIXth century, alleging the establishment of the public supervision over the activities of city, County and provincial hospitals. Contents of the powers of the Trustees, their objectives and main activities. Specific examples in the Danube region proved the thesis that among the Trustees were dominated by representatives of the nobility.

Assessment of the Baby Friendly Hospital Initiative Implementation in the Eastern Mediterranean Region

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Al-Jawaldeh, Ayoub; Abul-Fadl, Azza

2018-01-01

The Baby-Friendly Hospital Initiative (BFHI) is a global program for promoting support and protection for breastfeeding. However, its impact on malnutrition, especially in countries of the Eastern Mediterranean region (EMR) that are facing the turmoil of conflict and emergencies, deserves further investigation. Having said that, this paper aims to discuss the status and challenges to BFHI implementation in the EMR countries. Data on BFHI implementation, breastfeeding practices, and nutritional status were collected from countries through structured questionnaires, personal interviews, and databases. The 22 countries of the EMR were categorized as follows: 8 countries in advanced nutrition transition stage (group I), 5 countries in early nutrition transition stage (group II), 4 countries with significant undernutrition (group III), and 5 countries in complex emergency (group IV). The challenges to BFHI implementation were discussed in relation to malnutrition. BFHI was not implemented in 22.7% of EMR countries. Designated Baby-Friendly hospitals totaled 829 (group I: 78.4%, group II: 9.05%; group III: 7.36%; group: IV5.19%). Countries with advanced nutrition transition had the highest implementation of BFHI but the lowest breastfeeding continuity rates. On the other hand, poor nutritional status and emergency states were linked with low BFHI implementation and low exclusive breastfeeding rates but high continuity rates. Early initiation and longer duration of breastfeeding correlated negatively with overweight and obesity (p < 0.001). In countries with emergency states, breastfeeding continues to be the main source of nourishment. However, suboptimal breastfeeding practices prevail because of poor BFHI implementation which consequently leads to malnutrition. Political willpower and community-based initiatives are needed to promote breastfeeding and strengthen BFHI in the region. PMID:29534482

Assessment of the Baby Friendly Hospital Initiative Implementation in the Eastern Mediterranean Region.

Science.gov (United States)

Al-Jawaldeh, Ayoub; Abul-Fadl, Azza

2018-03-11

The Baby-Friendly Hospital Initiative (BFHI) is a global program for promoting support and protection for breastfeeding. However, its impact on malnutrition, especially in countries of the Eastern Mediterranean region (EMR) that are facing the turmoil of conflict and emergencies, deserves further investigation. Having said that, this paper aims to discuss the status and challenges to BFHI implementation in the EMR countries. Data on BFHI implementation, breastfeeding practices, and nutritional status were collected from countries through structured questionnaires, personal interviews, and databases. The 22 countries of the EMR were categorized as follows: 8 countries in advanced nutrition transition stage (group I), 5 countries in early nutrition transition stage (group II), 4 countries with significant undernutrition (group III), and 5 countries in complex emergency (group IV). The challenges to BFHI implementation were discussed in relation to malnutrition. BFHI was not implemented in 22.7% of EMR countries. Designated Baby-Friendly hospitals totaled 829 (group I: 78.4%, group II: 9.05%; group III: 7.36%; group: IV5.19%). Countries with advanced nutrition transition had the highest implementation of BFHI but the lowest breastfeeding continuity rates. On the other hand, poor nutritional status and emergency states were linked with low BFHI implementation and low exclusive breastfeeding rates but high continuity rates. Early initiation and longer duration of breastfeeding correlated negatively with overweight and obesity ( p < 0.001). In countries with emergency states, breastfeeding continues to be the main source of nourishment. However, suboptimal breastfeeding practices prevail because of poor BFHI implementation which consequently leads to malnutrition. Political willpower and community-based initiatives are needed to promote breastfeeding and strengthen BFHI in the region.

Assessment of the Baby Friendly Hospital Initiative Implementation in the Eastern Mediterranean Region

Directory of Open Access Journals (Sweden)

Ayoub Al-Jawaldeh

2018-03-01

Full Text Available The Baby-Friendly Hospital Initiative (BFHI is a global program for promoting support and protection for breastfeeding. However, its impact on malnutrition, especially in countries of the Eastern Mediterranean region (EMR that are facing the turmoil of conflict and emergencies, deserves further investigation. Having said that, this paper aims to discuss the status and challenges to BFHI implementation in the EMR countries. Data on BFHI implementation, breastfeeding practices, and nutritional status were collected from countries through structured questionnaires, personal interviews, and databases. The 22 countries of the EMR were categorized as follows: 8 countries in advanced nutrition transition stage (group I, 5 countries in early nutrition transition stage (group II, 4 countries with significant undernutrition (group III, and 5 countries in complex emergency (group IV. The challenges to BFHI implementation were discussed in relation to malnutrition. BFHI was not implemented in 22.7% of EMR countries. Designated Baby-Friendly hospitals totaled 829 (group I: 78.4%, group II: 9.05%; group III: 7.36%; group: IV5.19%. Countries with advanced nutrition transition had the highest implementation of BFHI but the lowest breastfeeding continuity rates. On the other hand, poor nutritional status and emergency states were linked with low BFHI implementation and low exclusive breastfeeding rates but high continuity rates. Early initiation and longer duration of breastfeeding correlated negatively with overweight and obesity (p < 0.001. In countries with emergency states, breastfeeding continues to be the main source of nourishment. However, suboptimal breastfeeding practices prevail because of poor BFHI implementation which consequently leads to malnutrition. Political willpower and community-based initiatives are needed to promote breastfeeding and strengthen BFHI in the region.

Dementia in older people admitted to hospital: a regional multi-hospital observational study of prevalence, associations and case recognition

Science.gov (United States)

Timmons, Suzanne; Manning, Edmund; Barrett, Aoife; Brady, Noeleen M.; Browne, Vanessa; O’Shea, Emma; Molloy, David William; O'Regan, Niamh A.; Trawley, Steven; Cahill, Suzanne; O'Sullivan, Kathleen; Woods, Noel; Meagher, David; Ni Chorcorain, Aoife M.; Linehan, John G.

2015-01-01

Background: previous studies have indicated a prevalence of dementia in older admissions of ∼42% in a single London teaching hospital, and 21% in four Queensland hospitals. However, there is a lack of published data from any European country on the prevalence of dementia across hospitals and between patient groups. Objective: to determine the prevalence and associations of dementia in older patients admitted to acute hospitals in Ireland. Methods: six hundred and six patients aged ≥70 years were recruited on admission to six hospitals in Cork County. Screening consisted of Standardised Mini-Mental State Examination (SMMSE); patients with scores dementia; with 29% in public hospitals. Prevalence varied between hospitals (P dementia had a previous diagnosis. Patients with dementia were older and frailer, with higher co-morbidity, malnutrition and lower functional status (P dementia (57%) on admission. Conclusion: dementia is common in older people admitted to acute hospitals, particularly in acute medical admissions, and rural hospitals, where services may be less available. Most dementia is not previously diagnosed, emphasising the necessity for cognitive assessment in older people on presentation to hospital. PMID:26420638

Quality of Care: A Review of Maternal Deaths in a Regional Hospital in Ghana.

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Adusi-Poku, Yaw; Antwil, Edward; Osei-Kwakye, Kingsley; Tetteh, Chris; Detoh, Eric Kwame; Antwi, Phyllis

2015-09-01

The government of Ghana and key stakeholders have put into place several interventions aimed at reducing maternal deaths. At the institutional level, the conduct of maternal deaths audit has been instituted. This also contributes to reducing maternal deaths as shortcomings that may have contributed to such deaths could be identified to inform best practice and forestall such occurrences in the future. The objective of this study was to review the quality of maternal care in a regional hospital. A review of maternal deaths using Quality of Care Evaluation Form adapted from the Komfo Anokye Teaching Hospital (KATH) Maternal Death Audit Evaluation Committee was used. About fifty-five percent, 18 (55%) of cases were deemed to have received adequate documentation, senior clinicians were involved in 26(85%) of cases. Poor documentation, non-involvement of senior clinicians in the management of cases, laboratory related issues particularly in relation to blood and blood products as well as promptness of care and adequacy of intensive care facilities and specialists in the hospital were contributory factors to maternal deaths . These are common themes contributing to maternal deaths in developing countries which need to be urgently tackled. Maternal death review with emphasis on quality of care, coupled with facility gap assessment, is a useful tool to address the adequacy of emergency obstetric care services to prevent further maternal deaths.

New perspectives in the study of “The School of Salamanca”

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Emanuele LACCA

2017-12-01

Full Text Available This contribution aims to rebuild some moments that have distinguished themselves in the study of the School of Salamanca during the last two years. The article will start from the conclusions of the conference Nuevos acercamientos a la historia de la Escuela de Salamanca (Salamanca, October 29-31, 2014, where it was explored the way to undertand how School of Salamanca can be studied nowadays and how these studies go through the new necessities of contemporary society.

MANEJO DE LOS RESIDUOS SOLIDOS HOSPITALARIOS EN EL SERVICIO DE ENFERMERIA, HOSPITAL REGIONAL HERMILIO VALDIZAN DE HUÁNUCO, 2015

OpenAIRE

Carbonelli Tuiro, Carbonelli Tuiro, Noemi Noemi

2017-01-01

Objetivo: Determinar el manejo de los residuos sólidos hospitalarios en el servicio de enfermería del Hospital Regional Hermilio Valdizan de Huánuco, 2015. Metodología: El presente Plan adopta la metodología descriptiva, prospectiva de corte transversal. Conclusiones: La cantidad de residuos hospitalarios según el área en el servicio de enfermería del Hospital Hermilio Valdizan fue mayor en el área de Emergencia con un promedio de residuos sólidos Biocontaminados al día de 11.56 kg; Res...

Enusa's contribution to economic progress in local and regional scope

International Nuclear Information System (INIS)

Sanchez Macias, J. L.; Rodriguez Lopez, F.

2010-01-01

In this paper, we analyze the economic impact of Enusa's activity in the province of Salamanca in the last 25 years. input-output techniques were used to obtain an estimation of the total effects. The results reveal that its contribution to wealth and employment creation has been very significant, making n economic engine in its influence area. In addition to that, there are spillover effects derived rom Enusa's leadership in human resources and quality management policies. (Author)

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.

Inpatient antibiotic consumption in a regional secondary hospital in New Zealand.

Science.gov (United States)

Hopkins, C J

2014-02-01

Reporting of antibiotic consumption in hospitals is a crucial component of antibiotic stewardship, but data from Australasian secondary hospitals are scarce. The hypothesis of this audit is that antibiotic consumption in secondary hospitals would be lower than in tertiary centres. The study aims to present the first published audit of antibiotic consumption from a secondary hospital in New Zealand compared with two tertiary centres. Hospital population-level data were retrospectively accessed to identify all systemic antibiotics dispensed to adult inpatients at Taranaki District Health Board during 2011. Consumption was calculated in defined daily doses per 100 inpatient-days and per 100 admissions, stratified by drug class. Comparison was against published data from two tertiary centres. Total consumption was lower, but that of high-risk antibiotic classes was higher than both tertiary centres. The relative consumption of lincosamides was 4.0 and 2.6 times higher than the two tertiary centres, with an associated 14% incidence of Clostridium difficile associated diarrhoea within 3 months. Our secondary hospital appears to consume the wrong types of antibiotic rather than too much. Data from all Australasian hospitals, stratified by clinical service area and hospital level, are required for clinically relevant benchmarking. © 2014 The Author; Internal Medicine Journal © 2014 Royal Australasian College of Physicians.

Evaluación de rendimiento de compuestos de ajo tipo Taiwán Evaluación de rendimiento de compuestos de ajo tipo Taiwán

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Briseida Mendoza Celedón

2012-02-01

Full Text Available Se evaluó el rendimiento y variables de calidad de compuestos de ajo (Allium sativum L., durante el ciclo otoño-invierno 2008-2009, en San Luis de la Paz, Gto., México. Se emplearon compuestos de ajo del tipo Taiwán, con resultados variables de acuerdo a su genotipo. Entre los compuestos sobresalieron por su altura de planta, rendimiento de bulbo, mayor peso promedio de bulbo y menor número de dientes por bulbo los siguientes: el Compuesto 4 (El pato, bodegas, Salamanca, Gto., el Compuesto 5 (Santa Teresa, tabla III, Salamanca, Gto., y el Compuesto 1 (Ajo sano, varias regiones del Edo. de Gto.. Es importante continuar con el programa de mejoramiento genético de ajo para el estado de Guanajuato, basado en selección de nuevas líneas de entre los compuestos mejores y con ayuda de técnicas como la eliminación de virus, para mejorar rendimiento y calidad del ajo. Field yield and bulb quality of garlic (Allium sativum L. compounds were evaluated during the 2008-2009 fall-winter cycle at the San Luis de la Paz, Gto., Mexico. Taiwan compounds were evaluated with variable results, depending on the genotype. Best plant height, bulb yield, higher weight per bulb and smaller clove number per bulb were obtained with: Compuesto 4 (El pato, bodegas, Salamanca, Gto., Compuesto 5 (Santa Teresa, tabla III, Salamanca, Gto., and Compuesto 1 (Ajo sano, varias regiones del Edo. de Gto.. It is important to continue with the program of garlic genetic breeding to Guanajuato state, based on selection of new garlic lines derived from the best compounds and using techniques as the virus elimination for improving yield and quality.

NIVEL DE SATISFACCIÓN DEL PACIENTE ADULTO POSTOPERADO RESPECTO AL CUIDADO DE ENFERMERÍA EN SERVICIO DE CIRUGÌA DEL HOSPITAL REGIONAL DE LAMBAYEQUE

OpenAIRE

Oliva Ramos, Pamela; Universidad Señor de Sipán

2014-01-01

 El presente estudio Nivel de Satisfacción del Paciente Adulto Postoperado Respecto al Cuidado de Enfermería en Servicio de Cirugía del Hospital Regional de Lambayeque Chiclayo 2013, tuvo como objetivo: Determinar el nivel de satisfacción en el paciente adulto postoperado respecto al cuidado de enfermería en servicio de cirugía del Hospital Regional de Lambayeque Chiclayo 2013. El diseño metodológico fue de tipo cuantitativo descriptivo simple, se utilizó como instrumento el cuestionario tipo...

A study on the indoor radon concentrations in hospitals in the Shillong region, Meghalaya

International Nuclear Information System (INIS)

Sharma, Yubaraj; Maibam, Deveshwori; Saxena, Atul; Ram, Priya P.; Walia, Devesh

2015-01-01

In this paper, we report our findings on radon survey in indoor environment which consists of around 105 rooms in 8 major hospitals in Shillong region and also present experimental estimates on the associated annual effective doses and life-time fatality risks. The survey has been undertaken using LR-115 Type 2 detectors. Radon activity concentration values were found to range from 65.66 Bq.m -3 to 783.77 Bq.m -3 with an arithmetic mean value of 260.4±138.3 Bq.m -3 and a geometric mean value of 228.4±1.67 Bq.m -3 . Distribution analysis of the radon activity concentration measured at the hospital rooms has been carried out. Of the total rooms surveyed, 60% have radon concentration more than the ICRP prescribed lower limit of 200 Bq.m -3 and about 4% of the rooms higher than the upper limit of 600 Bq.m -3 . Floor-wise study has been done and a decrease in radon concentration with increase in floor-number has been observed. (author)

[Development of a microbiology data warehouse (Akita-ReNICS) for networking hospitals in a medical region].

Science.gov (United States)

Ueki, Shigeharu; Kayaba, Hiroyuki; Tomita, Noriko; Kobayashi, Noriko; Takahashi, Tomoe; Obara, Toshikage; Takeda, Masahide; Moritoki, Yuki; Itoga, Masamichi; Ito, Wataru; Ohsaga, Atsushi; Kondoh, Katsuyuki; Chihara, Junichi

2011-04-01

The active involvement of hospital laboratory in surveillance is crucial to the success of nosocomial infection control. The recent dramatic increase of antimicrobial-resistant organisms and their spread into the community suggest that the infection control strategy of independent medical institutions is insufficient. To share the clinical data and surveillance in our local medical region, we developed a microbiology data warehouse for networking hospital laboratories in Akita prefecture. This system, named Akita-ReNICS, is an easy-to-use information management system designed to compare, track, and report the occurrence of antimicrobial-resistant organisms. Participating laboratories routinely transfer their coded and formatted microbiology data to ReNICS server located at Akita University Hospital from their health care system's clinical computer applications over the internet. We established the system to automate the statistical processes, so that the participants can access the server to monitor graphical data in the manner they prefer, using their own computer's browser. Furthermore, our system also provides the documents server, microbiology and antimicrobiotic database, and space for long-term storage of microbiological samples. Akita-ReNICS could be a next generation network for quality improvement of infection control.

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

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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.

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

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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.

Prevalence and Factors Associated with Hydatidiform Mole among Patients Undergoing Uterine Evacuation at Mbarara Regional Referral Hospital

OpenAIRE

Mulisya, Olivier; Roberts, Drucilla J.; Sengupta, Elizabeth S.; Agaba, Elly; Laffita, Damaris; Tobias, Tusabe; Mpiima, Derrick Paul; Henry, Lugobe; Augustine, Ssemujju; Abraham, Masinda; Hillary, Twizerimana; Mugisha, Julius

2018-01-01

Objective. We sought to determine the prevalence of and factors associated with hydatidiform molar gestations amongst patients undergoing uterine evacuation at Mbarara Regional Referral Hospital (MRRH), Mbarara, Uganda. Methods. This was a cross-sectional study carried out from November 2016 to February 2017. All patients admitted for uterine evacuation for nonviable pregnancy were included. The study registered 181 patients. Data were collected on sociodemographics, medical conditions, obste...

Decentralization and centralization of healthcare resources: investigating the associations of hospital competition and number of cardiologists per hospital with mortality and resource utilization in Japan.

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Park, Sungchul; Lee, Jason; Ikai, Hiroshi; Otsubo, Tetsuya; Imanaka, Yuichi

2013-11-01

To investigate the associations of hospital competition and number of cardiologists per hospital (indicating the decentralization and centralization of healthcare resources, respectively) with 30-day in-hospital mortality, healthcare spending, and length of stay (LOS) among patients with acute myocardial infarction (AMI) in Japan. We collected data from 23,197 AMI patients admitted to 172 hospitals between 2008 and 2011. Hospital competition and number of cardiologists per hospital were analyzed as exposure variables in multilevel regression models for in-hospital mortality, healthcare spending, and LOS. Other covariates included patient, hospital, and regional variables; as well as the use of percutaneous coronary intervention (PCI). Hospitals in competitive regions and hospitals with a higher number of cardiologists were both associated lower in-hospital mortality. Additionally, hospitals in competition regions were also associated with longer LOS durations, whereas hospitals with more cardiologists had higher spending. The use of PCI was also associated with reduced mortality, increased spending and increased LOS. Centralization of cardiologists at the hospital level and decentralization of acute hospitals at the regional level may be contributing factors for improving the quality of care in Japan. Policymakers need to strike a balance between these two approaches to improve healthcare provision and quality. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Occupational stressors, burnout and coping strategies between hospital and community psychiatric nurses in a Dublin region.

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McTiernan, K; McDonald, N

2015-04-01

Burnout negatively impacts the delivery of mental health services. Psychiatric nurses face stressors that are distinct from other nursing specialities. The research was conducted in Ireland and captured a relatively large sample of respondents. The results compared the stressors, coping strategies and burnout levels between hospital and community-based psychiatric nurses. Occupational stress can negatively impact on the well-being of psychiatric nurses, which in turn can lead to poor client care. There is a dearth of published research conducted in Ireland that examines stress within the discipline. A between-groups study, undertaken in February 2011, investigated stressors, burnout and coping strategies between hospital and community-based psychiatric nurses in a Dublin region. Sixty-nine participants (8 males and 61 females), aged between 18 to 60 years voluntarily completed the Mental Health Professional Stress Scale, the Maslach Burnout Inventory and the PsychNurse Methods of Coping Scale. The findings revealed that nurses were operating in a moderately stressful environment. Stressors focused on organizational issues as opposed to client issues. The main stressors identified were lack of resources, workload and organizational structures/processes. Both groups reported average levels of emotional exhaustion, low levels of depersonalization and average levels of personal accomplishment. A Mann-Whitney U-test and Independent Samples t-test found significant differences between hospital and community-based nurses regarding depersonalization and personal accomplishment, respectively. Hospital nurses reported higher depersonalization scores, and community nurses had a greater sense of personal accomplishment. The personal accomplishment scores of hospital nurses were below mental health professional norms. No significant differences emerged regarding coping strategies. Avoidant coping strategies were favoured by both groups. It is recommended that interventions

Association between Ambient Temperatures and Mental Disorder Hospitalizations in a Subtropical City: A Time-Series Study of Hong Kong Special Administrative Region.

Science.gov (United States)

Chan, Emily Y Y; Lam, Holly C Y; So, Suzanne H W; Goggins, William B; Ho, Janice Y; Liu, Sida; Chung, Phoebe P W

2018-04-14

Background : Mental disorders have been found to be positively associated with temperature in cool to cold climatic regions but the association in warmer regions is unclear. This study presented the short-term association between temperatures and mental disorder hospitalizations in a subtropical city with a mean annual temperature over 21 °C. Methods : Using Poisson-generalized additive models and distributed-lagged nonlinear models, daily mental disorder hospitalizations between 2002 and 2011 in Hong Kong were regressed on daily mean temperature, relative humidity, and air pollutants, adjusted for seasonal trend, long-term trend, day-of-week, and holiday. Analyses were stratified by disease class, gender and age-group. Results : 44,600 admissions were included in the analysis. Temperature was positively associated with overall mental-disorder hospitalizations (cumulative relative risk at 28 °C vs. 19.4 °C (interquartile range, lag 0-2 days) = 1.09 (95% confidence interval 1.03, 1.15)), with the strongest effect among the elderly (≥75 years old). Transient mental disorders due to conditions classified elsewhere and episodic mood disorders also showed strong positive associations with temperature. Conclusion : This study found a positive temperature-mental-disorder admissions association in a warm subtropical region and the association was most prominent among older people. With the dual effect of global warming and an aging population, targeted strategies should be designed to lower the disease burden.

Enterovirus infections in hospitals of Ile de France region over 2013.

Science.gov (United States)

Molet, Lucie; Saloum, Kenda; Marque-Juillet, Stéphanie; Garbarg-Chenon, Antoine; Henquell, Cécile; Schuffenecker, Isabelle; Peigue-Lafeuille, Hélène; Rozenberg, Flore; Mirand, Audrey

2016-01-01

The monitoring and genotyping of Enterovirus (EV) infections can help to associate particular or severe clinical manifestations with specific EV types and to identify the aetiology of infectious outbreaks. To describe the epidemiological features of EV infections diagnosed during the year 2013 in the Greater Paris area (Ile de France). During 2013, 2497 samples taken from 470 patients in 33 hospitals of Ile-de France were tested for EV genome by RT-PCR. EV genotyping was performed by the National Reference Centre (NRC) laboratories. EV infections were retrospectively reviewed by retrieving clinical and genotyping data from the NRC database. Of the 2497 samples, 490 (19.6%) was positive for EV genome detection. These EV infections represented 88.7% and 24.1%, respectively, of all reported regional and national infections. Twenty-seven different genotypes were identified. Echovirus 30 (E-30) accounted for 54.1% of all characterized strains and caused a large outbreak. Four severe neonatal infections were reported, of which two were caused by EV-A71. Respiratory infections involving EV-D68 were observed in two adults. One fatal case of Coxsackievirus A2-associated myocarditis was reported. Monitoring EV infections in combination with EV genotyping via the French EV network characterized the epidemiology of EV infections in the Ile de France region in 2013 and documented severe EV infections associated with EV-A71 or CV-A2. Copyright © 2015 Elsevier B.V. All rights reserved.

Instalaciones mecánicas para un hospital ubicado en la selva-hospital regional de pucallpa

OpenAIRE

Montoya Alcoser, Carlos Augusto; Montoya Alcoser, Carlos Augusto

1986-01-01

En un Hospital moderno» las Instalaciones y los Equipos por ellas accionado constituye la parte más importante; lo que se puede llamar la parte dinámica» la vida del Hospital. Las Instalaciones deben satisfacer las exigencias de los equipos utilizados en la medicina para el diagnóstico y tratamiento» así como los equipos pertenecientes a los servicios generales y auxiliares. En este caso la presente TESIS tiene como finalidad elaborar y proyectar, dentro de los aspectos técnicos y econó...

Origen de la casiterita detrítica en los aluviones recientes de Tirados de la Vega-Golpejas (Salamanca

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Fort González, R.

1987-04-01

Full Text Available Two cassiterite anomalies have been detected in the Regato de los Lentiscos and Tirados de la Vega alluviums. in the Golpejas area (Salamanca. The granometric and morphometric parameters of these cassiterites have been compared with those shown by the cassiterite crystal ocurrying in the Golpejas granite. The comparison between the two groups of data allow us to conclude that the anomaly observed in the Regato de los Lentiscos has been originated by the disperssion of the cassiterite from the primary deposit of Golpejas. On the contrary. the anomaly ocuring in the alluviums to the south of Tirados de la Vega shows a different origin, and is coming from stanniferous veins. The factor analysis corroborates the differentiation mentionated aboye. and indicates a migration capacite of about 3 Kms. from the stanniferous deposits of Golpejas for the alluvial cassiterite.En el sector Tirados de la Vega-Golpejas han sido detectadas dos anomalías de casiterita en los aluviones del Regato de los Lentiscos y en otros existentes al sur de Tirados de la Vega. El estudio granométrico y morfométrico de éstas casiteritas. contrastado con el de la casiterita procedente del granito de Golpejas. permite asegurar que la anomalía del Regato de los Lentiscos se debe a la dispersión de la casiterita de aquel granito. mientras que la de Tirados de la Vega procede de filones estanníferos. La aplicación del análisis factoral corrobora este hecho y permite diferenciar las casiteritas que proceden de rocas graníticas de aquellas que vienen de filones estanníferos. Según esto se puede indicar que la capacidad de migración de la casiterita desde el yacimiento estannífero de Golpejas es de unos 3 Kms.

Healthcare waste management practices and risk perceptions: findings from hospitals in the Algarve region, Portugal.

Science.gov (United States)

Ferreira, Vera; Teixeira, Margarida Ribau

2010-12-01

The management of healthcare wastes is receiving greater attention because of the risks to both human health and the environment caused by inadequate waste management practices. In that context, the objective of this study was to analyse the healthcare waste management practices in hospitals of the Algarve region, Portugal, and in particular to assess the risk perceptions of, and actual risk to, healthcare staff. The study included three of the six hospitals in the region, covering 41% of the bed capacity. Data were collected via surveys, interviews, and on-site observations. The results indicate that waste separation is the main deficiency in healthcare waste practice, with correct separation being positively related to the degree of daily contact with the waste. Risk perceptions of healthcare staff show the highest levels for the environment (4.24) and waste workers (4.08), and the lowest for patients (3.29) and visitors (2.80), again being positively associated with the degree of daily contact. Risk perceptions of healthcare staff are related to the difficulties of the correct separation of wastes and the lack of knowledge concerning the importance of that separation. The risk of infection with needlesticks/sharps is higher during patient care than during waste handling, and the frequency of these injuries is related to the daily tasks of each healthcare group (doctors, nurses, and housekeepers). Furthermore, legislative definitions and classifications of healthcare wastes appear to have conditioned the management practices associated with, and the perceptions of risk concerning, healthcare wastes. Copyright © 2010 Elsevier Ltd. All rights reserved.

[Frequency and in vitro susceptibility antiparasitic of Blastocystis hominis from patients admitted to the Hospital Regional Lambayeque, Peru].

Science.gov (United States)

Silva-Díaz, Heber; Flores-Esqueche, Lorena; Llatas-Cancino, Dunalia; Guevara Vásquez, Génesis; Silva-García, Teresa

2016-01-01

To describe the frequency and antiparasitic in vitro susceptibility of Blastocystis hominis in patients admitted to theHospital Regional Lambayeque, Peru. A cross-sectional study was conducted from January to August 2015 at 313 patients of all ages. B. hominis detection was performed on serial fecal samples by direct microscopic examination and microculture in modified Locke solution. The in vitro susceptibility testing against the drug metronidazole, nitazoxanide, trimethoprim-sulfamethoxazole and erythromycin was performed in 24 strains of B. hominis, which grew up (microculture method) in 10 double concentrations of each antimicrobial (from 256 ug/ml to 0.5 ug/mL) plus a control. 46.3% (145/313) of the sample had B. hominis, also the age between 12 to 17 years and 60 years was associated with higher frequency of parasites (OR: 2.93 and 2.62). The minimum inhibitory concentration (MIC) 90 of metronidazole and nitazoxanide was 3.19 ug/mL and 11.19 ug/ml, respectively, whereas the MIC 90 of trimethoprim-sulfamethoxazole and erythromycin were above 256 ug/mL. B. hominis occurs in high frequency in patients admitted to the Hospital Regional in Lambayeque, proving to be an important problem of public health in the region. Also B. hominis isolated from these patients were shown to be susceptible in vitro to low concentrations of metronidazole and nitazoxanide so they could be chosen for treatment of this parasite.

Problems and solutions on issues of medical care quality in community-acquired pneumonia in hospitals of Saratov region

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Lotsmanov Yu.F.

2011-06-01

Full Text Available Qualitative assessment of diagnostics and treatment of patients with community-acquired pneumonia (CAP was carried out in ten therapeutic departments of urban and district hospitals of Saratov region, using quality indicators (Qls. Each case of CAP was assessed in expert health care quality (HCQ card according to the diagnostic and treatment quality federal standards and the basic Ql. The application of Ql in CAP patients allowed revealing the following: low CAP agent isolation rate; late hospitalization of CAP patients; low frequency of sputum bacteriological and bacterioscopic investigations prior to antibiotic therapy; insufficient frequency of step-by-step introduction of antibiotics. Recommendations on CAP patients dispenserization were not properly prescribed; recommendations on vaccination were absent. The basic measures of HCQ improvement are as follows: organizing for each CAP patient therapeutic and diagnostic quality control according to Ql; quick administrative decisions; using of HCQ expertise during the first 2-3 days of treatment to correct diagnosis and treatment; optimizing hospital diagnostic resources (laboratory and instrumental and rational pharmacotherapy

Impact of a Baby-Friendly hospital on breastfeeding indicators in Shaqlawa district in Erbil governorate, Kurdistan region of Iraq.

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Shaker, N Z; Hasan, S S; Ismail, Z A

2016-03-15

This study aimed to assess the impact of the Baby-Friendly Hospital Initiative on WHO-defined breastfeeding indicators in Shaqlawa district in Kurdistan region of Iraq. A household survey was carried out on a purposive non-probability sample of 200 mothers with a child aged < 30 months. Mothers were interviewed using a structured form to determine demographic data and feeding practices of the most recent child. The rate of early initiation of breastfeeding was 38.1%, exclusive breastfeeding was 15.4% and continued breastfeeding was 61.0% and 39.5% at 1 and 2 years of age respectively. A significant relationship was found between delivery at the Baby- Friendly accredited hospital and early initiation of breastfeeding but not with exclusive or continued breastfeeding. While continued breastfeeding at 1 year and 2 year was good, early initiation and exclusive breastfeeding indicators were not at an acceptable level, which indicates an ineffective role for the Baby-Friendly Hospital Initiative.

Pediatric disaster preparedness of a hospital network in a large metropolitan region.

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Ferrer, Rizaldy R; Balasuriya, Darshi; Iverson, Ellen; Upperman, Jeffrey S

2010-01-01

We describe pediatric-related emergency experiences and responses, disaster preparation and planning, emergency plan execution and evaluation, and hospital pediatric capabilities and vulnerabilities among a disaster response network in a large urban county in the West Coast of the United States. Using semistructured key informant interviews, the authors conducted qualitative research between March and April 2008. Eleven hospitals and a representative from the community clinic association agreed to participate (86 percent response rate) and a total of 22 key informant interviews were completed. Data were analyzed using ATLAS.ti.v.5.0, a qualitative analytical software program. Although hospitals have infrastructure to respond in the event of a large-scale disaster, well-established disaster preparedness plans have not fully accounted for the needs of children. The general hospitals do not anticipate a surge of pediatric victims in the event of a disaster, and they expect that children will be transported to a children's hospital as their conditions become stable. Even hospitals with well-established disaster preparedness plans have not fully accounted for the needs of children during a disaster. Improved communication between disaster network hospitals is necessary as incorrect information still persists.

Reduction of the nosocomial meticillin-resistant Staphylococcus aureus incidence density by a region-wide search and follow-strategy in forty German hospitals of the EUREGIO, 2009 to 2011

NARCIS (Netherlands)

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

2013-01-01

Meticillin-resistant Staphylococcus aureus (MRSA) disseminates between hospitals serving one patient catchment area. Successful prevention and control requires concerted efforts and regional surveillance. Forty hospitals located in the German EUREGIO have established a network for combating MRSA. In

Musculoskeletal Problems Among Greek Perioperative Nurses in Regional Hospitals in Southern Peloponnese : Musculoskeletal Problems in Perioperative Nurses.

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Bakola, Helen; Zyga, Sofia; Stergioulas, Apostolos; Kipreos, George; Panoutsopoulos, George

2017-01-01

The surgery unit is a particularly labor-intensive environment in the hospital. Studies reflect the correlation of labor risk factors for musculoskeletal injuries among nurses but few have investigated the relationship to perioperative nurses. The purpose of this study is the identification and definition of ergonomic risk factors in the operating room and their connection with musculoskeletal disorders in perioperative nurses in regional hospitals in Greece. Forty four Greek perioperative nurses working in regional hospitals in southern Peloponnese participated. Anonymous self-administered questionnaire was used to collect the data, which consisted of three parts (investigating musculoskeletal symptoms, description of work, psychometric evaluation). The analysis was done with the statistical program SPSS.19. Symptoms of musculoskeletal problems emerged. Specifically, 54.4% in the lumbar, 47.7% in the neck, 45.5% in the shoulder, followed by smaller percentages of the hip, knee, elbow and ankle. 6.8% of participants indicated no musculoskeletal symptoms in the last year while 74.9% of those who had symptoms presented them in two or more areas. Activities rated as a major problem among others were the manual handling, tools with weight and vibration etc. 100% of respondents agreed that the work in the surgery unit is demanding and has anxiety. The lack of support from the government (81.8%), combined with the low perioperative nurses (6.8%) having the opportunity to participate in administrative decisions concerning them were related to problems in the organization and management of work. Apart from engineers target factors, a main aim should be the organization of work within the framework of a national policy based on European directives on the protection and promotion of the health and safety of workers.

Factors affecting performance of hospital nurses in Riyadh Region, Saudi Arabia.

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Al-Ahmadi, Hanan

2009-01-01

The purpose of this paper is to identify factors influencing performance of hospital nurses in Riyadh Region, Saudi Arabia. Specific objectives were to estimate self-reported performance, and determine whether differences in employee demographics, job satisfaction, and organizational commitment, influenced performance. In total, 15 hospitals were randomly selected. The questionnaire was sent to all nurses (1,834) in these facilities and 923 nurses responded. Statistical analysis included correlation, t-test, and regression analysis. The study finds that job performance is positively correlated with organizational commitment, job satisfaction and personal and professional variables. Both job satisfaction and organizational commitment are strong predictors of nurses' performance. Job performance is positively related to some personal factors, including years of experience, nationality, gender, and marital status. Level of education is negatively related to performance. The findings of this study have a limited generalisability due to the fact that all measures used are based on self-reports. Future research may be directed to other objective measures of performance. Emphasis should be placed on effective supervision, empowerment, and a better reward system. Cultural diversity is a reality for most health organizations in Saudi Arabia; therefore, they need to adopt effective human resources strategies that aim to improve commitment and retention of qualified workers, and build a high performance organizational culture based on empowerment, open communication, and appreciation of impact of national culture on work attitudes. This study fulfills a research gap in the area of nursing performance, and its relationship with work attitudes in Saudi Arabia. The paper also highlights the impact of national culture on job performance and work attitude among nurses in Saudi Arabia, and other countries facing the issue of multi-national work force.

Infection Prevention Strategy in Hospitals in the Era of Community-Associated Methicillin-Resistant Staphylococcus aureus in the Asia-Pacific Region: A Review.

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Cho, Sun Young; Chung, Doo Ryeon

2017-05-15

Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has emerged as an important cause of healthcare-associated infection. CA-MRSA clones have replaced classic hospital MRSA clones in many countries and have shown higher potential in transmission and virulence than hospital MRSA clones. In particular, the emergence of CA-MRSA in the Asia-Pacific region is concerning owing to insufficient infection control measures in the region. The old strategies for infection prevention and control of MRSA comprised adherence to standard precaution and policy of active screening of MRSA carriers and decolonization, and it has been controversial which strategy is better in terms of outcome and cost-effectiveness. Epidemiological changes in MRSA has made the development of infection prevention strategy more complicated. Based on the literature review and the questionnaire survey, we considered infection prevention strategies for healthcare settings in the Asia-Pacific region in the era of CA-MRSA. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

Capnocytophaga canimorsus sepsis: two clinical cases at the Bolzano Regional Hospital

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Patrizia Innocenti

2010-12-01

Full Text Available Capnocytophaga canimorsus is a commensal bacterium in the oral cavity of dogs and cats and has been isolated from humans with a history of dog or cat bites or scratches. C. canimorsus are capnophilic facultative anaerobic, fastidious gram negative fusiform rods, included in the CDC group DF-2 or dysgonic fermenter 2. The bacterium can cause severe illness in patients at elevated risk i.e. after splenectomy, with alcohol addiction, chronic lung or liver diseases or immunosuppression. In 2010 at the Bolzano Regional Hospital (Northern-Italy C. canimorsus was isolated from blood cultures in two splenectomised patients suffering from septicaemia.The bacterium is difficult to cultivate because of its specific requirements for nutrients as well as to identify with routine automated instruments; therefore we used molecular typing by 16S rDNA sequencing.The true number of C. canimorsus infections is probably underestimated due to the fastidious growth of the organism. However, given the severity of the disease and the poor outcome one should consider this bacterium to apply appropriate diagnostic methods for this etiologic agent.

Gastrointestinal malignancies at five regional referral hospitals in ...

African Journals Online (AJOL)

The distribution of oesophageal, liver, stomach and colorectal cancers diagnosed per year across the five referral hospitals was ... Conclusion: Oesophageal, liver, stomach and colorectal cancer remain the most common gastrointestinal malignancies and their rate is .... intake, poor dietary patterns such as consumption of a.

Working Hours of Surgical Residence: Perspective of a Group of Surgeons in a Regional Hospital in Hong Kong

OpenAIRE

Lo, Siu-Fai; Spurgeon, Peter

2007-01-01

The Accreditation Council for Graduate Medical Education and European working time directive have restricted residents' workweek to 80 and 48 hours, respectively. Impacts on resident's training and health services are under evaluation in western countries. However, relevant studies are deficient in Hong Kong. Methods: Surgeons in a regional hospital of Hong Kong were recruited. Opinions were collected by semi-structured questionnaire. Results: Response rate was 82%. Most respondents agr...

Hebrew Hermeneutics and Inquisitorial Persecution: The Case of The Hebraist from Salamanca Martín Martínez de Cantalapiedra (XVI^th Century

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Ricardo Muñoz Solla

2016-12-01

Full Text Available

Halfway through the 16th century in Spain the reading and interpretation of the Bible based on its original languages involved a very real danger for humanists who were seeking a better understanding of the Scriptures. The exclusive authority of the Latin Vulgate version declared by the Council of Trent in 1546 hindered the intellectual work of many Biblicists and Theologians, who were subjected to tight ideological control. In this context it must be considered the case of the Hebraist and scholar from the University of Salamanca, Martín Martínez de Cantalapiedra (1518-1579, who was prosecuted by the Inquisition of Valladolid in 1572 along with his colleagues Fray Luis de León and Gaspar de Grajal. All of them were accused of deviating from the genuine sense of the Vulgate in their more literal interpretations of the Masoretic text. The purpose of this article is to provide new evidence for the intellectual biography of Master Martínez de Cantalapiedra as well a to analyze the hermeneutical principles exposed during his inquisitorial in which he defended the Hebrew knowledge as an essential means of interpreting the Old Testament.

[Assessment of the announcement procedure in 29 cancer-accredited hospitals in the Aquitaine region: the EVADA project].

Science.gov (United States)

Rongère-Casteigt, Julie; Pinon, Elodie; Domecq, Sandrine; Hoppe, Stéphanie; Bousser, Véronique; Vimard, Edwige; Saillour-Glenisson, Florence

2015-01-01

An announcement procedure is mandatory to obtain accreditation to treat cancer patients. Health care professionals in the Aquitaine region evaluated the organization of this announcement procedure in their institutions and the patients' perception, in order to initiate actions to improve the structure and traceability of this procedure. Self-assessment approach based on a retrospective study plan comprising three concomitant steps: organizational audit, medical records audit and patient experience survey. 29 institutions participated in the study. Heterogeneous organizations were observed, although progress had been made in the deployment of the announcement procedure in terms of personnel training,formal organization and the resources devoted to this procedure, but there remains considerable room for improvement in terms of traceability, coordination between doctors and nursing staff, and referral of patients to supportive care. This evaluation triggered active mobilization of hospital teams concerning the announcement procedure in the Aquitaine region and a better awareness of the patient's perception. The regional dynamic allowed exchanges between institutions, facilitating the implementation of improvement actions.

[Outsourcing of nursing human resources from ethical to management: a survey in a Lazio Region Hospital].

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d'Amore, Maurizia; Peroni, Antonia

2008-01-01

In 2006, 279 nurses of a Lazio Region Hospital were assessed to verify whether certain Human Resources decisions, such as outsourcing, can negatively influence their working motivation and sense of belonging to a health organization and whether any dissatisfaction can be attributed to poor ethical information within the health service. The research method had a descriptive basis and for data collection a questionnaire with 35 questions was issued. Results showed that nurses felt strongly involved in the study and interesting aspects for management of human resources emerged, depicting an organization lacking in motivation : this confirmed one of the aspects of the study : poor levels of motivation and sense of belonging can be correlated to insufficient ethical information in local health organizations. The main working needs that emerged among the nurses of this hospital regarded economical retribution (90%), security and success (88%) , belonging (86%) and self-satisfaction (77%): the need for power was relatively low (40%). The strong points of the study were : the strong involvement of nurses, the value of the information gathered regarding working motivation, sense of belong to a nursing organization , working needs , ethical information in health environments, organization according to targets. The limits of the study were: limited number of nurses in outsourcing at the time of the study (12%), impossibility of comparing the results with data prior to the outsourcing choices made by the hospital in question.

Does diabetes mellitus comorbidity affect in-hospital mortality and length of stay? Analysis of administrative data in an Italian Academic Hospital.

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Valent, Francesca; Tonutti, Laura; Grimaldi, Franco

2017-12-01

Hospitalized patients with comorbid diabetes mellitus may have worse outcomes than the others. We conducted a study to assess whether comorbid diabetes affects in-hospital mortality and length of stay. For this population-based study, we analyzed the administrative databases of the Regional Health Information System of the Region Friuli Venezia Giulia, where the Hospital of Udine is located. Hospital discharge data were linked at the individual patient level with the regional Diabetes Mellitus Registry to identify diabetic patients. For each 3-digit ICD-9-CM discharge diagnosis code, we assessed the difference in length of stay and in-hospital mortality between diabetic and non-diabetic patients. We conducted both univariate and multivariate analyses, adjusted for age, sex, Charlson's comorbidity score, and urgency of hospitalization, through linear and logistic regression models. After adjusting for potential confounders, diabetes significantly increased the risk of in-hospital death among patients hospitalized for bacterial pneumonia (OR = 1.94) and intestinal obstruction (OR = 4.23) and length of stay among those admitted for several diagnoses, including acute myocardial infarction and acute renal failure. Admission glucose blood level was associated with in-hospital death in patients with pneumonia and intestinal obstruction, and increased length of stay for several conditions. Patients with diabetes mellitus who are hospitalized for other health problems may have increased risk of in-hospital death and longer hospital stay. For this reason, diabetes should be promptly recognized upon admission and properly managed.

Depositional Environments of Late Danian Plant Localities: Chubut Provice, Patagonia, Argentina

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Comer, E.; Slingerland, R. L.; Wilf, P.

2010-12-01

and bi-directional currents. Unique features within these two facies such as microdeltas and plane parallel lamination indicate complex micro-environments and flow patterns. Fossil plant remains lie within lateral accretion sets or siltstone facies both above and below the trough cross-bedded sandstone facies. At the top of the Salamanca we reach facies 6 and 7 which transition from sandstone to black mudstone of the Banco Negro. Mammal fossils found in the Banco Negro identify it as a non-marine continental facies. The Late Paleocene Rio Chico formation that overlies the Banco Negro is identified as a continental fluvial formation indicating that facies 6 represents emptying of the estuary and a longstanding regional transition from a marine to a continental environment. To understand the origin of the tidal flows, a paleogeographic model of the Late Danian Patagonian shelf was constructed from facies distributions within the Salamanca Fm. A 2D hydrodynamic model driven by predicted tides in the paleo-Atlantic produces a tidal range of approximately 2m and strong ebb and flood tides throughout the central estuary. These observations are consistent with our interpretation of a meso-tidal estuarine environment as the paleo-flora accumulation site.

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...

Risk factors associated with in-hospital mortality in elderly patients admitted to a regional trauma center after sustaining a fall.

Science.gov (United States)

Cartagena, L J; Kang, A; Munnangi, S; Jordan, A; Nweze, I C; Sasthakonar, V; Boutin, A; George Angus, L D

2017-06-01

Falls are a significant cause of mortality in the elderly patients. Despite this, the literature on in-hospital mortality related to elderly falls remains sparse. Our study aims to determine the risk factors associated with in-hospital mortality in elderly patients admitted to a regional trauma center after sustaining a fall. All elderly case records with fall-related injuries between 2003 and 2013 were retrospectively analyzed for demographic characteristics, injury severities, comorbidity factors and clinical outcomes. Logistic regression analysis was used to examine the risk factors associated with in-hospital mortality. In total, 1026 elderly patients with fall-related injuries were included in the study. The average age of patients was 80.94 ± 8.16 years. Seventy seven percent of the patients had at least one comorbid condition. Majority of the falls occurred at home. More than half of the patients fell from ground level. Overall, the in-hospital mortality rate was 16 %. Head injury constituted the most common injury sustained in patients who died (77 %). In addition to age, ISS, GCS, ICU admission and anemia were significantly (P fall patients. Ground-level falls in the elderly can be devastating and carry a significant mortality rate. Elderly patients with anemia were two times more likely to die in the hospital after sustaining a fall in our study population. Increased focus on anemia which is often underappreciated in elderly fall patients can be beneficial in improving outcomes and reducing in-hospital mortality.

Necesidad de asistencia educativa al niño hospitalizado

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Marian SERRADAS FONSECA

2009-11-01

Full Text Available RESUMEN: Teniendo en cuenta las necesidades educativas del niño enfermo y a su vez la necesidad de compensar y normalizar en la medida de lo posible la situación de estos niños, presentamos los resultados obtenidos en la investigación que hemos llevado a cabo en el Hospital Clínico Universitario y el Hospital «Virgen de la Vega» de Salamanca, y que hace referencia a la situación y tratamiento de niños hospitalizados en edad escolar. Los resultados indican niveles moderados de ansiedad en los niños como un estado producto de su hospitalización, además estos resultados arrojaron diferencias significativas entre los niños que asisten al aula hospitalaria de los que no reciben ningún tipo de atención educativa en el estado de la ansiedad. De acuerdo a estos resultados y desde la perspectiva de la pedagogía hospitalaria, defendemos la necesidad de desarrollar programas de intervención educativa en el ámbito hospitalario como una alternativa en la reducción de la ansiedad infantil hospitalaria, por ser este trastorno uno de los más frecuentes dentro de las reacciones de los niños enfermos hospitalizados.ABSTRACT: Taking into account the educational needs of sick children and in turn, the need to compénsate and normalize the situation of these children as much as possible, we present the results obtained in the research we carried out in the University Clinical Hospital and the «Virgen de la Vega» Hospital in Salamanca. This research refers to the situation and treatment of school-aged hospitalised children. The results indícate modérate levéis of anxiety in the children as a condition produced by their hospitalisation. Furthermore, these results show significant differences in this state of anxiety between the children who attend the hospital classroom and those that receive no type of educational attention. In accordance with these results and from the perspective of hospital education, we defend the need to develop

Determining the Organizational Intelligence Level of Hospitals in Our Region

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Khayat Moghadam S

2013-10-01

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

Frecuencia de micosis en pacientes inmunosuprimidos de un hospital regional de la Ciudad de México Frequency of mycoses in immunosuppressed patients in a regional hospital in Mexico City

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Francisca Hernández-Hernández

2003-12-01

Full Text Available OBJETIVO: Aislar e identificar hongos en diferentes especímenes de pacientes inmunocomprometidos, atendidos en un hospital de la Ciudad de México, y determinar su asociación con micosis. MATERIAL Y MÉTODOS: Se realizó un estudio de tipo observacional transversal en pacientes del Hospital Regional General Ignacio Zaragoza, de junio de 1999 a mayo de 2000. De 108 pacientes se procesaron 268 especímenes para estudio micológico que incluyó examen directo, frotis, cultivos y microcultivos en medios específicos además de pruebas bioquímicas. La mayoría de pacientes tenía diagnóstico clínico de tuberculosis pulmonar y de síndrome de inmunodeficiencia adquirida. RESULTADOS: Se obtuvieron 183 aislamientos de levaduras y 66 de hongos filamentosos. Se diagnosticaron 45 micosis que en su mayoría correspondieron a candidosis pulmonar (32 casos. Las especies de Candida más frecuentes asociadas a patología fueron Candida albicans y C parapsilosis. Se obtuvieron cinco aislamientos de Cryptococcus neoformans variedad neoformans, uno de C albidus, tres de Histoplasma capsulatum y uno de Geotrichum candidum, asociados a infección micótica. CONCLUSIONES: El 41.6% de los pacientes estudiados presentaron una micosis asociada principalmente a síndrome de inmunodeficiencia adquirida y a tuberculosis pulmonar.OBJECTIVE: To isolate and identify the fungi in specimens collected from immunocompromised patients seen in Mexico City hospital, and to assess their association with mycosis. MATERIAL AND METHODS: A total of 268 specimens from 108 patients were processed for mycological study, including direct examination, smears, cultures, and microcultures in specific media, in addition to biochemical tests. Most of the patients had been diagnosed with pulmonary tuberculosis and Acquired Immunodeficiency Syndrome (AIDS. RESULTS: One hundred and eighty-three yeasts and 66 mycelial fungi were isolated. Forty-five mycoses were diagnosed; the most frequent

Out-of-hospital cardiac arrest: the prospect of E-CPR in the Maastricht region.

Science.gov (United States)

Sharma, A S; Pijls, R W M; Weerwind, P W; Delnoij, T S R; de Jong, W C; Gorgels, A P M; Maessen, J G

2016-02-01

The current outcome of out-of-hospital cardiac arrest (OHCA) patients in the Maastricht region was analysed with the prospect of implementing extracorporeal cardiopulmonary resuscitation (E-CPR). A retrospective analysis of adult patients who were resuscitated for OHCA during a 24-month period was performed. 195 patients (age 66 [57-75] years, 82 % male) were resuscitated for OHCA by the emergency medical services and survived to admission at the emergency department. Survival to hospital discharge was 46.2 %. Notable differences between non-survivors and survivors were observed and included: age (70 [58-79] years) vs. (63 [55-72] years, p = 0.01), chronic heart failure (18 vs. 7 %, p = 0.02), shockable rhythm (67 vs. 99 %, p < 0.01), and return of spontaneous circulation (ROSC) at departure from the site of the arrest (46 vs. 99 %, p < 0.01) and on arrival to the emergency department (43 vs. 98 %, p < 0.01), respectively. Acute coronary syndrome was diagnosed in 32 % of non-survivors vs. 59 % among survivors, p < 0.01. Therapeutic hypothermia was provided in non-survivors (20 %) vs. survivors (43 %), p < 0.01. Percutaneous coronary intervention (PCI) was performed in 14 % of non-survivors while 52 % of survivors received PCI (p < 0.01). No statistical significance was observed in terms of gender, witnessed arrest, bystander CPR, or automated external defibrillator deployed among the cohort. At hospital discharge, moderately severe neurological disability was present in six survivors. These observations are compatible with the notion that a shockable rhythm, ROSC, and post-arrest care improve survival outcome. Potentially, initiating E-CPR in the resuscitation phase in patients with a shockable rhythm and no ROSC might serve as a bridge to definite treatment and improve survival outcome.

Transmission of measles among healthcare Workers in Hospital W, Xinjiang Autonomous Region, China, 2016.

Science.gov (United States)

Jia, Haimei; Ma, Chao; Lu, Mengting; Fu, Jianping; Rodewald, Lance E; Su, Qiru; Wang, Huaqin; Hao, Lixin

2018-01-12

As China approaches the elimination of measles, outbreaks of measles continue to occur. Healthcare workers (HCWs) are known to be at high risk of infection and transmission of measles virus. A measles outbreak occurred in a hospital in Xinjiang Uighur Autonomous Region of the People's Republic of China. We report an investigation of this outbreak and its implications for measles elimination and outbreak preparedness. We conducted a retrospective search for measles cases using hospital records. Information on cases was collected by interview, and was used to determine epidemiological linkages. We surveyed HCWs to determine their demographic characteristics, disease history and vaccination status, and knowledge about measles. We identified 19 cases, ages 18 to 45 years, in Hospital W between December 2015 and January 2016; 14 were laboratory-confirmed, and 5 were epidemiologically linked. The primary case was a 25-year-old neurology department nurse who developed a rash on 22 December 2015 that was reported on 11 January 2016. She continued working and living with her workmates in a dormitory during her measles transmission period. Among the 19 infected HCWs, 2 had received a dose of measles-containing vaccine (MCV) before the outbreak, and 16 had unknown vaccination status. Outbreak response immunization activities were started on 8 January in a non-selective manner by offering vaccine regardless of vaccination history; 605(68%) of 890 HCWs were vaccinated. The HCW survey had a 73% response rate (646/890); 41% of HCWs reported that they had received MCV before outbreak, and 56% exhibited good knowledge of measles symptoms, transmission, complications, and vaccination. Low MCV coverage, low measles knowledge among HCWs, delayed reporting of measles cases, and absence of proper case management were associated with this outbreak. Training and vaccinating HCWs against measles are essential activities to prevent measles virus transmission among HCWs.

Perceptions on hospitality when visiting secluded communities of guaranis, caiçaras e quilombolas in Paraty region

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Luis Alberto Beares

2008-10-01

Full Text Available Tourism in secluded communities puts different cultures in contact with each other and must be handled carefully not to cause environmental damage as well as cultural loss which might jeopardize the local development and create hostile relationships. The proposal of in sito tourism, considering the local memory and patrimony as a hospitality potential, was observed during technical visitations to three communities located in the Paraty region and surroundings: Guarani, Caiçara (fishermen and Quilombola(African slaves descendants. Through field work involving visitations to communities and interviews with locals, information regarding cultural differences and the importance of the land occupation in the history of each of the communities was assessed. The common link in the history of these peoples is the struggle for the right of land possession. During visits when people shared their territory various forms of hospitality in each community were verified, issued from different cultures and cultural values.

Forskning på regionshospitaler i Region Midtjylland og Region Nordjylland

DEFF Research Database (Denmark)

Lauszus, Finn Friis; Nielsen, Gunnar Lauge; Petersen, Lars Jelstrup

2013-01-01

The quantity of interest, experience, and barriers to research in non-university hospitals in Denmark is undocumented. Therefore, a questionnaire was distributed to all employees at non-university hospitals in two Danish regions. The results showed that a substantial number of medical doctors were...

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.

Can National Healthcare-Associated Infections (HAIs) Data Differentiate Hospitals in the United States?

Science.gov (United States)

Masnick, Max; Morgan, Daniel J; Sorkin, John D; Macek, Mark D; Brown, Jessica P; Rheingans, Penny; Harris, Anthony D

2017-10-01

OBJECTIVE To determine whether patients using the Centers for Medicare and Medicaid Services (CMS) Hospital Compare website (http://medicare.gov/hospitalcompare) can use nationally reported healthcare-associated infection (HAI) data to differentiate hospitals. DESIGN Secondary analysis of publicly available HAI data for calendar year 2013. METHODS We assessed the availability of HAI data for geographically proximate hospitals (ie, hospitals within the same referral region) and then analyzed these data to determine whether they are useful to differentiate hospitals. We assessed data for the 6 HAIs reported by hospitals to the Centers for Disease Control and Prevention (CDC). RESULTS Data were analyzed for 4,561 hospitals representing 88% of registered community and federal government hospitals in the United States. Healthcare-associated infection data are only useful for comparing hospitals if they are available for multiple hospitals within a geographic region. We found that data availability differed by HAI. Clostridium difficile infections (CDI) data were most available, with 82% of geographic regions (ie, hospital referral regions) having >50% of hospitals reporting them. In contrast, 4% of geographic regions had >50% of member hospitals reporting surgical site infections (SSI) for hysterectomies, which had the lowest availability. The ability of HAI data to differentiate hospitals differed by HAI: 72% of hospital referral regions had at least 1 pair of hospitals with statistically different risk-adjusted CDI rates (SIRs), compared to 9% for SSI (hysterectomy). CONCLUSIONS HAI data generally are reported by enough hospitals to meet minimal criteria for useful comparisons in many geographic locations, though this varies by type of HAI. CDI and catheter-associated urinary tract infection (CAUTI) are more likely to differentiate hospitals than the other publicly reported HAIs. Infect Control Hosp Epidemiol 2017;38:1167-1171.

The Influence of Quality Assurance and Supportive Supervision on the Quality of Medical Care in Children’s Hospitals of the Municipal Level of the Rostov Region

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Tatiana V. Kulichenko

2017-01-01

Full Text Available Background. Improving the quality of medical care is the absolute priority of the World Health Organization and all socially-oriented ministries and departments around the world.Objective. Our aim was to evaluate the effectiveness of quality  assurance and supportive supervision in municipal hospitals to improve the quality of medical care for children (by the example of the Rostov region.Methods. The open observational study included 10 second-level hospitals in the Rostov Region. At the start of the project, the quality of inpatient care for children in the region was audited based on recommendations and tools of the World Health Organization, and training of medical personnel was organized. Monitoring visits to hospitals were carried out by experts every 3 months (supportive supervision. Reaudit of the quality of care was conducted a year later.Results. As a result of regular quality assurance and supportive supervision of hospitals during the first year of operation, such indicators of the quality of medical care as the availability of medical equipment for emergency care for children, the infrastructure of children’s departments, the triage and provision of emergency care in children’s departments, managing patients with various acute conditions (fever, diarrhea, respiratory diseases, supporting care, internal quality assurance, accessibility to standards of care and clinical guidelines for the diagnosis and treatment of various diseases, respect for children’s rights were significantly (p < 0.05 improved.Conclusion. Supportive supervision and regular external quality assurances of hospitals contribute to a rapid increase in the quality of medical care for children.

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

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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.

Relationships between aeroallergen levels and hospital admissions for asthma in the Brussels-Capital Region: a daily time series analysis.

Science.gov (United States)

Guilbert, Ariane; Cox, Bianca; Bruffaerts, Nicolas; Hoebeke, Lucie; Packeu, Ann; Hendrickx, Marijke; De Cremer, Koen; Bladt, Sandrine; Brasseur, Olivier; Van Nieuwenhuyse, An

2018-04-11

Outdoor pollen grain and fungal spore concentrations have been associated with severe asthma exacerbations at the population level. The specific impact of each taxon and the concomitant effect of air pollution on these symptoms have, however, still to be better characterized. This study aimed to investigate the short-term associations between ambient concentrations of various aeroallergens and hospitalizations related to asthma in the Brussels-Capital Region (Belgium), an area recording especially high rates of admissions. Based on administrative records of asthma hospitalizations and regular monitoring of 11 tree/herbaceous pollen taxa and 2 fungal spore taxa, daily time series analyses covering the 2008-2013 period were performed. Effects up to 6 days after exposure were captured by combining quasi-Poisson regression with distributed lag models, adjusting for seasonal and long-term trends, day of the week, public holidays, mean temperature and relative humidity. Effect modification by age and air pollution (PM, NO 2 , O 3 ) was tested. A significant increase in asthma hospitalizations was observed for an interquartile range increase in grass (5.9%, 95% CI: 0.0, 12.0), birch (3.2%, 95% CI: 1.1, 5.3) and hornbeam (0.7%, 95% CI: 0.2, 1.3) pollen concentrations. For several taxa including grasses, an age modification effect was notable, the hospitalization risk tending to be higher in individuals younger than 60 years. Air pollutants impacted the relationships too: the risk appeared to be stronger for grass and birch pollen concentrations in case of high PM 10 and O 3 concentrations respectively. These findings suggest that airborne grass, birch and hornbeam pollen are associated with severe asthma exacerbations in the Brussels region. These compounds appear to act in synergy with air pollution and to more specifically affect young and intermediate age groups. Most of these life-threatening events could theoretically be prevented with improved disease diagnosis

Regional Disparities in Romania. Contribution of the Regional Operational Program to Health Infrastructure

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VICTOR PLATON

2013-01-01

Full Text Available Health infrastructure is one of the weaknesses of socio-economic development in Romania and in other European states. In order to get a better picture of the Romanian health system issues, this paper analyzes a number of statistical indicators considered representative for the national and European health infrastructure for a 20 years period, between 1990 and 2010. Our paper has three main objectives: (a to identify the main trends for health infrastructure in some of the European Union countries; (b to describe the evolution of the health system in Romania, the comparative situation at the European level as well as regional level indicators dynamics; (c to overview the Regional Operational Program in Romania, how much does it help the regional health infrastructure in our country. At the European level, there is a constant decrease in the number of hospital beds. For this indicator, Romania has slightly higher values than the European average. We must mention that the hospital beds indicator offers limited information on health infrastructure which also includes medical equipment and specific devices and practices. The number of hospitals in Romania increased with 18.9% during the last 20 years (1990-2010. During the observed timeline, the number of hospitals in Romania had a constant positive evolution at regional level. The number of doctors in hospitals has an increasing trend at the local as well as at the international level. Romania has a number of doctors twice lower than the European average (3.6 doctors for one thousand inhabitants. The Regional Operational Program (ROP has a limited influence in achieving the objectives stated in Applicants Guide for Priority Axis 3. Major Intervention Area 3.1. This happens because supporting infrastructure improvements will not create institutional modernization. The financial contribution through ROP will result in the modernization of 11% of the existing hospitals in Romania.

Observaciones ecológicas en la Isla de Salamanca (Depto. del Magdalena, Colombia Observaciones ecológicas en la Isla de Salamanca (Depto. del Magdalena, Colombia

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Schnetter Marie-Luise

1969-06-01

Full Text Available Von August 1965 bis Juni 1967 wurden auf der Isla de Salamanca ökologische Untersuchungen durchgeführt. Das genannte Gebiet liegt an der kolumbianischen Atlantikküste zwischen Barranquilla und Ciénaga und wird im Norden von der karibischen See und im Süden von der Ciénaga Grande de Santa Marta begrenzt. Die mittlere Jahrestemperatur beträgt 28° C. Die Trockenzeit dauert fünf Monate, die jährliche Niederschlagsmenge liegt wahrscheinlich bei 700 mm. Der Boden besteht überall aus Sand.  Weite Teile der Insel, vor allem im Westen, sind mit Mangrove bedeckt. Im Osten, wo die Untersuchungen durchgeführt wurden, breitet sich auf höher gelegenen Stellen ein 5-7 m hohes Gebüsch aus Dornsträuchern und Kakteen aus, In Gebieten, die sich wenig über Meeresniveau erheben, ist der Boden versalzen und entweder vegetationslos oder mit Halophyten, vor allem Batis maritima und Sesuvium portulacastrum, bedeckt. Die Bodenversalzung wird hauptsächlich durch bis an die Oberfläche aufsteigendes und dort verdunstendes salzhaltiges Grundwasser verursacht.  Während der Trockenzeit lagert sich auf den unbewachsenen Flächen eine Salzkruste ab, die in der Regenzeit durch Niederschläge ausgewaschen wird. Der Salzgehalt der mit Halophyten bestandenen Gebiete kann in der Trockenzeit über den der unbewachsenen Stellen ansteigen, was möglicherweise auf die Wasseraufnahme durch die Pflanzen und den dadurch verstärkten Wasserentzug zurückzuführen ist.  Soweit das Grundwasser dicht unter der Bodenoberfläche steht, ist ein das ganze Jahr über hoher Bodenwassergehalt vorhanden. Je mehr das Niveau ansteigt, desto geringer wird er, Am Ende der Trockenzeit kann die Wasserversorgung an mit Pflanzen bestandenen Stellen stärker beansprucht sein als an vegetationslosen. Jedoch hält in der Regenzeit der bewachsenen Boden die Niederschläge besser fest als der unbewachsene. Der Trockenbusch breitet sich nur an solchen Stellen aus, an denen das salzhaltige

Impacto de la concentración parcelaria en el paisaje de un municipio del sur de Salamanca, en una zona de espacios naturales protegidos

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García Rodríguez, María del Pilar

2011-12-01

Full Text Available The objective of this paper is to analyse the impacts caused by the concentration of land holdings on the landscape of Escurial de la Sierra, a village located in the south of the province of Salamanca (Spain. This village is part of the Biosphere Reserve of the Francia and Bejar mountain ranges (UNESCO 2006 due to the importance of its vegetation/flora, fauna and landscape. In order to observe the effect of the concentrations, several satellite images taken before and after the concentration process have been compared. The creation of 8 metre wide tracks by cutting trees and flattening the land has caused the disappearance of many hectares of forests which were either mature or in a process of regeneration. The fencing of the new parcels of land is causing the fragmentation and insularity of the land, resulting in a major impact on the metapoblational dynamics of the rich invertebrate land fauna.

[es] El objetivo del trabajo es analizar el impacto que la concentración parcelaria ha provocado en el paisaje del municipio de Escurial de la Sierra situado en el sur de la provincia de Salamanca (España. Se encuadra dentro de la Reserva de la Biosfera de las Sierras de Francia y Béjar (UNESCO 2006 con valores florísticos, faunísticos y paisajísticos muy importantes. Para ver los efectos de la concentración se comparan imágenes de satélite anteriores y posteriores a ella. La creación de pistas con desbroce y aplanamiento de hasta 8 m de anchura ha provocado la desaparición de numerosas hectáreas de bosque maduro o en recuperación. El vallado al que se están sometiendo las nuevas parcelas provoca una fragmentación e insularización del territorio con el consiguiente impacto sobre los sistemas de dinámica metapoblacional de la rica fauna de vertebrados terrestres. [fr] L’objectif de l’étude est d’analyser l’impact que la concentration parcellerait a provoqué dans le paysage de la municipalité d’Escurial de la

THE ROLE OF REGIONAL CENTERS AND UNIVERSITY CHILDREN’S HOSPITAL IN DEVELOPMENT OF HOME MECHANICAL VENTILATION NETWORK

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Rsovac Snezana

2017-08-01

Full Text Available Application of home mechanical ventilators represents the future in the treatment of children with chronic respiratory insufficiency. In this way patients are treated in the home environment, they have full support from their families, they are protected against nosocomial infections and their condition is monitored by medical staff. The role of regional centers is very important in the future development of the home mechanical ventilation network. Doctors in these centers under the full support of the University Children's Hospital physicians can assist and monitor the treatment of children on the household respirators.

Local-regional anesthesia in the management of stingray stings: Experience of the Bouffard medical-surgical hospital in Djibouti.

Science.gov (United States)

Vanoye, C; Lacroix, G; Le Gonidec, E; Couret, A; Benois, A; Peigne, V

2017-02-01

Stingray injuries are very painful. Systemic analgesics are ineffective, and the use of local-regional anesthesia has been reported. This retrospective descriptive study reviewed all cases of stingray injuries seen at the emergency department of the Bouffard Hospital (Djbouti, Africa) between 2011 and 2014. The study included 35 patients. Most of the injuries (n= 31, 89%) concerned the lower limbs. Median pain intensity was 6 [5-8] on a visual analog scale of 0 (no pain) to 10. The following systemic medications were administered: acetaminophen to 13 (27%) patients, morphine to 8 (23%), and tramadol to 6 (17%). In all, 25 (71%) patients received local-regional anesthesia, 15 (60%) by injections at the ankle. All procedures were successful, and no adverse event was reported. This study reports clinical data about stingray injuries in the Red Sea area and highlights the interest of local-regional anesthesia in their management. Most of the procedures were distal and could be performed by trained emergency physicians.

Geographic Region and Profit Status Drive Variation in Hospital Readmission Outcomes Among Inpatient Rehabilitation Facilities in the United States.

Science.gov (United States)

Daras, Laura Coots; Ingber, Melvin J; Deutsch, Anne; Hefele, Jennifer Gaudet; Perloff, Jennifer

2017-12-22

To examine whether there are differences in inpatient rehabilitation facilities' (IRFs') all-cause 30-day postdischarge hospital readmission rates vary by organizational characteristics and geographic regions. Observational study. IRFs. Medicare fee-for-service beneficiaries discharged from all IRFs nationally in 2013 and 2014 (N = 1166 IRFs). Not applicable. We applied specifications for an existing quality measure adopted by Centers for Medicare & Medicaid Services for public reporting that assesses all-cause unplanned hospital readmission measure for 30 days postdischarge from inpatient rehabilitation. We estimated facility-level observed and risk-standardized readmission rates and then examined variation by several organizational characteristics (facility type, profit status, teaching status, proportion of low-income patients, size) and geographic factors (rural/urban, census division, state). IRFs' mean risk-standardized hospital readmission rate was 13.00%±0.77%. After controlling for organizational characteristics and practice patterns, we found substantial variation in IRFs' readmission rates: for-profit IRFs had significantly higher readmission rates than did not-for-profit IRFs (Preadmission rates than did IRFs in New England that had the lowest rates. Our findings point to variation in quality of care as measured by risk-standardized hospital readmission rates after IRF discharge. Thus, monitoring of readmission outcomes is important to encourage quality improvement in discharge care planning, care transitions, and follow-up. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Social capital in a regional inter-hospital network among trauma centers (trauma network): results of a qualitative study in Germany.

Science.gov (United States)

Loss, Julika; Weigl, Johannes; Ernstberger, Antonio; Nerlich, Michael; Koller, Michael; Curbach, Janina

2018-02-26

As inter-hospital alliances have become increasingly popular in the healthcare sector, it is important to understand the challenges and benefits that the interaction between representatives of different hospitals entail. A prominent example of inter-hospital alliances are certified 'trauma networks', which consist of 5-30 trauma departments in a given region. Trauma networks are designed to improve trauma care by providing a coordinated response to injury, and have developed across the USA and multiple European countries since the 1960s. Their members need to interact regularly, e.g. develop joint protocols for patient transfer, or discuss patient safety. Social capital is a concept focusing on the development and benefits of relations and interactions within a network. The aim of our study was to explore how social capital is generated and used in a regional German trauma network. In this qualitative study, we performed semi-standardized face-to-face interviews with 23 senior trauma surgeons (2013-14). They were the official representatives of 23 out of 26 member hospitals of the Trauma Network Eastern Bavaria. The interviews covered the structure and functioning of the network, climate and reciprocity within the network, the development of social identity, and different resources and benefits derived from the network (e.g. facilitation of interactions, advocacy, work satisfaction). Transcripts were coded using thematic content analysis. According to the interviews, the studied trauma network became a group of surgeons with substantial bonding social capital. The surgeons perceived that the network's culture of interaction was flat, and they identified with the network due to a climate of mutual respect. They felt that the inclusive leadership helped establish a norm of reciprocity. Among the interviewed surgeons, the gain of technical information was seen as less important than the exchange of information on political aspects. The perceived resources derived from

Regional and temporal variations in coding of hospital diagnoses referring to upper gastrointestinal and oesophageal bleeding in Germany

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Garbe Edeltraut

2011-08-01

Full Text Available Abstract Background Health insurance claims data are increasingly used for health services research in Germany. Hospital diagnoses in these data are coded according to the International Classification of Diseases, German modification (ICD-10-GM. Due to the historical division into West and East Germany, different coding practices might persist in both former parts. Additionally, the introduction of Diagnosis Related Groups (DRGs in Germany in 2003/2004 might have changed the coding. The aim of this study was to investigate regional and temporal variations in coding of hospitalisation diagnoses in Germany. Methods We analysed hospitalisation diagnoses for oesophageal bleeding (OB and upper gastrointestinal bleeding (UGIB from the official German Hospital Statistics provided by the Federal Statistical Office. Bleeding diagnoses were classified as "specific" (origin of bleeding provided or "unspecific" (origin of bleeding not provided coding. We studied regional (former East versus West Germany differences in incidence of hospitalisations with specific or unspecific coding for OB and UGIB and temporal variations between 2000 and 2005. For each year, incidence ratios of hospitalisations for former East versus West Germany were estimated with log-linear regression models adjusting for age, gender and population density. Results Significant differences in specific and unspecific coding between East and West Germany and over time were found for both, OB and UGIB hospitalisation diagnoses, respectively. For example in 2002, incidence ratios of hospitalisations for East versus West Germany were 1.24 (95% CI 1.16-1.32 for specific and 0.67 (95% CI 0.60-0.74 for unspecific OB diagnoses and 1.43 (95% CI 1.36-1.51 for specific and 0.83 (95% CI 0.80-0.87 for unspecific UGIB. Regional differences nearly disappeared and time trends were less marked when using combined specific and unspecific diagnoses of OB or UGIB, respectively. Conclusions During the study

Artificial Intelligence techniques for big data analysis

OpenAIRE

Aditya Khatri

2017-01-01

During my stay in Salamanca (Spain), I was fortunate enough to participate in the BISITE Research Group of the University of Salamanca. The University of Salamanca is the oldest university in Spain and in 2018 it celebrates its 8th centenary. As a computer science researcher, I participated in one of the many international projects that the research group has active, especially in big data analysis using Artificial Intelligence (AI) techniques. AI is one of BISITE's main lines of rese...

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

Drug Prescribing Pattern in Two Hospitals in Mwanza, Northwest ...

African Journals Online (AJOL)

Prof. Kongola

A retrospective cross-sectional study to evaluate compliance with Tanzanian guidelines,. World Health Organization (WHO) guidelines, and various other aspects of drug prescription at Sekou Toure Regional Hospital and Magu Hospital both in Mwanza. Region of Tanzania was carried out. In particular, the study was ...

La aldea del Hierro Inicial del Cerro de San Vicente (Salamanca, España: Resultados de las excavaciones entre 1990 y 2006 a la luz de algunos debates actuales

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Antonio BLANCO-GONZÁLEZ

2017-01-01

Full Text Available Este artículo recoge algunos de los principales resultados de las excavaciones arqueológicas efectuadas entre 1990 y 2006 en el yacimiento de la Primera Edad del Hierro (800-400 cal AC del Cerro de San Vicente (Salamanca. El trabajo aborda dos cuestiones mal conocidas, centrándose en las últimas ocupaciones del asentamiento, por ser las mejor investigadas: a los procesos de formación y acumulación de restos en una aldea con arquitectura de barro; y b una caracterización social de sus habitantes. La anatomía interna de este asentamiento muestra la persistencia de usos y la superposición de desechos y estructuras. Las viviendas carecen de enseres domésticos, aparecen colmatadas con adobes y en ocasiones incendiadas. Respecto a la organización social, se detectan síntomas de división interna: las casas con atrio y sus dependencias auxiliares se cercan. Las estrategias agrarias complejas constatadas pudieron haber facilitado la acumulación de riqueza por algunas familias, dentro de una organización social heterárquica.

Performance evaluation of knowledge management among hospital employees.

Science.gov (United States)

Chang, Ying-Ying; Hsu, Pi-Fang; Li, Min-Hua; Chang, Ching-Ching

2011-01-01

The purpose of this study is to investigate the cognition of knowledge management (KM) among hospital employees and the relationship between KM and the KM enabler activities (financial, customer, internal business processes, learning and growth) in a regional hospital in Taiwan. Both qualitative and quantitative research were used in this study. The instrument was conducted using in-depth interviews of three policy-makers as participants. The quantitative data were collected from a regional hospital in the Northern part of Taiwan with a 77 percent effective response rate (n=154). The findings in this paper indicate that the cognition and demand for KM in subordinates is close to the expectations of policy-makers. The policy-makers expect subordinates working in the hospital to be brave in taking on new responsibilities and complying with hospital operation norms. KM is emphasized as a powerful and positive asset. Moreover, understanding KM predicts good performance in an organization. The findings in this paper can be generalized to other regional hospitals. The findings may be applied to a wider population. This study can provide insights into the perceptions and cognitions of workers in a hospital about KM and the activities of KM enablers. The responses and perceptions observed in the interviews in this study, as well as the quantitative research results could be useful to other hospitals and individuals who engage KM as a new management trend. This study suggested KM guidelines for policy-makers who are experienced managers.

Allegheny County Hospitals

Data.gov (United States)

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

Candida species distribution and fluconazole susceptibility of blood isolates at a regional hospital in Passo Fundo, RS, Brazil

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Maira Giseli C. Silva

2015-06-01

Full Text Available ABSTRACT Introduction: Candidemia is a bloodstream infection produced by Candida genus yeasts. Objective: The purpose of this study was to characterize the epidemiology and the fluconazole susceptibility in Candida species isolated from patients at a regional hospital in Passo Fundo, RS. Methods: Records from the laboratory were used to identify patients with positive blood cultures for Candida between 2010 and 2011. The in vitro activity of fluconazole was determined using the disk diffusion method. Results: Were analyzed 24 positive blood cultures for Candida and found a 54.16% mortality rate. C. albicans was the most prevalent species, followed by C. parapsilosis and C. krusei. For susceptibility to fluconazole, C. albicans, C. parapsilosis and C. tropicalis showed 100% sensitivity. However, C. krusei was 100% resistant; and C. glabrata, 50% resistant. Conclusion: The high mortality and fluconazole resistance rates emphasize the importance of the diagnosis of candidemia in a hospital environment.

[The computer assisted pacemaker clinic at the regional hospital of Udine (author's transl)].

Science.gov (United States)

Feruglio, G A; Lestuzzi, L; Carminati, D

1978-01-01

For a close follow-up of large groups of pacemaker patients and for evaluation of long term pacing on a reliable statistical basis, many pacemaker centers in the world are now using computer systems. A patient data system with structured display records, designed to give complete, comprehensive and surveyable information and which are immediately retrievable 24 hours a day, on display or printed sets, seems to offer an ideal solution. The pacemaker clinic at the Regional Hospital of Udine has adopted this type of system. The clinic in linked to a live, on-line patient data system (G/3, Informatica Friuli-Venezia Giulia). The input and retrieval of information are made through a conventional keyboard. The input formats have fixed headings with coded alternatives and a limited space for comments in free text. The computer edits the coded information to surveyable reviews. Searches can be made on coded information and data of interest.

Clarification of the antecedents of hospital nurse organizational citizenship behavior -- an example from a Taiwan regional hospital.

Science.gov (United States)

Chu, Cheng-I; Lee, Ming-Shinn; Hsu, Hsiang-Ming; Chen, I-Chi

2005-12-01

Organizational citizenship behaviors (OCB) are deemed indispensable due to their importance in promoting positive relationships among employees and involving employees in the organization's activities. OCB is believed to facilitate attainment of a hospital's goals and enhance a hospital's performance. The aim of this study is to extend the work of previous studies by providing an integrated model of OCB and demonstrate its applicability in a non-Western culture. Questionnaires were completed by 314 non-supervisory hospital nurses, each of whom was given a supervisor rating for their OCB. Exploratory factor analysis was used to assess the convergent and discriminant validity of the variables in the model. Multiple regression analysis was used because it provided estimates of net effects and explanatory power. The results showed that job satisfaction, supervisor support, job involvement, and procedural justices had significant effects on the nurses' citizenship behaviors. Since the study used a non-Western site in one of Taiwan's health care institutions, its overall findings should contribute to further understanding of the cross-cultural aspects of OCB.

PRENATAL ASSESSMENT OF THEIR WOMEN OF REGIONAL HOSPITAL IN THE CITY OF TEFÉ-AM

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Márcio Antônio Couto Ferreira

2011-04-01

Full Text Available With the objective of evaluating the quality of prenatal and analyse the epidemiological data of their women in the city of Tefé, in the interior of the Amazon, was a study descriptive and quantitative, secondary source documentation, by evaluation of the book of records that contain information about the card of their women who attended prenatal 93 in Tefé Regional Hospital of that city in April 2009. The results showed that the average age of women in labour was 23.3 years, most completed elementary education, and more than 50% have stable relationship, being three the number of children. Regarding prenatal assessment, 55% prenatal began until the fourth month, approximately 46% held six consultations during the prenatal,22.6% had 65.6% have 6 queries, at least 1 time basic examinations and 77% were immunized. The comparison of these results with other studies conducted in different regions of Brazil served as a tool to compare prenatal assessment in several Brazilian States. Is of great value the result of this research for improvement of care, since there are no records of assessment of quality of care provided during prenatal Amazonas State and also to encourage new research in the State.

The effects of hospital reforms on the management of public hospitals in Tanzania: Challenges and lessons learnt.

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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.

[Complexity of care and organizational effectiveness: a survey among medical care units in nine Lombardy region hospitals].

Science.gov (United States)

Pasquali, Sara; Capitoni, Enrica; Tiraboschi, Giuseppina; Alborghetti, Adriana; De Luca, Giuseppe; Di Mauro, Stefania

2017-01-01

Eleven medical care units of nine Lombardy Region hospitals organized by levels of care model or by the traditional departmental model have been analyzed, in order to evaluate if methods for complexity of patient-care evaluation represent an index factor of nursing organizational effectiveness. Survey with nine Nurses in managerial position was conducted between Nov. 2013-Jan. 2014. The following factors have been described: context and nursing care model, staffing, complexity evaluation, patient satisfaction, staff well-being. Data were processed through Microsoft Excel. Among Units analysed ,all Units in levels of care and one organized by the departmental model systematically evaluate nursing complexity. Registered Nurses (RN) and Health Care Assistants (HCA) are on average numerically higher in Units that measure complexity (0.55/ 0.49 RN, 0.38/0.23 HCA - ratio per bed). Adopted measures in relation to changes in complexity are:rewarding systems, supporting interventions, such as moving personnel within different Units or additional required working hours; reduction in number of beds is adopted when no other solution is available. Patient satisfaction is evaluated through Customer Satisfaction questionnaires. Turnover, stress and rate of absenteeism data are not available in all Units. Complexity evaluation through appropriate methods is carried out in all hospitals organized in levels of care with personalized nursing care models, though complexity is detected with different methods. No significant differences in applied managerial strategies are present. Patient's satisfaction is evaluated everywhere. Data on staffing wellbeing is scarcely available. Coordinated regional actions are recommended in order to gather comparable data for research, improve decision making and effectiveness of Nursing care.

[Ryazan hospital--80 years].

Science.gov (United States)

Klimov, A S; Gromov, M F

2012-02-01

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

[Clinical pharmacy: Evaluation of physician's satisfactions and expectations in a French regional hospital].

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Jennings, P; Lotito, A; Baysson, H; Pineau-Blondel, E; Berlioz, J

2017-03-01

The purpose of the study was to evaluate physician's satisfaction with the clinical pharmacy activities in a French regional hospital. Data were collected by face-to-face interviews carried out by a public health intern with physicians from 14 different departments of medicine and surgery. A specifically designed questionnaire was used for this study. This contained 18 closed-ended questions, 3 open-ended questions and 6 questions relating to the multidisciplinary analysis of prescriptions of elderly patients. The questionnaire was proposed to 78 physicians, of which 62 replied (participation rate of 79%). Thirty-seven percent were interns (23/62), 19% were assistants (12/62) and 44% were senior physicians (27/62). Clinical pharmacy satisfaction levels were generally very high. In regard to clinical skills, 87% of the physicians were satisfied with pharmacists' competencies and 91% by the pertinence of transmitted information. Ninety-five percent of the physicians were also satisfied by the logistical aspect and the relationship with pharmacists (reactivity, availability and communication). Analysis of the open-ended questions showed that physicians were in favour of the increased presence of clinical pharmacists on the wards. This study shows a high level of physician satisfaction in relation to the clinical pharmacy activities in our hospital, and should be viewed as a strong endorsement of the work of the clinical pharmacy. This study highlights some areas of improvement such as increase presence of the clinical pharmacists on the wards. In order to assess periodically our activity, this study must be repeated in the future. Copyright © 2016 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

VT Hospital Site Locations

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

Hospital differences in rates of cesarean deliveries in the Sardinian region: An observational study

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Massimo Cannas

2014-11-01

Full Text Available Background: The rates of cesarean deliveries have been increasing steadily in several European countries in recent decades, with Italy having the second-highest rate (38% in 2010, causing concern and debate about the appropriateness of many interventions. Moreover, some recent studies suggest that rates of common obstetric interventions are not homogeneous across hospitals, maybe not only because of patient case mix but also possibly because of different hospital practices and cultures. Thus, it is important to investigate whether the variation in rates of cesarean sections can be traced back to patient characteristics or whether it depends upon context variables at the hospital level. Objective and method: Using official hospital abstracts on deliveries that occurred in Sardinia over a two-year period, we implement multilevel logistic regression models in order to assess whether the observed differences in cesarean rates across hospitals can be justified by case-mix differences across hospitals. Results: The between-hospital variation in rates of cesarean delivery is estimated to be 0.388 in the model with only the intercept and 0.382 in the model controlling for the mother’s clinical and sociodemographic characteristics. Conclusions: The results show that taking into account the individual characteristics of delivered mothers is not enough to justify the observed variation across hospital rates, suggesting the important role of unobserved variables at the hospital level in determining cesarean section rates.

Anemia y deficiencia de hierro en mujeres en edad reproductiva usuarias del Hospital Regional de Villa Hayes, Paraguay

OpenAIRE

Jessica Riveros; Gloria Echagüe; Santiago Evers; Laura Mendoza

2015-01-01

La anemia es un problema de salud pública a nivel mundial. En Paraguay, existen datos limitados sobre la frecuencia de anemia en mujeres en edad reproductiva no gestantes. Este estudio piloto descriptivo de corte transverso tuvo como objetivo determinar la frecuencia de anemia y deficiencia de hierro, el estado nutricional, hábitos alimentarios y tóxicos en 99 mujeres no gestantes en edad reproductiva de 18 a 48 años que acudieron al Hospital Regional de Villa Hayes en Octubre del 2.014. La a...

A case study of hospital operations management.

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Cheng, T C

1987-12-01

This paper discusses a study to investigate various operations management problems in a newly opened, modern regional hospital in Hong Kong. The findings of the study reveal that there exist in the hospital a number of current and potential problem areas. Recommendations for solving these problems are suggested with a view to improving the overall operational efficiency and effectiveness of the hospital.

EXPERIENCIAS PSICOSEXUALES DE PACIENTES HISTERECTOMIZADAS DEL SERVICIO DE GINECOLOGÍA DEL HOSPITAL REGIONAL DOCENTE LAS MERCEDES – CHICLAYO 2013

OpenAIRE

Núñez Manayay, Tania Mercedes; Universidad Señor de Sipán; Vera Ñañez, Huendy Jame; Universidad Señor de Sipán

2014-01-01

 La presente investigación cualitativa titulada Experiencias psicosexuales de pacientes histerectomizadas del servicio de Ginecología del Hospital Regional Docente las Mercedes – Chiclayo 2013 tuvo como objetivo describir las experiencias psicosexuales de pacientes histerectomizadas. Con diseño estudio de caso; la muestra conformada por siete pacientes post histerectomizadas de seis meses a un año; en la recolección de datos se utilizó la observación y la entrevista semiestructurada, las que ...

[Prevalence of anemia in pregnancy, Pucallpa Regional Hospital, Perú].

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Becerra, C; Gonzales, G F; Villena, A; de la Cruz, D; Florián, A

1998-05-01

Population based health surveys in Peru show that the general fertility rates, proportion of pregnant adolescents, and maternal and child morbidity are higher in the jungle regions than in other parts of the country. Endemic intestinal parasitic diseases increase the risk of anemia in pregnant women already suffering from iron, folic acid, and other nutritional deficiencies. This is the most common complication of pregnancy in many Latin American countries and is often associated with premature labor, low birthweight, and perinatal mortality. There are very few studies on this subject based on jungle populations and no reliable estimates of the prevalence of anemia in local pregnant women. The present study was designed to determine the prevalence of anemia in pregnant women attending the Regional Hospital in Pucallpa, located in the Peruvian jungle, from January 1993 to June 1995. This cross-sectional study, which was based on the registries of prenatal and childbirth services encompassing 1,015 pregnant women, looked into the potential association between anemia and such variables as the mother's chronological age, schooling, previous pregnancies, and weight at the beginning of pregnancy. Maternal hemoglobin levels were compared with the newborns' weight at birth. The prevalence of anemia in this population sample was 70.1%. This value was not modified when adjusted for maternal age, schooling, or interval between births. Anemia prevalence was directly related to the number of previous pregnancies and inversely related to weight gain during pregnancy. The perinatal mortality rate was 37.7 per 1,000 births. Neither this rate nor the birthweights were associated with the mother's degree of anemia. A multivariate regression analysis showed that maternal body weight at the start of pregnancy (P = 0.0001), weight gain during pregnancy (P = 0.0001), and the number of pregnancies (P = 0.008) are predictors of birthweight. Results showed that the high prevalence of

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

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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.

Survey of advanced radiation technologies used at designated cancer care hospitals in Japan

International Nuclear Information System (INIS)

Shikama, Naoto; Tsujino, Kayoko; Nakamura, Katsumasa; Ishikura, Satoshi

2014-01-01

Our survey assessed the use of advanced radiotherapy technologies at the designated cancer care hospitals in Japan, and we identified several issues to be addressed. We collected the data of 397 designated cancer care hospitals, including information on staffing in the department of radiation oncology (e.g. radiation oncologists, medical physicists and radiation therapists), the number of linear accelerators and the implementation of advanced radiotherapy technologies from the Center for Cancer Control and Information Services of the National Cancer Center, Japan. Only 53% prefectural designated cancer care hospitals and 16% regional designated cancer care hospitals have implemented intensity-modulated radiotherapy for head and neck cancers, and 62% prefectural designated cancer care hospitals and 23% regional designated cancer care hospitals use intensity-modulated radiotherapy for prostate cancer. Seventy-four percent prefectural designated cancer care hospitals and 40% regional designated cancer care hospitals employ stereotactic body radiotherapy for lung cancer. Our multivariate analysis of prefectural designated cancer care hospitals which satisfy the institute's qualifications for advanced technologies revealed the number of radiation oncologists (P=0.01) and that of radiation therapists (P=0.003) were significantly correlated with the implementation of intensity-modulated radiotherapy for prostate cancer, and the number of radiation oncologists (P=0.02) was correlated with the implementation of stereotactic body radiotherapy. There was a trend to correlate the number of medical physicists with the implementation of stereotactic body radiotherapy (P=0.07). Only 175 (51%) regional designated cancer care hospitals satisfy the institute's qualification of stereotactic body radiotherapy and 76 (22%) satisfy that of intensity-modulated radiotherapy. Seventeen percent prefectural designated cancer care hospitals and 13% regional designated cancer care hospitals

The financial impact of hospitals on the local economy--2 new factors.

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Rotarius, Timothy; Liberman, Aaron

2014-01-01

This research effort presents a descriptive analysis of the financial impact that several hospitals have on their local economy. An earlier study published by the authors included 3 distinct, yet overlapping components of financial impact: (1) the hospital system as a major health care provider, (2) the hospital system as a large employer, and (3) the hospital system as an entity whose employees contribute greatly to their local community. This new study added additional financial impact factors: (4) the hospital system as an organization committed to major construction projects in pursuit of its health services mission, and (5) the hospital system as an entity that pays taxes to government agencies. The inextricable relationship of these 5 categories both increases and enhances the impact of the hospital system on the local region. The results of this updated and expanded analysis suggest strongly that the hospital system represents 1 of the primary contributors to the economy of the region. The hospital system adds $3 billion to the $28 billion local economy, which means that the hospital system and its employees are responsible for 10.7% of the total economic prowess of the region.

Tumors and tumor - like lesions of the oro - facial region at Mayo hospital, Lahore - a five year study

International Nuclear Information System (INIS)

Riaz, N.; Warriach, R.A.

2011-01-01

The oro-facial region including the oral cavity, the maxilla and mandible and related tissues can be the site of a multitude of neoplastic conditions. These tumours have a predilection for the entire facial region; however, odontogenic tumours tend to affect the mandible more than the maxilla. We report results from a retrospective study spanning five years on the frequency, clinical presentation, sites and character of orofacial tumors seen in the main referral hospital of Pakistan. Patients and Methods: Records of consecutive patients of all age and sex seen by the author's team at the Department of Oral and Maxillofacial Surgery, Mayo Hospital with tumours affecting the oro-facial region from January 2005 to December 2009 were retrieved, coded and entered into a database. The data were then analyzed by age, sex, presenting signs and symptoms, site of lesion, and their histology. Results: A total of 237 patients with oro-facial swellings were retrieved from the registry. The complete data set was obtained for 189 patients, comprising 108 (57.9%) males and 81 (42%) females. The most common clinical presenting features were mandibular facial swelling (63%), intra-oral swelling (55%), and ulceration (29%). The tumors were found in the mandible 67 (35%), buccal mucosa 33 (17%), floor of the mouth 22 (11%) and tongue 29 (15%). The remainder making up almost 20% was found in the palate, submandibular region, pre auricular region and lips. Ninety three (49.2%) of the patients presented with lesions that were classified as malignant of which 64 (69%) were diagnosed as squamous cell carcinoma (SCC). seventy (37.0%) had benign odontogenic tumors and twenty six (13.7%) had non-odontogenic tumor - like lesions. Sixty - four (69%) of malignant tumors were squamous cell carcinoma; sixty four (86.4%) of the benign odontogenic tumors were classified as ameloblastoma. The mean age at presentation of all lesions was 40.4 years with over 50% of benign lesions in patients aged

Bootstrapping data envelopment analysis of efficiency and productivity of county public hospitals in Eastern, Central, and Western China after the public hospital reform.

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Wang, Man-Li; Fang, Hai-Qing; Tao, Hong-Bing; Cheng, Zhao-Hui; Lin, Xiao-Jun; Cai, Miao; Xu, Chang; Jiang, Shuai

2017-10-01

China implemented the public hospital reform in 2012. This study utilized bootstrapping data envelopment analysis (DEA) to evaluate the technical efficiency (TE) and productivity of county public hospitals in Eastern, Central, and Western China after the 2012 public hospital reform. Data from 127 county public hospitals (39, 45, and 43 in Eastern, Central, and Western China, respectively) were collected during 2012-2015. Changes of TE and productivity over time were estimated by bootstrapping DEA and bootstrapping Malmquist. The disparities in TE and productivity among public hospitals in the three regions of China were compared by Kruskal-Wallis H test and Mann-Whitney U test. The average bias-corrected TE values for the four-year period were 0.6442, 0.5785, 0.6099, and 0.6094 in Eastern, Central, and Western China, and the entire country respectively, with average non-technical efficiency, low pure technical efficiency (PTE), and high scale efficiency found. Productivity increased by 8.12%, 0.25%, 12.11%, and 11.58% in China and its three regions during 2012-2015, and such increase in productivity resulted from progressive technological changes by 16.42%, 6.32%, 21.08%, and 21.42%, respectively. The TE and PTE of the county hospitals significantly differed among the three regions of China. Eastern and Western China showed significantly higher TE and PTE than Central China. More than 60% of county public hospitals in China and its three areas operated at decreasing return scales. There was a considerable space for TE improvement in county hospitals in China and its three regions. During 2012-2015, the hospitals experienced progressive productivity; however, the PTE changed adversely. Moreover, Central China continuously achieved a significantly lower efficiency score than Eastern and Western China. Decision makers and administrators in China should identify the causes of the observed inefficiencies and take appropriate measures to increase the efficiency of county

[Historical exploration of Acapulco hospitals, Guerrero, Mexico].

Science.gov (United States)

Fajardo-Ortiz, Guillermo; Salcedo-Alvarez, Rey Arturo

2006-01-01

This study attempts to recount the history of the main hospitals of the port of Acapulco from colonial times until the end of the 20th century. The Augustine friars began hospital care at the end of the first part of the 16th century. Later, Bernardino Alvarez (1514?-1584), with the support of the Spanish crown, founded the first formal hospital in Acapulco called Hospital de Nuestra Señora de la Consolación (Our Lady of Consolation Hospital). During the 16th and 17th centuries, the sick were attended by friars, and by the end of the 19th century there were physicians and surgeons. From the end of the Independence War until the end of the 19th century, the port did not have any true hospital. The first degreed physicians and surgeons arrived and resided in Acapulco in 1920. In 1938, the Hospital Civil Morelos (Morelos Civil Hospital) began providing services. It was replaced by the Hospital General de Acapulco (General Hospital of Acapulco). At the fourth decade of the past century the Cruz Roja (Red Cross) was created. In 1957 the hospital services of the Instituto Mexicano del Seguro Social (IMSS, Mexican Institute of Social Security), which was founded in 1963, was inaugurated with the Unidad Medico/Social (Medical and Social Unit) of the IMSS in Acapulco. This began the journey of modernity in Acapulco. In 1992, Hospital Regional Vicente Guerrero (Regional Hospital Vicente Guerrero) of the IMSS, initiated its services. In 1960, medical services for civil workers and their families were housed in the Hospital Civil Morelos (Morelos Civil Hospital). Shortly afterwards, the Instituto de Seguridad y Servicios Sociales para los Trabajadores del Estado (ISSSTE, Security and Social Services Institute for State Employees) had their own hospital. During the 20th century, Acapulco has added other hospital services to care for members of the navy and armed forces, as well as for those persons with financial resources for private care.

Analysis of hospital logistics and costs of the Clinical Engineering Sector in a Philanthropic Hospital

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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.

Study of radiological risk at the Regional Hospital of Trujillo-Peru

International Nuclear Information System (INIS)

Regalado C, S.; Benavente A, T.; Celedonio O, E.; Vasquez A, M.

1996-01-01

The irradiation doses have been measured in operators, patients and members of public, who attend the diagnostic service of the Hospital Regional Docente in Trujillo, Peru by using TLD-100 and TLD-200. For cranium test, the results are 8,68 x 10 -3 mSv in operators and 7,8 x 10 -4 mSv in members of the public. It means a fatal cancer risk of 3,7 x 10 -7 and 3,9 x 10 -8 , respectively. For patients, the equivalent doses in the examined organs are 0,181 mSv in lung; 4,982 mSv in spine; 6,466 mSv in abdomen; 6,039 mSv in pelvis and 2,174 mSv in cranium. In order to maximize benefits for patients, a quality control program was carried out in x-ray equipment. It consisted in the measurement of an effective, average and maximum kilovoltage, as well as in the determination of the HVL, linearity, exposition time and coincidence between luminous and radiation fields. It was concluded that the measured doses are similar to the international ones reported. In the same way, it is indicated that it is possible to reduce risks in patients and operators by regulating kilo-voltages, adjusting the radiation fields and electronic calibration equipment. (authors). 4 refs., 2 tabs

Morbimortalidad neonatal durante seis meses en un hospital regional en Ghana

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María Caridad Corría Santos

2014-08-01

Full Text Available Se realizó un trabajo descriptivo de corte transversal sobre la morbimortalidad en la unidad de cuidados intensivos neonatales del Hospital Regional Sunyani de Ghana, en un periodo de seis meses, desde agosto de 2009 hasta enero de 2010, con el objetivo de determinar el comportamiento de la morbimortalidad de 170 neonatos, que necesitaron de estos servicios en el periodo estudiado. Se revisaron las entidades o eventos clínicos definidos y diagnosticados al egreso, así como la cantidad de pacientes que sobrevivieron y los fallecidos. Los datos fueron obtenidos de historias clínicas y el libro de registro del referido servicio. Los resultados se presentaron en tablas y mediante el empleo de la estadística porcentual. La prematuridad estuvo presente en 89 pacientes (52%, seguido de la asfixia, en 51 (30% y de la sepsis neonatal, en 46 (27%. Fallecieron 33 neonatos (19,4% y sobrevivieron 137 (80,6%. Las entidades clínicas más frecuentes en los fallecidos fueron: prematuridad en 21 pacientes (63%, asfixia perinatal en 19 neonatos (57,6% y la sepsis en 9 (27,3%. Un paciente falleció (0,6% con diagnóstico de tétanos neonatal. La letalidad y la sobrevida se comportaron como en la generalidad de los países en vías de desarrollo

Hospital-related incidents; causes and its impact on disaster preparedness and prehospital organisations

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Khorram-Manesh Amir

2009-06-01

Full Text Available Abstract Background A hospital's capacity and preparedness is one of the important parts of disaster planning. Hospital-related incidents, a new phenomenon in Swedish healthcare, may lead to ambulance diversions, increased waiting time at emergency departments and treatment delay along with deterioration of disaster management and surge capacity. We aimed to identify the causes and impacts of hospital-related incidents in Region Västra Götaland (western region of Sweden. Methods The regional registry at the Prehospital and Disaster Medicine Center was reviewed (2006–2008. The number of hospital-related incidents and its causes were analyzed. Results There were an increasing number of hospital-related incidents mainly caused by emergency department's overcrowdings, the lack of beds at ordinary wards and/or intensive care units and technical problems at the radiology departments. These incidents resulted in ambulance diversions and reduced the prehospital capacity as well as endangering the patient safety. Conclusion Besides emergency department overcrowdings, ambulance diversions, endangering patient s safety and increasing risk for in-hospital mortality, hospital-related incidents reduces and limits the regional preparedness by minimizing the surge capacity. In order to prevent a future irreversible disaster, this problem should be avoided and addressed properly by further regional studies.

Quality of stroke care at an Irish Regional General Hospital and Stroke Rehabilitation Unit.

LENUS (Irish Health Repository)

Walsh, T

2012-01-31

BACKGROUND: Robust international data support the effectiveness of stroke unit (SU) care. Despite this, most stroke care in Ireland are provided outside of this setting. Limited data currently exist on the quality of care provided. AIM: The aim of this study is to examine the quality of care for patients with stroke in two care settings-Regional General Hospital (RGH) and Stroke Rehabilitation Unit (SRU). METHODS: A retrospective analysis of the stroke records of consecutive patients admitted to the SRU between May-November 2002 and April-November 2004 was performed applying the UK National Sentinel Audit of Stroke (NSAS) tool. RESULTS: The results of the study reveal that while SRU processes of care was 74% compliant with standards; compliance with stroke service organisational standards was only 15 and 43% in the RGH and SRU, respectively. CONCLUSION: The quality of stroke care in our area is deficient. Comprehensive reorganisation of stroke services is imperative.

Candidemia in a major regional tertiary referral hospital – epidemiology, practice patterns and outcomes

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Jocelyn Qi-Min Teo

2017-03-01

Full Text Available Abstract Background Candidemia is a common cause of nosocomial bloodstream infections, resulting in high morbidity and mortality. This study was conducted to describe the epidemiology, species distribution, antifungal susceptibility patterns and outcomes of candidemia in a large regional tertiary referral hospital. Methods A retrospective surveillance study of patients with candidemia was conducted at Singapore General Hospital between July 2012 and December 2015. In addition, incidence densities and species distribution of candidemia episodes were analysed from 2008 to 2015. Results In the period of 2012 to 2015, 261 candidemia episodes were identified. The overall incidence was 0.14/1000 inpatient-days. C. glabrata (31.4%, C. tropicalis (29.9%, and C. albicans (23.8% were most commonly isolated. The incidence of C. glabrata significantly increased from 2008 to 2015 (Coefficient 0.004, confidence interval 0–0.007, p = 0.04. Fluconazole resistance was detected primarily in C. tropicalis (16.7% and C. glabrata (7.2%. fks mutations were identified in one C. albicans and one C. tropicalis. Candidemia episodes caused by C. tropicalis were more commonly encountered in patients with haematological malignancies (p = 0.01, neutropenia (p < 0.001 and higher SAPS II scores (p = 0.02, while prior exposure to echinocandins was associated with isolation of C. parapsilosis (p = 0.001. Echinocandins (73.3% were most commonly prescribed as initial treatment. The median (range time to initial treatment was 1 (0–9 days. The 30-day in-hospital mortality rate was 49.8%. High SAPS II score (Odds ratio, OR 1.08; 95% confidence interval, CI 1.05–1.11 and renal replacement therapy (OR 5.54; CI 2.80–10.97 were independent predictors of mortality, while drain placement (OR 0.44; CI 0.19–0.99 was protective. Conclusions Decreasing azole susceptibilities to C. tropicalis and the emergence of echinocandin resistance suggest that susceptibility

Hospitalization flow in the public and private systems in the state of Sao Paulo, Brazil.

Science.gov (United States)

Rocha, Juan Stuardo Yazlle; Monteiro, Rosane Aparecida; Moreira, Marizélia Leão

2015-01-01

OBJECTIVE To describe the migration flows of demand for public and private hospital care among the health regions of the state of Sao Paulo, Brazil.METHODS Study based on a database of hospitalizations in the public and private systems of the state of Sao Paulo, Southeastern Brazil, in 2006. We analyzed data from 17 health regions of the state, considering people hospitalized in their own health region and those who migrated outwards (emigration) or came from other regions (immigration). The index of migration effectiveness of patients from both systems was estimated. The coverage (hospitalization coefficient) was analyzed in relation to the number of inpatient beds per population and the indexes of migration effectiveness.RESULTS The index of migration effectiveness applied to the hospital care demand flow allowed characterizing health regions with flow balance, with high emigration of public and private patients, and with high attraction of public and private patients.CONCLUSIONS There are differences in hospital care access and opportunities among health regions in the state of Sao Paulo, Brazil.

Treatment of non-Hodgkin lymphoma and mature В-cell acute leukemia in children and adolescents: data of Russian regional hospitals

Directory of Open Access Journals (Sweden)

Ye. V. Samochatova

2014-07-01

Full Text Available The article presents treatment results of 233 patients (children and adolescents under 19 years old; median — 8.76 years with CD20-positive non-Hodgkin lymphomas and B-cell acute leukemia (B-NHL/B-AL received chemotherapy (BFM B-NHL 90–95 protocols or combined chemo-immunotherapy with rituximab (B-NHL-2004mab protocol. Combined chemo-immunotherapy was used for patients with Burkitt lymphoma, diffuse large cells lymphomas stage III–IV and B-AL, and included cytoreductive phase, 6 polychemotherapy (PCT courses and rituximab. PCT courses are similar to those of original BFM B-NHL90 protocol, except for the first 2 courses, where daily methotrexate dose was reduced from 5 to 1 g/m2/24 h. Rituximab infused IV 12 hours before the start of first 4 chemotherapy courses at a dose of 375 mg/m2. The data in the questionnaires form have been submitted from 28 pediatric specialized hospitals from 27 Russia regions over the past 5 years (2005–2009. Protocol with rituximab has proved to be more effective than chemotherapy alone. The authors discuss the possibility of using combined chemo-immunotherapy for the treatment of B-NHL/B-AL at regional hospitals and the prospects for further treatment results improvement in this group of tumors.

Treatment of non-Hodgkin lymphoma and mature В-cell acute leukemia in children and adolescents: data of Russian regional hospitals

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Ye. V. Samochatova

2011-01-01

Full Text Available The article presents treatment results of 233 patients (children and adolescents under 19 years old; median — 8.76 years with CD20-positive non-Hodgkin lymphomas and B-cell acute leukemia (B-NHL/B-AL received chemotherapy (BFM B-NHL 90–95 protocols or combined chemo-immunotherapy with rituximab (B-NHL-2004mab protocol. Combined chemo-immunotherapy was used for patients with Burkitt lymphoma, diffuse large cells lymphomas stage III–IV and B-AL, and included cytoreductive phase, 6 polychemotherapy (PCT courses and rituximab. PCT courses are similar to those of original BFM B-NHL90 protocol, except for the first 2 courses, where daily methotrexate dose was reduced from 5 to 1 g/m2/24 h. Rituximab infused IV 12 hours before the start of first 4 chemotherapy courses at a dose of 375 mg/m2. The data in the questionnaires form have been submitted from 28 pediatric specialized hospitals from 27 Russia regions over the past 5 years (2005–2009. Protocol with rituximab has proved to be more effective than chemotherapy alone. The authors discuss the possibility of using combined chemo-immunotherapy for the treatment of B-NHL/B-AL at regional hospitals and the prospects for further treatment results improvement in this group of tumors.

Hospital emergency preparedness

African Journals Online (AJOL)

Tamara Shefer

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

Survey on changes of breast cancer radiotherapy in four hospitals within southeast coastal region of China

International Nuclear Information System (INIS)

Ji Yongling; Liu Jingjie; Tian Ye; Li Xianming; Zhu Yaqun; Yu De; Du Xianghui

2010-01-01

Objective: to explore the changes and the tendency of breast cancer radiotherapy in China within the past decade. Methods: A survey on breast cancer radiotherapy in 1999 and 2006 was conducted in 4 hospitals located within the southeast coastal region of China, including patients' clinical characteristics, the purpose of radiotherapy and its techniques. Results: The percentage of breast conservative treatment (BCT) increased from 3% in 1999 to 13% in 2006. For radiotherapy techniques in 2066 compared with 1999, the growth trend was found in use of breast immobilization devices (80% vs. 46%), treatment planning system (70% vs. 23%), and CT simulation (14% vs. 0). The frequency was increased in the chest wall irradiation after mastectomy (90% vs. 67%), but decreased in internal mammary region (30% vs. 76%) and axilla (37% vs. 69%) treatment. There were no differences in total dose and fractionation prescription. Conclusions: BCT was performed more frequently, but post-mastectomy radiotherapy was still essential option in China at present. Although some advanced techniques were applied frequently in clinical practice. Simulation, treatment planning, and irradiation target design were urgent for improvement and standardization. (authors)

Evaluation of nutritional support in a regional hospital.

Science.gov (United States)

Morán López, Jesús Manuel; Hernández González, Miriam; Peñalver Talavera, David; Peralta Watt, María; Temprano Ferreras, José Luis; Redondo Llorente, Cristina; Rubio Blanco, María Yolanda

2018-05-08

Disease-related malnutrition (DRM) is highly prevalent in Spanish hospitals (occurring in 1 out of every 4 patients). The 'Más Nutridos' Alliance has developed an action plan to detect and treat DRM. In Extremadura (Spain), the public health system has included nutritional screening as the only mechanism to fight malnutrition. The results of this strategy are evaluated here. An agreement study was conducted in standard clinical practice. Variables collected included the following rates: nutritional screening at entry, coded nutritional diagnoses, nutritional status assessment, nutritional requirements, successful nutritional therapy, weight and height at entry and discharge, referral to a nutritional support unit (NSU). Standards to comparison based on the results of the Netherland Program to Fight Malnutrition. Nutritional screening rate at entry was 20.5% (95% CI: 18.00-21.00). Coding and nutritional status assessment rate at entry was 13%. Weight and height were both measured in 16.5% of patients at entry and 20% at discharge. Nutritional requirements were estimated in 30% and were poorly monitored (13.3%). Only 15% of patients were referred to a NSU. Significantly lower values were found for all indicators as compared to standards, with kappa values lower than 0.2 in all cases. Data analysis showed poorer results when patients referred to the NSU were excluded. A strategy to fight malnutrition based on nutritional screening alone is highly inefficient in hospitals such as HVP. Copyright © 2018 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.

Predictors of regional Medicare expenditures for otolaryngology physician services.

Science.gov (United States)

Smith, Alden; Handorf, Elizabeth; Arjmand, Ellis; Lango, Miriam N

2017-06-01

To describe geographic variation in spending and evaluate regional Medicare expenditures for otolaryngologist services with population- and beneficiary-related factors, physician supply, and hospital system factors. Cross-sectional study. The average regional expenditures for otolaryngology physician services were defined as the total work relative value units (wRVUs) collected by otolaryngologists in a hospital referral region (HRR) per thousand Medicare beneficiaries in the HRR. A multivariable linear regression model tested associations with regional sociodemographics (age, sex, race, income, education), the physician and hospital bed supply, and the presence of an otolaryngology residency program. In 2012, the mean Medicare expenditure for otolaryngology provider services across HRRs was 224 wRVUs per thousand Medicare beneficiaries (standard deviation [SD] 104), ranging from 31 to 604 wRVUs per thousand Medicare beneficiaries. In 2013, the average Medicare expenditures for each HRR was highly correlated with expenditures collected in 2012 (Pearson correlation coefficient .997, P = .0001). Regional Medicare expenditures were independently and positively associated with otolaryngology, medical specialist, and hospital bed supply in the region, and were negatively associated with the supply of primary care physicians and presence of an otolaryngology residency program after adjusting for other factors. The magnitude of associations with physician supply and hospital factors was stronger than any population or Medicare beneficiary factor. Wide variations in regional Medicare expenditures for otolaryngology physician services, highly stable over 2 years, were strongly associated with regional health system factors. Changes in health policy for otolaryngology care may require coordination with other physician specialties and integrated hospital systems. NA. Laryngoscope, 127:1312-1317, 2017. © 2016 The American Laryngological, Rhinological and Otological Society

The impact of ice-skating injuries on orthopaedic admissions in a regional hospital.

LENUS (Irish Health Repository)

Dillon, J P

2012-02-03

Since the opening of a temporary ice-rink in our hospital\\'s catchment area, we have observed an increase in patients requiring in-patient treatment for orthopaedic intervention. The authors performed a prospective analysis of all patients admitted to our unit over a one-month period. Epidemiological data, wearing of protective gear and skater experience were collected. Fracture type, treatment required, average length of hospital stay and number of days missed from work was also recorded. Ice-skating injuries accounted for 7.7% of our total admissions over the study period. There was a significant variation noted in the types of fracture sustained ranging from comminuted fractures of the radial head to spiral fractures of the tibia. The average length of hospital stay was 2.6 days and average time missed from work was 6.1 weeks. This paper highlights the potential serious injuries that can occur in ice-skating and their impact on admissions to our orthopaedic unit.

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.

Frecuencia de micosis en pacientes inmunosuprimidos de un hospital regional de la Ciudad de México

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Hernández-Hernández Francisca

2003-01-01

Full Text Available OBJETIVO: Aislar e identificar hongos en diferentes especímenes de pacientes inmunocomprometidos, atendidos en un hospital de la Ciudad de México, y determinar su asociación con micosis. MATERIAL Y MÉTODOS: Se realizó un estudio de tipo observacional transversal en pacientes del Hospital Regional General Ignacio Zaragoza, de junio de 1999 a mayo de 2000. De 108 pacientes se procesaron 268 especímenes para estudio micológico que incluyó examen directo, frotis, cultivos y microcultivos en medios específicos además de pruebas bioquímicas. La mayoría de pacientes tenía diagnóstico clínico de tuberculosis pulmonar y de síndrome de inmunodeficiencia adquirida. RESULTADOS: Se obtuvieron 183 aislamientos de levaduras y 66 de hongos filamentosos. Se diagnosticaron 45 micosis que en su mayoría correspondieron a candidosis pulmonar (32 casos. Las especies de Candida más frecuentes asociadas a patología fueron Candida albicans y C parapsilosis. Se obtuvieron cinco aislamientos de Cryptococcus neoformans variedad neoformans, uno de C albidus, tres de Histoplasma capsulatum y uno de Geotrichum candidum, asociados a infección micótica. CONCLUSIONES: El 41.6% de los pacientes estudiados presentaron una micosis asociada principalmente a síndrome de inmunodeficiencia adquirida y a tuberculosis pulmonar.

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.

La musealización del Patrimonio Histórico Educativo en Zamora // Musealization of the Educational heritage in Zamora.

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Blanca Flor Herrero Morán

2014-06-01

Full Text Available (ES Actualmente existe un único museo dedicado al patrimonio histórico-educativo ubicado en Zamora, el Centro Museo Pedagógico de la Universidad de Salamanca (CEMUPE. Ahora bien, dado que el objetivo de este artículo es analizar la musealización del patrimonio educativo en Zamora, junto a la reflexión sobre el contenido, el continente y el proyecto museístico de dicho museo se incluye una referencia a diferentes iniciativas museísticas llevadas a cabo en la capital como: exposiciones temporales, exposiciones permanentes, o la propuesta de un museo pedagógico regional. (EN There is a unique museum dedicated to the historic educational heritage located in Zamora, the University of Salamanca Teaching Center Museum (CEMUPE. However, since the objective of this article is to analyze the musealization of the educational heritage in Zamora, next to the reflection on the content, the continent and the Museum Project, we include a reference to different museums initiatives carried out in the city as: temporary exhibitions, permanent exhibitions, or the proposal for a regional pedagogical Museum.

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

Long-term evaluation of a hospital-based violence intervention program using a regional health information exchange.

Science.gov (United States)

Bell, Teresa M; Gilyan, Dannielle; Moore, Brian A; Martin, Joel; Ogbemudia, Blessing; McLaughlin, Briana E; Moore, Reilin; Simons, Clark J; Zarzaur, Ben L

2018-01-01

Hospital-based violence intervention programs (HVIP) aim to reduce violent-injury recidivism by providing intensive case management services to high-risk patients who were violently injured. Although HVIP have been found effective at reducing recidivism, few studies have sought to identity how long their effects last. Additionally, prior studies have been limited by the fact that HVIP typically rely on self-report or data within their own healthcare system to identify new injuries. Our aim was to quantify the long-term recidivism rate of participants in an HVIP program using more objective and comprehensive data from a regional health information exchange. The study included 328 patients enrolled in Prescription for Hope (RxH), an HVIP, between January 2009 and August 2016. We obtained RxH participants' emergency department (ED) encounter data from a regional health information exchange database from the date of hospital discharge to February 2017. Our primary outcome was violent-injury recidivism rate of the RxH program. We also examined reasons for ED visits that were unrelated to violent injury. We calculated a 4.4% recidivism rate based on 8 years of statewide data, containing 1,575 unique encounters. More than 96% of participants were matched in the state database. Of the 15 patients who recidivated, only five were admitted for their injury. More than half of new violence-related injuries were treated outside of the HVIP-affiliated trauma center. The most common reasons for ED visits were pain (718 encounters), followed by suspected complications or needing additional postoperative care (181 encounters). Substance abuse, unintentional injuries, and suicidal ideation were also frequent reasons for ED visits. The low, long-term recidivism rate for RxH indicates that HVIPs have enduring positive effects on the majority of participants. Our results suggest that HVIP may further benefit patients by partnering with organizations that work to prevent suicide

De-hospitalization of the pediatric day surgery by means of a freestanding surgery center: pilot study in the lazio region

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Mangia Giovanni

2012-02-01

Full Text Available Abstract Background Day surgery should take place in appropriate organizational settings. In the presence of high volumes, the organizational models of the Lazio Region are represented by either Day Surgery Units within continuous-cycle hospitals or day-cycle Day Surgery Centers. This pilot study presents the regional volumes provided in 2010 and the additional volumes that could be provided based on the best performance criterion with a view to suggesting the setting up of a regional Freestanding Center of Pediatric Day Surgery. Methods This is an observational retrospective study. The activity volumes have been assessed by means of a DRG (Diagnosis Related Group-specific indicator that measures the ratio of outpatients to the total number of treated patients (freestanding indicator, FI. The included DRGs had an FI exceeding the 3rd quartile present in at least a health-care facility and a volume exceeding 0.5% of the total patients of the pediatric surgery and urology facilities of the Lazio Region. The relevant data have been provided by the Public Health Agency and relate to 2010. The best performance FI has been used to calculate the theoretical volume of transferability of the remaining facilities into freestanding surgery centers. Patients under six months of age and DRGs common to other disciplines have been excluded. The Chi Square test has been used to compare the FI of the health-care facilities and the FI of the places of origin of the patients. Results The DRG provided in 2010 amounted to a total of 5768 belonging to 121 types of procedures. The application of the criteria of inclusion have led to the selection of seven final DRG categories of minor surgery amounting to 3522 cases. Out of this total number, there were 2828 outpatients and 694 inpatients. The recourse of the best performance determines a potential transfer of 497 cases. The total outpatient volume is 57%. The Chi Square test has pointed to a statistically significant

Post-Travel Consultations in a Regional Hub City Hospital, Japan.

Science.gov (United States)

Yaita, Kenichiro; Sakai, Yoshiro; Iwahashi, Jun; Masunaga, Kenji; Hamada, Nobuyuki; Watanabe, Hiroshi

2016-01-01

To clarify the characteristics of post-travel consultation services in Japan, particularly in the provinces, we analyzed our post-travel patients in the travel clinic of Kurume University Hospital located in Kurume City (a regional hub City in southwestern Japan). Sixty post-travel patients visited our clinic between April 2008 and October 2014 and participated in this study: 55 were Japanese and five were foreign. We summarized and compared the characteristics of the patients after dividing the Japanese participants into long-term travelers (>14 days) and short-term travelers (≤14 days). The foreign travelers were described in a separate analysis. Of the 55 Japanese travelers, the mean age (± standard deviation) was 37.3 ± 16.3 years, and 36 patients (65%) were men. Southeast Asia was the major destination (30/55, 55%), and business was stated as the major reason for travel (16/55, 29%). Post-exposure rabies prophylaxis (16/55, 29%) was the most common purpose for the consultations. There were 34 participants (62%) who were classified as short-term travelers. Fewer of the short-term travelers stated receiving pre-travel consultations compared with long-term travelers (11% vs. 79%, p=0.0002). The five foreign travelers included one dengue fever patient and two malaria patients. Most post-travel Japanese patients visited our clinic were short-term travelers who had not received any pre-travel consultation. One of the most common complaints, post-exposure rabies prophylaxis, could have been avoided to some extent by appropriate pre-travel consultations. The results of this study suggest that pre-travel consultations should therefore be encouraged for both long- and short-term travelers.

Association between in-hospital mortality and renal dysfunction in 186,219 patients hospitalized for acute stroke in the Emilia-Romagna region of Italy.

Science.gov (United States)

Fabbian, Fabio; Gallerani, Massimo; Pala, Marco; De Giorgi, Alfredo; Salmi, Raffaella; Dentali, Francesco; Ageno, Walter; Manfredini, Roberto

2014-11-01

Using a regional Italian database, we evaluated the relationship between renal dysfunction and in-hospital mortality (IHM) in patients with acute stroke (ischemic/hemorrhagic). Patients were classified on the basis of renal damage: without renal dysfunction, with chronic kidney disease (CKD), and with end-stage renal disease (ESRD). Of a total of 186,219 patients with a first episode of stroke, 1626 (0.9%) had CKD and 819 (0.4%) had ESRD. Stroke-related IHM (total cases) was independently associated with CKD, ESRD, atrial fibrillation (AF), age, and Charlson comorbidity index (CCI). In patients with ischemic stroke (n=154,026), IHM remained independently associated with CKD, ESRD, AF, and CCI. In patients with hemorrhagic stroke (n=32,189), variables that were independently associated with IHM were CKD, ESRD, and AF. Renal dysfunction is associated with IHM related to stroke, both ischemic and hemorrhagic, with even higher odds ratios than those of other established risk factors, such as age, comorbidities, and AF. © The Author(s) 2013.

Association between value-based purchasing score and hospital characteristics

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Borah Bijan J

2012-12-01

Full Text Available Abstract Background Medicare hospital Value-based purchasing (VBP program that links Medicare payments to quality of care will become effective from 2013. It is unclear whether specific hospital characteristics are associated with a hospital’s VBP score, and consequently incentive payments. The objective of the study was to assess the association of hospital characteristics with (i the mean VBP score, and (ii specific percentiles of the VBP score distribution. The secondary objective was to quantify the associations of hospital characteristics with the VBP score components: clinical process of care (CPC score and patient satisfaction score. Methods Observational analysis that used data from three sources: Medicare Hospital Compare Database, American Hospital Association 2010 Annual Survey and Medicare Impact File. The final study sample included 2,491 U.S. acute care hospitals eligible for the VBP program. The association of hospital characteristics with the mean VBP score and specific VBP score percentiles were assessed by ordinary least square (OLS regression and quantile regression (QR, respectively. Results VBP score had substantial variations, with mean score of 30 and 60 in the first and fourth quartiles of the VBP score distribution. For-profit status (vs. non-profit, smaller bed size (vs. 100–199 beds, East South Central region (vs. New England region and the report of specific CPC measures (discharge instructions, timely provision of antibiotics and beta blockers, and serum glucose controls in cardiac surgery patients were positively associated with mean VBP scores (p Conclusions Although hospitals serving the poor and the elderly are more likely to score lower under the VBP program, the correlation appears small. Profit status, geographic regions, number and type of CPC measures reported explain the most variation among scores.

Global Dynamics in Travel, Tourism, and Hospitality

OpenAIRE

Pappas, Nikolaos; Bregoli, Ilenia

2016-01-01

Worldwide, tourism is the third largest economic activity in direct earnings after petroleum and automobile industries, and by far the largest one if indirect earnings are also taken into consideration. Taking into account the profound economic impact the tourism and hospitality industries can have on regions and cities around the world, further research in this area is critical.\\ud \\ud Global Dynamics in Travel, Tourism, and Hospitality takes a holistic approach to tourism and hospitality op...

Tres tesis doctorales dirigidas por don Manuel de Terán; el paisaje residencial en Madrid (Dolores Brandis, la enseñanza en Madrid (Ana Olivera y el barrio de Salamanca (Rafael Más.

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Aurelio Nieto Codina

2016-09-01

Full Text Available La investigación geográfica en España tiene en Manuel de Terán unas de sus personalidades clave, sus aportaciones científicas y su experiencia docente han marcado la evolución de nuestra disciplina; además, su presencia en el mundo académico y cultural hacen de él una figura imprescindible para entender la evolución de la ciencia en nuestro país. Ejemplificamos su labor como promotor de la investigación geográfica glosando tres tesis, que se encuadran dentro de los estudios referidos a la geografía urbana de Madrid, una de las líneas de investigación prioritaria del maestro. En primer lugar, el análisis del barrio de Salamanca, fragmento clave del ensanche histórico madrileño en su sector NE, obra de Rafael Mas. Después, la evolución histórica del paisaje residencial de Madrid y sus ejemplos tipo hasta la década de los setenta, realizada por Dolores Brandis. En tercer lugar, el estudio de la enseñanza en Madrid, una función urbana básica y un derecho de los ciudadanos estudiada por Ana Olivera. Estas obras son testimonio, entre otras, de la existencia de una escuela geográfica surgida de Manuel de Terán.In Spain, Manuel Teranwas some of its key personalities in geographical researchers, their scientific contributions and his teaching experience have marked the evolution of this discipline; in addition, its presence in the academic and cultural world make it an indispensable tool for understanding the evolution of science in our country. We exemplify its work in promoting geographical research glossing three theses, which fall within the studies related to the urban geography of Madrid, one of the priority research lines of the teacher. First,the analysis of the Salamanca district of Madrid historical key fragment extension in its NE Ensanche, written by Rafael Mas. Then, the historical evolution of residential landscape of Madrid and typical examples until the early seventies by Dolores Brandis. Third

Death of Dementia Patients in Psychiatric Hospitals and Regional Supply of Psychiatric Services: Study of the National Data from 1996 to 2014 in Japan.

Science.gov (United States)

Nakanishi, Miharu; Niimura, Junko; Yamasaki, Syudo; Nishida, Atsushi

2017-01-01

Japan designates psychiatric inpatient care for behavior management of individuals with dementia and for helping dementia patients discharge to home. However, there has been no examination of the effectiveness of this strategy. The present study investigated the association between dementia and the discharge destination of patients in psychiatric hospitals. Data from the National Patient Survey, which is a nationally representative cross-sectional survey of inpatient care, were used. The 96,420 patients with dementia or other mental illness who were discharged from psychiatric hospitals in September of every 3 years from 1996 to 2014 were included in analyses. Of the 96,420 discharged patients, 13,823 had dementia as the primary disease. Of the 13,823 dementia patients, 3,865 (28.0%) were discharged to home, 3,870 (28.0%) were admitted to a facility or other care settings, 3,574 (25.9%) were admitted to another hospital, and 2,514 (18.2%) died. Patients were more likely to die in psychiatric hospital if their primary disease was dementia, and they had resided in a region that provided fewer home visits for psychiatric nursing care or had available a larger number of psychiatric hospital beds per capita. Psychiatric inpatient care may be ineffective as a treatment for the challenging behaviors of dementia. A community mental health system for behavior management should be constructed in parallel with a reduction in the number of hospital beds allotted for psychiatric care.

The World Health Organization Performance Assessment Tool for Quality Improvement in Hospitals (PATH): an analysis of the pilot implementation in 37 hospitals

NARCIS (Netherlands)

Groene, Oliver; Klazinga, Niek; Kazandjian, Vahé; Lombrail, Pierre; Bartels, Paul

2008-01-01

OBJECTIVE: To evaluate the pilot implementation of the World Health Organization Performance Assessment Tool for Quality Improvement in hospitals (PATH). DESIGN: Semi-structured interviews with regional/country coordinators and Internet-based survey distributed to hospital coordinators. SETTING: A

Can you see me? Experiences of nurses working night shift in Australian regional hospitals: a qualitative case study.

Science.gov (United States)

Powell, Idona

2013-10-01

To report a study that explored the experiences of night-shift nurses, focusing on employee interrelationships and work satisfaction. Night-shift nurses are a critical component in hospital care making it essential to understand the experiences that give meaning to their work and understand how these nurses and the organization can benefit from their contribution to hospital care. A literature review revealed minimal research in this area. Qualitative case study. A qualitative case study using semi-structured interviews and self-completed diaries was conducted in 2010 in regional public hospitals in Australia. Participants were 14 nurses working nights half or more of their shifts in medical or surgical wards. Thematic analysis identified four major areas of concern: work relationships, work environment, work practices and lifestyle impact. Notably, work relationships were most meaningful for nurses on the same shift; night-shift nurses experienced working conditions inferior to their daytime counterparts including a perception of minimal leadership. Despite limited education opportunities, night shift provided opportunity for professional growth for some nurses with a slippage in skills for others; night shift provided flexibility for family and social activities, yet impeded these same activities, primarily due to pervasive fatigue. Night-shift nurses considered their role critical, yet believed that they were poorly regarded. The strong interpersonal relationships developed between night-shift workers need to be capitalized on whilst developing a more effective leadership model, improved work environment, more equitable professional development, and genuine recognition of the critical role of night nurses. © 2013 Blackwell Publishing Ltd.

Multi-state survey of healthcare-associated infections in acute care hospitals in Brazil.

Science.gov (United States)

Fortaleza, C Magno Castelo Branco; Padoveze, M C; Kiffer, C R Veiga; Barth, A L; Carneiro, Irna C do Rosário Souza; Giamberardino, H I Garcia; Rodrigues, J L Nobre; Santos Filho, L; de Mello, M J Gonçalves; Pereira, M Severino; Gontijo Filho, P Pinto; Rocha, M; Servolo de Medeiros, E A; Pignatari, A C Campos

2017-06-01

Healthcare-associated infections (HCAIs) challenge public health in developing countries such as Brazil, which harbour social inequalities and variations in the complexity of healthcare and regional development. To describe the prevalence of HCAIs in hospitals in a sample of hospitals in Brazil. A prevalence survey conducted in 2011-13 enrolled 152 hospitals from the five macro-regions in Brazil. Hospitals were classified as large (≥200 beds), medium (50-199 beds) or small sized (48 h of admission to the study hospitals at the time of the survey were included. Trained epidemiologist nurses visited each hospital and collected data on HCAIs, subjects' demographics, and invasive procedures. Univariate and multivariate techniques were used for data analysis. The overall HCAI prevalence was 10.8%. Most frequent infection sites were pneumonia (3.6%) and bloodstream infections (2.8%). Surgical site infections were found in 1.5% of the whole sample, but in 9.8% of subjects who underwent surgical procedures. The overall prevalence was greater for reference (12.6%) and large hospitals (13.5%), whereas medium- and small-sized hospitals presented rates of 7.7% and 5.5%, respectively. Only minor differences were noticed among hospitals from different macro-regions. Patients in intensive care units, using invasive devices or at extremes of age were at greater risk for HCAIs. Prevalence rates were high in all geographic regions and hospital sizes. HCAIs must be a priority in the public health agenda of developing countries. Copyright © 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Increasing Regional Anesthesia Use in a Serbian Teaching Hospital through an International Collaboration

Directory of Open Access Journals (Sweden)

Curtis L. Baysinger

2017-06-01

Full Text Available Many low- and middle-income countries (LMICs report low rates of regional anesthesia (RA use for cesarean delivery (CD, despite its association with lower maternal major morbidity and mortality. Also, the prevalence of neuraxial analgesia for labor (NAL is often low in LMICs. We report on the results of a collaboration in clinical education over a multi-year period between Kybele Inc., an international non-profit organization, and Klinicki Centar Vojvodine (CCV, a teaching hospital in Novi Sad, Serbia, to increase RA use for CD and NAL at CCV. From late 2011 through 2015, teams from Kybele participated in annual to biannual didactic conferences and week-long bedside teaching efforts involving obstetric and anesthesia staff from CCV and surrounding hospitals. Ongoing contact occurred at least weekly between Kybele and the host to discuss progress. De-identified quality improvement data on total deliveries, numbers of elective and non-elective CDs, number of vaginal deliveries, type of anesthesia for CD, and the number of NALs were collected. RA use for CD increased to 25% in year 2015 versus 14% in base year 2011 [odds ratio (OR: 2.05; 95% confidence interval (CI: 1.73,2.42; p < 0.001]. NAL increased to 10.5% of laboring women in 2015 versus 1.2% in 2011 (OR: 9.6; 95% CI: 7.2, 12.8; p < 0.001. Greater increases for RA use during non-elective CD were observed between 2011 and 2015 (1.4 versus 7.5% of total CD; OR: 5.52; 95% CI: 2.63, 8.41; p < 0.001 relative to elective CD (12.5 versus 17.5% of total CD; OR: 1.48; 95% CI: 1.23, 1.77; p < 0.001. Overall, RA for CD increased during the 4 year collaboration but was not as great as reported in other countries with similar health-care demographics utilizing a similar program. Detailed descriptions of program interventions and barriers to change at CCV are presented.

Increasing Regional Anesthesia Use in a Serbian Teaching Hospital through an International Collaboration.

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Baysinger, Curtis L; Pujic, Borislava; Velickovic, Ivan; Owen, Medge D; Serafin, Joanna; Shotwell, Matthew S; Braveman, Ferne

2017-01-01

Many low- and middle-income countries (LMICs) report low rates of regional anesthesia (RA) use for cesarean delivery (CD), despite its association with lower maternal major morbidity and mortality. Also, the prevalence of neuraxial analgesia for labor (NAL) is often low in LMICs. We report on the results of a collaboration in clinical education over a multi-year period between Kybele Inc., an international non-profit organization, and Klinicki Centar Vojvodine (CCV), a teaching hospital in Novi Sad, Serbia, to increase RA use for CD and NAL at CCV. From late 2011 through 2015, teams from Kybele participated in annual to biannual didactic conferences and week-long bedside teaching efforts involving obstetric and anesthesia staff from CCV and surrounding hospitals. Ongoing contact occurred at least weekly between Kybele and the host to discuss progress. De-identified quality improvement data on total deliveries, numbers of elective and non-elective CDs, number of vaginal deliveries, type of anesthesia for CD, and the number of NALs were collected. RA use for CD increased to 25% in year 2015 versus 14% in base year 2011 [odds ratio (OR): 2.05; 95% confidence interval (CI): 1.73,2.42; p  < 0.001]. NAL increased to 10.5% of laboring women in 2015 versus 1.2% in 2011 (OR: 9.6; 95% CI: 7.2, 12.8; p  < 0.001). Greater increases for RA use during non-elective CD were observed between 2011 and 2015 (1.4 versus 7.5% of total CD; OR: 5.52; 95% CI: 2.63, 8.41; p  < 0.001) relative to elective CD (12.5 versus 17.5% of total CD; OR: 1.48; 95% CI: 1.23, 1.77; p  < 0.001). Overall, RA for CD increased during the 4 year collaboration but was not as great as reported in other countries with similar health-care demographics utilizing a similar program. Detailed descriptions of program interventions and barriers to change at CCV are presented.

[Current status of "hospital-clinic" and "hospital-pharmacy" cooperation for inhalation therapy -based on hospital surveys throughout Japan].

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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.

Efficiency and productivity of hospitals in Vietnam.

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Pham, Thuy Linh

2011-01-01

The purpose of this paper is to examine the relative efficiency and productivity of hospitals during the health reform process. Data envelopment analyses method (DEA) with the input-oriented variable-returns-to-scale model was used to calculate efficiency scores. Malmquist total factor productivity index approach was then employed to calculate productivity of hospitals. Data of 101 hospitals was extracted from databases of the Ministry of Health, Vietnam from the years 1998 to 2006. There was evidence of improvement in overall technical efficiency from 65 per cent in 1998 to 76 per cent in 2006. Hospitals' productivity progressed around 1.4 per cent per year, which was mainly due to the technical efficiency improvement. Furthermore, provincial hospitals were more technically efficient than their central counterparts and hospitals located in different regions performed differently. The paper provides an insight in the performance of Vietnamese public hospitals that has been rarely examined before and contributes to the existing literature of hospital performance in developing countries

Treatment outcome for a sample of patients with Class II division 1 malocclusion treated at a regional hospital orthodontic department.

LENUS (Irish Health Repository)

Burden, D J

1998-01-01

This retrospective study assessed the outcome of orthodontic treatment of 264 patients with Class II division 1 malocclusion (overjet greater than 6 mm). The sample comprised patients who had completed their fixed appliance orthodontic treatment at a regional hospital orthodontic unit in the Republic of Ireland. The PAR Index (Peer Assessment Rating) was used to evaluate treatment outcome using before and after treatment study casts. The results revealed that treatment for this particular type of malocclusion was highly effective with a very few patients failing to benefit from their orthodontic treatment.

Spatial distribution for diarrhea hospitalization in São Paulo State

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Fernanda Pires Cecchetti Vaz

Full Text Available Abstract Objectives: to identify spatial pattern on hospitalization rates of children with diarrhea in the counties in São Paulo State. Methods: ecological and exploratory study on hospitalized data of children with diarrhea under the age of four in 2008 and 2012, the IDH mothers with low schooling level and children living with a low income less than half minimum wage were obtained from Datasus and inserted into digital map of the counties in São Paulo State. Moran's global index (I and Pearson's coefficients correlation and thematic maps of hospitalization rates of 1,000 children, Moran maps and kernel map were calculated. Results: there were 34, 802 hospital admissions, with an average rate of 4.7 hospitalizations / 1,000 children (SD=7.2. Hospitalization rates were correlated only with schooling (r= 0.09, p<0.05. Moran's index for hospitalization rate was I=0.31(p<0.01. The thematic map of the hospital admission rates showed a cluster of counties in the west of the State; the kernel map showed a higher density of hospitalization in this region and the Moran map identified 57 counties which deserve attention. Conclusions: the results provide subsidies for the counties and regional managers to implement measurements aiming to reduce these rates.

Trends in Regionalization of Care for ST-Segment Elevation Myocardial Infarction

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Renee Y. Hsia

2017-09-01

Full Text Available Introduction: California has led successful regionalized efforts for several time-critical medical conditions, including ST-segment elevation myocardial infarction (STEMI, but no specific mandated protocols exist to define regionalization of care. We aimed to study the trends in regionalization of care for STEMI patients in the state of California and to examine the differences in patient demographic, hospital, and county trends. Methods: Using survey responses collected from all California emergency medical services (EMS agencies, we developed four categories – no, partial, substantial, and complete regionalization – to capture prehospital and inter-hospital components of regionalization in each EMS agency’s jurisdiction between 2005–2014. We linked the survey responses to 2006 California non-public hospital discharge data to study the patient distribution at baseline. Results: STEMI regionalization-of-care networks steadily developed across California. Only 14% of counties were regionalized in 2006, accounting for 42% of California’s STEMI patient population, but over half of these counties, representing 86% of California’s STEMI patient population, reached complete regionalization in 2014. We did not find any dramatic differences in underlying patient characteristics based on regionalization status; however, differences in hospital characteristics were relatively substantial. Conclusion: Potential barriers to achieving regionalization included competition, hospital ownership, population density, and financial challenges. Minimal differences in patient characteristics can establish that patient differences unlikely played any role in influencing earlier or later regionalization and can provide a framework for future analyses evaluating the impact of regionalization on patient outcomes.

A retrospective study on the outcomes of cataract surgery in an Eastern Regional Health Authority hospital of Trinidad and Tobago

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Ebiakpo-aboere Sonron

2015-09-01

Full Text Available Background. Worldwide, cataract is a major cause of blindness. The paper aims to evaluate factors associated with borderline and poor outcomes of cataract surgery at an Eastern Regional Health Authority (ERHA hospital in Trinidad and Tobago.Materials and Methods. A hospital-based, retrospective study was done on 401 patients who had undergone cataract surgery (unilateral and bilateral at an ERHA Hospital between March 2009 and September 2014. Data was collected on variables concerning demographic, medical history, surgical history, ocular findings and visual acuity (VA. The outcome variable of interest was Snellen’s post-operative (presenting VA which was transformed into a dichotomous variable with borderline and poor outcomes as one and good outcomes as the other. Data were analysed using univariate and multivariate logistic regression analyses.Results. Good outcome (presenting VA 6/18 or better was seen in 350 (67% eyes. The fitted model consisted of ocular co-morbidity (OR =2.133; 95% CI [1.346–3.380], hypertension (OR = 0.520; 95% CI [0.381–0.928], surgical procedure (OR = 1.56; 95% CI [1.004–2.425], good preoperative VA (OR = 0.388, 95% CI [0.211–0.714], borderline preoperative VA (OR = 0.485; 95% CI = [0.278–0.843] and year of first visit to clinic (OR = 2.243; 95% CI [1.215–4.141].Conclusion. There is a need for community-based outreach to increase awareness of eye health and diseases. It is recommended that the general population is encouraged to take responsibility for personal management. The facilities at the Hospital should also be enhanced.

[Current situation of pediatric emergency in tertiary and teaching hospitals in 15 provinces, municipalities and autonomous regions in China Mainland].

Science.gov (United States)

2014-12-01

Pre-hospital care, emergency department and critical care medicine are the key components of emergency medical service system. Two investigations about the pediatric critical care medicine in China mainland showed great progress. In recent years, most hospitals in China mainland have established emergency department, hardware configuration and staff status were gradually standardized. But most of the emergency departments mainly provide service to adult patients and pediatric emergency medicine lags behind. The purpose of this investigation was to understand the current situation and main problems of pediatric emergency in China mainland. A questionnaire developed by the Subspecialty Group of Pediatrics, Chinese Society of Emergency Medicine and the Subspecialty Group of Emergency Medicine, Chinese Society of Pediatrics was e-mailed to the members of the above-mentioned two subspecialty groups. The contents of the questionnaire included 46 items which were divided into 5 categories: the general situation of the hospital, the pediatric emergency setting and composition, key equipments and techniques, staff status, training program and running data from 2011 to 2012. Sixty-three questionnaires were delivered and 27 (42.9%) hospitals responded which located in 15 different provinces, municipalities and autonomous regions. Among the 27 hospitals, 10 (37.0%) had no pediatric resuscitation room; 25 (92.6%) had no equipments for cardiac output monitor and gastric lavage; 13 (48.1%) had no bedside fibrolaryngoscope or fiberbronchoscope; 5 (18.5%) had no blood gas analyzer; 4 (14.8%) without respirator, defibrillator, bedside radiography or ultrasonic equipment; 2 (7.4%) had no neonatal incubator; 9 (33.3%) could not do intraossous infusion. The average ratio of professional emergency pediatricians to all physicians was 43.5%. Twenty hospitals incompletely filled in the pediatric emergency running data. The main problems existing in pediatric emergency include: imperfect

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

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Klapalova Alena

2013-06-01

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

A New Approach to Identify High Burnout Medical Staffs by Kernel K-Means Cluster Analysis in a Regional Teaching Hospital in Taiwan.

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Lee, Yii-Ching; Huang, Shian-Chang; Huang, Chih-Hsuan; Wu, Hsin-Hung

2016-01-01

This study uses kernel k-means cluster analysis to identify medical staffs with high burnout. The data collected in October to November 2014 are from the emotional exhaustion dimension of the Chinese version of Safety Attitudes Questionnaire in a regional teaching hospital in Taiwan. The number of effective questionnaires including the entire staffs such as physicians, nurses, technicians, pharmacists, medical administrators, and respiratory therapists is 680. The results show that 8 clusters are generated by kernel k-means method. Employees in clusters 1, 4, and 5 are relatively in good conditions, whereas employees in clusters 2, 3, 6, 7, and 8 need to be closely monitored from time to time because they have relatively higher degree of burnout. When employees with higher degree of burnout are identified, the hospital management can take actions to improve the resilience, reduce the potential medical errors, and, eventually, enhance the patient safety. This study also suggests that the hospital management needs to keep track of medical staffs' fatigue conditions and provide timely assistance for burnout recovery through employee assistance programs, mindfulness-based stress reduction programs, positivity currency buildup, and forming appreciative inquiry groups. © The Author(s) 2016.

A New Approach to Identify High Burnout Medical Staffs by Kernel K-Means Cluster Analysis in a Regional Teaching Hospital in Taiwan

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Yii-Ching Lee PhD

2016-11-01

Full Text Available This study uses kernel k-means cluster analysis to identify medical staffs with high burnout. The data collected in October to November 2014 are from the emotional exhaustion dimension of the Chinese version of Safety Attitudes Questionnaire in a regional teaching hospital in Taiwan. The number of effective questionnaires including the entire staffs such as physicians, nurses, technicians, pharmacists, medical administrators, and respiratory therapists is 680. The results show that 8 clusters are generated by kernel k-means method. Employees in clusters 1, 4, and 5 are relatively in good conditions, whereas employees in clusters 2, 3, 6, 7, and 8 need to be closely monitored from time to time because they have relatively higher degree of burnout. When employees with higher degree of burnout are identified, the hospital management can take actions to improve the resilience, reduce the potential medical errors, and, eventually, enhance the patient safety. This study also suggests that the hospital management needs to keep track of medical staffs’ fatigue conditions and provide timely assistance for burnout recovery through employee assistance programs, mindfulness-based stress reduction programs, positivity currency buildup, and forming appreciative inquiry groups.

[How to make regional medicine revive from the medical crisis or collapse due to the severe paucity of medical doctors: a plan with "the magnet hospital"].

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Itoh, Tsunetoshi

2009-01-01

In 2002-2003, the practice of doctors lending their names to appear as "staff" of hospitals became known. Problems regarding funds from public hospitals were also revealed. Tohoku University asked regional societies how to improve the medical situation, and redefined its responsibilities. The Educational Development Center for Local Medicine and Department of Local Medical Service System were set up (2005-2008). A severe shortage of medical doctors prevails in Japan: the number of doctors per population is at the 4th lowest among OECD countries, and the number per hospital bed is the lowest. We have no nursing homes whose beds are not counted as hospital beds. The number of faculty staff in Japanese medical schools is 1/3 to those of Western countries. The reported number of doctors working in hospitals and offices surpasses that by census for medical doctors by >40,000. Japanese doctors work for >60 hours per week. I propose essential plans to improve Japanese situation for medical service: 1. Immediately increase the number of doctors by at least 50%. Based on our calculation, we need 450,000 doctors. 2. When the shortage of doctors is severe, establish a magnet hospital with c.a. 500 beds for every 200,000 population, capable of treating highly emergency patients and attracting doctors who need medical training. Hospitals should not belong to each city or town. 3. Establish a comprehensive organization to nurture doctors on a long-term basis. It should consist of a medical school, hospitals, and the prefectural government. It should help doctors to move between hospitals, and be responsible both for designing doctors' career paths and for allocating them appropriately.

[Long-term psychiatric hospitalizations].

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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

Lung cancer risk and pollution in an industrial region of Northern Spain: a hospital-based case-control study.

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López-Cima, María Felicitas; García-Pérez, Javier; Pérez-Gómez, Beatriz; Aragonés, Nuria; López-Abente, Gonzalo; Tardón, Adonina; Pollán, Marina

2011-01-25

Asturias, an Autonomous Region in Northern Spain with a large industrial area, registers high lung cancer incidence and mortality. While this excess risk of lung cancer might be partially attributable to smoking habit and occupational exposure, the role of industrial and urban pollution also needs to be assessed. The objective was to ascertain the possible effect of air pollution, both urban and industrial, on lung cancer risk in Asturias. This was a hospital-based case-control study covering 626 lung cancer patients and 626 controls recruited in Asturias and matched by ethnicity, hospital, age, and sex. Distances from the respective participants' residential locations to industrial facilities and city centers were computed. Using logistic regression, odds ratios (ORs) and 95% confidence intervals (95%CIs) for categories of distance to urban and industrial pollution sources were calculated, with adjustment for sex, age, hospital area, tobacco consumption, family history of cancer, and occupation. Whereas individuals living near industries displayed an excess risk of lung cancer (OR = 1.49; 95%CI = 0.93-2.39), which attained statistical significance for small cell carcinomas (OR = 2.23; 95%CI = 1.01-4.92), residents in urban areas showed a statistically significant increased risk for adenocarcinoma (OR = 1.92; 95%CI = 1.09-3.38). In the Gijon health area, residents in the urban area registered a statistically significant increased risk of lung cancer (OR = 2.17; 95%CI = 1.25-3.76), whereas in the Aviles health area, no differences in risk were found by area of exposure. This study provides further evidence that air pollution is a moderate risk factor for lung cancer.

Hospital-based stroke care in Ireland: results from one regional register.

LENUS (Irish Health Repository)

Fan, C W

2000-01-01

Most patients with acute stroke are admitted to hospital. If stroke services in this country are to be improved, we need accurate and reliable information about the types of stroke patients being admitted, their present management and outcome.

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

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

2017-12-01

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

Hospital Preparedness to Respond to Biological and Chemical Terrorist Attack

International Nuclear Information System (INIS)

Florin, P.

2007-01-01

There is a growing concern about the terrorist use of chemical or biological agents against civilian population. A large proportion of hospitals are probably poorly prepared to handle victims of chemical or biological terrorism. At national level, starting with 2008 hospitals will be under the administration and control of local authorities. That is good opportunities for local authorities and public health office to tailor the activity of the hospitals to the real needs in the area of responsibility, and to allocate the suitable budget for them. Commonly hospitals are not fully prepared to respond to massive casualty disaster of any kind, either i their capacity to care for large numbers of victims or in their ability to provide care in coordination with a regional or national incident command structure. Preparedness activities to respond properly to chemical or biological attack including the adequate logistic, the principle of training and drill for the hospital emergency units and medical personal, communication and integration of the hospital team in local and regional civil response team are developed by the author.(author)

Hospital capacity and management preparedness for pandemic influenza in Victoria.

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Dewar, Ben; Barr, Ian; Robinson, Priscilla

2014-04-01

This study was designed to investigate acute hospital pandemic influenza preparedness in Victoria, Australia, particularly focussing on planning and management efforts. A prospective study was conducted by questionnaire and semi-structured interview of health managers across the Victorian hospital system from July to October 2011. Participants with responsibility for emergency management, planning and operations were selected from every hospital in Victoria with an emergency department to complete a questionnaire (response rate 22/43 = 51%). Each respondent was invited to participate in a phone-based semi-structured interview (response rate 11/22 = 50%). Rural/regional hospitals demonstrated higher levels of clinical (86%) and non-clinical (86%) staff contingency planning than metropolitan hospitals (60% and 40% respectively). Pandemic plans were not being sufficiently tested in exercises or drills, which is likely to undermine their effectiveness. All respondents reported hand hygiene and standard precautions programs in place, although only one-third (33%) of metropolitan respondents and no rural/regional respondents reported being able to meet patient needs with high levels of staff absenteeism. Almost half Victoria's healthcare workers were unvaccinated against influenza. Hospitals across Victoria demonstrated different levels of influenza pandemic preparedness and planning. If a more severe influenza pandemic than that of 2009 arose, Victorian hospitals would struggle with workforce and infrastructure problems, particularly in rural/regional areas. Staff absenteeism threatens to undermine hospital pandemic responses. Various strategies, including education and communication, should be included with in-service training to provide staff with confidence in their ability to work safely during a future pandemic. © 2014 The Authors. ANZJPH © 2014 Public Health Association of Australia.

Organization of infection control in European hospitals.

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Hansen, S; Zingg, W; Ahmad, R; Kyratsis, Y; Behnke, M; Schwab, F; Pittet, D; Gastmeier, P

2015-12-01

The Prevention of Hospital Infections by Intervention and Training (PROHIBIT) survey was initiated to investigate the status of healthcare-associated infection (HCAI) prevention across Europe. This paper presents the methodology of the quantitative PROHIBIT survey and outlines the findings on infection control (IC) structure and organization including management's support at the hospital level. Hospitals in 34 countries were invited to participate between September 2011 and March 2012. Respondents included IC personnel and hospital management. Data from 309 hospitals in 24 countries were analysed. Hospitals had a median (interquartile range) of four IC nurses (2-6) and one IC doctor (0-2) per 1000 beds. Almost all hospitals (96%) had defined IC objectives, which mainly addressed hand hygiene (87%), healthcare-associated infection reduction (84%), and antibiotic stewardship (66%). Senior management provided leadership walk rounds in about half of hospitals, most often in Eastern and Northern Europe, 65% and 64%, respectively. In the majority of hospitals (71%), sanctions were not employed for repeated violations of IC practices. Use of sanctions varied significantly by region (P hospitals should be a public health priority. Copyright © 2015. Published by Elsevier Ltd.

[Results of pulmonary embolism treatment in a tertiary hospital short stay unit. Is this the right place?].

Science.gov (United States)

Rosa Salazar, V; Bernal Martínez, L; García Pino, M J; Hernández Contreras, M E; García Méndez, M M; García Pérez, B; Marras Fernández-Cid, C

2016-01-01

To determine the mean stay (MS) of patients with pulmonary embolism (PE) in a thrombosis unit (TU) with a short stay unit (SSU) in a tertiary hospital. To compare the data collected with those of other hospitals in the same region, of other regions (Autonomous Communities [AACC]), and within the same hospital in the year before the SSU opened. A descriptive retrospective observational study that included patients with a diagnosis of PE in the University Hospital Virgen de la Arrixaca (HCUVA) in 2012. These data were classified by hospital department, and used for calculating the mean stay. This was then compared with that of other hospitals in our region, with the rest of the regions, and with the data in 2007 (the last year without a TU). A total of 113patients with PE were included, 60 (53%) in the TU with an MS of 4.39, in Oncology, 7.45, and Internal Medicine (IM), 15.38days. There were no deaths in the TU and only 3 (5%) readmissions. Published data showed that the MS in all hospitals in our region was 8.25, 5.18 in our hospital, and higher in the rest of hospitals. The best AACC was the Basque Country with an MS of 6.85days. In 2007, there were 70patients with PE in the HCUVA, 34 (49%) in IM, with an MS of 8.50, Oncology 11 (31%) with an MS 9.64, and Chest Diseases 3 (4.3%) with an MS 19days, and with an overall mortality of 11% and a rate of readmissions in IM of 6%. The mean stay for a PE in the SSU of a TU was lower than in the rest of the hospital departments, lower than the rest hospitals of our region, lower than the rest of the regions, and lower than any department of our hospital before the SSU existed, without increasing the readmission or mortality rate. Copyright © 2015 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

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

Science.gov (United States)

Flessa, Steffen

2005-12-01

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

Determination of antibiotics in sewage from hospitals, nursery and slaughter house, wastewater treatment plant and source water in Chongqing region of Three Gorge Reservoir in China

Energy Technology Data Exchange (ETDEWEB)

Xiaosong, Chang [Department of Environmental Hygiene, School of Military Preventive Medicine, Third Military Medical University, Chongqing 400038 (China); Meyer, Michael T [United States Geological Survey, 4821 Quail Crest Place, Lawrence, Kansas 66049 (United States); Xiaoyun, Liu [Center for Disease Prevention and Control, Lanzhou Military Region, Lanzhou 730020 (China); Qing, Zhao; Hao, Chen; Jian, Chen; Zhiqun, Qiu; Lan, Yang [Department of Environmental Hygiene, School of Military Preventive Medicine, Third Military Medical University, Chongqing 400038 (China); Jia, Cao [Department of Military Toxicology, School of Military Preventive Medicine, Third Military Medical University, Chongqing 400038 (China); Shu Weiqun, E-mail: xm0630@sina.co [Department of Environmental Hygiene, School of Military Preventive Medicine, Third Military Medical University, Chongqing 400038 (China)

2010-05-15

Sewage samples from 4 hospitals, 1 nursery, 1 slaughter house, 1 wastewater treatment plant and 5 source water samples of Chongqing region of Three Gorge Reservoir were analyzed for macrolide, lincosamide, trimethoprim, fluorouinolone, sulfonamide and tetracycline antibiotics by online solid-phase extraction and liquid chromatography-tandem mass spectrometry. Results showed that the concentration of ofloxacin (OFX) in hospital was the highest among all water environments ranged from 1.660 mug/L to 4.240 mug/L and norfloxacin (NOR, 0.136-1.620 mug/L), ciproflaxacin (CIP, ranged from 0.011 mug/L to 0.136 mug/L), trimethoprim (TMP, 0.061-0.174 mug/L) were commonly detected. Removal range of antibiotics in the wastewater treatment plant was 18-100% and the removal ratio of tylosin, oxytetracycline and tetracycline were 100%. Relatively higher removal efficiencies were observed for tylosin (TYL), oxytetracycline (OXY) and tetracycline (TET)(100%), while lower removal efficiencies were observed for Trimethoprim (TMP, 1%), Epi-iso-chlorotetracycline (EICIC, 18%) and Erythromycin-H{sub 2}O (ERY-H{sub 2}O, 24%). Antibiotics were removed more efficiently in primary treatment compared with those in secondary treatment. - This study give the first insight into the concentration of antibiotics in receiving waters from 4 hospitals, 1 nursery, 1 slaughter house, 1 wastewater treatment plant and 5 source water of Chongqing region of Three Gorge Reservoir

Determination of antibiotics in sewage from hospitals, nursery and slaughter house, wastewater treatment plant and source water in Chongqing region of Three Gorge Reservoir in China

International Nuclear Information System (INIS)

Chang Xiaosong; Meyer, Michael T.; Liu Xiaoyun; Zhao Qing; Chen Hao; Chen Jian; Qiu Zhiqun; Yang Lan; Cao Jia; Shu Weiqun

2010-01-01

Sewage samples from 4 hospitals, 1 nursery, 1 slaughter house, 1 wastewater treatment plant and 5 source water samples of Chongqing region of Three Gorge Reservoir were analyzed for macrolide, lincosamide, trimethoprim, fluorouinolone, sulfonamide and tetracycline antibiotics by online solid-phase extraction and liquid chromatography-tandem mass spectrometry. Results showed that the concentration of ofloxacin (OFX) in hospital was the highest among all water environments ranged from 1.660 μg/L to 4.240 μg/L and norfloxacin (NOR, 0.136-1.620 μg/L), ciproflaxacin (CIP, ranged from 0.011 μg/L to 0.136 μg/L), trimethoprim (TMP, 0.061-0.174 μg/L) were commonly detected. Removal range of antibiotics in the wastewater treatment plant was 18-100% and the removal ratio of tylosin, oxytetracycline and tetracycline were 100%. Relatively higher removal efficiencies were observed for tylosin (TYL), oxytetracycline (OXY) and tetracycline (TET)(100%), while lower removal efficiencies were observed for Trimethoprim (TMP, 1%), Epi-iso-chlorotetracycline (EICIC, 18%) and Erythromycin-H 2 O (ERY-H 2 O, 24%). Antibiotics were removed more efficiently in primary treatment compared with those in secondary treatment. - This study give the first insight into the concentration of antibiotics in receiving waters from 4 hospitals, 1 nursery, 1 slaughter house, 1 wastewater treatment plant and 5 source water of Chongqing region of Three Gorge Reservoir

[Motivation perception measurement of intermediate directors in three complex hospitals of the Region of the Maule, Chile].

Science.gov (United States)

Bustamante-Ubilla, Miguel Alejandro; del Río-Rivero, María Carolina; Lobos-Andrade, Germán Enrique; Villarreal-Navarrete, Patricia Isabel

2009-01-01

In this work, a questionnaire was designed and perceptions of motivation and demotivation of middle managers in three hospitals in the Region del Maule, Chile were measured. The fieldwork was carried out between September and October, 2006. A questionnaire that included 57 statements to measure attitude was administered and qualified according to a five-point Likert-type scale. The population studied included l25 professionals that supervise roughly 3 800 employees. Ten variables were identified, 5 motivational and 5 demotivational. Notable among the motivational variables are vocation and service-oriented spirit; among the demotivational variables are lack of recognition and commitment. It is affirmed that both motivational variables as well as demotivational variables are essentially qualitative and that economic and salary variables are less relevant and less hierarchical.

Gastrointestinal Fistula: Audit of management in a remote hospital ...

African Journals Online (AJOL)

Background: The management of gastrointestinal fistula continues to present considerable challenge to the surgeon in general and gastrointestinal surgeon in particular. Objectives: To audit the management and report the outcome of the gastrointestinal fistula in a remote hospital. Setup: Eldamazeen Hospital is a regional ...

Ownership and technical efficiency of hospitals: evidence from Ghana using data envelopment analysis.

Science.gov (United States)

Jehu-Appiah, Caroline; Sekidde, Serufusa; Adjuik, Martin; Akazili, James; Almeida, Selassi D; Nyonator, Frank; Baltussen, Rob; Asbu, Eyob Zere; Kirigia, Joses Muthuri

2014-04-08

In order to measure and analyse the technical efficiency of district hospitals in Ghana, the specific objectives of this study were to (a) estimate the relative technical and scale efficiency of government, mission, private and quasi-government district hospitals in Ghana in 2005; (b) estimate the magnitudes of output increases and/or input reductions that would have been required to make relatively inefficient hospitals more efficient; and (c) use Tobit regression analysis to estimate the impact of ownership on hospital efficiency. In the first stage, we used data envelopment analysis (DEA) to estimate the efficiency of 128 hospitals comprising of 73 government hospitals, 42 mission hospitals, 7 quasi-government hospitals and 6 private hospitals. In the second stage, the estimated DEA efficiency scores are regressed against hospital ownership variable using a Tobit model. This was a retrospective study. In our DEA analysis, using the variable returns to scale model, out of 128 district hospitals, 31 (24.0%) were 100% efficient, 25 (19.5%) were very close to being efficient with efficiency scores ranging from 70% to 99.9% and 71 (56.2%) had efficiency scores below 50%. The lowest-performing hospitals had efficiency scores ranging from 21% to 30%.Quasi-government hospitals had the highest mean efficiency score (83.9%) followed by public hospitals (70.4%), mission hospitals (68.6%) and private hospitals (55.8%). However, public hospitals also got the lowest mean technical efficiency scores (27.4%), implying they have some of the most inefficient hospitals.Regarding regional performance, Northern region hospitals had the highest mean efficiency score (83.0%) and Volta Region hospitals had the lowest mean score (43.0%).From our Tobit regression, we found out that while quasi-government ownership is positively associated with hospital technical efficiency, private ownership negatively affects hospital efficiency. It would be prudent for policy-makers to examine the

Hospital Costs of Foreign Non-Resident Patients: A Comparative Analysis in Catalonia, Spain.

Science.gov (United States)

Arroyo-Borrell, Elena; Renart-Vicens, Gemma; Saez, Marc; Carreras, Marc

2017-09-14

Although patient mobility has increased over the world, in Europe there is a lack of empirical studies. The aim of the study was to compare foreign non-resident patients versus domestic patients for the particular Catalan case, focusing on patient characteristics, hospitalisation costs and differences in costs depending on the typology of the hospital they are treated. We used data from the 2012 Minimum Basic Data Set-Acute Care hospitals (CMBD-HA) in Catalonia. We matched two case-control groups: first, foreign non-resident patients versus domestic patients and, second, foreign non-resident patients treated by Regional Public Hospitals versus other type of hospitals. Hospitalisation costs were modelled using a GLM Gamma with a log-link. Our results show that foreign non-resident patients were significantly less costly than domestic patients (12% cheaper). Our findings also suggested differences in the characteristics of foreign non-resident patients using Regional Public Hospitals or other kinds of hospitals although we did not observe significant differences in the healthcare costs. Nevertheless, women, 15-24 and 35-44 years old patients and the days of stay were less costly in Regional Public Hospitals. In general, acute hospitalizations of foreign non-resident patients while they are on holiday cost substantially less than domestic patients. The typology of hospital is not found to be a relevant factor influencing costs.

[Patients' diet in "Town" and "City" hospitals in Belgrade].

Science.gov (United States)

Stojanović, Svetlana; Jovanović-Simić, Jelena

2009-01-01

The roots of hospital foundation in Serbs date from the 12th century, when the hospitals in the monasteries Hilandar (1199) and Studenica (1207) were established. The "Town" Hospital of Belgrade was founded in 1841, which had the status of town and regional hospital until 1881. After that, it was transformed into a general state-owned hospital based on the Law of National Health Protection. The inhabitants of Belgrade obtained a municipal hospital again in 1935, when the "City" Hospital was founded in Zvezdara municipality, named at that period Bulbulder. By researching and observing hospital diet development of municipal hospitals in Belgrade, it was concluded that from the very beginning of the "Town" Hospital functioning there was awareness about its significance, place and role in the overall treatment of patients. Hospital diet, regardless of existing knowledge as the part of medical doctrines of particular time-periods, was often conditioned by limited hospital budgets and under the influence of different social movements and wartime periods

The cost of lower respiratory tract infections hospital admissions in the Canadian Arctic

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Anna Banerji

2013-08-01

Full Text Available Background . Inuit infants who reside in the Nunavut (NU regions of Arctic Canada have extremely high rates of lower respiratory tract infections (LRTIs associated with significant health expenditures, but the costs in other regions of Arctic Canada have not been documented. Objective . This prospective surveillance compares, across most of Arctic Canada, the rates and costs associated with LRTI admissions in infants less than 1 year of age, and the days of hospitalization and costs adjusted per live birth. Design . This was a hospital-based surveillance of LRTI admissions of infants less than 1 year of age, residing in Northwest Territories (NT, the 3 regions of Nunavut (NU; [Kitikmeot (KT, Kivalliq (KQ and Qikiqtani (QI] and Nunavik (NK from 1 January 2009 to 30 June 2010. Costs were obtained from the territorial or regional governments and hospitals, and included transportation, hospital stay, physician fees and accommodation costs. The rates of LRTI hospitalizations, days of hospitalization and associated costs were calculated per live birth in each of the 5 regions. Results . There were 513 LRTI admissions during the study period. For NT, KT, KQ, QI and NK, the rates of LRTI hospitalization per 100 live births were 38, 389, 230, 202 and 445, respectively. The total days of LRTI admission per live birth were 0.25, 3.3, 2.6, 1.7 and 3 for the above regions. The average cost per live birth for LRTI admission for these regions was $1,412, $22,375, $14,608, $8,254 and $10,333. The total cost for LRTI was $1,498,232 in NT, $15,662,968 in NU and $3,874,881 in NK. Medical transportation contributed to a significant proportion of the costs. Conclusion . LRTI admission rates in NU and Nunavik are much higher than that in NT and remain among the highest rates globally. The costs of these admissions are exceptionally high due to the combination of very high rates of admission, very expensive medical evacuations and prolonged hospitalizations

Does a global budget superimposed on fee-for-service payments mitigate hospitals' medical claims in Taiwan?

Science.gov (United States)

Hsu, Pi-Fem

2014-12-01

Taiwan's global budgeting for hospital health care, in comparison to other countries, assigns a regional budget cap for hospitals' medical benefits claimed on the basis of fee-for-service (FFS) payments. This study uses a stays-hospitals-years database comprising acute myocardial infarction inpatients to examine whether the reimbursement policy mitigates the medical benefits claimed to a third-payer party during 2000-2008. The estimated results of a nested random-effects model showed that hospitals attempted to increase their medical benefit claims under the influence of initial implementation of global budgeting. The magnitudes of hospitals' responses to global budgeting were significantly attributed to hospital ownership, accreditation status, and market competitiveness of a region. The results imply that the regional budget cap superimposed on FFS payments provides only blunt incentive to the hospitals to cooperate to contain medical resource utilization, unless a monitoring mechanism attached with the payment system.

Review of Juan Coloma, «"Década de la pasión", "Cántico de la resurrección" de don Juan Coloma, conde de Elda y virrey de Cerdeña. Añádese en apéndice su poesía profana y el epistolario diplomátic con don Juan de Zúñiga», ed. Pedro M. Cátedra y Javier Burguillo, Salamanca, SEMYR, 2015, 532 pp. ISBN 978-84-941708-7-4

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Martín Zulaica Lopez

2017-05-01

Full Text Available Review of Juan Coloma, «Década de la pasión», «Cántico de la resurrección» de don Juan Coloma, conde de Elda y virrey de Cerdeña. Añádese en apéndice su poesía profana y el epistolario diplomátic con don Juan de Zúñiga, ed. Pedro M. Cátedra y Javier Burguillo, Salamanca, SEMYR, 2015, 532 pp. ISBN 978-84-941708-7-4

Assessment of hospital-based adult triage at emergency receiving ...

African Journals Online (AJOL)

The study was conducted in 6 of the 7 hospitals in the region. ... gency department, the rest receive emergency patients/perform triage from .... gional Referral Hospital (government facility) with emer- ... sionals who were involved in daily initial management of ..... for receiving emergency cases can be complex especially.

[Lateral hostilities among emergency and critical care nurses. Survey in five hospitals of the Tuscany Region].

Science.gov (United States)

Bambi, Stefano; Becattini, Giovanni; Pronti, Fabio; Lumini, Enrico; Rasero, Laura

2013-01-01

Lateral hostilities among emergency and critical care nurses. Survey in five hospitals of Tuscany Region. Introduction. Lateral hostilities (LHs) are a kind of workplace violence. They are defined as varieties of cruel, rude, antagonistic interactions between people at the same hierarchical level. Nurses are affected by LH from 5.7% to 65%, leading to reduced work motivation, psycho-physical disorders, and in some cases, drop out of the nursing profession. Objective. To quantify the LHs among nurses in the emergency departments (ED) and intensive care units (ICU) in 5 hospitals of Tuscany (Italy). To show the impact on the quality of their psycho-physical and professional lives. Method. Exploratory-descriptive study, through closed-ended questionnaire. Results. 360/444 nurses (81%); 294 (81.6%) were victims of LHs during the past 12 months. Gossiping, complaints shared with others without discussing with the concerned person, and sarcastic comments were the most reported LHs. LHs occur more in EDs than ICUs (respectively 90% and 77%; p=0.0038). No statistically significant differences were observed for gender, age, or years of experience. The 17.7% of nurses asked to be moved from the ward, and 6.9% left it; 6.9% respondents had thought to leave the nursing profession; 235 (65.2%) experienced at least one LHs related disorder during the last year. Most reported symptoms were low morale, anxiety, and sleep disturbances. Conclusions. The incidence of LH and related disorders is high in EDs and ICUs, determining a low professional and psycho-physical quality of life.

Profile of Epilepsy in a Regional Hospital in Al Qassim, Saudi Arabia

Science.gov (United States)

Hamdy, Nermin A; Alamgir, Mohammad Jawad; Mohammad, El Gamri E; Khedr, Mahmoud H; Fazili, Shafat

2014-01-01

Introduction Epilepsy is a diverse set of chronic neurological disorders characterized by seizures. It is one of the most common of the serious neurological disorders. About 3% of people will be diagnosed with epilepsy at some time in their lives. Objectives We aimed to address the commonest types of seizures, their aetiologies, EEG and neuroimaging results and prognosis of patients presented to neurology services of the King Fahad Specialist Hospital- AlQassim (KFSH). Methodology In this retrospective epidemiological study we investigated the medical records of patients with epilepsy, who attended the neurology services of KFSH, during the study period (26/10/2011–26/4/2012). Results The study included 341 patients; 189 (55.4%) males and 152 (44.6%) females. Their ages ranged between 12 and 85 years (mean ± SD = 31±16.9). The majority of patients had Generalised Tonic Clonic Seizures (76.2%), followed by Complex Partial Seizures (7.6%). 73% of our patients had idiopathic epilepsy. The commonest causes for symptomatic epilepsy were Cerebro Vascular Accidents and Head trauma. Hemiplegia, mental retardation and psychiatric illness were the commonest comorbidity. 69.3% of patients had controlled seizures. Patients with idiopathic epilepsy were significantly controlled than patients with symptomatic epilepsy (P=0.01), and those using one Anti Epileptic Drug were significantly controlled compared to patients using polytherapy (P=0.0001) there was no significant relation between controlled seizure and duration of illness or hospitalization or EEG changes. Conclusion Seizure types, aetiology, drug therapy, Comorbidities and outcome in a tertiary care hospital in Saudi Arabia are similar to previous local and international studies. 35.3% of patients were hospitalized, higher rates than previous studies. Seizure control was better in generalized seizures and idiopathic epilepsy compared to complex partial seizures or partial seizures with secondary generalization and

[Analysis of the technical efficiency of hospitals in the Spanish National Health Service].

Science.gov (United States)

Pérez-Romero, Carmen; Ortega-Díaz, M Isabel; Ocaña-Riola, Ricardo; Martín-Martín, José Jesús

To analyse the technical efficiency and productivity of general hospitals in the Spanish National Health Service (NHS) (2010-2012) and identify explanatory hospital and regional variables. 230 NHS hospitals were analysed by data envelopment analysis for overall, technical and scale efficiency, and Malmquist index. The robustness of the analysis is contrasted with alternative input-output models. A fixed effects multilevel cross-sectional linear model was used to analyse the explanatory efficiency variables. The average rate of overall technical efficiency (OTE) was 0.736 in 2012; there was considerable variability by region. Malmquist index (2010-2012) is 1.013. A 23% variability in OTE is attributable to the region in question. Statistically significant exogenous variables (residents per 100 physicians, aging index, average annual income per household, essential public service expenditure and public health expenditure per capita) explain 42% of the OTE variability between hospitals and 64% between regions. The number of residents showed a statistically significant relationship. As regards regions, there is a statistically significant direct linear association between OTE and annual income per capita and essential public service expenditure, and an indirect association with the aging index and annual public health expenditure per capita. The significant room for improvement in the efficiency of hospitals is conditioned by region-specific characteristics, specifically aging, wealth and the public expenditure policies of each one. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Retinopathy of prematurity: the high cost of screening regional and remote infants.

Science.gov (United States)

Yu, Tzu-Ying; Donovan, Tim; Armfield, Nigel; Gole, Glen A

2018-01-25

Demand for retinopathy of prematurity (ROP) screening is increasing for infants born at rural and regional hospitals where the service is not generally available. The health system cost for screening regional/remote infants has not been reported. The objective of this study is to evaluate the cost of ROP screening at a large centralized tertiary neonatal service for infants from regional/rural hospitals. This is a retrospective study to establish the cost of transferring regional/rural infants to the Royal Brisbane and Women's Hospital for ROP screening over a 28-month period. A total of 131 infants were included in this study. Individual infant costs were calculated from analysis of clinical and administrative records. Economic cost of ROP screening for all transfers from regional/rural hospitals to Royal Brisbane and Women's Hospital. The average economic cost of ROP screening for this cohort was AUD$5110 per infant screened and the total cost was AUD$669 413. The average cost per infant screened was highest for infants from a regional centre with a population of 75 000 (AUD$14 856 per child), which was also geographically furthest from Brisbane. No infant in this cohort transferred from a regional nursery reached criteria for intervention for ROP by standard guidelines. Health system costs for ROP screening of remote infants at a centralized hospital are high. Alternative strategies using telemedicine can now be compared with centralized screening. © 2018 Royal Australian and New Zealand College of Ophthalmologists.

Factores predisponentes a labio leporino y/o paladar hendido en pacientes atendidos en el Hospital Regional de Loreto periodo 2008 - 2014.

OpenAIRE

Ferreira Díaz, Frederick; Rodríguez Vásquez, Jean Frank

2015-01-01

El propósito del presente trabajo de investigación fue determinar los factores predisponentes relacionados a labio leporino y/o paladar hendido en pacientes atendidos en el Hospital Regional de Loreto período 2008 - 2014. La investigación fue cuantitativa, el diseño no experimental, descriptivo simple, transversal. Los resultados fueron: El género masculino fue el más prevalente con el 52,5%. El tipo de lesión más prevalente fue fisura del paladar con el 55%, seguido de labio leporino unilate...

Improving regional variation using quality of care measures

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Scott A Berkowitz

2009-11-01

Full Text Available Scott A Berkowitz1, Gary Gerstenblith1, Robert Herbert2, Gerard Anderson1,21Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; 2Center for Hospital Finance and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USAAbstract: There is significant regional variability in the quality of care provided in the United States. This article compares regional performance for three measures that focus on transitions in care, and the care of patients with multiple conditions. Admissions for people with ambulatory care-sensitive conditions, hospital readmissions within 30 days of discharge, and compliance with practice guidelines for people with three chronic conditions (congestive heart failure, chronic obstructive pulmonary disease, and diabetes were analyzed using data drawn from the Centers for Medicare & Medicaid Services’ Standard Analytic Files for 5% of a 2004 national sample of Medicare beneficiaries which was divided by hospital referral regions and regional performance. There were significant regional differences in performance which we hypothesize could be improved through better care coordination and system management.Keywords: performance, quality, chronic condition, ambulatory care, sensitive conditions, readmissions

One year survey of hospitalized psoriatic patients and their treatment in Razi Hospital

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Farnaghi F

1998-05-01

Full Text Available During one year survey, 77 psoriatic patients were hospitalized in the dermatology department of Razi Hospital. This comprised 19% of admitted patients in this period. 29% (n=22 of psoriatic patients had previous history of hospitalization. On admission, the mean age of patients was 32.8 years, the mean and peak age of disease onset were 26.46 and between 11-20 years, respectively. 14% (n=10 of the patients had a family history of psoriasis and 70% (n=7 of those with a positive family history had their age of onset under 20 years. Involvement of different regions was as follows: Scalp: 88% (n=68, nails: 53% (n=41 and joints (arthritis: 10% (n=8. Psoriasis was associated with scrotal tongue in 19% (n=13 and with geographic tongue in 10% (n=8 of patients. Regarding the medical treatment, the drugs which were used most frequently were tigason in 34% (n=41 and ditranol in 22% (n=26 of the cases. The mean duration of hospitalization was 39.29 days and most patients were discharged from the hospital in a good condition without any serious complication. During this period 9% of patients had a relapse of their disease.

Health resource allocation and productive efficiency of Chinese county hospitals: data from 1993 to 2005.

Science.gov (United States)

Gai, Ruoyan Y; Zhou, Chengchao C; Xu, Lingzhong Z; Zhu, Min; Wang, Xingzhou Z; Li, Shixue X; Zheng, Wengui G; Song, Peipei P; Yang, Xuelai L; Fang, Liyi Y; Zhen, Yancheng C; Tang, Wei

2010-10-01

This study aims to assess trends in the productive efficiency of China's county hospitals during the economic transition using data from 1993 to 2005. A data envelopment analysis (DEA) framework was used to calculate the efficiency score of county hospitals in all 31 provinces. A C²R model and a BC² model were devised to respectively calculate overall and scale efficiency and pure technical efficiency at the hospital's current scale. Models included four inputs (number of medical staff; number of beds; value of fixed capital; and hospital expenditures) and three outputs (outpatient and emergency visits, number of inpatients, and hospital revenue) in total. As the results, geographical disparities in health resource allocation and county hospital productivity were noted. From 1993 to 2005, the number of county hospitals increased and their inputs, e.g. fixed capital in particular, grew rapidly. However, the amount of both outpatient and inpatient services declined somewhat especially in the middle and the western regions. The overall efficiency at the national level decreased slightly. County hospitals in the eastern region tended to have better overall, scale, and technical efficiency in comparison to the middle and the western regions. In conclusion, county hospitals are inefficient due to their enlarged scale and the reduced amount of health care services they provide. This issue should be addressed especially in the middle and the western regions, where health resources are far more limited and yet wasted. The effects of ongoing health sector reform on the productivity of county hospitals must be monitored and evaluated.

Performance Budgeting in Practice: the Case of Danish Hospital Management

DEFF Research Database (Denmark)

Jakobsen, Mads Leth; Pallesen, Thomas

2017-01-01

Danish public hospitals to see how performance budgeting works in the regions where the fundamental problems of performance information are negligible and the regions statutorily obligated to increase public sector efficiency by performance budgeting. The analysis shows that the regions in general have...

Key findings from a prospective trauma registry at a regional hospital in Southwest Cameroon.

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Alain Chichom-Mefire

Full Text Available Trauma is a leading cause of morbidity and mortality worldwide. Data characterizing the burden of trauma in Cameroon is limited. Regular, prospective injury surveillance can address the shortcomings of existing hospital administrative logs and medical records. This study aims to characterize trauma as seen at the emergency department (ED of Limbe Regional Hospital (LRH and assess the completeness of data obtained by a trauma registry.From January 2008 to October 2013, we prospectively captured data on injured patients using a strategically designed, context-relevant trauma registry instrument. Indicators around patient demographics, injury characteristics, delays in accessing care, and treatment outcomes were recorded. Descriptive, bivariate, and multivariate statistical analyses were conducted. About 5,617 patients, aged from 0.5-95years (median age of 26 years, visited the LRH ED with an injury; 67% were male. Students (27% were the most affected occupation category. Road traffic injuries (RTIs (56%, assault (22%, and domestic injuries (13% were the leading causes of injury. Two-thirds of RTIs were motorcycle-related. Working in transportation (AOR 4.42, p<0.001 and law enforcement (AOR 1.73, p = 0.004 were significant predictors of having a RTI. The trauma registry showed a significant improvement in completeness of all data (p<0.001 and it improved over time compared with previous administrative records. However, proportions of missing data still ranged from 0.5% to 8.2% and involved respiratory rate or Glasgow Coma scale.Implementation of a context-appropriate trauma registry in resource-constrained settings is feasible. Providing valuable, high-quality data, the trauma registry can inform trauma care quality improvement efforts and policy development. Study findings indicate the need for injury prevention interventions and policies that will prioritize high-risks groups, such as those aged 20-29 years, and those in occupations requiring

Being treated in higher volume hospitals leads to longer progression-free survival for epithelial ovarian carcinoma patients in the Rhone-Alpes region of France

OpenAIRE

Huguet, Marius; Perrier, Lionel; Bally, Olivia; Benayoun, David; De Saint Hilaire, Pierre; Beal Ardisson, Dominique; Morelle, Magali; Havet, Nathalie; Joutard, Xavier; Meeus, Pierre; Gabelle, Philippe; Provençal, Jocelyne; Chauleur, Céline; Glehen, Olivier; Charreton, Amandine

2018-01-01

Background To investigate the relationship between hospital volume activities and the survival for Epithelial Ovarian Carcinoma (EOC) patients in France. Methods This retrospective study using prospectively implemented databases was conducted on an exhaustive cohort of 267 patients undergoing first-line therapy during 2012 in the Rhone-Alpes Region of France. We compared Progression-Free Survival for Epithelial Ovarian Carcinoma patients receiving first-line therapy in high- (i.e. ≥ 12 cases/...

Creación de un Aula de Formación en Atención Farmacéutica en la Universidad de Salamanca

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Martín Suárez A

2014-12-01

Full Text Available Objetivos: Formar un grupo de trabajo, de estudiantes, farmacéuticos y profesores, que lidere actividades formativas y proyectos de investigación en atención farmacéutica desde un aula de la Facultad de Farmacia. Material y métodos: Fases del proyecto: Organización del espacio físico y obtención de recursos, formación del equipo, identidad y medios de difusión de las actividades, diseño de las líneas de trabajo. Resultados y discusión: Se ha constituido el equipo responsable: decano de la Facultad, vicedecano responsable de Proyección Farmacéutica, profesor de Atención farmacéutica, titulares de farmacia comunitaria, representante del CGCOF y estudiante de posgrado. Con recursos aportados por la Facultad se ha acondicionado un aula con espacio para impartir talleres a 24 personas, mesas de trabajo y 12 ordenadores. Se ha diseñado un logo y una página en la web de la Facultad. Se ha catalogado una biblioteca, y organizado un sistema de préstamo, con material bibliográfico y software donado por el CGCOF. Se han definido tres líneas de trabajo: impartir talleres de formación en competencias y habilidades asistenciales, impulsar la realización de trabajos Fin de Grado y coordinar un grupo de investigación profesionales-universidad. En conclusión, se ha creado AUSAF, un Aula de Atención Farmacéutica en la Universidad de Salamanca, que pretende la colaboración entre profesionales farmacéuticos y universidad para iniciar proyectos de investigación y adecuar la formación de nuestros graduados a la evolución actual de la profesión, hacia una farmacia asistencial centrada en el paciente. También pretende servir de apoyo a la formación continua de los profesionales.

Embarazo adolescente en un Hospital de Paraguay durante el 2011

OpenAIRE

Cabañas Acosta, Beatriz Mercedes; Escobar Salinas, Jorge Sebastián

2016-01-01

Objetivo: Describir las características epidemiológicas del embarazo adolescente en el Hospital Regional de Coronel Oviedo, Paraguay.Material y Métodos: Estudio observacional descriptivo de corte transversal, con muestreo no probabilístico de casos consecutivos, con revisión de historias clínicas de las embarazadas adolescentes que acudieron al Hospital Regional de Coronel Oviedo, Paraguay entre los meses enero y diciembre del año 2011.Resultados: Se incluyeron 167 historias clínicas de mujer...

Intensidade de ruído em hospital de 222 leitos na 18ª Regional de Saúde - PR Noise level in a 222 bed hospital in the 18th health region - PR

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Marcelo Henrique Otenio

2007-04-01

Full Text Available A poluição sonora ambiental torna-se hoje onipresente e beira o intolerável. Nos hospitais, os avanços tecnológicos trazem, como conseqüência, níveis de ruído potencialmente danosos. Muito do ruído no hospital provém mais de dentro, do que de fora desse ambiente, sendo as principais causas de ruído em Unidade de Terapia Intensiva, por exemplo, os equipamentos e a conversação entre a equipe hospitalar. O objetivo deste trabalho foi avaliar o nível de ruído nos diversos ambientes hospitalares, em Hospital de 222 leitos na 18ª RS de Saúde - PR. MATERIAIS E MÉTODOS: Conduziu-se, em março de 2005 no período de 24 horas, em dez setores. Forma de Estudo: Aferição do nível de ruído ambiental utilizando um Decibelímetro modelo 1350. RESULTADOS: O nível de ruído encontrado em nosso estudo apresentou média total de 63,7 dB(A, que excede os valores máximos permitidos de 45 dB recomendados pela Associação Brasileira de Normas Técnicas (1987. CONCLUSÃO: Nos setores analisados, o nível de ruído encontrado neste está consideravelmente acima do recomendado. A equipe hospitalar deve estar consciente do ruído e dos efeitos deste, para que possa atuar de maneira mais efetiva na redução da poluição sonora, beneficiando assim a função laborativa dos profissionais e recuperação dos pacientes.Environment noise pollution is common place today, at intolerable levels. In hospitals, technological developments have, as a consequence, potentially harmful noise levels. Much of the hospital noise comes from inside, rather than outside, and the major source of such noise is the Intensive Care Unit, for example equipment and hospital staff talk. Our goal with the present study was to investigate the noise level present in the different hospital environments, within a 222 bed hospital located at the 18th health zone, PR. MATERIALS AND METHODS: The study was carried out in March, 2005, during a period of 24 hours, in tem different

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

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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

[Trends in hospital care].

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Vecina Neto, Gonzalo; Malik, Ana Maria

2007-01-01

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

Rocky mountain spotted fever hospitalizations among American Indians.

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Demma, Linda J; Holman, Robert C; Mikosz, Christina A; Curns, Aaron T; Swerdlow, David L; Paisano, Edna L; Cheek, James E

2006-09-01

To describe the epidemiology of Rocky Mountain spotted fever (RMSF) among American Indians/Alaska Natives (AI/ANs), we conducted a retrospective analysis of hospitalization records with an RMSF diagnosis using Indian Health Service (IHS) hospital discharge data for calendar years 1980-2003. A total of 261 RMSF hospitalizations were reported among AIs, for an average annual hospitalization rate of 1.21 per 100,000 persons; two deaths were reported (0.8%). Most hospitalizations (88.5%) occurred in the Southern Plains region, where the rate was 4.23 per 100,000 persons. Children 1-4 years of age had the highest age-specific hospitalization rate of 2.50 per 100,000 persons. The overall annual RMSF hospitalization rate declined during the study period. Understanding the epidemiology of RMSF among AI/ANs and educating IHS/tribal physicians on the diagnosis of tick-borne diseases remain important for the prompt treatment of RMSF and the reduction of the disease occurrence among AI/ANs, particularly in high-risk areas.

Regional Incentives and Patient Cross-Border Mobility: Evidence from the Italian Experience

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Elenka Brenna

2015-06-01

Full Text Available Background In recent years, accreditation of private hospitals followed by decentralisation of the Italian National Health Service (NHS into 21 regional health systems has provided a good empirical ground for investigating the Tiebout principle of “voting with their feet”. We examine the infra-regional trade-off between greater patient choice (due to an increase in hospital services supply and financial equilibrium, and we relate it to the significant phenomenon of Cross-Border Mobility (CBM between Italian regions. Focusing on the rules supervising the financial agreements between regional authorities and providers of hospital care, we find incentives for private accredited providers in attracting patient inflows. Methods The analysis is undertaken from an institutional, regulatory and empirical perspective. We select a sample of five regions with higher positive CBM balance and we examine regional regulations governing the contractual agreements between purchasers and providers of hospital care. According to this sample, we provide a statistical analysis of CBM and apply a Regional Attraction Ability Index (RAAI, aimed at testing patient preferences for private/public accredited providers. Results We find that this index is systematically higher for private providers, both in the case of distance/boundary patients and of excellence/general hospitals. Conclusion Conclusions address both financial issues regarding the coverage of regional healthcare systems and equity issues on patient healthcare access. They also raise concerns on the new European Union (EU directive inherent to patient mobility across Europe.

Regional incentives and patient cross-border mobility: evidence from the Italian experience.

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Brenna, Elenka; Spandonaro, Federico

2015-03-20

In recent years, accreditation of private hospitals followed by decentralisation of the Italian National Health Service (NHS) into 21 regional health systems has provided a good empirical ground for investigating the Tiebout principle of "voting with their feet". We examine the infra-regional trade-off between greater patient choice (due to an increase in hospital services supply) and financial equilibrium, and we relate it to the significant phenomenon of Cross-Border Mobility (CBM) between Italian regions. Focusing on the rules supervising the financial agreements between regional authorities and providers of hospital care, we find incentives for private accredited providers in attracting patient inflows. The analysis is undertaken from an institutional, regulatory and empirical perspective. We select a sample of five regions with higher positive CBM balance and we examine regional regulations governing the contractual agreements between purchasers and providers of hospital care. According to this sample, we provide a statistical analysis of CBM and apply a Regional Attraction Ability Index (RAAI), aimed at testing patient preferences for private/public accredited providers. We find that this index is systematically higher for private providers, both in the case of distance/boundary patients and of excellence/general hospitals. Conclusions address both financial issues regarding the coverage of regional healthcare systems and equity issues on patient healthcare access. They also raise concerns on the new European Union (EU) directive inherent to patient mobility across Europe. © 2015 by Kerman University of Medical Sciences.

The Impact of Hospital Closures and Hospital and Population Characteristics on Increasing Emergency Department Volume: A Geographic Analysis.

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Lee, David C; Carr, Brendan G; Smith, Tony E; Tran, Van C; Polsky, Daniel; Branas, Charles C

2015-12-01

Emergency visits are rising nationally, whereas the number of emergency departments is shrinking. However, volume has not increased uniformly at all emergency departments. It is unclear what factors account for this variability in emergency volume growth rates. The objective of this study was to test the association of hospital and population characteristics and the effect of hospital closures with increases in emergency department volume. The study team analyzed emergency department volume at New York State hospitals from 2004 to 2010 using data from cost reports and administrative databases. Multivariate regression was used to evaluate characteristics associated with emergency volume growth. Spatial analytics and distances between hospitals were used in calculating the predicted impact of hospital closures on emergency department use. Among the 192 New York hospitals open from 2004 to 2010, the mean annual increase in emergency department visits was 2.7%, but the range was wide (-5.5% to 11.3%). Emergency volume increased nearly twice as fast at tertiary referral centers (4.8%) and nonurban hospitals (3.7% versus urban at 2.1%) after adjusting for other characteristics. The effect of hospital closures also strongly predicted variation in growth. Emergency volume is increasing faster at specific hospitals: tertiary referral centers, nonurban hospitals, and those near hospital closures. This study provides an understanding of how emergency volume varies among hospitals and predicts the effect of hospital closures in a statewide region. Understanding the impact of these factors on emergency department use is essential to ensure that these populations have access to critical emergency services.

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

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Inma Crespo

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

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

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

2015-01-01

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

[Social skills in emergency and critical care professionals of a regional public hospital].

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Leal Costa, C; Luján Cebrián, I; Gascón García, J; Ferrer Villalonga, L; Van-der Hofstadt Román, C J

2010-01-01

To assess the social skills of health care professionals in the emergency and critical care units of the regional hospital Vega Baja and analyze the association between a series of sociodemographic and professionals variables and social skills. A cross-sectional, descriptive study. Two evaluation tools were used. These included a sociodemographic and professional variables questionnaire, and the Elena Gismero's Social Skills Scale (SSS). A response rate of 82.6% was obtained. Considering the standards made by the author in SSS validation, it can be seen that the sample has obtained a medium-high score in each one of the aspects. Significant differences have been found when considering the sociodemographic variable gender as an independent variable with the complete score of SSS (F=6.555; p=0.013), and with the scale dimensions, self-expression in social situations (F=4.468; p=0.039) and making a demand (F=7.982; p=0.007). In each one of the SSS dimensions, the sample has obtained a slightly higher score than the standard sample and it within the 50-69 percentile. This indicates the existence of a medium-high level of Social Skill. The doctors score higher than the nurses, although these differences are not statistically significant. Copyright © 2010 Elsevier España, S.L. y SEEIUC. All rights reserved.

Post-acute referral patterns for hospitals and implications for bundled payment initiatives.

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Lau, Christopher; Alpert, Abby; Huckfeldt, Peter; Hussey, Peter; Auerbach, David; Liu, Hangsheng; Sood, Neeraj; Mehrotra, Ateev

2014-09-01

Under new bundled payment models, hospitals are financially responsible for post-acute care delivered by providers such as skilled nursing facilities (SNFs) and home health agencies (HHAs). The hope is that hospitals will use post-acute care more prudently and better coordinate care with post-acute providers. However, little is known about existing patterns in hospitals׳ referrals to post-acute providers. Post-acute provider referrals were identified using SNF and HHA claims within 14 days following hospital discharge. Hospital post-acute care network size and concentration were estimated across hospital types and regions. The 2008 Medicare Provider Analysis and Review claims for acute hospitals and SNFs, and the 100% HHA Standard Analytic Files were used. The mean post-acute care network size for U.S. hospitals included 57.9 providers with 37.5 SNFs and 23.4 HHAs. The majority of these providers (65.7% of SNFs, 60.9% of HHAs) accounted for 1 percent or less of a hospital׳s referrals and classified as "low-volume". Other post-acute providers we classified as routine. The mean network size for routine providers was greater for larger hospitals, teaching hospitals and in regions with higher per capita post-acute care spending. The average hospital works with over 50 different post-acute providers. Moreover, the size of post-acute care networks varies considerably geographically and by hospital characteristics. These results provide context on the complex task hospitals will face in coordinating care with post-acute providers and cutting costs under new bundled payment models. Copyright © 2014 Elsevier Inc. All rights reserved.

Washoe Med of Reno shares real patient testimonials to build hospital image.

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2006-01-01

The three-hospital system offers the region's most comprehensive treatment programs for cancer and heart and neurological disorders, as well as pediatric urgent care and the region's only women's heart program. Washoe Med was named one of the country's Top 100 Integrated Healthcare Networks, a Hospital of Choice by the American Alliance of Healthcare Providers, and was recently recognized as one of "Nevada's Best Companies to Work For" by Nevada Business Journal. Its marketing department along with agency Estipona Vialpando Partners created a successful integrated marketing campaign to rebrand the hospital and create external and internal ad campaigns.

Radiology integration in a multi-hospital system.

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Welch, D

1999-01-01

In 1989, Salt Lake City's Intermountain Health Care (IHC) began a process to reduce costs and streamline processes. Divided into four geographic regions, IHC consists of 24 hospitals and 100 clinics, a 400-member practitioner-physician group, and a staff of 23,000. IHC determined that three Salt Lake Valley hospitals, part of its Urban Central Region, must become one entity with shared management and a reduced staff to cover operations at all three hospitals. Management of the three radiology departments were charged with creating an integration process for the three hospitals. Two directors were selected to manage radiology and meet the outlined goals. Difficulty arose when one director needed to make changes in a facility managed by the other. The directors found that structuring by modality allowed them to plan for all three facilities, standardize equipment purchases and create integrated rather than departmental programs. As consolidation was taking place in top management, employees worried what the resulting changes meant for their jobs. Many were unfamiliar with the concepts of team structure and continuous quality improvement. Various courses and meetings were held to educate staff members and bring them up to new standards. Most successful were the meetings that allowed staff from different facilities to come together and share ideas. Although travel was an issue, these meetings quickly helped move the integration processes forward as peer relationships were developed. Employees were recruited for cross-training and new staff worked wherever needed. As they began to share data, the three hospitals identified best-practice and internal benchmarks. IHC is now ready to hire a single director to manage the radiology departments at the three Salt Lake Valley hospitals.

Epidemiology of Endometriosis in France: A Large, Nation-Wide Study Based on Hospital Discharge Data

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Peter von Theobald

2016-01-01

Full Text Available We aimed to assess the prevalence of hospitalization for endometriosis in the general population in France and in each French region and to describe temporal trends, rehospitalization rates, and prevalence of the different types of endometriosis. The analyses were carried out on French hospital discharge data and covered the period 2008–2012 and a population of 14,239,197 women of childbearing age. In this population, the prevalence of hospitalization for endometriosis was 0.9%, ranging from 0.4% to 1.6% between regions. Endometriosis affected 1.5% of hospitalized women of childbearing age, ranging from 1.0% to 2.4% between regions. The number of patients hospitalized for endometriosis significantly increased over the study period (p<0.01. Of these, 4.2% were rehospitalized at least once at one year: ranging from 2.7% to 6.3% between regions. The cumulative rehospitalization rate at 3 years was 6.9%. The types of endometriosis according to the procedures performed were as follows: ovarian (40–50%, peritoneal (20–30%, intestinal (10–20%, and ureteral or bladder (<10%, with significant differences between regions. This is the first detailed epidemiological study of endometriosis in France. Further studies are needed to assess the reasons for the increasing prevalence of endometriosis and for the significant differences in regional prevalence of this disease.

Measuring distance through dense weighted networks: The case of hospital-associated pathogens.

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Tjibbe Donker

2017-08-01

Full Text Available Hospital networks, formed by patients visiting multiple hospitals, affect the spread of hospital-associated infections, resulting in differences in risks for hospitals depending on their network position. These networks are increasingly used to inform strategies to prevent and control the spread of hospital-associated pathogens. However, many studies only consider patients that are received directly from the initial hospital, without considering the effect of indirect trajectories through the network. We determine the optimal way to measure the distance between hospitals within the network, by reconstructing the English hospital network based on shared patients in 2014-2015, and simulating the spread of a hospital-associated pathogen between hospitals, taking into consideration that each intermediate hospital conveys a delay in the further spread of the pathogen. While the risk of transferring a hospital-associated pathogen between directly neighbouring hospitals is a direct reflection of the number of shared patients, the distance between two hospitals far-away in the network is determined largely by the number of intermediate hospitals in the network. Because the network is dense, most long distance transmission chains in fact involve only few intermediate steps, spreading along the many weak links. The dense connectivity of hospital networks, together with a strong regional structure, causes hospital-associated pathogens to spread from the initial outbreak in a two-step process: first, the directly surrounding hospitals are affected through the strong connections, second all other hospitals receive introductions through the multitude of weaker links. Although the strong connections matter for local spread, weak links in the network can offer ideal routes for hospital-associated pathogens to travel further faster. This hold important implications for infection prevention and control efforts: if a local outbreak is not controlled in time

International Symposium on Gas Kinetics (11th) Held in Assisi (Perugia), Italy on 2-7 September 1990. Book of Abstracts

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1990-09-07

CROSSED-BEAM CONDITIONS L. Bafiares and A. Gonz’a1ez Urefia Departamento de Quimica Fisica. Facultad de Quimica . Universidad Complutense de Madrid. 28040...Departamento de Quinica Fisica, Universidad del Pais Vasco, Bilbao, Spainand J.M.Alvariiio, Departamento de Quimica Fisica, Universidad de Salamanca...ilbao (Spain) Jesus Matcos, Dcparlamenlo de Quimnica Fisie:n, Fnrullad de Quimica , Salamanca (Spain) Antonio Lagani, Dipareimento di Chirnica

Using data from a multi-hospital clinical network to explore prevalence of pediatric rickets in Kenya

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Karuri, Stella W.; Murithi, Maureen K.; Irimu, Grace; English, Mike

2017-01-01

Background: Nutritional rickets is a public health concern in developing countries despite tropical climates and a re-emerging issue in developed countries. In this study, we reviewed pediatric admission data from the Clinical Information Network (CIN) to help determine hospital and region based prevalence of rickets in three regions of Kenya (Central Kenya, Western Kenya and Nairobi County). We also examine the association of rickets with other diagnosis, such as malnutrition and pneumonia, and study the effect of rickets on regional hospital stays. Methods: We analyzed discharge records for children aged 1 month to 5 years from county (formerly district) hospitals in the CIN, with admissions from February 1 st 2014 to February 28 th 2015. The strength of the association between rickets and key demographic factors, as well as with malnutrition and pneumonia, was assessed using odds ratios. The Fisher exact test was used to test the significance of the estimated odd ratios. Kaplan-Meier curves were used to analyze length of hospital stays. Results: There was a marked difference in prevalence across the three regions, with Nairobi having the highest number of cases of rickets at a proportion of 4.01%, followed by Central Region at 0.92%. Out of 9756 admissions in the Western Region, there was only one diagnosis of rickets. Malnutrition was associated with rickets; this association varied regionally. Pneumonia was found to be associated with rickets in Central Kenya. Children diagnosed with rickets had longer hospital stays, even when cases of malnutrition and pneumonia were excluded in the analysis. Conclusion: There was marked regional variation in hospital based prevalence of rickets, but in some regions it is a common clinical diagnosis suggesting the need for targeted public health interventions. Factors such as maternal and child nutrition, urbanization and cultural practices might explain these differences. PMID:29062911

[Hospital information system performance for road traffic accidents analysis in a hospital recruitment based area].

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Jannot, A-S; Fauconnier, J

2013-06-01

Road traffic accidents in France are mainly analyzed through reports completed by the security forces (police and gendarmerie). But the hospital information systems can also identify road traffic accidents via specific documentary codes of the International Classification of Diseases (ICD-10). The aim of this study was therefore to determine whether hospital stays consecutive to road traffic accident were truly identified by these documentary codes in a facility that collects data routinely and to study the consistency of results from hospital information systems and from security forces during the 2002-2008 period. We retrieved all patients for whom a documentary code for road traffic accident was entered in 2002-2008. We manually checked the concordance of documentary code for road traffic accident and trauma origin in 350 patient files. The number of accidents in the Grenoble area was then inferred by combining with hospitalization regional data and compared to the number of persons injured by traffic accidents declared by the security force. These hospital information systems successfully report road traffic accidents with 96% sensitivity (95%CI: [92%, 100%]) and 97% specificity (95%CI: [95%, 99%]). The decrease in road traffic accidents observed was significantly less than that observed was significantly lower than that observed in the data from the security force (45% for security force data against 27% for hospital data). Overall, this study shows that hospital information systems are a powerful tool for studying road traffic accidents morbidity in hospital and are complementary to security force data. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Quality of communication about medicines in United States hospitals: A national retrospective study.

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Mullings, Lauren; Sankaranarayanan, Jayashri

Despite the benefits of improving transitions across care, literature is very limited on inpatient "Communication about Medicines" (ComMed) by staff across United States (U.S.) hospitals. To evaluate ComMed quality variations by hospital characteristics. In a cross-sectional, retrospective study of publicly available U.S. Medicare's Hospital Consumer Assessment of Health Care Plans Survey (HCAHPS) data (January 2013-September 2014), ComMed quality (high = above average/excellent vs. low = average/below average/poor star ratings) of 3125 hospitals were compared across region, rural-urban location, and health information technology (HIT) infrastructure giving providers access to patients' electronic medical records. Multivariate logistic regression analysis was conducted with adjusting for confounders (hospital - bed size, ownership, type, ED services, the number of completed HCAHPS surveys). After adjusting for other characteristics, Midwest versus Western region hospitals (OR = 1.55, 95% CI: 1.21-1.98, p=quality. Hospitals' small bed-size, physician/non-profit ownership, critical-access type, absent ED services, and 100-299 HCAHPS completed surveys were more likely to be associated with high ComMed quality. One of the first national studies found significant variations in ComMed quality across U.S. hospitals by location (high in Midwest and low in Northeast regions and urban areas) and by access to HIT infrastructure (high) after controlling for other hospital characteristics. With this baseline data, hospital providers and policymakers can design, implement, and evaluate service programs with pharmacists and HIT to enhance ComMed quality in the future delivery of patient-centered care. Copyright © 2016 Elsevier Inc. All rights reserved.

Disparities in Infectious Disease Hospitalizations for American Indian/Alaska Native People

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Holman, Robert C.; Folkema, Arianne M.; Singleton, Rosalyn J.; Redd, John T.; Christensen, Krista Y.; Steiner, Claudia A.; Schonberger, Lawrence B.; Hennessy, Thomas W.; Cheek, James E.

2011-01-01

Objectives We described disparities in infectious disease (ID) hospitalizations for American Indian/Alaska Native (AI/AN) people. Methods We analyzed hospitalizations with an ID listed as the first discharge diagnosis in 1998–2006 for AI/AN people from the Indian Health Service National Patient Information Reporting System and compared them with records for the general U.S. population from the Nationwide Inpatient Survey. Results The ID hospitalization rate for AI/AN people declined during the study period. The 2004–2006 mean annual age-adjusted ID hospitalization rate for AI/AN people (1,708 per 100,000 populiation) was slightly higher than that for the U.S. population (1,610 per 100,000 population). The rate for AI/AN people was highest in the Southwest (2,314 per 100,000 population), Alaska (2,063 per 100,000 population), and Northern Plains West (1,957 per 100,000 population) regions, and among infants (9,315 per 100,000 population). ID hospitalizations accounted for approximately 22% of all AI/AN hospitalizations. Lower-respiratory--tract infections accounted for the largest proportion of ID hospitalizations among AI/AN people (35%) followed by skin and soft tissue infections (19%), and infections of the kidney, urinary tract, and bladder (11%). Conclusions Although the ID hospitalization rate for AI/AN people has declined, it remains higher than that for the U.S. general population, and is highest in the Southwest, Northern Plains West, and Alaska regions. Lower-respiratory-tract infections; skin and soft tissue infections; and kidney, urinary tract, and bladder infections contributed most to these health disparities. Future prevention strategies should focus on high-risk regions and age groups, along with illnesses contributing to health disparities. PMID:21800745

Reseñas

Directory of Open Access Journals (Sweden)

HC Reseñas

2010-02-01

Full Text Available CUESTA, JOSEFINA. «Italianos y españoles en Francia 1938-1946». Tres coloquios: Salamanca, Turin, París, 1991. DAHRENDORF, R. Reflexiones sobre la revolución en Europa. Carta pensada para un caballero de Varsovia. Barcelona, Emecé Editores, 1991. 193 págs. HOBSBAWM, ?. J. Naciones y nacionalismos desde 1780. Barcelona, Edit. Crítica, 1991. 207 págs. TORRE, H. DE LA (coord. Portugal, España y Europa. Cien años de desafío (1890-1990. UNED, Centro Regional de Extremadura, Mérida, 1991. ARCAS CUBERO, F. El País de la Olla. La imagen de España en la prensa satírica malagueña de la Restauración Málaga, Editorial Arguval, 1990, 206 págs. GOMEZ MOLLEDA, M8 DOLORES Actas del Congreso Internacional Cincuentenario de Unamuno. Salamanca, Ediciones Universidad de Salamanca, 1989, 639 págs. CALATAYUD, R.; FERNANDEZ SORIA, J. M.; LÁZARO LORENTE, L. M. et allí Cuestiones Histórico-Educativas. España. Siglos XVIII-XX Valencia, Universitat de Valencia, Dpto. de Historia de la Educación, 1991, 422 págs. CABRERA, M.; SANTOS, J.; MARTIN ACEÑA, P. (Comps. Europa en crisis. 1919-1939. Madrid, Editorial Pablo Iglesias, 1991, 346 págs. MAURICE, J.; MAGNIEN, B. et BUSSY GENEVOIS, D. (dirs.. Pueblo, movimiento obrero y cultura en la España contemporánea. P. U. V., Saint-Denis, 1990, 318 págs. GARCIA DE CORTÁZAR, F; AZCONA, J. M. El nacionalismo vasco. Madrid, Historia 16, 1991, 217 págs. BALCELLS, ?. El nacionalismo catalán Madrid, Historia 16, 1991, 236 págs. LAGUNA, J. M: Historia de la Comunidad Europea. Bilbao, Ediciones Mensajero, 1991, 303 págs. CARASA SOTO, P.: Historia de la Beneficencia en Castilla y León. Poder y pobreza en la sociedad castellana. Secretariado de Publicaciones, Universidad de Valladolid, 1991. PEREZ MENA YO, V. Europa y la Seguridad Social Madrid, 1990 (Fundación Universidad y Empresa núm. 175 colección monografías profesionales GRANJA SAINZ, J. L. de la República y Guerra Civil en Euskadi. (Del pacto

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

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

2018-01-01

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

Possibilities of ICT in hospital classrooms

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Mª Paz Prendes Espinosa

2012-07-01

Full Text Available The investigation presented has a conclusion of improving the educative attention that children who find themselves in the care of hospital receive during considerable amount of time (and that during this period, they attend classes overseen by the hospital through the use of ICT and the design and validation a network protocol, which is based on the use of telematics tools Web 2.0. After undergoing the investigations and experiments related to the topic, we come to the conclusion that in the majority of cases, the playful use of ICT in the hospital classrooms dominates the educative. This educative experiment originates from the collaboration between investigators from different universities, experts in educative technology and the teaching staff from hospital classrooms in the region of Murcia. In this assignment we present the actions taken, the phase in which right now we find the project and the actions yet to be completed.

[Care for elderly patients in Africa: Analysis of the financial implications of the SESAME plan on the budget of the regional hospital center in Thies, Senegal].

Science.gov (United States)

Faye, A; Diousse, P; Seck, I; Diongue, M; Ndiaye, P; Diagne-Camara, M; Tal-Dia, A; Dia, La

2010-04-01

The SESAME plan has been implemented at the Thies Regional Hospital Center (TRHC) for one year. The purpose of this study was to analyze the financial implications of the plan on the hospital budget for the sustainability of care for persons aged 60 and over. This descriptive study included analysis of budget data from October 2006 to September 2007 plus information obtained by interviewing the accountant and head of SESAME plan. The number of patients managed, sources of CHRT funding, grants from various SESAME plan partners, and expenditures for each partner were determined. The weight of the SESAME plan in the CHRT operating budget was determined by calculating the ratio of the overall cost of care for elderly persons in relation to the hospital's revenues and SESAME grants. During the study period, the CHRT received a total of 17375 elderly persons including 89% with no pension or social security. The institute pension scheme (IPRES) covered 21% of the plan as compared to 79% for the state. Utilization plan grants in relation to funding source was 41% for IPRES and 124% for the State. The total cost of services provided to beneficiaries of the SESAME plan exceeded the aggregate amount by 26 083 847 CFA francs. The weight of the SESAME plan in the operating cost of the CHRT was 17%. Prefinancing a plan to cover elderly care in hospitals should be sufficient to prevent deficits from impacting negatively on the operating budget of the hospital.

Administrative management of dental departments in hospitals in Taiwan: A field survey

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Tsang-Lie Cher

2012-12-01

Conclusion: For the overall administrative management of dental departments, medical centers were superior to regional hospitals, which were better than district hospitals. In order to elevate the quality, we suggest that dental department should be included in teaching hospital accreditation, and the criteria we used can be taken for reference for the dental department accreditation in the future.

Human milk use in Australian hospitals, 1949-1985.

Science.gov (United States)

Thorley, Virginia

2012-07-01

This paper will draw mainly on the experiences of fourteen women to explore the use of expressed human milk by hospitals in Australia from the postwar period through to 1985. The purpose is to provide a snapshot of common practices before the decline of human milk banking and other uses of expressed breastmilk in Australian hospitals, thus providing a source for future comparison against the more rigorous, uniform practices being instituted in the new milk banks of the early-21st century. The ten mothers included were a convenience sample drawn from the author's networks, with recruitment continuing till a range of hospital types and a majority of states were included. Three of the mothers also had experience as trainee midwives and midwives, and four midwives contributed their experiences as staff members, only. The hospitals ranged from large teaching hospitals to small private hospitals and were in metropolitan, regional and country locations. The practices included routine expression and expression for specific purposes, whether for the mother's own baby or to donate. Some hospitals pooled the donor milk for premature or sick babies.

Colonization with hospital flora and its associated risk factors in neonates hospitalized in neonatal ward of a teaching center in Isfahan, Iran.

Science.gov (United States)

Shirani, Kiana; Mostafavizadeh, Kamyar; Ataei, Behrouz; Akhani, Khatere

2018-01-01

Due to the high incidence and prevalence of infection in neonatal ward, especially Neonatal Intensive Care Units (NICUs) reported by different studies and the important role of colonization with hospital germs in the development of nosocomial infections, we intended to evaluate the risk of colonization with hospital germs in neonates and its associated risk factors. This cross-sectional, descriptive-analytical study was conducted in 2016 in a Teaching Center in Iran. In total, 51 neonates were selected based on the inclusion criteria, and after recording their information in a checklist, samples were taken by swab from outer ear, axilla, and groin for culture. Neonates with negative culture from mentioned regions were enrolled in the study. The swab samples again were taken and sent for culture from mentioned regions in at least 3 days after hospitalization. Culture results from first and second sampling were collected and analyzed statistically. This study was conducted on 51 neonates. The mean gestational age among the neonates ranged from 35.25 (Week) ± 2.98. 22 girls (43.1%) and 29 boys (56.9%), most of them were born by cesarean. Based on the results of logistic regression, a significant association was found between the occurrence of colonization of hospital flora and the place hospitalization of the newborns (odds ratio (OR): 4.750; 95% confidence interval (CI): 1.26-17.85). This study revealed that the only risk factors of colonization with hospital flora in neonates are the type of delivery and place of hospitalization. Based on findings of the study, it is recommended to focus on efforts in increasing the rate of natural birth as well as improving conditions of infection control in NICUs to reduce the number of incidences of colonization with hospital flora in neonates.

Presentations and Preceding factors of Drug Overdose amongst adolescents admitted to a Large Regional Hospital.

LENUS (Irish Health Repository)

Maduemem, KE

2018-04-01

Suicide is the third most common cause of death among adolescents globally, and poisoning is the leading method of attempted suicide. Survival after self-poisoning or drug overdose (OD) is common, providing an opportunity for secondary prevention. The aim of this study was to highlight pattern of presentations and preceding factors of OD in an adolescent population. We retrospectively evaluated the data of 85 adolescents presenting to a large regional hospital with OD over a 3-year period. The female-to-male ratio was 4.3:1. The median age of adolescents was 15.83 (range: 11.32 – 16.98) years. History of deliberate self-harm (DSH) was documented in 44.7%. Twenty-eight (33%) patients had been under the care of the CAMHS prior to index admission. Acetaminophen was the commonest drug used. Depression was the most common cause of mental illness in the study group. Substance abuse and conduct disorder were significantly commoner in males (p<0.05). Self-poisoning including OD in adolescence is a strong predictor of suicide; understanding the probable triggers can be significant in establishing appropriate prevention strategies.

[Regional geriatric team--a model for cooperation between nursing homes and hospitals].

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Sellaeg, Wenche Frogn

2005-04-21

Few studies describe and evaluate the use of ambulatory geriatric teams in nursing homes. This article gives an account of a model in which a multidisciplinary group from the local hospital has been visiting 17 communities in Norway twice a year for 11 years. The ambulatory geriatric team includes a geriatrician, a geriatric nurse, a physiotherapist and an occupational therapist. Their aim is to raise the quality of geriatric assessment and care and to enhance the cooperation between the hospital and the nursing homes in the communities. The team members are doing a comprehensive geriatric assessment of some of the patients; they assess cases for further referral, and examine patients with declining functioning with a view to rehabilitation. The team provides instruction in various aspects of geriatrics to community care professionals. Much time is devoted to discussions on problems raised by the staff, such as management of patients with dementia-related behavioural problems, and to provide feedback to staff-members. The team liaise between hospitals, nursing homes and community care services in the communities in order to enhance communication between the professionals involved. An evaluation of the team was done on behalf of the National Institute of Health through a postal questionnaire which was returned by 223 doctors, nurses and allied health care professionals. The results indicate that visits by the ambulatory team improve the knowledge of doctors and allied professionals about diseases in the elderly; 92% reported that they now felt they were doing a better job.

Lean techniques to improve the flow of critically ill patients in a health region with its epicenter in the intensive care unit of a reference hospital.

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Sirvent, J M; Gil, M; Alvarez, T; Martin, S; Vila, N; Colomer, M; March, E; Loma-Osorio, P; Metje, T

2016-01-01

To analyze whether the application of Lean techniques to improve the flow of critically ill patients in a health region with its epicenter in the intensive care unit (ICU) of a reference hospital. Observational study with pre and post intervention analysis. ICU of a reference hospital. We design projects and a value stream map of flow and compared pre and post intervention. We recorded demographic data, patient transfers by EMS for lack of beds and delay times in the discharge from ICU to ward. Multidisciplinary meetings and perform daily visual panel, with high priority ICU discharge. We promote temporary relocation of critically ill patients in other special areas of the hospital. We performed a professional satisfaction questionnaire with pre and post implementation of process. We make a statistical analysis of pre and post-intervention comparisons. We planned for 2013 and progressively implemented in 2014. Analysis of patients entering the critical process flow 1) evaluate patients who must transfer for lack of beds, focusing on a diagnosis: pre 10/22 vs. 3/21 post (P=.045); 2) analysis of time delay in the discharge from the ICU to ward: 360.8±163.9minutes in the first period vs. 276.7±149.5 in the second (P=.036); and 3) personal professional satisfaction questionnaire, with 6.6±1.5 points pre vs. 7.5±1.1 in post (P=.001). Analysis of indicators such as the ICU acquired infections, length of ICU stay, the rate of re-admissions and mortality, with no significant differences between the two periods. The application of Lean techniques in the critically ill process had a positive impact on improving patient flow within the health region, noting a decrease of transfers outside the region due to lack of beds, reduced delayed discharge from ICU to conventional ward and increased satisfaction of ICU professionals. Copyright © 2015 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

The effect of contextual factors on unintentional injury hospitalization: from the Korea National Hospital Discharge Survey.

Science.gov (United States)

Lee, Hye Ah; Han, Hyejin; Lee, Seonhwa; Park, Bomi; Park, Bo Hyun; Lee, Won Kyung; Park, Ju Ok; Hong, Sungok; Kim, Young Taek; Park, Hyesook

2018-03-13

It has been suggested that health risks are affected by geographical area, but there are few studies on contextual effects using multilevel analysis, especially regarding unintentional injury. This study investigated trends in unintentional injury hospitalization rates over the past decade in Korea, and also examined community-level risk factors while controlling for individual-level factors. Using data from the 2004 to 2013 Korea National Hospital Discharge Survey (KNHDS), trends in age-adjusted injury hospitalization rate were conducted using the Joinpoint Regression Program. Based on the 2013 KNHDS, we collected community-level factors by linking various data sources and selected dominant factors related to injury hospitalization through a stepwise method. Multilevel analysis was performed to assess the community-level factors while controlling for individual-level factors. In 2004, the age-adjusted unintentional injury hospitalization rate was 1570.1 per 100,000 population and increased to 1887.1 per 100,000 population in 2013. The average annual percent change in rate of hospitalizations due to unintentional injury was 2.31% (95% confidence interval: 1.8-2.9). It was somewhat higher for females than for males (3.25% vs. 1.64%, respectively). Both community- and individual-level factors were found to significantly influence unintentional injury hospitalization risk. As community-level risk factors, finance utilization capacity of the local government and neighborhood socioeconomic status, were independently associated with unintentional injury hospitalization after controlling for individual-level factors, and accounted for 19.9% of community-level variation in unintentional injury hospitalization. Regional differences must be considered when creating policies and interventions. Further studies are required to evaluate specific factors related to injury mechanism.

Infection control in anaesthesia in regional, tertiary and central ...

African Journals Online (AJOL)

2012-09-10

Sep 10, 2012 ... King Edward VIII Hospital; Nelson R Mandela School of Medicine, University of KwaZulu-Natal ... Samuel R, MBChB, DipHIVMan, FCPath(Viro)(SA), Specialist Virologist, Inkosi Albert Luthuli ... 12 regional level hospitals.

Prevalent infant feeding practices among the mothers presenting at a tertiary care hospital in Garhwal Himalayan region, Uttarakhand, India

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Vyas Kumar Rathaur

2018-01-01

Full Text Available Introduction: There is paucity of studies on infant feeding practices from the rural areas of garhwal Himalayas of the state of uttarakhand. The present study was designed to assess the infant feeding practices in Garhwal region. Infant feeding practices have significant implications on a child's health. Early nutritional status especially during the first year of life has been shown to have a significant effect on child health and development. Optimal infant feeding practices are crucial for nutritional status, growth, development, health, and ultimately the survival of infants and young children. The study of infant feeding practices is essential before formulation of any interventional programme. Settings and Design: A study was conducted in HNB Base Hospital and Teaching Institute with the aim to assess the infant feeding practices and the prevalence of malnutrition in the study population reporting at the hospital in garhwal region of uttarakhand. Methods and Material: This is an observational cross sectional study. 275 infants were included in the study. After taking informed consent, case study forms were filled by interviewing the infants' mothers. Weight, length and head circumference of each infant was also measured. The information thus obtained was compiled, tabulated and analysed statistically. Results: The study findings revealed that 46.4% infants in the age group 0-5 months were breastfed within 1 hour of birth. 52.8% infants aged 0-5 months of were exclusively breastfed. 33.6% infants in age group 0-5 months received prelacteal feeds. 53.12% infants in age group 6-8 months received solid, semi-solid or soft food, in addition to breast milk. 53.33% infants were partially or fully bottle fed. Age appropriate feeding was found in 56% infants. The percentage of wasting, stunting and underweight in 0-5 months was 33.6%,30.4% and 36.8% respectively . The percentage of wasting, stunting and underweight in 6-11 months was 28%, 26.5% and

Perceived barriers to the regionalization of adult critical care in the United States: a qualitative preliminary study

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Rubenfeld Gordon D

2008-11-01

Full Text Available Abstract Background Regionalization of adult critical care services may improve outcomes for critically ill patients. We sought to develop a framework for understanding clinician attitudes toward regionalization and potential barriers to developing a tiered, regionalized system of care in the United States. Methods We performed a qualitative study using semi-structured interviews of critical care stakeholders in the United States, including physicians, nurses and hospital administrators. Stakeholders were identified from a stratified-random sample of United States general medical and surgical hospitals. Key barriers and potential solutions were identified by performing content analysis of the interview transcriptions. Results We interviewed 30 stakeholders from 24 different hospitals, representing a broad range of hospital locations and sizes. Key barriers to regionalization included personal and economic strain on families, loss of autonomy on the part of referring physicians and hospitals, loss of revenue on the part of referring physicians and hospitals, the potential to worsen outcomes at small hospitals by limiting services, and the potential to overwhelm large hospitals. Improving communication between destination and source hospitals, provider education, instituting voluntary objective criteria to become a designated referral center, and mechanisms to feed back patients and revenue to source hospitals were identified as potential solutions to some of these barriers. Conclusion Regionalization efforts will be met with significant conceptual and structural barriers. These data provide a foundation for future research and can be used to inform policy decisions regarding the design and implementation of a regionalized system of critical care.

Teleradiology service for mission hospitals: initial experiences in Ethiopia and Kenya

OpenAIRE

Matthew Larrison; Stanley G. Cheng; Stephen McManus

2016-01-01

Throughout their history, mission hospitals have provided high quality and lifesaving medical care to regions of the world where medical care is sparse. These hospitals are generally built and equipped through a combination of governmental and non-governmental sources. As advances in diagnostic medical imaging have progressed and become mainstream in the developed world, mission hospitals have adopted advanced imaging modalities. These modalities provide early diagnosis and treatment options ...

The Role of Bokavirus and Metapneumovirus in Development Acute Respiratory Infections in Hospitalized Patients in 2011—2014 years in Penza Region

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I. A. Malova

2016-01-01

Full Text Available The article presents the results of a comparative analysis of the clinical data, laboratory and instrumental examination methods in patients with bokavirus (HBoV and metapnevmovirus (HMPV infections, hospitalized in the infectious disease Department of MSU № 59 Zarechnyj sity Penza region. From 713 patients with verified diagnosis with 42 (5.89% PCR revealed metapnevmovirus infection, at 18 (2.52% bokavirus, at 34 (4.77% mixed infection, most often by HBoV on and HMPV were children up to 7 years, were accompanied by lesions of the upper and lower respiratory tract infections, fever, intoxication, adenopathy.

Evaluation of paediatric injury hospitalization incidence at Hospital Ward in Grudziądz

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Ewa Barczykowska

2016-05-01

4Correction Unit No. 2 in Grudziadz     Mailing address: Marta Lewicka, Collegium Medicum im. L. Rydygiera w Bydgoszczy, UMK w Toruniu, ul. Techników 3, 85-801 Bydgoszcz, Poland; Phone 52 585 21 93, e-mail: marta_grabinska@hotmail.com   Abstract Introduction. Children's and adolescents' injuries are a serious medical problem, as they lead to substantial medical and socio-economic effects. Aim of the paper. The aim of the conducted research was to analyze incidence and causes of hospitalizing children between birth and 18 years of age on the grounds of injuries. Material and methods. Medical histories of 2 832 children between birth and 18 years of age treated for injuries in 2006-2010 in Wladyslaw Bieganski Regional Specialist Hospital in Grudziadz were analyzed. Results. Correlations between treatment method and subsequent years of research (p<0,05, between children's age group and type of injury, and between type of injury and season of the year and hospitalization time, were shown to be statistically significant. No correlation was found in the studied population between subsequent years of research and injury types or residence of the injured. Conclusions. 1. The most frequent causes for placing children in the hospital were cranioencephalic injuries, injuries to the osteoarticular system, and burns. 2. The children's age determined the type of injury inflicted. Children in the youngest age group were most frequently hospitalized for burns, children in the age of 3-6 years for foreign bodies, and in the group of 7-18 years of age for injuries to the chest and to the osteoarticular system. 3. Boys were more frequently injured in a manner requiring hospital treatment than girls were. 4. A decisive majority of injured children required only conservative treatment and a stay in the hospital for no more than 3 days. 5. A constant tendency of higher occurence of injuries in children during spring and summer, was observed. Keywords: children, injuries

Hidden Costs of Hospital Based Delivery from Two Tertiary Hospitals in Western Nepal.

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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

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

Reengineering knowledge for e-tourism and hospitality curricula

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Jing Fu

2016-12-01

Full Text Available E-tourism and hospitality represents the development of tourism and hospitality to integrate ICT tools and has significantly changed the industry over the last decade. In order to meet the new needs, knowledge service suppliers (i.e. the university must meet the requirements and social developments of the tourism industry. The quality of e-tourism and hospitality curriculum depends largely on the education quality and its subsequent implementation. The research reveals that higher education is not currently meeting the needs of the industry, especially in the Greater Mekong Sub-region countries. This article focuses on two major problems, which represent a disparity between the knowledge needs of the tourism and hospitality industry and the knowledge provided by curricula in higher education. The authors leverage a knowledge engineering perspective so as to bridge the gap between knowledge demand and supply as related to e-tourism and hospitality curriculum design.

Regions of High Out-Of-Hospital Cardiac Arrest Incidence and Low Bystander CPR Rates in Victoria, Australia.

Science.gov (United States)

Straney, Lahn D; Bray, Janet E; Beck, Ben; Finn, Judith; Bernard, Stephen; Dyson, Kylie; Lijovic, Marijana; Smith, Karen

2015-01-01

Out-of-hospital cardiac arrest (OHCA) remains a major public health issue and research has shown that large regional variation in outcomes exists. Of the interventions associated with survival, the provision of bystander CPR is one of the most important modifiable factors. The aim of this study is to identify census areas with high incidence of OHCA and low rates of bystander CPR in Victoria, Australia. We conducted an observational study using prospectively collected population-based OHCA data from the state of Victoria in Australia. Using ArcGIS (ArcMap 10.0), we linked the location of the arrest using the dispatch coordinates (longitude and latitude) to Victorian Local Government Areas (LGAs). We used Bayesian hierarchical models with random effects on each LGA to provide shrunken estimates of the rates of bystander CPR and the incidence rates. Over the study period there were 31,019 adult OHCA attended, of which 21,436 (69.1%) cases were of presumed cardiac etiology. Significant variation in the incidence of OHCA among LGAs was observed. There was a 3 fold difference in the incidence rate between the lowest and highest LGAs, ranging from 38.5 to 115.1 cases per 100,000 person-years. The overall rate of bystander CPR for bystander witnessed OHCAs was 62.4%, with the rate increasing from 56.4% in 2008-2010 to 68.6% in 2010-2013. There was a 25.1% absolute difference in bystander CPR rates between the highest and lowest LGAs. Significant regional variation in OHCA incidence and bystander CPR rates exists throughout Victoria. Regions with high incidence and low bystander CPR participation can be identified and would make suitable targets for interventions to improve CPR participation rates.

Hospital Variation in Cesarean Delivery: A Multilevel Analysis.

Science.gov (United States)

Vecino-Ortiz, Andres I; Bardey, David; Castano-Yepes, Ramon

2015-12-01

To assess the issue of hospital variations in Colombia and to contribute to the methodology on health care variations by using a model that clusters the variance between hospitals while accounting for individual-level reimbursement rates and objective health-status variables. We used data on all births (N = 11,954) taking place in a contributory-regimen insurer network in Colombia during 2007. A multilevel logistic regression model was used to account for the share of unexplained variance between hospitals. In addition, an alternative variance decomposition specification was further carried out to measure the proportion of such unexplained variance due to the region effect. Hospitals account for 20% of the variation in performing cesarean sections, whereas region explains only one-third of such variance. Variables accounting for preferences on the demand side as well as reimbursement rates are found to predict the probability of performing cesarean sections. Hospital variations explain large variances within a single-payer's network. Because this insurer company is highly regarded in terms of performance and finance, these results might provide a lower bound for the scale of hospital variation in the Colombian health care market. Such lower bound provides guidance on the relevance of this issue for Colombia. Some factors such as demand-side preferences and physician reimbursement rates increase variations in health care even within a single-payer network. This is a source of inefficiencies, threatening the quality of health care and financial sustainability. The proposed methodology should be considered in further research on health care variations. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Association Between Community Social Capital and Hospital Readmission Rates.

Science.gov (United States)

Brewster, Amanda L; Lee, Suhna; Curry, Leslie A; Bradley, Elizabeth H

2018-05-31

Hospital readmissions remain frequent, and are partly attributable to patients' social needs. The authors sought to examine whether local community levels of social capital are associated with hospital readmission rates. Social capital refers to the connections among members of a society that foster norms of reciprocity and trust, which may influence the availability of support for postdischarge recovery after hospitalization. Associations between hospital-wide, risk-stratified readmission rates for hospitals in the United States (n = 4298) and levels of social capital in the hospitals' service areas were examined. Social capital was measured by an index of participation in associational activities and civic affairs. A multivariate linear regression model was used to adjust for hospital and community factors such as hospital financial performance, race, income, and availability of heath care services. Results showed that higher social capital was significantly associated with lower readmission rates (P social capital in its region, but in areas of low social capital, it may be possible for public or philanthropic sectors to buttress the types of institutions that address nonmedical causes of readmission.

[Impact of the chemotherapy protocols for metastatic breast cancer on the treatment cost and the survival time of 371 patients treated in three hospitals of the Rhone-Alpes region].

Science.gov (United States)

Paviot, B Trombert; Bachelot, T; Clavreul, G; Jacquin, J-P; Mille, D; Rodrigues, J-M

2009-10-01

The chemotherapy of the metastatic breast cancer is characterized by the diversity of the treatment protocols and the utilisation of new expensive molecules posing the double problem of outcomes for the patients and financial effects for the hospitals. This survey describes the different chemotherapy treatments prescribed in the metastatic breast cancer and the direct costs supported by the hospitals according to the patient survival time. A cohort of 371 patients treated for a metastatic breast cancer was followed in three hospitals of the Rhone-Alpes region between 2001 and 2006. The detail of their different antineoplasic treatments, as well as the purchase cost of the drugs and their cost of hospital administration, the cost of the other hospital stays are presented in relation with the survival. The median survival time (35,8 months; CI 95%: [31.7-39.1]) since the first metastasis does not differ significantly according to the hospital. Ninety-three different chemotherapy protocols are observed combining from one to five molecules. Thirty-two different molecules are identified. In first line treatment, there is a significant difference in the use of the new molecules according to hospital (Chi(2) test; P cost of a chemotherapy treatment is 3,919 euro (+/- 8,069 euro), the higher cost is observed for trastuzumab (23,443 euro). The average time period before the beginning of a new chemotherapy line is 212 days (+/- 237 days) and the mean cost of hospital stay during this period is 3,903 euro (+/- 4,097 euro). If no impact of the chemotherapy treatment strategy is observed on the survival time of the patient, it is the opposite for the hospital treatment cost. These results are asking for a better control system of the authorization procedure of new molecules marketing and the harmonization of the practices.

Reutilización de Hachas Pulimentadas en Rodamientos «Modernos» de Molinos de Agua en las Cercanías de los Arribes del Duero (Salamanca

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Luis BENITO DEL REY

2009-10-01

Full Text Available RESUMEN: Se estudian aquí dos hachas pulimentadas que fueron reutilizadas posteriormente como piezas de rodamientos (guíos o gorrones de los molinos de agua en las cercanías de los Arribes del Duero en la provincia de Salamanca. Dureza, forma y tamaño son los motivos fundamentales de su elección. Las piezas estudiadas son, a juzgar por su desgaste, piezas de desecho. Parece que las piedras son mejores rodamientos que el hierro bajo el agua, la cual a su vez les sirve de refrigerador impidiendo su fuerte calentamiento al girar. Como complemento se añaden dos cantos rodados que podrían ser piezas hembras (bollas o canaletas en las que se han introducido y girado los guíos.RÉSUMÉ: On étudie ici deux haches polies qui ont été réut'lisées postérieurement comme pièces de coussinets («guíos» ou «gorrones» des moulins d'eau dans les proximités des Arribes du Duero dans la province de Salamamque. Dureté, forme et grandeur sont les motifs fondamentaux de leur élection. Les pièces étudiées sont, si on juge leur usure, des pièces de déchet. Il semble que les pierres sont meilleurs coussinets que le fer sous l'eau, laquelle, à son tour, leur sert de réfrigérateur en empêchant leur fort éohauffement en tournant. Comme complément on étudie aussi deux galets qui pourraient être des pièces femelle («bollas» ou «canaletas» dans lesquelles se sont introduits et ont tourné les pièces-mâle («guíos».

Implementation of integration strategies between primary care units and a regional general hospital in Brazil to update and connect health care professionals: a quasi-experimental study protocol.

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Bracco, Mario Maia; Mafra, Ana Carolina Cintra Nunes; Abdo, Alexandre Hannud; Colugnati, Fernando Antonio Basile; Dalla, Marcello Dala Bernardina; Demarzo, Marcelo Marcos Piva; Abrahamsohn, Ises; Rodrigues, Aline Pacífico; Delgado, Ana Violeta Ferreira de Almeida; Dos Prazeres, Glauber Alves; Teixeira, José Carlos; Possa, Silvio

2016-08-12

Better communication among field health care teams and points of care, together with investments focused on improving teamwork, individual management, and clinical skills, are strategies for achieving better outcomes in patient-oriented care. This research aims to implement and evaluate interventions focused on improving communication and knowledge among health teams based on points of care in a regional public health outreach network, assessing the following hypotheses: 1) A better-working communication process between hospitals and primary health care providers can improve the sharing of information on patients as well as patients' outcomes. 2) A skill-upgrading education tool offered to health providers at their work sites can improve patients' care and outcomes. A quasi-experimental study protocol with a mixed-methods approach (quantitative and qualitative) was developed to evaluate communication tools for health care professionals based in primary care units and in a general hospital in the southern region of São Paulo City, Brazil. The usefulness and implementation processes of the integration strategies will be evaluated, considering: 1) An Internet-based communication platform that facilitates continuity and integrality of care to patients, and 2) A tailored updating distance-learning course on ambulatory care sensitive conditions for clinical skills improvements. The observational study will evaluate a non-randomized cohort of adult patients, with historical controls. Hospitalized patients diagnosed with an ambulatory care sensitive condition will be selected and followed for 1 year after hospital discharge. Data will be collected using validated questionnaires and from patients' medical records. Health care professionals will be evaluated related to their use of education and communication tools and their demographic and psychological profiles. The primary outcome measured will be the patients' 30-day hospital readmission rates. A sample size of 560

Análise da produção e taxa de geração de resíduos sólidos de serviços de saúde do Hospital Universitário Regional de Maringá = Production analysis and generation rate of solid health-care waste at Maringá Regional University Hospital

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Lucila Akiko Nagashima

2007-07-01

Full Text Available Os resíduos sólidos de serviços de saúde (RSSS representam reduzida parcela do total dos resíduos sólidos urbanos gerados diariamente por uma cidade. Considerando a própria origem, parte desses resíduos apresenta riscos e dificuldades especiais em seu manejo, devido especialmente ao caráter infeccioso de alguns componentes. Estasconstatações associadas à necessidade de conhecer a situação dos RSSS do Hospital Universitário Regional de Maringá motivaram a elaboração do estudo. A pesquisa buscou identificar as diferentes fontes geradoras, caracterizar qualitativa e quantitativamente osresíduos gerados determinando a taxa de geração diária. A caracterização foi efetuada mediante a pesagem dos resíduos, acompanhamento das atividades internas do hospital, quanto aos procedimentos de coleta, armazenamento interno e externo e transporte de seus resíduos sólidos. Constatou-se que do total de resíduos gerados, cerca de 53% são considerados contaminados, percentual creditado como não-satisfatório para uma parcela significante de bibliografia consultada.Solid health-care waste (SHCW represents only a small fraction of the total urban solid waste generated daily in a city. Taking its origin into consideration, part of this waste presents risks and special difficulties in handling, especially due to the infectious aspects of some components. The elaboration of study was motivated by these findings, associated with the need to find out the conditions of the SHCW from the Maringá Regional University Hospital. The research attempted to identify the different generating sources, quantifying and qualifying the generated waste, and determining the daily generated rate. The characterization was done by weighing the waste, observing internal hospital activities regarding collection procedures, internal and external storage and transportation of the waste. It was verified that from the total generated waste, around 53% is considered

Specialty and full-service hospitals: a comparative cost analysis.

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Carey, Kathleen; Burgess, James F; Young, Gary J

2008-10-01

To compare the costs of physician-owned cardiac, orthopedic, and surgical single specialty hospitals with those of full-service hospital competitors. The primary data sources are the Medicare Cost Reports for 1998-2004 and hospital inpatient discharge data for three of the states where single specialty hospitals are most prevalent, Texas, California, and Arizona. The latter were obtained from the Texas Department of State Health Services, the California Office of Statewide Health Planning and Development, and the Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project. Additional data comes from the American Hospital Association Annual Survey Database. We identified all physician-owned cardiac, orthopedic, and surgical specialty hospitals in these three states as well as all full-service acute care hospitals serving the same market areas, defined using Dartmouth Hospital Referral Regions. We estimated a hospital cost function using stochastic frontier regression analysis, and generated hospital specific inefficiency measures. Application of t-tests of significance compared the inefficiency measures of specialty hospitals with those of full-service hospitals to make general comparisons between these classes of hospitals. Results do not provide evidence that specialty hospitals are more efficient than the full-service hospitals with whom they compete. In particular, orthopedic and surgical specialty hospitals appear to have significantly higher levels of cost inefficiency. Cardiac hospitals, however, do not appear to be different from competitors in this respect. Policymakers should not embrace the assumption that physician-owned specialty hospitals produce patient care more efficiently than their full-service hospital competitors.

Incidence of hospital referred head injuries in Norway: a population based survey from the Stavanger region

DEFF Research Database (Denmark)

Heskestad, Ben; Baardsen, Roald; Helseth, Eirik

2009-01-01

it with previous Norwegian studies. METHODS: All head injured patients referred to Stavanger University Hospital during a one-year period (2003) were registered in a partly prospective and partly retrospective study. The catchment area for the hospital is strictly defined to a local population of 283...

In Hospital Stroke Mortality: Rates and Determinants in Southwestern Saudi Arabia

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Adel A. Alhazzani

2018-05-01

Full Text Available Objectives: The present study analyzed in-hospital first-time stroke mortality in southwestern Saudi Arabia over one-year to assess the in-hospital stroke case fatality rate, mortality rate and explore the factors associated with in-hospital stroke mortality. Study Design: Hospital based follow-up study. Methods: First-time stroke patients admitted to all hospitals in Asser region over one-year period (January through December 2016 were included in the study. Data about personal characteristics, pre-stroke history and clinical criteria, on admission clinical criteria, in-hospital complications and survival status were collected. The last reported Aseer region population was used to calculate age and sex stroke mortality rate per 100,000 population/year. Hazard ratios (HR and concomitant 95% confidence intervals (95% CI were computed using multivariate Cox regression survival analysis. Kaplan-Meier curve survival analysis for stroke patients were plotted. Results: A total of 121 in-hospital deaths out of 1249 first-time stroke patients giving an overall case fatality rate (CFR of 9.7%. Non-significant difference with gender and age were observed in CFR. Overall, in-hospital stroke mortality rate was 5.58 per 100,000/year. Males and elders showed a significantly higher mortality rates. Multivariable Cox regression analyses revealed pre-stroke smoking (HR = 2.36, pre-stroke hypertension (HR = 1.77, post-stroke disturbed consciousness (HR = 6.86, poor mobility (HR = 2.60 and developing pulmonary embolism (HR = 2.63 as significant predictors of in-hospital stroke mortality. Conclusions: In Southwestern Saudi Arabia, the in-hospital stroke mortality rate is higher in men and increases with aging. The prognosis of acute stroke could be improved by smoking cessation, better control of hypertension and prevention of in hospital complication particularly pulmonary embolism.

Prevalence of Pressure Injury of Bedridden Patients, Hospitalized in a Public Hospital

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Sandra Marina Gonçalves Bezerra

2017-03-01

Full Text Available Objective: To analyze the prevalence of pressure injury in bedridden patients, hospitalized in a public hospital. Methodology: This is a cross-sectional study conducted in the city of Teresina, state of Piauí. The sample consisted of 27 bedridden patients, with pressure injuries. Results: The injury prevalence was 31,4%. From the 27 patients studied, 59.3% were elderly, 77.8% were male, 48.1% had circulatory system diseases, 22.2% had respiratory system diseases and 59.3% of the pressure injuries were located in the sacral region. Conclusion: The prevalence of pressure injury was high among bedridden patients, which shows the need of preventive measures, such as protocol implantation, use of scale of risk assessment, appropriate supporting surface, repositioning in bed, adequacy of dressings and instructions for patient discharge. Keywords: Pressure ulcer. Prevalence. Nursing.

[A program for optimizing the use of antimicrobials (PROA): experience in a regional hospital].

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Ugalde-Espiñeira, J; Bilbao-Aguirregomezcorta, J; Sanjuan-López, A Z; Floristán-Imízcoz, C; Elorduy-Otazua, L; Viciola-García, M

2016-08-01

Programs for optimizing the use of antibiotics (PROA) or antimicrobial stewardship programs are multidisciplinary programs developed in response to the increase of antibiotic resistant bacteria, the objective of which are to improve clinical results, to minimize adverse events and to reduce costs associated with the use of antimicrobials. The implementation of a PROA program in a 128-bed general hospital and the results obtained at 6 months are here reported. An intervention quasi-experimental study with historical control group was designed with the objective of assessing the impact of a PROA program with a non-restrictive intervention model to help prescription, with a direct and bidirectional intervention. The basis of the program is an optimization audit of the use of antimicrobials with not imposed personalized recommendations and the use of information technologies applied to this setting. The impact on the pharmaceutical consumption and costs, cost per process, mean hospital stay, percentage of readmissions to the hospital are described. A total of 307 audits were performed. In 65.8% of cases, treatment was discontinued between the 7th and the 10th day. The main reasons of treatment discontinuation were completeness of treatment (43.6%) and lack of indication (14.7%). The reduction of pharmaceutical expenditure was 8.59% (P = 0.049) and 5.61% of the consumption in DDD/100 stays (P=0.180). The costs by processes in general surgery showed a 3.14% decrease (p=0.000). The results obtained support the efficiency of these programs in small size hospitals with limited resources.

Obstetric regional analgesia in the Jesenice General hospital in year 2006

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Aleksandra Kern

2007-11-01

Full Text Available Background: The aim of this retrospective analysis of the obstetric regional analgesia (ORA in Jesenice General Hospital in year 2006 was to evaluate our work and present results. We analysed workload, quality of the analgesia and patients’ satisfaction. We also estimated the OR for vacuum extraction (VE in nulliparous labouring women having ORA. We compared quality of analgesia and total local analgesic consumption in nulliparous women having VE or spontaneous delivery.Methods: We performed retrospective analysis of labours with ORA in year 2006. All women received epiduraly mixture of 0.1 % bupivacaine with 2 µg of fentanyl per ml in intermittent boluses.The labour pain was assessed using visual analogue scale (VAS. We used median and interquartile range to describe distribution of these values and mean with standard deviation to describe distribution of other data (local anaesthetic consumption. We considered patient with pain VAS 3 or less adequately treated, VAS 4 and 5 sufficiently and VAS 6 and more insufficiently treated. We used odds ratio as measurement of risk for VE, t-test for differences in local anaesthetic consumption and Mann-Whitney test to evaluate differences in pain between tested groups.Results: 225 labouring women opted for ORA or 38 % of all labouring women in year 2006. We performed 224 ORA, 59 % during regular work, 41 % during turn of duty. 18 % of ORA were performed between 10 p.m. and 7.00 a.m. In 98 % of cases epidural analgesia was used. Anaesthesiologic work took 16 minutes in average (SD 6.06. Analgesia was started at VAS median 5 (IQR 4–6.5 and at average cervical dilatation 4.1 cm (SD 1.4. Average consumption of bupivacaine was 55 mg (SD 23.7 and fentanyl 91.7 µg (SD 46.5. Most common complications were inadequate analgesia, and misplacement of epidural catheter (10/222, dural tap (6/222, and unilateral analgesia (2/222. 70 labours were ended with VE (13 %; n = 532. There were 27 (8.7 %; n = 309 VE in

[Caesarean section in german hospitals: validity of hospital quality report data for monitoring C-section rates].

Science.gov (United States)

Junghänel, K; Renz-Polster, H; Jarczok, M N; Hornemann, A; Böhler, T; De Bock, F

2015-04-01

It is not known if "hospital quality reports" (HQR) document Caesarean (C-) section rates at the hospital level accurately enough for use as a reliable data source when it comes to explaining regional variations of C-sections in Germany by factors at the hospital level. We aimed to answer this question using HQR from hospitals in Baden-Württemberg as data source. Diagnostic and procedure codes from HQR for the year 2008 (HQRdata), were used to calculate numbers of births, numbers of C-sections, and rates of births by C-section (CSR) for 94 of 97 hospitals in Baden-Württemberg. These numbers were compared to internal hospital (IH) data delivered upon request by 80 of 97 hospitals and stemming from vital statistics, birth registry forms, or external quality assurance datasets. There was no difference in the number of births between HQR data and IH data, but the number of C-sections and the CSR differed significantly (pCSR calculated using HQR data was 4.9 ± 17.9% higher than CSR from IH data (absolute difference 1.5 ± 5.8%). The correlation between the 2 data sources was moderate (r=0.73). Only 55% of the variance in IH data-based CSR was explained by HQR data. The proportion between highest and lowest CSR in hospitals in Baden-Württemberg was 4.9 for HQR data and 3.6 for IH data. There are significant and relevant differences between C-section rates based on ei-ther HQR or IH data. This questions routine data from HQR for 2008 as a reliable data source for research work. © Georg Thieme Verlag KG Stuttgart · New York.

Impact of ALSO training on the management of prolonged labor and neonatal care at Kagera Regional Hospital, Tanzania

DEFF Research Database (Denmark)

Sorensen, Bjarke Lund; Rasch, Vibeke; Massawe, Siriel

2010-01-01

OBJECTIVE: To evaluate the management of prolonged labor and neonatal care before and after Advanced Life Support in Obstetrics (ALSO) training. METHODS: Staff involved in childbirth at Kagera Regional Hospital, Tanzania, attended a 2-day ALSO provider course. In this prospective intervention study...... conducted between July and November 2008, the management and outcomes of 558 deliveries before and 550 after the training were observed. RESULTS: There was no significant difference in the rate of cesarean deliveries owing to prolonged labor, and vacuum delivery was not practiced after the intervention...... 5.6% to 71.5% (RR 12.71; 95% CI, 9.04-17.88). There was a significant decrease from 6 to 0 neonatal deaths before discharge among those born with an Apgar score after 1minute of 4 or more (P=0.03). CONCLUSION: ALSO training had no effect on the management of prolonged labor. Early contact between...

Specification and evaluation of a regional PACS in the SaxTeleMed project

Science.gov (United States)

Lemke, Heinz U.; Niederlag, W.; Heuser, H.

2002-05-01

During the early development phase of PACS, its implementation was mainly a matter of the radiological department of a hospital. This is changing rapidly and PACS planning and realization is increasingly seen in the context of a hospital-wide approach. With a growth of networking amongst healthcare institutions and the growing relevance of teleradiological scenarios, new strategies must be followed which take not only local but also regional and global aspects of PACS into consideration. One such regional PACS project was initiated by the Ministry of Social Welfare of the Free State of Saxony in Germany. This 'reference model program for the digitization of imaging procedures and communication of images between hospitals in the free state of Saxony' (SaxTeleMed) covers seven regional projects distributed throughout Saxony. Each regional project is organized around so called lead hospitals, which network with other cooperating hospitals and medical practices. The regional reference projects are designed to be largely independent from one another. In some instances, however, a network connection between reference projects is also considered. Altogether, 39 hospitals and medical centers are involved in the model program. The aim of this program is to test the technical, organizational, legal and economic problems in the area of digitization and networking within the free State of Saxony. With the knowledge gained it is expected to improve future investment decisions in healthcare and above all to implement secure systems.

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

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Sills ES

2013-03-01

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

[Prevalence of HPV high-risk serotypes detected by PCR in patients with normal cervical cytology at the Hospital Regional Adolfo López Mateos, ISSSTE].

Science.gov (United States)

Martínez-Portilla, R J; López-Velázquez, J L; Martínez-Rojas, G C; Aguilar-Villagómez, M I; De la Torre-Rendón, F E; Villafán-Bernal, J R

2016-09-01

Is fundamental to determine the prevalence of human papiloma virus (HVP) high-risk serotypes in local and regional population in order for health providers to offer patients, vaccines and treatments against specific population-based serotypes. To determine the prevalence of HPV High risk serotypes detected by PCR in patients with normal cytology from the ISSSTE Adolfo Lopez Mateos Regional Hospital. An observational, descriptive, prospective study was conducted from cervical cytologies and high risk HPV test by PCR in patients from the Regional Hospital Adolfo López Mateos, ISSSTE, during the period January 2013-December 2015. Cases of patients with negative cervical cytology were included. Information about age, the result of cervical cytology and high risk HPV test by PCR was obtained. The overall prevalence of HPV infection and the most prevalent serotypes by age groups were calculated. A total of 3258 cervical smears were performed, of which 2557 were negative (78.4%), from this, the global prevalence of HPV infection was 10.2% (n=262). We found that 1.8% (n = 45) of negative reports had HPV16 infection, 0.5% (n=13) had HPV18 and 8.9% (n = 227) were infected by Viral Pool of other high-risk serotypes. The prevalence of infection by viral pool of high risk serotypes was 11.5% in women <20 years, 12.9% in women between 20-29 years and 22.2% in women between 30-39 years. This prevalence was lower in patients older than 40 years (p<0.05). A higher prevalence of viral pool high risk serotypes was found in patients with normal cytology, than the HPV16 and HPV-8 prevalence, which was significantly higher in women younger than 40 years.

Predictors of adherence to antiretroviral therapy among people living with HIV and AIDS at the regional hospital of Sokodé, Togo.

Science.gov (United States)

Yaya, Issifou; Landoh, Dadja Essoya; Saka, Bayaki; Patchali, P'Niwè Massoubayo; Wasswa, Peter; Aboubakari, Abdoul-Samadou; N'Dri, Mathias Kouamé; Patassi, Akouda Akessiwe; Kombaté, Koussake; Pitche, Palokinam

2014-12-19

Adherence to antiretroviral therapy (ART) is beneficial in reducing the risk of emergence of HIV resistant strains. Adherence to ART among Persons Living with HIV/AIDS (PLWHA) is influenced by several factors related to the patient, the medication, and health facilities. In Togo, previous studies on adherence to ART have reported good adherence to ART during the first year of follow-up. However these may hide many disparities dues to cultural specificities which may differ across geographic areas of the country. We sought to determine the level of adherence to ART and document the associated factors among PLWHA at the regional hospital of Sokodé, Togo. This was an analytical cross-sectional study conducted from May to July 2013 at the regional hospital of Sokodé among 291 PLWHA who had been on ART for at least three months before the study. A total of 291 PLWHA on ART were enrolled in the study. The mean age (±SD) was 37.3 ± 9.3 years and the sex ratio (Male/Female) was 0.4. Among them, 195 (67.0%) were living with their partners and 210 (72.2%) had formal education. Two-thirds (194/291; 66.7%) of the PLWHA interviewed lived in urban areas. The global adherence to ART was 78.4%; the factors associated with ART adherence were: level of education (aOR = 3.54; p = 0.027), alcohol consumption (aOR = 0.43; p = 0.033), ART perception (aOR = 2.90; p = 0.026) and HIV status disclosure to sexual partner (aOR = 7.19; p ≤ 0.001). Although the level of adherence to ART in this study was higher than those reported in some studies in Sub-Saharan Africa, it remains sub-optimal and needs improvement. This may therefore hinder the implementation of efficient interventions related to access to ART services.

Bordetella pertussis diagnosis in children under five years of age in the Regional Hospital of Cajamarca, Northern Peru.

Science.gov (United States)

Del Valle-Mendoza, Juana; Casabona-Oré, Veronica; Petrozzi-Helasvuo, Veronica; Cornejo-Tapia, Angela; Weilg, Pablo; Pons, Maria J; Cieza-Mora, Erico; Bazán-Mayra, Jorge; Cornejo-Pacherres, Hernan; Ruiz, Joaquin

2015-11-30

Bordetella pertussis is an important human pathogen that causes whooping cough (pertussis), an endemic illness responsible of significant morbidity and mortality, especially in infants and children. Worldwide, there are an estimated of 16 million cases of pertussis, resulting in about 195,000 child deaths per year. In Peru, pertussis is a major health problem that has been on the increase despite immunization efforts. The objective of this study was to determine the prevalence of B. pertussis among children under five years of age suspected to have whopping cough in Cajamarca, Peru. Children diagnosed with whooping cough admitted to the Hospital Regional de Cajamarca from August 2010 to July 2013 were included. Nasopharyngeal samples were obtained for B. pertussis culture and polymerase chain reaction (PCR) detection. In 133 children, the pertussis toxin and IS481 gene were detected in 38.35% (51/133) of the cases by PCR, while only 9.02% (12/133) of the Bordetella cultures were positive. The most frequent symptoms in patients with positive B. pertussis were paroxysm of coughing 68.63% (35/51), cyanosis 56.86% (29/51), respiratory distress 43.14% (22/51), and fever 39.22% (20/51). Pneumonia and acute bronchial obstructive syndrome were present in 17.65% (9/51) and 13.72% (7/51) of the cases, respectively. B. pertussis is responsible for an important proportion of whooping cough in hospitalized children in Cajamarca. Epidemiologic surveillance programs for B. pertussis are essential in Peru, especially in children who could most benefit from the vaccine.

The Danish database for acute and emergency hospital contacts

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Lassen AT

2016-10-01

eventually include data from the local and regional clinical logistic systems.Descriptive data: The DDAEHC also includes age, sex, Charlson Comorbidity Index conditions, civil status, residency, and discharge diagnoses. The DDAEHC expects to include 1.7 million acute and emergency contacts per year.Conclusion: The DDAEHC is a new database established by the Danish Regions including all acute and emergency hospital contacts in Denmark. The database includes specific outcome and process health care quality indicators as well as demographic and other basic information with the purpose to be used for enhancement of quality of acute care. Keywords: emergency care, emergency department, mortality, rehospitalization, quality of care

[A survey on diet manuals in Italian hospitals].

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Donini, L M; Riti, M; Castellaneta, E; Ceccarelli, P; Civale, C; Passaretti, S; del Balzo, V; Cannella, C

2009-01-01

Hospital catering is very important to counteract the onset of malnutrition due to either undernutrition or overnutrition and for dietetic treatment. The aim of the study was to evaluate nutritional quality of the hospital dietetic manual used in some Italian hospitals and to analyze the role of the institutional Catering Service and of the Department of Clinical Nutrition. A survey has been carried out, in some Italian hospitals, using a questionnaire to point out the characteristics of hospitals, the typology of catering service, of the diets and of the staff of the Department of Clinical Nutrition. Only 22% of the hospitals has answered; three Italian regions (Umbria, Molise, Basilicata) are completely missing; -each hospital has a specific dietetic manual in most cases completely different from structure and nutritional quality point of view; the staff acting in this field is absolutely insufficient in term of numerousness and of professional typologies. Hospital in-patients are not homogeneous as for age, dietary needs and diseases, so it's necessary to treat them with an ad hoc nutritional intervention not established in advance in a dietetic manual; if from an organisation point of view it is necessary to have such a dietetic manual, it has to be based on nutritional guidelines and recommended dietary allowances.

Modelamiento de material particulado emitidos por coquización. Municipio de Samaca, Boyacá

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Alfredo Ramos Moreno

2017-01-01

Full Text Available El modelamiento de la dispersión de los contaminantes en la atmósfera es una herramienta que permite realizar predicciones a escalas urbanas y regionales de la calidad del aire en este caso para sólidos totales en suspensión (PST y material particulado (MP10 provenientes de la zona productora de coque del municipio de Samacá compuesta por las veredas Loma Redonda, La Chorrera y Salamanca. Para el modelamiento se tuvo en cuenta el modelo de dispersión Gaussiana a través del software AERMOD. Para la evaluación de los contaminantes, se analizaron dos ambientes de modelación: urbano y rural. Se determinaron las concentraciones de PST y MP10 (μg/m3 durante 18 días por medio de monitoreo a través de dos estaciones ubicadas en el hospital del municipio y en la vereda salamanca encontrando que superan los límites permisibles (100 y 50 μg/m3 fijados en la Resolución 610 de 2010 del MAVDT. Se analizó la información meteorológica y topográfica complementada con el inventario de fuentes de emisión como información de entrada para el proceso de modelamiento de contaminantes atmosférica emitida por coquización.

Readmissions due to traffic accidents at a general hospital.

Science.gov (United States)

Paiva, Luciana; Monteiro, Damiana Aparecida Trindade; Pompeo, Daniele Alcalá; Ciol, Márcia Aparecida; Dantas, Rosana Aparecida Spadotti; Rossi, Lídia Aparecida

2015-01-01

to verify the occurrence and the causes of hospital readmissions within a year after discharge from hospitalizations due to traffic accidents. victims of multiple traumas due to traffic accidents were included, who were admitted to an Intensive Care Unit. Sociodemographic data, accident circumstances, body regions affected and cause of readmission were collected from the patient histories. among the 109 victims of traffic accidents, the majority were young and adult men. Most hospitalizations due to accidents involved motorcycle drivers (56.9%). The causes of the return to the hospital were: need to continue the surgical treatment (63.2%), surgical site infection (26.3%) and fall related to the physical sequelae of the trauma (10.5%). The rehospitalization rate corresponded to 174/1,000 people/year. the hospital readmission rate in the study population is similar to the rates found in other studies. Victims of severe limb traumas need multiple surgical procedures, lengthier hospitalizations and extended rehabilitation.

Readmissions due to traffic accidents at a general hospital

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Luciana Paiva

2015-08-01

Full Text Available AbstractObjective: to verify the occurrence and the causes of hospital readmissions within a year after discharge from hospitalizations due to traffic accidents.Methods: victims of multiple traumas due to traffic accidents were included, who were admitted to an Intensive Care Unit. Sociodemographic data, accident circumstances, body regions affected and cause of readmission were collected from the patient histories.Results: among the 109 victims of traffic accidents, the majority were young and adult men. Most hospitalizations due to accidents involved motorcycle drivers (56.9%. The causes of the return to the hospital were: need to continue the surgical treatment (63.2%, surgical site infection (26.3% and fall related to the physical sequelae of the trauma (10.5%. The rehospitalization rate corresponded to 174/1,000 people/year.Conclusion: the hospital readmission rate in the study population is similar to the rates found in other studies. Victims of severe limb traumas need multiple surgical procedures, lengthier hospitalizations and extended rehabilitation.

The effect of hospital organizational characteristics on postoperative complications.

Science.gov (United States)

Knight, Margaret

2013-12-01

To determine if there is a relationship between the risk of postoperative complications and the nonclinical hospital characteristics of bed size, ownership structure, relative urbanicity, regional location, teaching status, and area income status. This study involved a secondary analysis of 2006 administrative hospital data from a number of U.S. states. This data, gathered annually by the Agency for Healthcare Research and Quality (AHRQ) via the National Inpatient Sample (NIS) Healthcare Utilization Project (HCUP), was analyzed using probit regressions to measure the effects of several nonclinical hospital categories on seven diagnostic groupings. The study model included postoperative complications as well as additional potentially confounding variables. The results showed mixed outcomes for each of the hospital characteristic groupings. Subdividing these groupings to correspond with the HCUP data analysis allowed a greater understanding of how hospital characteristics' may affect postoperative outcomes. Nonclinical hospital characteristics do affect the various postoperative complications, but they do so inconsistently.

Implementing the first regional hospice palliative care program in Ontario: the Champlain region as a case study.

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Pereira, José; Contant, Jocelyne; Barton, Gwen; Klinger, Christopher

2016-07-26

Regionalization promotes planning and coordination of services across settings and providers to meet population needs. Despite the potential advantages of regionalization, no regional hospice palliative care program existed in Ontario, Canada, as of 2010. This paper describes the process and early results of the development of the first regional hospice palliative care program in Ontario. The various activities and processes undertaken and the formal agreements, policies and documents are described. A participative approach, started in April 2009, was used. It brought together over 26 health service providers, including residential hospices, a palliative care unit, community and hospital specialist consultation teams, hospitals, community health and social service agencies (including nursing), individual health professionals, volunteers, patients and families. An extensive stakeholder and community vetting process was undertaken that included work groups (to explore key areas such as home care, the hospital sector, hospice and palliative care unit beds, provision of care in rural settings, e-health and education), a steering committee and input from over 320 individuals via e-mail and town-halls. A Transitional Leadership Group was elected to steer the implementation of the Regional Program over the summer of 2010. This group established the by-laws and details regarding the governance structure of the Regional Program, including its role, responsibilities, reporting structures and initial performance indicators that the Local Health Integration Network (LHIN) approved. The Regional Program was formally established in November 2010 with a competency-based Board of 14 elected members to oversee the program. Early work involved establishing standards and performance indicators for the different sectors and settings in the region, and identifying key clinical needs such as the establishment of more residential hospice capacity in Ottawa and a rural framework to ensure

THE IMPLEMENTATION OF THE SYSTEMATIZATION OF NURSING ICU - NEONATAL HOSPITAL REGIONAL DE CÁCERES-MT

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Eliene de Souza Porto

2013-01-01

Full Text Available The study aimed to analyze the implementation of the Nursing Care System (NCS in the ICU - Neonatal Hospital Regional de Cáceres Dr. Anthony Fontes - HRCAF. This is an exploratory qualitative approach with descriptive profile of the case study. Data were collected through interviews with five nurses from ICU - Neonatal, using as research instrument, a questionnaire containing open and closed questions and analyzing a chart. The results showed that nurses know and realize the importance of NCS as a methodological tool that guides the practice of care and as professional recognition, although not held by all. The analysis of the records showed that there Systematization of Nursing Care at this clinic. Of the 707 days analyzed records there were only 30 (4.25% Nursing Research, none (0.0% record Diagnosis and Planning, 57 (8.26% days with record Deployment, Assessment and 23 record (3.24% in which its registered nursing care, assistance totaling 15.55% recorded in medical records. With the completion of this study, it was noted that the SAE often becomes impossible in practice of nursing because of various difficulties such as lack of time, lack of human resources, work overload, and the generic form organizational structure.

Hospital sector: further trends in privatization

DEFF Research Database (Denmark)

Christiansen, Terkel

2009-01-01

Due to a strike among nurses in the spring of 2008, the existing waiting time guarantee of one month was suspended until June 1, 2009. Regions turned to private hospitals to assist reducing the hump of patients. It has been claimed that the private sector used to be favorably treated by the Liber...

Hospital staffing and hospital costs.

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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%.

APPROACH TO ASSESSING THE PREPAREDNESS OF HOSPITALS TO POWER OUTAGES

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Lenka BREHOVSKÁ

2017-06-01

Full Text Available Within the secondary impacts of electricity blackouts, it is necessary to pay attention to facilities providing medical care for the population, namely the hospitals. Hospitals represent a key position in the provision of health care also in times of crisis. These facilities must provide constant care; it is therefore essential that the preparedness of such facilities is kept at a high level. The basic aim of this article is to analyse the preparedness of hospitals to power outages (power failures, blackouts within a pilot study. On that basis, a SWOT analysis is used to determine strengths and weaknesses of the system of preparedness of hospitals to power outages and solutions for better security of hospitals are defined. The sample investigated consists of four hospitals founded by the Regional Authority (hospitals Nos. 1-4 and one hospital founded by the Ministry of Health of the Czech Republic (hospital No. 5. The results of the study shows that most weaknesses of the preparedness of hospitals are represented by inadequately addressed reserves of fuel for the main backup power supply, poor knowledge of employees who are insufficiently retrained, and old backup power supplies (even 35 years in some cases.

Access block in NSW hospitals, 1999-2001: does the definition matter?

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Forero, Roberto; Mohsin, Mohammed; Bauman, Adrian E; Ieraci, Sue; Young, Lis; Phung, Hai N; Hillman, Kenneth M; McCarthy, Sally M; Hugelmeyer, C David

2004-01-19

To estimate the magnitude of access block and its trend over time in New South Wales hospitals, using different definitions of access block, and to explore its association with clinical and non-clinical factors. An epidemiological study using the Emergency Department Information System datasets (1 January 1999 to 31 December 2001) from a sample of 55 NSW hospitals. Prevalence of access block measured by four different definitions; strength of association between access block, type of hospital, year of presentation, mode and time of arrival, triage category (an indicator of urgency), age and sex. Rates of access block (for all four definitions) increased between 1999 and 2001 by 1%-2% per year. There were increases across all regions of NSW, but urban regions in particular. Patients presenting to Principal Referral hospitals and those who arrived at night were more likely to experience access block. After adjusting for triage category and year of presentation, the mode of arrival, time of arrival, type of hospital, age and sex were significantly associated with access block. Access block continues to increase across NSW, whatever the definition used. We recommend that hospitals in NSW and Australia move to the use of one standard definition of access block, as our study suggests there is no significant additional information emerging from the use of multiple definitions.

Malignant lymphomas in the material of the ENT Department of the Babinski Regional Hospital in Wroclaw

International Nuclear Information System (INIS)

Lewandowski, A.; Hejjamy, R.; Turek, W.; Gul, E.

1994-01-01

Two main groups of malignant lymphomas: Hodgkin's and non-Hodgkin's lymphomas have been presented as a poster. Their epidemiology has been discussed and attention has been called to the frequency of their occurrence in ENT diseases. Special attention has been also called to the significance of congenital and acquired immune deficiency syndromes and infectious factors in malignant lymphomas etiology. Histological classification has been described presenting difficulties in the division of non-Hodgkin's lymphomas and significance of the classification. in finding the appropriate way of treatment. Pathogenesis and diagnostic difficulties have been presented and attention to the significance of histologic diagnosis of lymphonodes taken as a whole from the neck. The aim of that was to avoid non-specific inflammatory changes which often occur in axillary and inguinal nodules described with special emphasis on out of nodules neoplastical changes. 23 cases of malignant lymphomas treated in the ENT Dept. of the Babinski Regional Hospital in Wroclaw in the years 1982-1992 have been presented. Special attention has been called to the correlation between advancement and ways of treatment. Two cases of lymphoma have been shown in the pictures. (author)

Adherence to Canadian C-Spine Rule in a regional hospital: a retrospective study of 406 cases.

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Paxton, Mark; Heal, Clare F; Drobetz, Herwig

2012-10-01

Cervical spine radiography may be over-utilised in an emergency department setting. The Canadian C-Spine Rule has been developed to reduce unnecessary radiography. Our aim was to retrospectively determine the proportion of cervical spine radiographs requested through the emergency department for trauma patients that were clinically indicated, according to the Canadian C-Spine Rule. This was a cross-sectional survey conducted at a regional centre in Northern Queensland, Australia. All cervical spine radiographs for trauma, performed at the Mackay Base Hospital from 1 January 2009 to the 31 December 2009, were reviewed. The relevant patient charts were audited for evidence of indications for radiography. Of 406 patients in the study, 155 patients (38%) (95% confidence interval 33.3%, 42.7%) had cervical spine imaging performed that was not indicated according to the Canadian C-Spine Rule. None of these patients had a significant cervical spine injury on radiography. Applying the Canadian C-Spine Rule would have safely reduced the incidence of cervical spine radiography by 38%. This would also reduce costs, patient morbidity and radiation exposure. © 2012 The Authors. Journal of Medical Imaging and Radiation Oncology © 2012 The Royal Australian and New Zealand College of Radiologists.

China Dimensions Data Collection: Chinese County-Level Data on Hospitals and Epidemiology Stations, 1950-1985

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National Aeronautics and Space Administration — Chinese County-Level Data on Hospitals and Epidemiology Stations, 1950-1985 consists of hospital and epidemiological station data for the administrative regions of...

easuring the quality of health services provided at a Greek Public Hospital through patient satisfaction. Case Study: The General Hospital of Kavala

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Vasiliki A. Georgiadou

2017-06-01

Full Text Available Purpose: The aim of this study is to examine the quality of hospital services as perceived by patients in terms of patient satisfaction with services. Design/Methodology/Approach: A conceptual framework of quality of hospital services, developed by Padma et al. (2009, composed by eight quality dimensions, applied the performance measurement model (SERVPERF, was used for the approach. The Quality Score Tool was a two-part questionnaire that quantified patient satisfaction with benchmarks of the quality dimensions. In order to investigate the above model, the case study method was utilized. The survey was conducted in a public regional hospital. Findings: Five (5 quality dimensions (5Qs have found having a significant impact on overall quality of service, measure of patient satisfaction in the hospital. These dimensions are on a hierarchical scale: "clinical care", "social responsibility", "staff quality", "infrastructure" and "Hospital reliability". Originality/Value: The results of this study can be used as a source of feedback to hospital management, meaning that they can essentially lead to improved adjustments or serve as a basis of process reengineering.

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

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Judith Kristeller

2017-05-01

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

HOW COULD HOSPITALS ACT IN AN AGEING SOCIETY?

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Leuca Mirela

2011-12-01

Full Text Available The demographic changes are of great importance for all European societies. Their impact and effects have multiple, deep facets. Each European healthcare and welfare system will be facing considerable changes in the new demographic context. The hospital sector plays an important role in each health system. This paper focuses on the impact of the demographic changes on hospitals, presents and analyzes statistical data for the German hospitals sector in order to underline the importance of the older age groups for the number of the hospital inpatient cases, the provided range of medical services and disciplines and for the hospital disease costs. The paper also reveals main findings from 30 interviews conducted in 2010 with German health experts (from hospitals, health insurance companies, universities, institutes and regional healthcare policy makers that accepted to answer questions referring to the demographic impact on the German healthcare system and hospital sector. The results of the interviews show that hospitals will have to act and react to the demographic changes. German hospitals might play different roles in the healthcare service provision for older people when engaging in new models of integrated care that will have to be developed. Processes, structures, human resources expertise, hospital service provision and medical departments will undergo major changes in response to the demographic challenges. Networks, centres of excellence for older persons and integrated care will probably be indispensable structures of the German healthcare system in the future. Strategic partnerships with pre- and post-hospital healthcare service providers are considered to be top priorities for German hospitals when facing the demographic challenge. Central case management and process optimization can be essential factors of success in the hospital care of the older, multimorbid patients. Acute geriatric medicine will be a main quality feature for the

Auditing stillbirths at Lower Umfolozi War Memorial Regional Hospital

African Journals Online (AJOL)

on stillbirths in developing countries and rural settings, where the majority of such births occur. ... The stillbirth rate at LUWMRH is much higher than that at other regional ... deaths, stillbirths, early and late neonatal deaths, cases of birth.

Hospitality within hospital meals—Socio-material assemblages

DEFF Research Database (Denmark)

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

2016-01-01

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

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

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Glenn A. Melnick PhD

2016-06-01

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

[Neuromeningeal cryptococcosis in patients infected with HIV at Agadir regional hospital, (Souss-Massa, Morocco)].

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